Distraction osteogenesis is a technique used to regenerate bone by gradually separating a bone in two pieces. It works by placing tension stresses across the bone gap which stimulates new bone growth. It has been used to treat various craniofacial abnormalities and avoid problems with conventional surgery. The history of distraction osteogenesis dates back to 1905 but it was pioneered and expanded upon by Ilizarov in the 1950s for limb lengthening. It has since been adapted for use in the craniofacial region including the mandible, maxilla and midface.
1. The document discusses features, etiology, and treatment of anterior open bite and deep bite. It describes skeletal, dental, soft tissue, and growth features of high and low angle cases.
2. Cephalometric measurements used to assess open bite and deep bite tendencies are described, including overbite depth indicator, Jarabak ratio, and UAFH-LAFH ratio.
3. Causes of open bite discussed include habits, enlarged adenoids, and posterior rotation of the mandible. Deep bite causes include class II skeletal pattern and anterior rotation of the mandible.
This document discusses different types of anchorage in orthodontics. Anchorage is defined as the resistance to tooth movement provided by anatomical units. There are different classifications of anchorage based on the manner of force application, location, and number of teeth providing resistance. Intra-oral sources include teeth and bone, while extra-oral includes occipital bone and muscles. Anchorage requirements depend on factors like number of teeth moving, type of movement, treatment duration, and occlusal interlock. Anchorage loss can be prevented by reinforcing the anchorage unit, subdividing tooth movement, using tipping movements, controlling forces, and using temporary skeletal anchorage.
Hybrid appliances are specifically and individually tailored to exploit the natural processes of growth and development. Such an approach represents a departure from the practice of adopting a "named" appliance for the treatment of a class of malocclusion
Distraction Osteogenesis in OrthodonticsWaqar Jeelani
Distraction osteogenesis is a surgical technique that involves gradually separating bone segments that have been cut. This causes new bone to form in between the segments. There are several phases to this process including latency, distraction, consolidation, and remodeling. Historically, Codivilla first reported limb lengthening in 1905 but it was Ilizarov who developed the technique in the 1950s using gradual distraction. Since then it has been used for many purposes like lengthening the mandible to treat deficiencies. Planning involves factors like the distraction device used, bone quality, and distractor orientation. It can have advantages over other techniques like allowing for more correction and growing tissues with the patient.
Craniofacial anomalies /certified fixed orthodontic courses by Indian dental ...Indian dental academy
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.
Primary failure of eruption (PFE) is characterized by the non-syndromic failure of permanent teeth to erupt in the absence of a mechanical obstruction or known local/systemic cause. It can result in complete failure or initial eruption followed by failure. The cause is unknown but has a genetic component. It occurs in 1% of first molars and more commonly in females and molars. Diagnosis is often retrospective as orthodontic extrusion is unsuccessful. Treatment options include restorative work, segmental osteotomy, or extraction. Multiple failure of eruption can be due to local factors like supernumeraries or arch deficiency, systemic factors like genetic disorders or endocrinopathies, or be id
This document provides an overview of rapid maxillary expansion (RME) in orthodontics. It discusses the history of RME dating back to 1860. It also covers anatomy related to RME, including the midpalatal suture. Key topics covered include indications and contraindications for RME, types of expansion screws used, jackscrew turn schedules, and different types of RME appliances such as the Haas expander and Hyrax expander. The document is an educational resource on the clinical use and mechanics of RME.
This document provides information on performing a functional examination as part of an orthodontic diagnosis. It discusses examining the postural rest position and maximum intercuspation, as well as the temporomandibular joint, orofacial dysfunction, and various functional movements. Methods for determining and registering the postural rest position are described. Examination of swallowing, tongue posture, speech, lips, respiration, and craniofacial skeletal relationships are also covered to evaluate orofacial dysfunction. The document emphasizes that a functional examination is important for a complete orthodontic diagnosis beyond just a static evaluation of dental relationships.
1. The document discusses features, etiology, and treatment of anterior open bite and deep bite. It describes skeletal, dental, soft tissue, and growth features of high and low angle cases.
2. Cephalometric measurements used to assess open bite and deep bite tendencies are described, including overbite depth indicator, Jarabak ratio, and UAFH-LAFH ratio.
3. Causes of open bite discussed include habits, enlarged adenoids, and posterior rotation of the mandible. Deep bite causes include class II skeletal pattern and anterior rotation of the mandible.
This document discusses different types of anchorage in orthodontics. Anchorage is defined as the resistance to tooth movement provided by anatomical units. There are different classifications of anchorage based on the manner of force application, location, and number of teeth providing resistance. Intra-oral sources include teeth and bone, while extra-oral includes occipital bone and muscles. Anchorage requirements depend on factors like number of teeth moving, type of movement, treatment duration, and occlusal interlock. Anchorage loss can be prevented by reinforcing the anchorage unit, subdividing tooth movement, using tipping movements, controlling forces, and using temporary skeletal anchorage.
Hybrid appliances are specifically and individually tailored to exploit the natural processes of growth and development. Such an approach represents a departure from the practice of adopting a "named" appliance for the treatment of a class of malocclusion
Distraction Osteogenesis in OrthodonticsWaqar Jeelani
Distraction osteogenesis is a surgical technique that involves gradually separating bone segments that have been cut. This causes new bone to form in between the segments. There are several phases to this process including latency, distraction, consolidation, and remodeling. Historically, Codivilla first reported limb lengthening in 1905 but it was Ilizarov who developed the technique in the 1950s using gradual distraction. Since then it has been used for many purposes like lengthening the mandible to treat deficiencies. Planning involves factors like the distraction device used, bone quality, and distractor orientation. It can have advantages over other techniques like allowing for more correction and growing tissues with the patient.
Craniofacial anomalies /certified fixed orthodontic courses by Indian dental ...Indian dental academy
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.
Primary failure of eruption (PFE) is characterized by the non-syndromic failure of permanent teeth to erupt in the absence of a mechanical obstruction or known local/systemic cause. It can result in complete failure or initial eruption followed by failure. The cause is unknown but has a genetic component. It occurs in 1% of first molars and more commonly in females and molars. Diagnosis is often retrospective as orthodontic extrusion is unsuccessful. Treatment options include restorative work, segmental osteotomy, or extraction. Multiple failure of eruption can be due to local factors like supernumeraries or arch deficiency, systemic factors like genetic disorders or endocrinopathies, or be id
This document provides an overview of rapid maxillary expansion (RME) in orthodontics. It discusses the history of RME dating back to 1860. It also covers anatomy related to RME, including the midpalatal suture. Key topics covered include indications and contraindications for RME, types of expansion screws used, jackscrew turn schedules, and different types of RME appliances such as the Haas expander and Hyrax expander. The document is an educational resource on the clinical use and mechanics of RME.
