This document provides clinical tips for orthodontists to increase consistency when using a straight-wire appliance. It discusses using "Active Early" case management protocols to control torsion and arch development early in treatment. Diagnosing patients in their natural head position and optimizing micro-esthetics in finishing are emphasized. Bonding brackets to optimize esthetics rather than the center of teeth and using broader arch forms for better esthetics are also recommended.
The all-on-6 dental implants procedure is used to replace the entire upper or lower set of teeth. This dental procedure is used to restructure a patient’s mouth, generally done when the patients have lost a significant number of teeth in one or both jaws.
The All-on-6 dental implant procedure creates a permanent prosthesis by using six dental implants. It acts as a support for a bridge or over-denture. Six implants are positioned in the lower or upper jawbone to anchor prosthetic teeth in place permanently.
All-on-6 dental implant offers several benefits such as quick recovery, pearl white smile, no need of removable dentures, patient can bite and chew food, just like natural teeth.
To book an appointment contact :
Dr.Rajat Sachdeva
MDS MS MBA
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalimplantindia.co.in
• www.dentalclinicindelhi.com
• www.dentalcoursesdelhi.com
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
• For Dentists : https://goo.gl/6t8DD5
Select slides from the Implant Restorative Study Club's August 2014 meeting. The lecture was provided by Dr. Douglas Weir, a Prosthodontist practicing in Bloomington, Indiana.
Indications & contra indications of implant supported prosthesis / implant de...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
The all-on-6 dental implants procedure is used to replace the entire upper or lower set of teeth. This dental procedure is used to restructure a patient’s mouth, generally done when the patients have lost a significant number of teeth in one or both jaws.
The All-on-6 dental implant procedure creates a permanent prosthesis by using six dental implants. It acts as a support for a bridge or over-denture. Six implants are positioned in the lower or upper jawbone to anchor prosthetic teeth in place permanently.
All-on-6 dental implant offers several benefits such as quick recovery, pearl white smile, no need of removable dentures, patient can bite and chew food, just like natural teeth.
To book an appointment contact :
Dr.Rajat Sachdeva
MDS MS MBA
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
• Our Websites:
• www.sachdevadentalcare.com
• www.dentalimplantindia.co.in
• www.dentalclinicindelhi.com
• www.dentalcoursesdelhi.com
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
• For Dentists : https://goo.gl/6t8DD5
Select slides from the Implant Restorative Study Club's August 2014 meeting. The lecture was provided by Dr. Douglas Weir, a Prosthodontist practicing in Bloomington, Indiana.
Indications & contra indications of implant supported prosthesis / implant de...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
Precision attachments in prosthodontics/ orthodontics short term coursesIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Retention and support in removable partial denture kalpanaKumari Kalpana
Retention of a removable prosthesis is a unique concern when compared with other prosthesis. Forces acting to displace the prosthesis from the tissue can consist of gravity acting against a maxillary prosthesis, the action of adherent foods acting to displace the prosthesis on opening of the mouth in chewing, or functional forces acting across a fulcrum to unseat the prosthesis.
Article "Dental Implants: Third Generation of Teeth" is published in Ecronicon (EC Dental Science) an International Journal of Dentistry based in the United Kingdom.
A three dimensional finite element analysis of tilted or parallel implant.ppt...enochrao
In the Nobel biocare's model , the so-called All-on-Four protocol, four dental implants are placed in the interforaminal region of the edentulous mandible to support full-arch fixed prostheses.In Nobel biocare’s design, the posterior implants are tilted distally to a maximum of 45 degrees. The soul purpose of this finite element study was to determine and evaluate the stress concentration in peri-implant bone during two different loading conditions and the values obtained , will be used to compare with another design in which the four implants are placed parallel to each other and perpendicular to the occlusal plane. Three-dimensional finite element models consisted of mandibular bone, four dental implants inserted in two different configurations—with the distal implants tilted (model A) or four parallel implants (model S)—and hybrid superstructures. Two loading conditions (178 N/central incisors or 300 N/left first molar) were considered, and von Mises stress values were determined. During anterior loading, higher stress concentrations were detected in the peri-implant bone of all four implants in model A. During posterior loading, lower stress concentrations were observed around the anterior implants of model A; however, the tilted posterior implants were subjected to higher stresses in every condition. Application of either of these designs was successful in reducing peri-implant stress in one loading condition. However, neither design demonstrated better performance in both loading conditions; therefore, within the limitations of this study, neither design demonstrated clearly superior performance.
Interocclusal records / dental implant courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Digital workflow in full mouth rehabilitation using CBCTApurva Thampi
This is a journal club presentation on the digital workflow of a full mouth rehabilitation using implants and as CBCT as a guide.
