This case report describes the full mouth rehabilitation of a patient with short clinical crowns in the mandibular anterior teeth and edentulous maxilla. A thorough examination including diagnostic wax-up determined 2mm of additional crown length was needed via crown lengthening surgery. Single crowns were placed on the anterior teeth along with a maxillary complete denture and mandibular removable partial denture with a lingual plate. The treatment aimed to prevent extrusion of the anterior teeth and reduce forces on the maxilla to avoid combination syndrome. A 4 month recall found healthy gingiva and the patient was satisfied with function and esthetics.
Partial or complete edentulism has multiple implications in relation to function, esthetics and future rehabilitative treatment. This case report illustrates the management of a patient with extreme consequences of partial edentulism in the maxillary arch and total edentulism in the mandibular arch. The main clinical findings were unopposed remaining teeth, over eruption of the remaining teeth, loss of vertical dimension of occlusion, and significant disfigurement of the occlusal plane. Following the diagnostic procedure, a well-coordinated prosthodontic treatment involving liaison with other dental disciplines was indicated. The management involved an innovative combination of fixed and removable prostheses in conjunction with intentional root canal therapy of the remaining natural teeth. Series of provisional prostheses were applied to facilitate the transition to the final treatment.
Key-words: Edentulism, Vertical dimension, Provisional Restoration, Fixed and Removable prosthesis
Root Resection – A Dark Horse in Management Offurcation Involved Maxillary Mo...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Quinidine, Albino rats, Pentylenetetrazole, Gap junctionsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This presentation is a review of MANDIBULAR MOLAR ROOT RESECTION VERSUS IMPLANT THERAPY A RETROSPECTIVE NONRANDOMIZED STUDYZ
afiropoulos GG, Hoffmann O, Kasaj A, Willershausen B, Deli G, Tatakis DN.Journal of Oral Implantology, 2009
Partial or complete edentulism has multiple implications in relation to function, esthetics and future rehabilitative treatment. This case report illustrates the management of a patient with extreme consequences of partial edentulism in the maxillary arch and total edentulism in the mandibular arch. The main clinical findings were unopposed remaining teeth, over eruption of the remaining teeth, loss of vertical dimension of occlusion, and significant disfigurement of the occlusal plane. Following the diagnostic procedure, a well-coordinated prosthodontic treatment involving liaison with other dental disciplines was indicated. The management involved an innovative combination of fixed and removable prostheses in conjunction with intentional root canal therapy of the remaining natural teeth. Series of provisional prostheses were applied to facilitate the transition to the final treatment.
Key-words: Edentulism, Vertical dimension, Provisional Restoration, Fixed and Removable prosthesis
Root Resection – A Dark Horse in Management Offurcation Involved Maxillary Mo...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Quinidine, Albino rats, Pentylenetetrazole, Gap junctionsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This presentation is a review of MANDIBULAR MOLAR ROOT RESECTION VERSUS IMPLANT THERAPY A RETROSPECTIVE NONRANDOMIZED STUDYZ
afiropoulos GG, Hoffmann O, Kasaj A, Willershausen B, Deli G, Tatakis DN.Journal of Oral Implantology, 2009
An Assessment on the Clinical Performance of Non-carious Cervical Restorationsasclepiuspdfs
Cervical restorations were known as the least durable type of restoration. Therefore, it is important for clinician to identify the contributing factors that may lead to failure of the restorations. Objective: The purpose of this study was to compare the clinical performance in terms of type of restorative materials and the influence of clinical handling technique of non-carious cervical restorations. Materials and Methods: This cross-sectional study was carried out to patients with restorations on non-carious cervical lesions (NCCLs) at Universiti Sains Islam Malaysia dental clinic. The clinical performance of the restorations was evaluated using the ratings of the United States Public Health Service criteria and analyzed using the Pearson Chi-square.