This document provides information on performing a functional examination as part of an orthodontic diagnosis. It discusses examining the postural rest position and maximum intercuspation, as well as the temporomandibular joint, orofacial dysfunction, and various functional movements. Methods for determining and registering the postural rest position are described. Examination of swallowing, tongue posture, speech, lips, respiration, and craniofacial skeletal relationships are also covered to evaluate orofacial dysfunction. The document emphasizes that a functional examination is important for a complete orthodontic diagnosis beyond just a static evaluation of dental relationships.
This document discusses soft tissue analysis for orthodontic treatment planning. It covers clinical examination including natural head position, lip assessment, and frontal and profile views. Key measurements and landmarks are defined such as facial thirds, nasolabial angle, lip lengths, and chin position. Factors that influence soft tissues like tooth movement and growth are also addressed.
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 document discusses distraction osteogenesis, which is a technique for regenerating bone and soft tissue by gradually separating bone segments that have been surgically cut. It describes the history, biological process, phases involving surgery, latency period and distraction period, factors to consider like rate and rhythm of distraction, applications for maxillofacial deficiencies and reconstruction, and techniques involved. Distraction osteogenesis is an alternative to orthognathic surgery that allows for gradual adjustment of bony and soft tissues.
This document discusses Class II Division 2 malocclusion. Key points:
- Class II Division 2 is characterized by retroclined upper incisors and a retropositioned lower first molar. The overjet is usually minimal but may be increased.
- It has a prevalence of 1.5-17.7% and is highly associated with impacted canines.
- The etiology involves genetic and environmental factors like soft tissue pressures retroclining the upper incisors.
- Treatment aims to correct the skeletal and dental relationships, overbite, and achieve a functional occlusion. Options include growth modification, fixed appliances, orthognathic surgery, or a combination. Anchorage is
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 general indications for SARPE are skeletal maturity, transverse maxillary deficiency, excessive display of buccal corridors when smiling, and anterior crowding.
This document describes Dr. Duane Grummons' posteroanterior (PA) cephalometric analysis for evaluating facial asymmetry. The analysis involves constructing reference lines and planes to compare bilateral landmarks and structures. Measurements are made of linear distances, angles, ratios and volumetric comparisons. The comprehensive analysis evaluates multiple structures and parameters while the summary analysis focuses on key dental and skeletal factors. The analysis is useful for orthodontic-surgical treatment planning to determine the extent and location of asymmetries and surgical corrections needed.
Distraction osteogenesis /certified fixed orthodontic courses by Indian denta...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
0091-9248678078
Class II Malocclusion (Camouflage Treatment)Kristel Keith
There are three main patterns of tooth movement that can be used to correct a Class II malocclusion: 1) nonextraction treatment with Class II elastics, 2) retraction of the upper incisors into a premolar extraction space, and 3) distal movement of the upper teeth. Distal movement of the upper teeth is challenging but can be improved with temporary skeletal anchorage to move the molars backwards up to 6mm, correcting the molar relationship. For adolescents with Class II malocclusions, growth modification alone may not be enough and orthognathic surgery to advance the mandible may be necessary if little growth is expected.
This document discusses various considerations and approaches for treatment planning in orthodontics. It addresses topics such as developing a problem list, involving patients in decision making, decisions around arch expansion versus extraction for crowding, growth modification versus camouflage for skeletal problems, and specific approaches for treating Class II and Class III malocclusions. Key points covered include contemporary guidelines for extraction, factors in rapid versus slow palatal expansion, limitations of tooth movement alone to correct skeletal issues, and caveats of different treatment strategies.
A scissor bite, also known as a Brodie bite, is a malocclusion where the maxillary molars are positioned outward or the mandibular molars are positioned inward, causing the molars to overlap without contact when the mouth is closed. It is characterized by labial eruption of the upper molars or lingual tipping of the lower molars due to an arch length discrepancy in the posterior region. Treatment involves using elastic forces or orthodontic appliances to correct the positioning of the molars, and recently miniplates or mini screws placed in the bone have provided skeletal anchorage for tooth movements without undesirable side effects.
This document discusses the management of occlusal cant, which is asymmetry in the vertical inclination of the occlusal plane. It begins by defining occlusal cant and exploring its causes such as facial asymmetry or asymmetric growth. Methods for evaluating occlusal cant like clinical exams, photos, and imaging are presented. Treatment options include orthodontics using devices like bite blocks or orthodontic surgery to level the occlusal plane. The document concludes that both the etiology and classification of an individual's occlusal cant should be considered to determine the best treatment approach.
“The study of orthodontia is indissolubly connected with that of art as related to the human face.” -Dr. Edward H. Angle.
Each person shares with the rest of the population a great many characteristics, but there are enough differences to make each human being a unique individual. Such limitless variation in the size, shape and relationship of the dental, skeletal and soft tissue facial structures are important in providing each individual with his or her own identity.
Face – Difficult object to measure accurately because of
– complex morphology
– sensitivity to eyes
– its soft nature.
One of goals of orthodontic treatment is creating a balanced & harmonious facial appearance. Craniofacial symmetry is one of the aspect of this harmony. Subject of symmetry or lack of symmetry of human face has been of considerable interest, particularly in the field of Orthodontics. Minor variation is a desirable variation of craniofacial structure which is perceived as esthetically pleasing and has no esthetic or functional significance. Asymmetry becomes important when it affects the function or esthetics of the person.
This document summarizes the biological basis of orthodontic tooth movement. It begins by introducing the structures involved, including the periodontium. When forces are applied, the periodontium and distant structures experience changes. Osteocytes in the alveolar bone act as mechanosensors, initiating remodeling responses. Fibroblasts in the periodontal ligament and gingiva also act as mechanosensors and transducers. Applied forces cause blood vessel reorganization and neovascularization. Neural responses also occur due to mechanical forces. Theories of tooth movement involve pressure, tension, blood flow changes, and new concepts like fluid shear stress. Cellular behaviors differ in tension and compression sites.
This document provides an overview of the classification of malocclusion. It begins with definitions of key terms like occlusion, ideal occlusion, normal occlusion, and malocclusion. It then reviews the historical development of classification systems. The need for a standardized classification is to aid in diagnosis, treatment planning, and communication between clinicians. The main types of malocclusion are described as intra-arch, inter-arch, and skeletal. Several historical classification systems are summarized, including Angle's classification which divides malocclusions into Classes I, II, and III based on molar relationships. Modifications to Angle's system by Dewey and Lischer are also briefly outlined.