The presentation and all the materials collected is available on request. Mail me at apurvathampi@gmail.com
Precision attachments in prosthodontics/ orthodontics short term coursesIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Retention and support in removable partial denture kalpanaKumari Kalpana
Retention of a removable prosthesis is a unique concern when compared with other prosthesis. Forces acting to displace the prosthesis from the tissue can consist of gravity acting against a maxillary prosthesis, the action of adherent foods acting to displace the prosthesis on opening of the mouth in chewing, or functional forces acting across a fulcrum to unseat the prosthesis.
Article "Dental Implants: Third Generation of Teeth" is published in Ecronicon (EC Dental Science) an International Journal of Dentistry based in the United Kingdom.
A three dimensional finite element analysis of tilted or parallel implant.ppt...enochrao
In the Nobel biocare's model , the so-called All-on-Four protocol, four dental implants are placed in the interforaminal region of the edentulous mandible to support full-arch fixed prostheses.In Nobel biocare’s design, the posterior implants are tilted distally to a maximum of 45 degrees. The soul purpose of this finite element study was to determine and evaluate the stress concentration in peri-implant bone during two different loading conditions and the values obtained , will be used to compare with another design in which the four implants are placed parallel to each other and perpendicular to the occlusal plane. Three-dimensional finite element models consisted of mandibular bone, four dental implants inserted in two different configurations—with the distal implants tilted (model A) or four parallel implants (model S)—and hybrid superstructures. Two loading conditions (178 N/central incisors or 300 N/left first molar) were considered, and von Mises stress values were determined. During anterior loading, higher stress concentrations were detected in the peri-implant bone of all four implants in model A. During posterior loading, lower stress concentrations were observed around the anterior implants of model A; however, the tilted posterior implants were subjected to higher stresses in every condition. Application of either of these designs was successful in reducing peri-implant stress in one loading condition. However, neither design demonstrated better performance in both loading conditions; therefore, within the limitations of this study, neither design demonstrated clearly superior performance.
Interocclusal records / dental implant courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Digital workflow in full mouth rehabilitation using CBCTApurva Thampi
This is a journal club presentation on the digital workflow of a full mouth rehabilitation using implants and as CBCT as a guide.
The presentation and all the materials collected is available on request. Mail me at apurvathampi@gmail.com
Relining & rebasing / dental implant courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Dr. William Roth
Introduction
The Roth Rx
Reasons For Modification
Treatment Philosophy
Treatment Goals
Roth Rationale
Selection Of Treatment Mechanics
Roth Set-up
Sequencing Of Treatment Objectives
Treatment Mechanics
Anchorage Considerations
Detailing Of Tooth Position
Advantages
Comparisons
Conclusions
full mouth rehabilitation/dental crown &bridge course by Indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Similar to Clinical tips to increase consistency using a selfligathing (20)
Las maloclusiones Clase II son de interés para los odontólogos debido a la alta prevalencia de este tipo de alteraciones. En los individuos con oclusión normal y adecuada relación esquelética, la proporción de crecimiento del maxilar y de la mandíbula está equilibrado y el resultado es un perfil ortognático y estéticamente agradable. En los individuos con maloclusiones Clase II, hay una discrepancia anteroposterior ( prognatismo maxilar y/o retroganatismo mandibular) y /o transversal , que puede o no estar acompañada con alteraciones dental.
El propósito de esta guía es proporcionar una perspectiva científicamente soportada, sobre la etiología, las características, el desarrollo y consideraciones generales de tratamiento de las maloclusiones de Clase II.
Las maloclusiones Clase II son de interés para los odontólogos debido a la alta prevalencia de este tipo de alteraciones. En los individuos con oclusión normal y adecuada relación esquelética, la proporción de crecimiento del maxilar y de la mandíbula está equilibrado y el resultado es un perfil ortognático y estéticamente agradable. En los individuos con maloclusiones Clase II, hay una discrepancia anteroposterior ( prognatismo maxilar y/o retroganatismo mandibular) y /o transversal , que puede o no estar acompañada con alteraciones dental.
El propósito de esta guía es proporcionar una perspectiva científicamente soportada, sobre la etiología, las características, el desarrollo y consideraciones generales de tratamiento de las maloclusiones de Clase II.