Effect of Calcium Hydroxide on Deep Caries Dentin: A Clinical Studyasclepiuspdfs
Objective: The aim of this study was to evaluate the clinical efficacy of calcium hydroxide on arresting deep carious lesions in permanent teeth. Methods: A total of 190 patients aged between 15 and 55 years old were selected for this clinical study. Calcium hydroxide was applied to fully matured permanent anterior or posterior teeth clinically and radiographically after 2 weeks, 3–4 weeks, 3 months, 6 months, and 1-year follow-up. Results: The overall survival rate was 89.4%. The findings of this study showed that calcium hydroxide is effective in arresting deep carious lesions and formation tertiary dentine as well as preservation teeth vitality. Conclusion: Calcium hydroxide is effective in reducing the risk of pulp exposure in deep carious lesion.
journal cub presentation on Bps denture/biofunctional prosthetic systemNAMITHA ANAND
watch video links below for better understanding
https://www.youtube.com/watch?v=_sR2Ip5p9RE
its a series of videos 1-7 beautiful videos explaining the construction of BPS DENTURES - step by step
THE ART AND SCIENCE OF TREATMENT PLANNING ON ORTHODONTIC EXTRUSIONAbu-Hussein Muhamad
Traumatized anterior teeth with subgingival fractures of crown are a challenge to treat. This paper reports the man¬agement of subgingival fractures of crown of the maxillary central incisor in an 29 year old female. The technique described here involves the use of fixed appliance, post and core with a loop fabricated on it for retention of fixed appliance.
Keywords: Fracture, Tooth, Root Extrusion, Crown Fracture.
Journal club on Minimally Invasive Single Implant Treatment (M.I.S.I.T.) base...Shilpa Shiv
Journal club on Minimally Invasive Single Implant Treatment (M.I.S.I.T.) based on ridge preservation and contour augmentation in patients with a high aesthetic risk profile, JCP 2015
An Interdisciplinary Approach for Improved Esthetic Results in the Anterior M...Abu-Hussein Muhamad
Maxillary midline diastema is usually the part of normal dental development during mixed dentition which requires no active treatment. But the continuing presence of it in an adult is an esthetic problem. The effective treatment of midline diastema depends on the etiological factors, size andextent of diastema. This clinical report describes a patient with uneven interdental space between anterior maxillary teeth, improper clinical crown lengths, tooth size discrepancies, and malocclusion. Key words: Diastema closure, midline diastema, Orthodontic treatment, Porcelain laminate veneers, Interdisciplinary approach
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.
Resin bonded prosthesis /certified fixed orthodontic courses by Indian 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.
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
An Assessment on the Clinical Performance of Non-carious Cervical Restorationsasclepiuspdfs
Cervical restorations were known as the least durable type of restoration. Therefore, it is important for clinician to identify the contributing factors that may lead to failure of the restorations. Objective: The purpose of this study was to compare the clinical performance in terms of type of restorative materials and the influence of clinical handling technique of non-carious cervical restorations. Materials and Methods: This cross-sectional study was carried out to patients with restorations on non-carious cervical lesions (NCCLs) at Universiti Sains Islam Malaysia dental clinic. The clinical performance of the restorations was evaluated using the ratings of the United States Public Health Service criteria and analyzed using the Pearson Chi-square.
Effect of Calcium Hydroxide on Deep Caries Dentin: A Clinical Studyasclepiuspdfs
Objective: The aim of this study was to evaluate the clinical efficacy of calcium hydroxide on arresting deep carious lesions in permanent teeth. Methods: A total of 190 patients aged between 15 and 55 years old were selected for this clinical study. Calcium hydroxide was applied to fully matured permanent anterior or posterior teeth clinically and radiographically after 2 weeks, 3–4 weeks, 3 months, 6 months, and 1-year follow-up. Results: The overall survival rate was 89.4%. The findings of this study showed that calcium hydroxide is effective in arresting deep carious lesions and formation tertiary dentine as well as preservation teeth vitality. Conclusion: Calcium hydroxide is effective in reducing the risk of pulp exposure in deep carious lesion.