Expansion in orthodontics /certified fixed orthodontic courses by Indian dent...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
0091-9248678078
RAPID MAXILLARY EXPANSION VS SLOW MAXILLARY EXPANSIONShehnaz Jahangir
This document provides an overview of rapid maxillary expansion (RME) vs slow maxillary expansion (SME). It discusses the historical perspective of maxillary expansion, articulation and ossification of the midpalatal suture, indications and contraindications for expansion, classifications based on activation and support, examples of RME and SME appliances, activation protocols, and the biomechanical aspects and effects of RME on skeletal and dental structures. Key differences between RME and SME include the rate of activation (rapid vs slow) and appliances used (tooth-borne vs tissue-borne).
This document summarizes research on jaw rotation during growth, maturation, and aging. It discusses how internal and external jaw rotation influence tooth eruption pathways and malocclusion development. Internal rotation moves the jaw forward and upward, while external rotation compensates by moving it backward and downward. A short face type has more anterior rotation leading to a deep bite, while a high face type has excessive backward rotation causing an open bite. Maturation and aging bring changes to soft tissues, teeth, alignment and occlusion. Growth continues in adults, with males showing net forward rotation and females backward rotation.
This document provides an overview of twin block therapy. It discusses the history, philosophy, design, construction, and stages of treatment using twin blocks. Twin blocks are functional appliances composed of separate upper and lower bite blocks. They are worn 24 hours a day to achieve rapid correction of malocclusions through forces transmitted to inclined planes covering the posterior teeth. Treatment typically involves an initial active phase followed by a support phase to stabilize results.
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
This document discusses soft tissue analysis for orthodontic treatment planning. It covers clinical examination including natural head position, lip assessment, and frontal and profile views. Key measurements and landmarks are defined such as facial thirds, nasolabial angle, lip lengths, and chin position. Factors that influence soft tissues like tooth movement and growth are also addressed.
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 document discusses distraction osteogenesis, which is a technique for regenerating bone and soft tissue by gradually separating bone segments that have been surgically cut. It describes the history, biological process, phases involving surgery, latency period and distraction period, factors to consider like rate and rhythm of distraction, applications for maxillofacial deficiencies and reconstruction, and techniques involved. Distraction osteogenesis is an alternative to orthognathic surgery that allows for gradual adjustment of bony and soft tissues.
This document discusses Class II Division 2 malocclusion. Key points:
- Class II Division 2 is characterized by retroclined upper incisors and a retropositioned lower first molar. The overjet is usually minimal but may be increased.
- It has a prevalence of 1.5-17.7% and is highly associated with impacted canines.
- The etiology involves genetic and environmental factors like soft tissue pressures retroclining the upper incisors.
- Treatment aims to correct the skeletal and dental relationships, overbite, and achieve a functional occlusion. Options include growth modification, fixed appliances, orthognathic surgery, or a combination. Anchorage is
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 general indications for SARPE are skeletal maturity, transverse maxillary deficiency, excessive display of buccal corridors when smiling, and anterior crowding.
This document describes Dr. Duane Grummons' posteroanterior (PA) cephalometric analysis for evaluating facial asymmetry. The analysis involves constructing reference lines and planes to compare bilateral landmarks and structures. Measurements are made of linear distances, angles, ratios and volumetric comparisons. The comprehensive analysis evaluates multiple structures and parameters while the summary analysis focuses on key dental and skeletal factors. The analysis is useful for orthodontic-surgical treatment planning to determine the extent and location of asymmetries and surgical corrections needed.
Distraction osteogenesis /certified fixed orthodontic courses by Indian denta...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
0091-9248678078
Class II Malocclusion (Camouflage Treatment)Kristel Keith
There are three main patterns of tooth movement that can be used to correct a Class II malocclusion: 1) nonextraction treatment with Class II elastics, 2) retraction of the upper incisors into a premolar extraction space, and 3) distal movement of the upper teeth. Distal movement of the upper teeth is challenging but can be improved with temporary skeletal anchorage to move the molars backwards up to 6mm, correcting the molar relationship. For adolescents with Class II malocclusions, growth modification alone may not be enough and orthognathic surgery to advance the mandible may be necessary if little growth is expected.
This document discusses various considerations and approaches for treatment planning in orthodontics. It addresses topics such as developing a problem list, involving patients in decision making, decisions around arch expansion versus extraction for crowding, growth modification versus camouflage for skeletal problems, and specific approaches for treating Class II and Class III malocclusions. Key points covered include contemporary guidelines for extraction, factors in rapid versus slow palatal expansion, limitations of tooth movement alone to correct skeletal issues, and caveats of different treatment strategies.
A scissor bite, also known as a Brodie bite, is a malocclusion where the maxillary molars are positioned outward or the mandibular molars are positioned inward, causing the molars to overlap without contact when the mouth is closed. It is characterized by labial eruption of the upper molars or lingual tipping of the lower molars due to an arch length discrepancy in the posterior region. Treatment involves using elastic forces or orthodontic appliances to correct the positioning of the molars, and recently miniplates or mini screws placed in the bone have provided skeletal anchorage for tooth movements without undesirable side effects.
This document discusses the management of occlusal cant, which is asymmetry in the vertical inclination of the occlusal plane. It begins by defining occlusal cant and exploring its causes such as facial asymmetry or asymmetric growth. Methods for evaluating occlusal cant like clinical exams, photos, and imaging are presented. Treatment options include orthodontics using devices like bite blocks or orthodontic surgery to level the occlusal plane. The document concludes that both the etiology and classification of an individual's occlusal cant should be considered to determine the best treatment approach.
“The study of orthodontia is indissolubly connected with that of art as related to the human face.” -Dr. Edward H. Angle.
Each person shares with the rest of the population a great many characteristics, but there are enough differences to make each human being a unique individual. Such limitless variation in the size, shape and relationship of the dental, skeletal and soft tissue facial structures are important in providing each individual with his or her own identity.
Face – Difficult object to measure accurately because of
– complex morphology
– sensitivity to eyes
– its soft nature.
One of goals of orthodontic treatment is creating a balanced & harmonious facial appearance. Craniofacial symmetry is one of the aspect of this harmony. Subject of symmetry or lack of symmetry of human face has been of considerable interest, particularly in the field of Orthodontics. Minor variation is a desirable variation of craniofacial structure which is perceived as esthetically pleasing and has no esthetic or functional significance. Asymmetry becomes important when it affects the function or esthetics of the person.
This document summarizes the biological basis of orthodontic tooth movement. It begins by introducing the structures involved, including the periodontium. When forces are applied, the periodontium and distant structures experience changes. Osteocytes in the alveolar bone act as mechanosensors, initiating remodeling responses. Fibroblasts in the periodontal ligament and gingiva also act as mechanosensors and transducers. Applied forces cause blood vessel reorganization and neovascularization. Neural responses also occur due to mechanical forces. Theories of tooth movement involve pressure, tension, blood flow changes, and new concepts like fluid shear stress. Cellular behaviors differ in tension and compression sites.
