This document presents two clinical case presentations. Case 1 involves a 65-year-old man with a chief complaint of difficulty eating due to missing posterior teeth. Examination found plaque-induced gingivitis, secondary caries, and loss of teeth. Treatment included scaling, root planing, restorations, and fixed bridges to replace missing teeth. Case 2 involves a 46-year-old man unhappy with his smile due to a visible metal screw. Examination found periodontitis, missing teeth, and a diastema. Treatment included veneers, crowns, a removable partial denture, and future bridges and implants to improve esthetics and function. Both cases provide diagnoses, treatment plans and options, and
Stainless steel crowns in Pediatric DentistryRajesh Bariker
A crown is a tooth shaped covering which is cemented to the tooth structure & its main function is to protect the tooth structure & retain the function
In this lecture I explain in step-by-step fashion the basics of Endodontic Diagnosis: Pulp Vitality Tests. a photo guide is attached to the guide to aid in better understanding of the topic
Stainless steel crowns in Pediatric DentistryRajesh Bariker
A crown is a tooth shaped covering which is cemented to the tooth structure & its main function is to protect the tooth structure & retain the function
In this lecture I explain in step-by-step fashion the basics of Endodontic Diagnosis: Pulp Vitality Tests. a photo guide is attached to the guide to aid in better understanding of the topic
Zirconium Dental Implants And Crown for Congenitally Missing Maxillary Latera...Abu-Hussein Muhamad
Zirconia implants were familiarized into dental implantology. Zirconia appears
to be an appropriate implant material due to its low plaque affinity, tooth like color, biocompatibility and mechanical properties. The following a case presentations will show how the acid-etched zirconia Implant can be used to functionally and aesthetically replace congenitally missing left lateral incisor tooth germ in the maxilla, and achieve optimal soft tissues and health.
Failures in FPDs and its management is very well described in this seminar and done according to the main books.
Described under classification of biologic, mechanical, aesthetics, Psychogenic, Maintenances Failures
Review of literature is also given in this presentation
Indications & contra indications of implant supported prosthesis /certified f...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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
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Fixed prosthodontic treatment can offer exceptional satisfaction for both patient and the dentist. Fixed Prosthodontics can transform an unhealthy, unattractive dentition with poor function into a comfortable, healthy occlusion capable of giving years of further service while greatly enhancing esthetics.
Nothing is more important in the construction of fixed partial dentures than an adequate diagnosis and a well-devised treatment plan. Although these two subjects are usually considered together. Astute dentists must recognize their subtle differences. Diagnosis is an evaluation of the condition of the patient when he presents for treatment. Treatment planning concerns the treatment procedures by which the dentist will restore the patient to an optimum state of dental health.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
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 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
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.
3. • 65 years old
• Non smoker
• Don’t have history with any systemic
disease or allergy.
• Only complain from Peptic ulcer.
• Medications: omeprazole 1-2/day.
4. I lost some of my posterior teeth long
time ago. And now I want it to be
replaced
• He is not able to eat properly . This was
since he lost some of his posterior teeth.
•
Chief complaint
Expectations
to have the best available treatment
option for his teeth. He want it to be
(fixed).
10. Periodontium
•
•
•
•
fair Oral hygiene.
Staining & general plaque
accumulation.
Normal pocket depth
around his teeth (1-3 mm).
Generalized mild to
moderate gingival recession
in upper and lower teeth.
11. DIAGNOSIS
523.00: plaque induced gingivitis.
521.09: secondary caries. 38,36,47
525.1: Loss of teeth due to extraction: 15,14,37,35,44,45,47.
521.81: fractured DB cusp : 17
522.6: Chronic apical periodontitis 41
521.20: Abrasion in the buccal surface 16,34,44
12. chief complaint
- not eating
properly
since he lost
multiple
posterior
teeth.
- Ugly smile
- Many
missing and
heavily
restored
teeth
- Discolored
upper incisor
Main problems
14. Meta-analysis of fixed partial denture survival
(Scurria, Bader et al. 1998)
10 years: 92%
15 years: 75%
*(failure was defined as fixed partial denture removal)
15. Discolored crown with metal core
“Zirconia opacity is very useful in adverse clinical situations, for example, for
masking of dyschromic abutment teeth”. (Paolo Manicone, 2007).
22. (Fair to Good)
All the teeth showed good
periodontal condition and
bone support.
However, having many large
filling and fixed prosthesis are
factors that could affect the
prognosis
Prognosis
25. • 46 years old
• Non smoker
• No history with any systemic disease
or allergy.
26. •
not happy with his smile as it shows metal
screw in the upper anterior region (Chief
complaint).
•
He want to close the diastema between the
upper central incisors.
Chief complaint
Expectations
• He wishes to get restorations for the missing
teeth that will fit very well with other existing
teeth.
• to restore the esthetic appearance of his
smile.
31. DIAGNOSIS
523.42: Chronic periodontitis, generalized.
525.51: Partial edentulism (14-18).
525.64: Fractured dental restorative material with
loss of material (tooth 12).