Las maloclusiones Clase III son las de menor incidencia, reportándose valores entre 3% y 13%
según la población estudiada. Se caracterizan por una posición mesial de la arcada dental inferior
con respecto a la superior, como consecuencia de ello se presenta una mordida cruzada anterior,
o en casos más ligeros contacto borde a borde de los incisivos. Debe ser tratada
tempranamente, alrededor de los cuatro años, para prevenir en lo posible un escaso desarrollo
transverso y anteroposterior del maxilar superior y contener el crecimiento de la mandíbula. (1,2)
El propósito de esta guía es proporcionar una perspectiva científicamente soportada, sobre la
etiología, las características, el desarrollo y consideraciones generales de tratamiento de las
maloclusiones de Clase III.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
Clinical tips to increase consistency using a selfligathing
1. Clinical tips to increase consistency using a
“Straight-Wire Appliance”
Published on November 17, 2015 by Orthodontic Practice
“Everything should be made as simple as possible, but not simpler.” — Einstein
Educational aims and objectives
This article aims to discuss some clinical aspects to increasing consistency using a “Straight-Wire Appliance.”
Expected outcomes
Orthodontic Practice US subscribers can answer the CE questions in our online quiz to earn 2 hours of CE
from reading this article. Correctly answering the questions will demonstrate the reader can:
Recognize certain clinical benefits to passive self-ligating mechanisms.
Identify Active Early Case Management Protocols.
Realize the importance of diagnosing in natural head position.
Identify some aspects oftorque expression.
See the value of optimizing microesthetics in finishing.
Orthodontic clinical procedures and esthetic preferences are evolving toward fuller lips, greater enamel
display, and wider smiles with a reduced tendency toward four-premolar extractions, with increased
preference for non-extraction treatment.1 The clinical approaches that we rely on today are different from
those earlier generations of orthodontists used frequently.1 Esthetic declines, once common with treatment,2
are no longer acceptable to the majority of patients,and “straight teeth,” once the predominant treatment goal,
is now secondary to strategies directed toward esthetic improvement3 (Figures 1-2).
Most orthodontists use a variation of the “Straight-Wire Appliance,” a concept that has dominated our
profession since Dr. Larry Andrews’ breakthrough article4 led to its development in the 1970s. In the last 2
decades,appliance developments have revolved around relatively minor changes in appliance prescription,
direct bonding,the development of PSL (Passive Self-Ligating)/ASL (Active Self-Ligating) ligating
mechanisms, increased use of sliding mechanics, and incorporating reduced force levels.5
The recognition that certain torsion concepts of“straight-wire” theory are not congruent with some modern
esthetic goals or with contemporary mechanics does not diminish the value of Dr. Andrews’ landmark
concepts.Orthodontists must appreciate the biomechanical flexibility that is required to use the appliance for
improving the quality of treatment results.
There was a gain in popularity in ASL/PSL systems during the 1990s when small wires in a larger “closed”
slot provided effective movement due to reduced Resistance to Sliding (RTS). For many orthodontists,when
larger rectangular wires were used during major tooth movement, results were disappointing5 with “sloppy
slots” that lacked control of axial inclination and rotations.Passive ligation demands very accurate slots with
special dimensions, particularly in the anterior region for obvious reasons.
2. We favor the use of a PSL mechanism for many reasons:quick wire changes,consistent bracket engagement,
lower forces and wire sliding with control, and improved hygiene, among others.We combine proven PSL
case management strategies6 and “Active Early” approaches7 to control torsion and arch development, with
the improved slot geometry and tighter tolerances of the H4™ appliance (Ortho Classic), along with more
esthetic arch forms.
Clinical Tips
Don’t get stuck in a biomechanics rut that doesn’t deliver exceptional esthetics: (Impressive
Smile and Facial Esthetics has been my field of interest for the last many years.) Most orthodontists
appreciate Andrews’ “Six Keys to Normal Occlusion” — (Key 1) the characteristics of molar
relationship, (Key 2) crown angulation or tip, (Key 3) crown inclination, (Key 4) no rotations,(Key
5) absence of spaces,and (Key 6) occlusal plane — as being important features of a sound functional
occlusion. The work of Dr. David Sarver clearly describes characteristics of great esthetics that
supplement the criteria applied to normal occlusions8.The biomechanics and case management used
by esthetically motivated orthodontists to achieve great occlusions are likely considerably different
from those who are mainly occlusally motivated. Put simply, “Great Occlusions don’t always equal
great esthetics,” so clinically, find ways to achieve both.