This document provides an overview of the classification of malocclusion. It begins with definitions of key terms like occlusion, ideal occlusion, normal occlusion, and malocclusion. It then reviews the historical development of classification systems. The need for a standardized classification is to aid in diagnosis, treatment planning, and communication between clinicians. The main types of malocclusion are described as intra-arch, inter-arch, and skeletal. Several historical classification systems are summarized, including Angle's classification which divides malocclusions into Classes I, II, and III based on molar relationships. Modifications to Angle's system by Dewey and Lischer are also briefly outlined.
Expansion in orthodontics /certified fixed orthodontic courses by Indian dent...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
0091-9248678078
RAPID MAXILLARY EXPANSION VS SLOW MAXILLARY EXPANSIONShehnaz Jahangir
This document provides an overview of rapid maxillary expansion (RME) vs slow maxillary expansion (SME). It discusses the historical perspective of maxillary expansion, articulation and ossification of the midpalatal suture, indications and contraindications for expansion, classifications based on activation and support, examples of RME and SME appliances, activation protocols, and the biomechanical aspects and effects of RME on skeletal and dental structures. Key differences between RME and SME include the rate of activation (rapid vs slow) and appliances used (tooth-borne vs tissue-borne).
This document summarizes research on jaw rotation during growth, maturation, and aging. It discusses how internal and external jaw rotation influence tooth eruption pathways and malocclusion development. Internal rotation moves the jaw forward and upward, while external rotation compensates by moving it backward and downward. A short face type has more anterior rotation leading to a deep bite, while a high face type has excessive backward rotation causing an open bite. Maturation and aging bring changes to soft tissues, teeth, alignment and occlusion. Growth continues in adults, with males showing net forward rotation and females backward rotation.
This document provides an overview of twin block therapy. It discusses the history, philosophy, design, construction, and stages of treatment using twin blocks. Twin blocks are functional appliances composed of separate upper and lower bite blocks. They are worn 24 hours a day to achieve rapid correction of malocclusions through forces transmitted to inclined planes covering the posterior teeth. Treatment typically involves an initial active phase followed by a support phase to stabilize results.
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
Squamous cell carcinoma is the most common type of tongue cancer. It usually appears as a pinkish-gray or red bump or sore on the side of the tongue. Symptoms include changes in the tongue's appearance, pain, and problems tasting or speaking. Squamous cell carcinoma generally affects older adults and is more common in men, as smoking and drinking alcohol increase risk. Treatment options depend on the size and extent of cancer but may include surgery, laser therapy, radiation, or chemotherapy. Regular dental exams and avoiding tobacco, excessive alcohol, and sun exposure can help prevent squamous cell carcinoma.
The document discusses causes and treatment options for discolored teeth. It describes extrinsic staining caused by substances like coffee and tea that deposit on teeth. Intrinsic staining involves internal color changes and can be from local factors like pulp necrosis or systemic factors like tetracycline use. Bleaching options include internal bleaching using thermocatalytic or walking bleaching techniques after root canal treatment or external bleaching with mouth guard or chair side bleaching. Risks of bleaching include external resorption, damage to restorations, or chemical burns.
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.
This document discusses distraction osteogenesis, a technique used to regenerate bone by gradually separating bone segments. It was introduced in 1951 by Ilizarov who used external fixation devices. The key steps involve cutting and separating the bone followed by slow distraction of 1mm per day which stimulates new bone formation. Both extraoral and intraoral devices are described. Applications include lengthening of the mandible for conditions like micrognathia. The process relies on stability of fixation, controlled distraction rate, and preservation of soft tissues. It allows reconstruction of craniofacial bones without growth factors.
This document discusses distraction osteogenesis, a technique where new bone is formed between vascular bone surfaces that are gradually pulled apart. It involves three phases: a latency period, distraction period where the bone surfaces are distracted 1mm per day, and consolidation period. Histologically, a fibrous interzone forms between the bone surfaces that takes on the role of a growth plate, with intramembranous ossification forming new bone columns across the gap. Key factors for successful new bone formation include stability of fixation, atraumatic corticotomy, and appropriate distraction rate and rhythm.
This document discusses different methods of cosmetic tooth whitening or bleaching. It describes intrinsic and extrinsic tooth discoloration and their causes. The main methods covered are in-office bleaching, laser bleaching, and dentist-prescribed home bleaching kits. In-office bleaching uses high concentration peroxide gels applied by the dentist. Home bleaching involves patients wearing custom-fitted trays with lower concentration peroxide gels overnight. Non-vital bleaching treats discoloration inside teeth without pulps. Factors like concentration, time, temperature, and additives affect bleaching results. Potential side effects include temporary tooth sensitivity.
This document discusses dental bleaching, including that it can lighten intrinsic and extrinsic stains, is done either in a dental office or at home, and depends on factors like age, habits, and trauma. It notes the risks can include chemical burns, sensitive teeth, and over-bleaching. It also recommends maintaining results by avoiding dark foods for a week after, not smoking, good oral hygiene, and continuing whitening products.
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
for online course please visit www.idalectures.com
for online interactive live courses/classes please visit
www.gotolectures.com.
This document provides an overview of dental bleaching (tooth whitening). It discusses the various causes of tooth discoloration and the mechanisms by which bleaching works to lighten teeth. The main types of bleaching are described as non-vital bleaching for discolored non-living teeth and vital bleaching for living teeth, which can be done at home or in-office with light acceleration. Safety concerns are noted along with the need for more long-term studies. Natural bleaching methods using ingredients like strawberries, baking soda, and other fruits are mentioned but caution is advised about enamel damage if overused.
This document discusses dental discoloration, its causes, and bleaching treatments. It covers extrinsic and intrinsic causes of staining and describes different types and degrees of tetracycline and fluorosis staining. Bleaching mechanisms and materials including hydrogen peroxide, sodium perborate, and carbamide peroxide are explained. Intracoronal and extracoronal bleaching techniques and their potential adverse effects are summarized.
The document discusses vital tooth bleaching. It begins by outlining the indications for bleaching, such as moderate tooth discolouration from fluorosis or aging. Contraindications include severe stains, hypersensitivity, or active caries.
At-home bleaching involves custom-fitted trays containing 10% carbamide peroxide, which breaks down to release hydrogen peroxide. The process involves taking impressions to fabricate trays that deliver the bleaching agent to the teeth overnight. Factors like concentration, temperature, pH, and time influence the bleaching effect.