524.30: Unspecified anomaly of tooth position
(diastema between 11.21)
32. chief complaint
Metal screw in
upper interior
effect esthetic
appearance
- Failure in old
crown restoration
- long edentulous
posterior area
- Deep gingival
pockets (more
than 7 mm upper
centrals.
Main problems
33. Phase 1:
•
•
Proposed treatment plan
•
Composite veneer (11,12).
(post & core) and crown restoration
(21)
Removable partial denture
Phase 2: (After 6 months of 1st phase).
• Re-evaluation of periodontal
condition.
• Bridge restoration supported by
implant (14-16,h15)
• Implant insertion with crown
restoration 46.
• Porcelain veneer (11,21).
34. (Willhite, 2005) proposed three
criteria for successful diastema
closure:
1. increase emergence profile with
natural contours at the gingiva and
tooth interface.
1. a completely closed gingival
embrasure.
1. a smooth subgingival margin that
does not catch on or shred dental
floss.
35. The objectives of prosthodontics treatment
1. Elimination.
1. Preservation.
2. Replacement.
( McGivney et al, McCracken's Removable Partial Prosthodontics, 2000).
42. Prognosis dependent on patients ability to
sustain stable periodontal condition, this will
be evaluated throughout phase 1.
Prognosis for removable denture: fair to poor
(due to inability of patient to accept this as
definitive treatment),
Crown restoration 12 : good prognosis
(dependent on quality of remaining tooth
structure, ferule, periodontal support, lack of heavy
occlusal loading, etc).
Prognosis
43. More references:
•
•
•
•
•
•
•
Chu, C. H., et al. (2011). "Treating a maxillary midline diastema in adult patients: a general
dentist's perspective." J Am Dent Assoc 142(11): 1258-1264.
Spear, F. and J. Holloway (2008). "Which all-ceramic system is optimal for anterior esthetics?" J
Am Dent Assoc 139 Suppl: 19S-24S.
Scurria, M. S., et al. (1998). "Meta-analysis of fixed partial denture survival: prostheses and
abutments." J Prosthet Dent 79(4): 459-464.
Goodacre, C. J., et al. (2003). "Clinical complications in fixed prosthodontics." J Prosthet Dent
90(1): 31-41.
Manicone, P. F., et al. (2007). "An overview of zirconia ceramics: basic properties and clinical
applications." J Dent 35(11): 819-826.
Beaumont, A. J., Jr. (2002). "An overview of esthetics with removable partial dentures."
Quintessence Int 33(10): 747-755.
Chang, Y.Y., Maximizing esthetic results on zirconia-based restorations. Gen Dent, 2011. 59(6): p.
440-5; quiz 446-7.
44. Christensen, G.J., Porcelain-fused-to-metal versus zirconia-based ceramic restorations, 2009. J Am
Dent Assoc, 2009. 140(8): p. 1036-9.
Eliasson, A., C.F. Arnelund, and A. Johansson, A clinical evaluation of cobalt-chromium metalceramic fixed partial dentures and crowns: A three- to seven-year retrospective study. J Prosthet
Dent, 2007. 98(1): p. 6-16.
Heintze, S.D. and V. Rousson, Survival of zirconia- and metal-supported fixed dental prostheses: a
systematic review. Int J Prosthodont, 2010. 23(6): p. 493-502.
Tinschert, J., et al., Structural reliability of alumina-, feldspar-, leucite-, mica- and zirconia-based
ceramics. J Dent, 2000. 28(7): p. 529-35.
Zarone, F., S. Russo, and R. Sorrentino, From porcelain-fused-to-metal to zirconia: clinical and
experimental considerations. Dent Mater, 2011. 27(1): p. 83-96.
Hello everybody. Happy to have you here again with another presentation.This time it is clinical presentation for two of case s that I have treated during my master education.
Lets start with the first case
In this case. The patient who visited our clinic is 65 years old. With no history of allergy or relevant medical problems.He only complain form peptic ulcer and use some medications for that.
The main reason for this patient to seek dental treatment was because of presence of many missing teeth in his mouth. And we are talking about posterior teeth in particular. Which is effecting the function and grinding food abilities.He informed us that he would like to get fixed set of teeth if it possible.Which is possible of course in his case as you will see in the coming slides.
After getting all history information we performed quick extra oral exam.And nothing was appearing abnormal.
During staring doing the intr oral exam.One is central incisors was restored with old metal ceramic restoration which showed un-esthetic appearance.The upper and lower arch showed many fillings many missing teeth.
From the occlusal view its clear how large and how many the fillings that the patient have in his mouth.And I actually we discovered some 2nd caries underneath some of this fillings.There was a fracture cusp in tooth 16.And temporary restoration in 27
During the OPG evaluation.We didn't’t see sings for bone pathology or decay.Accept for apical radiolucency in lower anterior teeth related to 41.It will be more obvious in the periapical X-ray.