Try “Active Early” case management protocols: In “Active Early” protocols,7 the appliance is
activated as early as possible, using the Smile Arc Protection (SAP9) bracket position to adjust
vertical position of the incisors, inverting groups of brackets when necessary to activate torsion in
the appliance, selecting archwire progressions that controlaxial inclination early in treatment, wider
arch forms that develop the posterior segments of the arches sooner, esthetic arch shape,ELSE
(Early Light Short Elastics) to control forces and moments, and appropriate disarticulation to
encourage early “wanted” tooth movements.6 This controls early vertical erupion and intrusion of
teeth. Using these strategies improves patient management efficiency for us (Figure 3).
Diagnose in Natural Head Position (NHP): Diagnosis for esthetics is based on how the patient
presents in day-to-day activity.8 As NHP is reasonably stable in both the short- and long-term,10 the
patient should be assessed comfortably standing,engaged in natural conversation,and generating
unposed smiles. The orthodontist then makes patient specific determinations of bracket height
progressions to generate optimal enamel display8 and assesses the requirement for creation of torsion
within the appliance to optimize axial inclination of the maxillary anterior teeth (Figure 4). Far too
many finished orthodontic patients end up with proclined maxillary incisors,so we are purposeful in
the assessment.
3. Optimize
tooth shape, and improve gingival contour prior to bonding: The value of optimizing micro-
esthetics in finishing is well appreciated.11 The less common strategy of creating a normalized
contourof the teeth through positive and negative coronoplasty prior to bonding creates a number of
opportunities.Ability to place brackets in vertical positions designed to enhance the smile arc,
simplified correction of rotational control, and more predictable performance in third order
movements are all benefits of normalizing tooth shape and contourprior to bonding.As SAP upper
bracket positions to optimize esthetics are frequently more gingival than conventional positions,soft
tissue recontouring can be a tremendous advantage when needed (Figure 5).
Increase torsion “built into” the appliance by “flipping” where needed: Torque expression is a
complex process dependent upon12 magnitude of torsion,wire stiffness or resilience, bracket design,
engagement angle, mode of ligation, wire dimension and corner radius of the wire, angulation of the
bracket, deformation of the bracket or wire undertorsion, manufacturing tolerances in the bracket
and the wire, initial tooth inclination, bracket position, and the measurement technique used to
evaluate torsion.Fortunately, to the clinician, it matters solely when/if torsion is developed within
the slot during commonly used archwire progressions.
4.
5. With the worldwide tendency to treat more patients without extractions, the control of proclination of the
maxillary anterior teeth has become a greater challenge. The correction of pre-existing crowding and
proclination, proclination associated with relief of crowding during traditional round wire mechanics, or
incisor proclination-associated Class III elastics is particularly problematic. The challenge for many non-
extraction patients has been in getting enough lingual crown torsion without having to resort to complex wire
bending to attain esthetic results. These are patients that benefit from “flipping (upper anteriors) and flocking
(upper cupid)” the maxillary anterior/canine brackets.13
The “tooth by tooth” method of varying torsion “built into” the appliance is not as efficient for us and
frequently requires either repositioning of brackets, or complex wire bending to finish precisely.14 In contrast,
“flipping and flocking” and varying torsion in groups is far more predictable, requires fewer bracket
repositions,and allows wire adjustments with uniformly “spun” wires (Figures 6-7).
Bond brackets to optimize esthetics not at the center of anatomic crown (FA): As today’s
treatment targets for incisor position in three planes of space are based on esthetics,8,15 the reliance
on “treatment built” into an appliance for the anterior teeth relative to the occlusal plane is not a
practical way to ensure esthetically superior results.In the “Active Early” approach, individualized
bracket positions based on esthetics7 (SAP)is combined with other initial planning considerations to
gain control of maxillary incisor vertical position. For patients with “flat” occlusal planes or those
that require increased enamel display, the divergence of the upperwire plane from molar to incisor
created by bracket position must increase to develop the smile arc by extruding the upper incisors
relative to the upperpremolars. In patients with normal occlusal planes, a more modest progression
in the upper wire plane is still advisable to protect the smile arc as we broaden the maxillary arch
with treatment. A modest progression in still advised in deep bite cases to avoid excessive reduction
in the smile arc as the overbite reduces. Compensating changes in the mandibular wire plane levels
the mandibular arch and establishes an optimum overbite. It is not necessary to have a deeper bite to
have a great smile arc.
Andrews’ “Six Keys” article, acknowledged as the catalyst for development of the first fully pre-adjusted
appliance, advocates using the centerof the clinical crown (FA), the long axis of the center of the clinical
6. crown, and the thickness of the clinical crown from the long axis to FA,5 as guides for bracket positioning.
This limits the usefulness of the appliance for patients whose teeth or faces deviate from “normal standards.”