This document discusses oral squamous cell carcinoma, including its definition, risk factors, signs and symptoms, diagnosis, treatment, and prevention. Key points:
- It is a malignant neoplasm of the oral cavity epithelium capable of local growth and metastasis. Major risk factors include tobacco use, alcohol consumption, and HPV infection.
- Common symptoms are non-healing sores, lumps, pain or difficulty swallowing. Diagnosis involves biopsy and imaging tests. Treatment options are surgery, radiation, chemotherapy and rehabilitation.
- Prevention focuses on reducing risk factors through health education and discouraging behaviors like smoking, as well as early detection through screening to find cancer at earlier, more treatable stages.
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
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
This document provides an overview of myofunctional appliances used in orthodontics. It discusses how they work to modify skeletal discrepancies by harnessing natural muscle forces. Different types of appliances are described, including activators, Frankel regulators, and Twin Blocks. Key factors in case selection and successful treatment outcomes with these appliances are highlighted, such as patient age and cooperation. The document also reviews concepts like Moss's functional matrix theory and how appliances can guide dental changes and bone growth. Contraindications and factors maximizing success are outlined.
The twin block appliance was developed in 1977 to treat a young patient with a Class II malocclusion caused by luxation of an upper central incisor. It consists of simple bite blocks with inclined planes at 70 degrees to apply forward and downward force on the mandible. The twin block uses natural muscle forces to encourage favorable skeletal and dental changes. It can be used to treat a variety of malocclusions in both growing and adult patients. Advancements in design have improved function, retention, and patient comfort.
This document discusses functional appliances used in orthodontic treatment. It describes the advantages and disadvantages of functional appliances, how they work to produce orthopedic, dentoalveolar and muscular changes, different types of functional appliances including activators and Frankel regulators, and guidelines for use and patient instruction.
Splints in orthodontics /certified fixed orthodontic courses by Indian denta...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
0091-9248678078
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
Controversies surrounding the efficacy of functional appliancesIndian 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
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Hybrid functional appliance/certified fixed orthodontic courses by Indian den...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
0091-9248678078
ABSTRACT- Background: Femoral shaft fractures are most common fractures in paediatric orthopaedic age
group. There are distinct methodologies to treat them. Elastic stable intramedullary nailing is one in every of them and a
longtime and reliable methodology for treating these fractures.
Aims: To evaluate the clinical, functional and radiological outcome of intramedullary fixation of displaced fracture
shaft femur in skeletally immature children using titanium elastic intramedullary nails.
Material and Methods: 65 Femoral shaft fracture in 60 children aged 6-14 years were fixed with titanium
intramedullary elastic nail under image intensifier control between July 2013 and June 2017.Two nails of proper and
equal diameter were used for fracture fixation. No external splint was used after surgery. Outcomes assessed on the
basis of Flynn et al scoring criterion.
Results: All patients achieved complete healing at a mean of 9.5 weeks. 51 fracture reduced by closed means but 14
needs open reduction. Common size of elastic nail used was 3mm. no major complication was recorded all were minor
and can be taken care off. Most common was entry site skin irritation recorded in 10 patients. 90% had excellent result
and 10% had satisfactory.
Conclusion: Elastic stable intramedullary nailing is the method of choice for the Femoral shaft fracture in paediatric
patients, because it is minimally invasive and provide six point fixation and shows very good functional and cosmetic
result. It allows early ambulation and shorter hospital stay and higher parent satisfaction. ESIN also provide flexural,
translational and rotational stability as well.
Key-words- Elastic stable intramedullary nailing (ESIN), Titanium elastic nail (TEN), Femoral shaft fracture,
Paediatric
Functional appliances
For general practitioners
Prepared by
Dr. M Alruby
Functional appliances are large category of orthodontic appliances that used primarily to reposition of the mandible in order to alter the muscular forces against the teeth and craniofacial skeleton.
Functional appliances are used for growth modification procedures that are aimed at intercepting and treating jaw discrepancies. They can bring about the following changes:
1- Change the relationship of the jaws.
2- Change the direction of the growth of the jaws.
3- Acceleration of desirable growth.
4- Provide more favorable environments foe developments of dentition through:
a- Modify the muscle function.
b- Relive abnormal muscle function.
c- Selectively alter the eruptive path o the teeth.
5- Selectively inhibit the skeletal growth.
Classification of functional appliances:
1- Myotonic appliances: they are functional appliances that depend on the muscle mass for their action.
2- Myodynamic appliances: they are functional appliances that depend on the muscle activity for their action.
3- Removable functional appliances: they are functional appliances that can remove and inserted into the mouth by the patient for example: activator and bionator.
Uses and indications of functional appliances:
1- When the muscle dysfunction play a role in etiology of malocclusion.
2- Where alteration of muscle function may provides an optimum condition for normal dentofacial development.
Functional appliances may be indicated in the following:
1- Anteroposterior discrepancies on mild disproportional bases as Class II, Class III.
2- Vertical discrepancies on mild disproportional skeletal bases (open bite or deep bite).
Timing of treatment:
All the functional appliances are probably most effective in the growing children to gain maximum benefits from pubertal growth spurt.
Treatment principle:
Functional appliances work on two broad principles:
1- Force application: comprehensive stress and strain act on the structures involved and result in a primary alteration in form with a secondary adaptation in function. Most of the fixed and removable appliances work on this principle.
2- Force elimination: this principle involves the elimination of abnormal and restrictive environmental influences on the dentition thereby allowing optimal development. Thus function is rehabilitated with secondary changes in form. All functional appliances are assemblies of a few simple components. Each component has a desired function and is generally incorporated for a specific purpose. The currently used appliances are made of combination from three basic functional components. They are bite planes, shields or screens and construction of working bites. These components produce skeletal and dentoalveolar changes by acting on the following:
1- Eruption (bite plane).
2- Linguofacial muscle balance (shields or screens).
3- Mandibular repositioning (construction of working bite).
Distraction osteogenesis is a technique where bone is lengthened by slowly pulling apart the fragments of a surgically cut bone. New bone forms in the gap created. It has advantages over orthognathic surgery like being safer, decreasing hospitalization time, and allowing treatment at a younger age as it regenerates both bone and soft tissues. There are different types including monofocal, bifocal, and trifocal distraction used for various bone defects. Distraction is done in phases including latency, distraction, consolidation, and retention using both internal and external distraction devices. It is used to treat conditions like jaw hypoplasia, asymmetry, and defects from tumors or trauma.
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
Expansion appliances /certified fixed orthodontic courses by Indian dental ac...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.
Functional appliances utilize the natural forces of the orofacial musculature to produce skeletal and dental changes. They are based on Moss's functional matrix theory which proposes that muscles and glands influence bone growth. Functional appliances can be active or passive and produce orthopedic, dentoalveolar, and muscular changes through forces of compression, elimination of restrictive influences, and mandibular repositioning. Common functional appliances discussed in the document include Bionators, Twin-Blocks, Herbst, Frankel Regulator, and Jasper Jumper. They vary in their mode of action, indications, advantages, and disadvantages.