Apical and bitewing x-ray large and deep filling that extend in some area close to alveolar bone level like in tooth 47.In the 1st quadrant the x-ray is showing expanding maxilllary sinus the reduce bone quantity.In the lower anterior area apical lesions seems to be related to tooth 41 (ENTER). tooth vitality test was applied to the tooth but it showed negative respond.
During evaluating the periodental and general oral cavity health.No deep pocket more than 4 mm was detected but the patient showed fair oral hygiene with some staining and plaque accumulation.
After gathering all the information from our clinical and radiographical exams.The patient diagnosed to have
The patient chief complaint SEEMS NOT TO BE different from his needs according to our clinical evaluation.Which is good since this mean that restore the missing teeth can restore function and meet patient expectation as possible.While restoring the discolored will help to improve the esthetic tooth in most aesthetic zone.
So to replace missing teeth.We had long discussion to reach the best treatment options for his case.(ENTER)Implant restoration showed in many studies that it can insure high success rate in long term follow up. But we can see in this case that we maybe don'ts enough bone in 1st quadrant. We have also risk to injured the mental nerve in 4th quadrant.(ENTER)RPD was one of possible option. (advantages and dis-advantages).(ENTER)But at the end we though its FPD seems the best option. Since its can provide fixed set of teeth with good aesthetic appearance. But most importantly, because we do have heavily restored neighboring teeth. (ENTER)Some of teeth already showed decay and fracture part that can be removed and restored with the FPD.
According to literature: The fixed partial dentures were estimated to have survived up 92% after 10 years in the meta-analyses conducted by Scurria in 1998.This percentage drop to become 75% after 15 years.
While in condition like this one, anterior tooth with discolored post need to be covered.zirconia has not only a color similar to teeth but is also opaque and mask the dischromic tooth.
We start the treatment by motivating instructing the patient in order to maintain good oral health.And to control the the active disease.Composite filling for the carious teeth.And root canal treatment for 41
Now we can take a look on the prosthetic part of our treatment plan.
Here, the Tooth 21 was restored with .. (ENTER) Zirconia based crown.
And we decided to restore the missing posterior teeth with(ENTER) fixed partial denture.
Here is occlucal view for upper and lower arch after finishing the prosthetic phase.
we believe the treatment performed will have good prognosis in the anterior zirconia crown.But fair prognosis expected for the posterior fixed bridge. Since it heavily restored with deep fillings with deep restoration margin especially in the 4th quadrant were we have deep margin in slightly tilted and non vital 47.
AStudy reported that caries or pulp vitality problems could be the most common complication associated with FPB.This will be the last slide for this case
And now for the 2nd case
Here Our patient is 46 year old He is Non smoker and without any relevant medical problems.
His main complaint was regarding un-aesthetic smile. Due to presence of large diastema and metal screw and upper anterior area.And he came to the clinic to fix his teeth problems.
Frontal and lateral few for the patient bite showing that previously mentioned problemsIn addition to large edentulous are in right side.
Occlusal view for the upper and lower arch
The panoramic x-ray can shows us general view of how far this edounleous area is extending. It can show also the genaral alveolar bone loss in upper and lower teeth
During our apical x-ray examinationIts clear the amount of alveolar bone resorption especially in upper incisors area.Probing depth values shoed deep pockets that reached 7mm in the central incisors. (ENTER)There was also sign of apical radioleucency related to tooth 35. (ENTER)
After gathering all the information from our clinical and radiographical exams.The patient diagnosed to have
Theunesthetic smile is the main reason for this patient seeks dental treatment. We have to take on consideration the missing teeth in right side. Which make the patient only able to bit in one side.
Since the patient is periodontal therapy to restore the teeth support. We designed our treatment plan into two phase.Phase 1 can work as temporary stage in order to restore aesthetic in anterior area and to fabricate removable denture for the long edentulous posterior area.The periondental condition will be re-evaluated after 6 month and if it showed improved teeth support condition we can proceed by doing porcelain veneer in upper centrals. And maybe implant restoration in the posterior region.
closing anterior diastemaand avoiding "black triangle "between the teeth is One of the most challenging task to most dentists.So, willlhite in his paper in 2005 proposed 3 criteria to close diastema in successful way.
In his book: removable partial prosthodontics, Mcgivney listed main 3 objectives of prosthodontics therapy, which is:the elimination of disease.the preservation of the health and relationship of the teeth and the health of the remaining oral tissues,. the selected replacement of lost teeth, and the restoration of function in an esthetically pleasing manner."
And lets take a look on the treatment that have been performed to this patient
To close the diastema, and restore lateral incisor with metal screw.We treat the centrals with composite veneer. (ENTER)And E max crown was the material of choice for tooth 12.
For the edentulous area in 1st quadrant.RPD was designed and fabricated to replace missing teeth in that area(ENTER)
Here frontal view for the pre- and post operative images for the anterior teeth
Pre and post operative images for the area that restored with RPD
at the end of this presentation I would to thank you all for listening. And special thank of course to : Armanameri for being supportive friendly. and for being allways their during the clinical time to help us and to answer our question. Thank you