We do not subscribe to the core “straight-wire” principle that the wire plane must parallel the occlusal plane
to attain excellent occlusions,and failure to adjust bracket height to adjust vertical positions of the maxillary
incisors can result in esthetic deterioration. SAP bracket placement strategy allows adjustment of the vertical
position of the maxillary incisors, which improves their display and the smile arc without increasing the
overbite (Figure 8).
Appreciate the reality of undersize wires and oversized slots: Contemporary fixed orthodontic
treatment is usually completed in wire sizes that are less than full dimension15 for the designed
bracket slot dimensions. This seems gentler on the patient, and the consequences ofthis incompletely
filled bracket lumen is torsional play that decreases engagement of the contact between the archwire
and the bracket.16 While decreasing friction — a potential benefit during early leveling, aligning, and
sliding mechanics — torsional play reduces control of axial inclination necessary for ideal esthetics.
In clinical practice, incremental increases in archwire size is NOT the most effective means of
controlling axial inclination when the slot isn’t filled7 (Figure 9).
Understand the appliance system you are using: Manufacturing tolerances also vary greatly so
that the ability of the appliance to generate torsion with a specific wire progression and deliver stated
appliance Rx17 is really what matters. Fortunately, to the clinician, it matters solely when/if torsion
develops within the slot during commonly used archwire progressions.Unfortunately,many
manufacturer’s tolerances often cause variable slot sizes, which makes torsion unpredictable.
However, with the H4 bracket, the manufacturing tolerances are predictably accurate, with reduced
slot depth leading to less wire adjustments. By varying bracket height with SAP bracket positioning
and “flipping and flocking” maxillary anterior brackets when needed,lingual crown torsion is
assured.By proper management of mandibular incisors, those teeth can be kept upright when
required (Figure 10).
Use broader arch forms for better esthetics: Dr. Pitts has found that broader arch width, (not in
the canine region) especially in the molars is more attractive, and smaller buccal corridors are
preferred in both men and women. The alignment and broadening of maxillary and mandibular
dental arches to reduce buccal corridors and producing “10” or “12” tooth smiles results in more
space for the anteriors to have more lingual crown torque/inclination. Of course, proper inclination
of the premolars and molars must be maintained upon broadening.Research has confirmed that final
arch width is a function of arch form, not of the bracket18 used during treatment, so an improved arch
form is required for improved esthetics.
One of the biggest impacts on transverse arch dimension in the molars, and arch form in general has been the
adoption of “Pitts’ Broad” arch forms in both nonadjustable and adjustable wire profiles (Ortho Classic). This
arch form improves the “flow” of mini-esthetics, making the attainment of a “12 tooth” smile much easier. By
using a moderate progression SAP bracket placement, the orthodontist can broaden the arches and still
maintain a beautiful smile arc (Figures 11-15). In short, the shape of the arch is just as important as the width.
Finish micro-esthetics details with optimal esthetics in mind: It was primarily the efforts of Dr.
David Sarver who classified the concepts ofmacro-, mini-, and micro-esthetics19. While optimizing
the “white and pink” tissues has been common practice in esthetic dentistry,it is less common in
orthodontics20.By mastering the techniques and disciplines applied in cosmetic dentistry,patients
have the potential to finish with wonderful micro-esthetics that provide the final touch to patients
who have well managed macro- and mini-esthetic results (Figure 16). We take particular care in
avoiding “black triangles” at the gingival papilla through management of contacts and connectors
during the finishing process.
7.
8. It is an exciting time to be in orthodontics.Contemporary esthetic-based diagnosis,a modern understanding of
how to optimize straight-wire appliances,use of advanced straight-wire appliances that control axial
inclination and rotations,using esthetic broader arch forms, adopting the “Active Early” approach to case
management, and finishing “white and pink” tissues foresthetics provide expanded opportunities for
improving esthetics.In the “Active Early” approach,lighter forces, applied earlier, for longer duration are
accomplishing many things more efficiently for the orthodontist and more gentleness forthe patient than has
ever been possible before.
Author Info
Tom Pitts, DDS, MSD, is a world-renowned lecturer and clinician, highly recognized for his continued
teaching of orthodontic finishing and clinical excellence. Dr. Pitts is an associate clinical professorat the
University of the Pacific and founder of the well-respected Pitts Progressive Study Club. Dr. Pitts has been
published in multiple journals and clinical publications. He has been actively teaching the orthodontic
community in a variety of settings both nationally and internationally since 1986.
9. Duncan Brown, DDS, MS, is a highly regarded international speaker and educator in passive ligation bracket
systems.Dr. Brown teaches regularly at the University of Alberta and University of Manitoba and is also a
Kodak/Carestream Dental speaker and consultant.
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