The Twin Block Appliance is a functional orthodontic appliance consisting of upper and lower removable bite blocks used to correct Class II malocclusions by repositioning the mandible forward through inclined occlusal planes which provide proprioceptive stimulus for bone growth; it was developed in the 1980s as an improvement on previous functional appliances and provides numerous orthodontic, dental, skeletal, soft tissue and airway benefits when worn as directed.
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
You can complete the whole process in 3-4 months.Salary range for DH/DT is around 2500-3500 Pounds per month.
Eligibility / requirements-
1. An International English Language Testing System (IELTS) certificate
at the appropriate level.(Within 2 yrs of application date )
2: A recent primary dental qualification that has been taught and examined in English..(Within 2 yrs of application date )
3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
If you are interested Please contact us for more details.
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...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.
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.
I –Aligners are made with FDA approved transparent thermoplastic materials using 3D scanning, 3D Printing and finally Trays with Pressure vacuum formers.
Dear Doctor,
Indian Dental Academy Now offers comprehensive online Orthodontics course.
Course includes:
1.whiteboard lecture presentations
2.Case Discussions
3.with hundreds of pictures.
4.Demo on Models
5.Demo on Patients
6. subtitles in your own language
12 months unlimited access and support @350 USD only.
For Demo please visit :www.idalectures.com/preview/
For more details visit: www.idalectures.com
Please contact us for any clarifications:
idalectures@gmail.com
indiandentalacademy@gmail.com
Thanks & Regards
Indian Dental Academy
--
Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
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
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...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
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian 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
Properties of Denture base materials /rotary endodontic coursesIndian 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
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Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
This document discusses dental occlusion concepts and philosophies for complete dentures. It introduces key terms like physiologic occlusion and defines different occlusion schemes like balanced articulation and monoplane articulation. The document discusses advantages and disadvantages of using anatomic versus non-anatomic teeth for complete dentures. It also outlines requirements for maintaining denture stability, such as balanced occlusal contacts and control of horizontal forces. The goal of occlusion for complete dentures is to re-establish the homeostasis of the masticatory system disrupted by edentulism.
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
This document discusses dental casting investment materials. It describes the three main types of investments - gypsum bonded, phosphate bonded, and ethyl silicate bonded investments. For gypsum bonded investments specifically, it details their classification, composition including the roles of gypsum, silica, and modifiers, setting time, normal and hygroscopic setting expansion, and thermal expansion. It provides information on how the properties of gypsum bonded investments are affected by their composition. The document serves as a comprehensive overview of dental casting investment materials.
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
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
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
🔥🔥🔥🔥🔥🔥🔥🔥🔥
إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
🔥🔥🔥🔥🔥🔥🔥🔥🔥
Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
How to Download & Install Module From the Odoo App Store in Odoo 17Celine George
Custom modules offer the flexibility to extend Odoo's capabilities, address unique requirements, and optimize workflows to align seamlessly with your organization's processes. By leveraging custom modules, businesses can unlock greater efficiency, productivity, and innovation, empowering them to stay competitive in today's dynamic market landscape. In this tutorial, we'll guide you step by step on how to easily download and install modules from the Odoo App Store.
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
2. Introduction
Distraction osteogenesis is the process of
slow bone expansion in which new bone is
generated in an osteotomy gap in
response to tension stresses placed across
the bone gap
Distraction osteogenesis has been used to
avoid the problems associated with
conventional surgery and to begin
correction at an earlier age
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3. History of distraction osteogenesis
1905 - First bone distraction was performed by Codivilla -for
the ttt of shortened femur
1927 - Lengthening of tibia – Abbott
B’cos of many complications DO did not clinically gain
acceptance
1954 - Ilizarov began his work on the lower extremity.He was
a Russian orthopedic surgeon who began using techniques that
combined compression,tension & then repeat bone
compression to heal fractured long bones with segmental
defects.He pioneered the radical concept that bone generation
could be reinitiated by the piezoelectric effect of tension,rather
than compression.Ten to fifteen years later,he expanded his
technique to include the ttt of shortened lower extremities.
1972 – Snyder et al – used swanson external fixater to
lengthen a canine mandible.
1975 – Bell & Epker – Described a technique of rapid palatal
expansion to increase the width of maxilla using a haas app
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4. 1976 – Michieli & Miotti – Reproduced Snyders work,using an IO
device
1984 – Kutsevliak & Sukachev – Lengthening a normal canine
mandible by 1.5mm using Ilizarov principles.
1989 –McCarthy et al - First human mandibular distraction
- Remmler et al described an experimental fronto-facial
advancement with DO technique in animals.
1993 – First midface distraction with buried devices was
performed.
- Steven.R.Cohen – Buried midface distraction on a child
with Anopthalmia & Left cranio-facial microsomia.
1994 & Early 1995 – First case of Multi-directional midface
distraction
1997 – Chin& Toth – Lefort III advancement with gradual
distraction using internal devices
- Polley & Figueroa – Discussed the management of
severe maxillary deficiency in childhood & adolescence
performing DO with an external adjustable,rigid distraction
device.
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5. INDICATIONS:
Cranio-facial microsomia ( unilateral / bilateral)
Nager’s syndrome
Treacher collins syndrome
Pierre robin syndrome
TMJ ankylosis
Post traumatic growth disturbances
Regeneration of mandibular condyle
Distraction of mandibular symphysis to correct
anterior crowding
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6. ADVANTAGES:
No need of autogenous bone grafting
Gradual distraction of not only the hard tissues but of
the soft tissues also
Multi-directional expansion of the skeleton
Minimal evidence of relapse
Ease to open & close the mouth & ease of
mastication
Reduced length of hospitalization & operating time
Applied at an younger age group
DISADVANTAGES:
Cutaneous scarring resulting from transcutaneous
fixation pins
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7. DIAGNOSIS & TREATMENT PLANNING ACCORDING
TO AN ORTHODONTIC
PERSPECTIVE
Pre-operative clinical evaluation is similar to the
examination carried out in preparation for
orthognathic or craniofacial surgery
Note forehead,orbital,zygomatic,external ear,position
& contour of the chin,inferior border&angle of the
mandible
Functional clinical examination should include
mandibular excursions,TMJ function
Nerve functions are also examined
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8. The role of orthodontics in treatment using DO falls
in three temporal phases:
1) Predistraction ttt planning & orthodontic preparation
2) Orthodontic / orthopedic therapy during distraction
& consolidation
3) Post consolidation orthodontic / orthopedic mgmt
Predistraction ttt planning
- Begins with careful appraisal of the dentition
- Dental malrelations must be eliminated that would
mechanically interfere with the movement of the
tooth bearing segment during distraction
- Fabrication & use of distraction stabilization
appliances which facilitate vector control during
distraction & maintain transverse maxillo-mandibular
relationship during distraction
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9. Indications for these appliances are
For patients who do not require specific tooth
movement before distraction
Are not in full orthodontic bands or brackets
Are very young & non-compliant
Maximum segment anchorage
Distraction stabilization appliances consist of banded
maxillary expansion appliance & a mandibular lingual
holding arch attached to two bands on either sides
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10. Orthodontic ttt during distraction&consolidation
Active orthodontics may continue thro’ out the ttt which
may include use of bands & brackets,elastics,head
gear,acrylic guidance appliances,etc
Interarch elastic traction applied during distraction has
shown to influence the vectors of distraction in the
vertical,AP &transverse directions
The most important use of elastic traction during
distraction is to prevent Laterognathism ( frequently
seen in the unilateral distraction of the mandible)
Use of cross elastics
to correct open bite
During active
distraction
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11. Orthodontic therapy after distraction & consolidation
After distraction the appliance is removed
The postdistraction ortho needs depends on whether the
mandibular distraction was unilateral or bilateral
In non-growing bilateral distraction patient,ortho finishing is
completed at this time
In unilateral distraction patient,it mostly involves occlusal plane
mgmt,correction of dental midlines,correction of maxillo-
mandibular disharmony
Orthodontic ttt of the growing children may consider future
distraction or orthognathic surgery
Bite plate for
correction of
Open bite after
Unilateral mand
DO
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12. BIOMECHANICS OF DISTRACTION TECHNIQUE
The biological force(arising from the surrounding neuromuscular
envelope) & mechanical force(under the clinicians control) that
shape the regenerate are key elements in determining the
appliance position
Biological
forces
Vector of the
medial &
lateral pterygoid
Vector of the masseter,tempolaris&suprahyoid muscleswww.indiandentalacademy.co
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13. The desired change in shape & function can be achieved by
selecting & controlling the force vectors(vertical,horizontal or
oblique)
F
O
R
C
E
V
E
C
T
O
R
S
Vertical
Horizontal
Oblique
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14. Device placement can be described as
vertical,horizontal or oblique
Vertical device placement causes an increase in the vertical
dimension of the mandibular ramus.The mandible autorotates
in a counterclockwise direction & the lower incisors take a more
advanced position.A posterior openbite may result
Horizontal device placement causes sagittal advancement of
the mandible.The mandible rotates in a clockwise direction
resulting in an openbite & the gonial angle opens
Oblique device placement results in an increase in both
horizontal & vertical dimensions of the ramus & body
Uniplanar devices have a straight screw that elongates in a
linear fashion when activated
Multiplanar devices have either a curvilinear track or
combination of screws that expand in linear,angular &
transverse direction
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16. Distraction devices
Internal/external
- Unidirectional
- Bidirectional
- Multiplanar
Direction of do
Horizontal
Vertical
oblique
Site of application
Unidirectional
Mandibular ramus
Body
Tooth-borne
Symphysis
Transport
Ridge augmentation
Monobloc midface
Lefort I
Lefort II
Lefort III
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17. INTRA-ORAL MANDIBULAR DO
DO has been shown to be an effective tech for mandibular
widening & lengthening where traditional orthognathic surgery
has important limitations
The IO approach of DO prevents damage to inferior alveolar
nerve & the developing dental follicles,avoids donor site
morbidity,eliminates hypertrophic scars,& minimizes the need
for blood transfusions
The IO device is placed either on the mandibular first molar
teeth & first bicuspids or on the second molars & premolars
The device is placed anteriorly to prevent interference with the
tongue
The distractor is cemented 1-2 days before surgical intervention
The device is activated 2mm 7 days after surgery
Rate of distraction – 1mm/day,activated once a day
Orthodontic tooth movement should not begin until removal of
the distraction appliance,8-12 weeks after surgerywww.indiandentalacademy.co
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18. After the stabilization period of 8-12 weeks active tooth
movement with light progressive forces is carried out
Either a tooth-borne or bone-borne appliance may be used to
widen the mandible
Device fixation is achieved with three arms anchored to the
bone & one arm secured to the dental arch
The appliance is activated 2mm immediately after placement
The distractor screw must be parallel to the occlusal plane to
prevent an anterior open bite from forming
To prevent any TMJ problems 6oz class II elastics are used
bilaterally for 2 months after the initiation of distraction
The device is removed after completion of the stabilization
period & osseous bone regeneration
A combined maxillary & mandibular DO is performed in patients
with hemifacial microsomia.Mandibular distraction in adults
leaves the patient with a severe alteration in the occlusion
requiring complex orthodontic ttt .To avoid this problem,an
incomplete lefort I osteotomy is performed simultaneously with
the mandibular corticotomy
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20. Mandibular Distraction-Devices
1) External Unidirectional distraction (McCarthy-1992 )
-The distractor consists of single calibrated rod with two clamps which
holds two 2mm half pins that are placed on either side of the
osteotomy
- Approx. 20-24mm of bone stock is necessary to place this device
- Disadvantages of this type of distractor includes
- Scarring due to pins
- Difficulty predicting the direction in which the distraction would
proceed
- Inability to change the direction of distraction once the process
has started
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21. 2) External Bi-directional distraction
- Provides an additional degree of freedom over Unidirectional
device
- Bi-directional distraction is necessary for correction of the two
step occlusal plane& ramus deficiency
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22. 3) Multiplanar Distraction:
- The device consists of a central housing with two worm gears
in different planes
- Two arms extend from the housing with pin clamps at either
ends
- Each quarter turn results in an expansion of 0.25mm
- Each arm is 20mm in length for a total linear expansion of
40mm
- Two activation screws enable changes in transverse & vertical
angulation
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23. 4) Internal Distraction
- Due to the criticism of the external distractors,internal distractors
were developed to eliminate the problems of facial scarring,pin tract
infections & high visibility
- McCarthy-1995- Introduced an intra-oral distraction appliance
tested on the canine model
- Vasquez & Diner – Developed two internal distractors-one for
lengthening of mandibular body & other for ramus
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24. 4) Tooth-Borne appliances:
- Razdolsky-1997- Introduced a completely tooth
borne IO distractor capable of linear changes(ROD
device)
- Current technique starts by fitting preformed SS
crowns to one tooth on either side of the anticipated
osteotomy site
- A rubber base impression is then taken & a IO
distractor is fabricated in the laboratory
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25. Mandibular widening
- Described by Guerrero & Constasti
- Indications include transverse deficiency as in Brodies syndrome
& certain congenital problems
- First devices used were same as that those used for maxillary
expansion
- Harper et al & Bell et al performed mandibular midline
osteotomies in adult monkeys employing cemented Hyrax-type
expansion appliance
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26. MAXILLARY DO
Maxillary hypoplasia is a common finding in patients with
repaired orofacial clefts
Rigid external distraction(RED)device enables to manage
patients with severe maxillary hypoplasia
The RED system consists of :
- Cranial halo – Provides skeletal anchorage & is attached
using scalp screws
- Vertical bar – Extends from cranial halo & is used to attach
the horizontal bar
- Horizontal bar – Carries the distraction screws which are
attached to the eyelet of the splint with a surgical wire so as to
enable forces to be applied to the maxilla
The horizontal bar can move up & down the vertical bar
Vector of distraction can be controlled by adjusting the position
of the horizontal bar & the eyelets
Latency period – 3-4 days
Rate of distraction – 1mm/daywww.indiandentalacademy.co
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27. Consolidation period – 2-3weeks
After consolidation period the device is removed ,the external
traction hooks & the eyelets cut & nighttime use of facemask is
initiated
Maxillary advancement by Do has many advantages over
conventional orthognathic procedures :
- Can be done at young age
- Direction of distraction can easily be controlled by the RED
device
- Minimal morbidity & blood loss
- No need for bone grafts
- Minimal relapse
- Can be easily removed without anaesthesia after distraction
The only limitation of this technique is in patients who lack
teeth or adequate bone in the cranial vault
Complication includes velopharyngeal incompetency
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29. MIDFACE DISTRACTION
Midface distraction can be carried out by intra-oral as well as
extra-oral devices
Development of Modular Internal Distraction(MID) system
permits wide spread use of buried distraction devices thro’out
the craniofacial region
Clinical indications include
- Cleft lip & palate
- Hemifacial microsomia
- Midface hypoplasia
- Syndromic craniosynostosis
- Treacher collins syndrome
The MID device allows the surgeon to fabricate custom internal
distraction devices for virtually any region of the craniofacial
skeleton
In children's with Syndromic craniosynostosis & severe midface
retrusion,monobloc osteotomies can be performed at younger
than 1yr of age www.indiandentalacademy.co
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30. In children aged 4-7yrs ,monobloc or lefort III
subcranial osteotomy can be done with less operative
morbidity
In children with cleft lip & palate distraction should
be performed at 6yrs of age to correct midface
deficiency
In children undergoing midface distraction,an acrylic
bite block is attached to the mandible to simulate the
increase in the vertical dimension of the maxilla after
distraction
Surgical hooks are placed on the anterior dentition as
well on the molar bands for application of reverse
headgear
The main advantage of midface distraction is the
reduction of infectious complications like epidural
abscess www.indiandentalacademy.co
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31. TRANSPORT DO
Transport DO is the technique of regenerating bone & soft
tissue in a discontinuity defect.
An osteotomy is made 1.5cm from the end of the distal stump
of bone adjacent to the discontinuity defect creating a transport
disc.
Using a distraction device,the transport disc is advanced thro’
the soft tissue discontinuity defect creating new bone within the
distraction gap,as the leading edges gets enveloped with a
fibrocartilagenous cap which is then removed at the end of
distraction process to establish osseous continuity
These characteristics of transport disc have been used to
recreate the mandibular articulation in the form of neocondyle
This tech has been applied for
- Correction of ramal height secondary to degenerative joint
disease
- Condylar resorption after orthognathic surgery
- Bony ankylosis
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33. Dental distraction
Liou & Huang (1998 ) stated that the process of
osteogenesis in the periodontal ligament during
orthodontic tooth movement is similar to the
osteogenesis in the mid-palatal suture during RPE
They proposed a new concept of ‘distracting the
periodontal ligament’ to elicit rapid canine retraction
in three weeks
At the time of first premolar extraction,the
interseptal bone distal to the canine is undermined
with a bone bur,grooving vertically inside the
extraction socket along the buccal & lingual sides &
extending obliquely towards the socket base
A tooth borne appliance(custom made) is then
placed to retract the canines into the extraction
space
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34. ALVEOLAR DISTRACTION
It involves mobilization,transport & fixation of a healthy
segment of bone adjacent to the deficient site
DO to increase the vertical height of an edentulous ridge by
approximately 9mm was successfully performed in dogs
Chin & Toth performed vertical alveolar distraction in a 17yr
old girl with a knife edge ridge
Indications:
Primary:
- Combined deficiency of the bone & the soft tissue
- Compromised wound healing environment
Secondary:
- Expansion of alveolar housing for:
- Creating site for implant placement
- Improve ridge esthetics for pontic
- Improve periodontal environment of adjacent teethwww.indiandentalacademy.co
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35. Indications:
Primary:
- Combined deficiency of the bone & the soft tissue
- Compromised wound healing environment
Secondary:
- Expansion of alveolar housing for:
- Creating site for implant placement
- Improve ridge esthetics for pontic
- Improve periodontal environment of adjacent teeth
- Expand alveolus for orthodontic tooth movement
Limitations:
- Minimum quantity of bone should be present
- Transport & anchorage segment should have adequate
strength
- Expansion occurs only in the direction of the transport
Complications:
- # of the transport,anchorage segment
- Premature consolidation
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36. The atrophied superior aspects of the ridge is resected & a
segmental osteotomy of the healthy bone is performed
The distractor is placed & after a latency period of 5 days
distraction is proceeded at a rate of 1mm/day for 9 days
The device is retained for 10days
After 6 weeks,osseointegrated implants is placed in the
greatly increased mass of bone
At the original location of the segment,is left a regeneration
chamber which has the natural capacity to heal by filling the
bone
ALVEOLAR DO
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37. Future directions
The future development of DO in craniofacial applications will
probably establish a more complete understanding of the
biology of new bone formation under the influence of gradual
traction
Major trends may include:
- Refinement of distraction protocols
- Modification of osteotomy techniques
- Further improvement of distraction devices
- Enhancement of regenerate maturation with pharmacologic
agents
Development of new techniques to monitor distraction
regenerate formation & remodeling
Recently bio-resorbable,mechanical & remote controlled
distractors have been introduced which require more extensive
study
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38. Conclusion:
Osteodisraction provides a means whereby bone can
be remodelled into different shapes to more
adequately address the nature of skeletal
deformities & asymmetries
Many of the congenital deformities that require
extensive musculoskeletal movements may be
addressed with fewer procedures eventually
achieving the same structural,functional & esthetic
results commonly seen with modern orthognathic
procedures
Future may witness the use of the concepts of
distraction osteogenesis to achieve better,faster &
more efficient tooth movement
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