journal cub presentation on Bps denture/biofunctional prosthetic systemNAMITHA ANAND
watch video links below for better understanding
https://www.youtube.com/watch?v=_sR2Ip5p9RE
its a series of videos 1-7 beautiful videos explaining the construction of BPS DENTURES - step by step
THE ART AND SCIENCE OF TREATMENT PLANNING ON ORTHODONTIC EXTRUSIONAbu-Hussein Muhamad
Traumatized anterior teeth with subgingival fractures of crown are a challenge to treat. This paper reports the man¬agement of subgingival fractures of crown of the maxillary central incisor in an 29 year old female. The technique described here involves the use of fixed appliance, post and core with a loop fabricated on it for retention of fixed appliance.
Keywords: Fracture, Tooth, Root Extrusion, Crown Fracture.
Journal club on Minimally Invasive Single Implant Treatment (M.I.S.I.T.) base...Shilpa Shiv
Journal club on Minimally Invasive Single Implant Treatment (M.I.S.I.T.) based on ridge preservation and contour augmentation in patients with a high aesthetic risk profile, JCP 2015
An Interdisciplinary Approach for Improved Esthetic Results in the Anterior M...Abu-Hussein Muhamad
Maxillary midline diastema is usually the part of normal dental development during mixed dentition which requires no active treatment. But the continuing presence of it in an adult is an esthetic problem. The effective treatment of midline diastema depends on the etiological factors, size andextent of diastema. This clinical report describes a patient with uneven interdental space between anterior maxillary teeth, improper clinical crown lengths, tooth size discrepancies, and malocclusion. Key words: Diastema closure, midline diastema, Orthodontic treatment, Porcelain laminate veneers, Interdisciplinary approach
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.
Resin bonded prosthesis /certified fixed orthodontic courses by Indian 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.
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
Resin bonded fpd /certified fixed orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
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
This presentation provide brief information about different types of cements in Dentistry. also you will find information about cementation tips and techniques. Recent resin cements are also included in this presentation
CEMENTATION PROCEDURES IN FIXED PARTIAL DENTURES/ dental crown & bridge coursesIndian dental academy
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Periodontally Accelerated Osteogenic Orthodontics with Piezoelectric Surgery...Abu-Hussein Muhamad
Piezosurgery has been applied in dentistry for many years. This paper reviews specifically the treatment applications that have been used in surgically assisted orthodontic treatment since the last decade. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a surgical technique which results in an increase in alveolar bone width, shorter treatment time, increase post-treatment stability, and decrease amount of apical root resorption. The aim of this case report is to compare the use of micro-motor and piezoelectric surgery unit during decortication in Periodontally Accelerated Osteogenic Orthodontics technique.
Key words: Piezoelectric surgery, piezosurgery, Periodontal regeneration , accelerated tooth movement
Fabrication of functional complete dentures for edentulous patients who have undergone hemimandibulectomy is a very arduous and demanding endeavor.
The most challenging situation encountered during this procedure is the deviation of the mandible to the resected side. The deviation of the mandible to the resected side is directly proportional to the loss of tissues in the area hemi-mandibulectomy has been performed.
In cases with Cantor and Curtis classes II, III, IV, and V, guide flange prosthesis would be a treatment modality. For guide flange prosthesis to be effective, the sufficient number of posterior teeth that are periodontally sound should be present in the opposite arch.
In patients where reconstruction is not done after resection of the mandible, scar tissue formation occurs over a period of time that stiffens the tissues and worsens prosthetic rehabilitation, leading to compromised treatment planning.
Periodontally Accelerated Osteogenic Orthodontics: A Surgical Technique and C...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...Abu-Hussein Muhamad
Abstract: Severe atrophy of the inferior alveolar process and underlying basal bone often results in problems with a lower denture. These problems include insufficient retention of the lower denture, intolerance to loading by the mucosa, pain, difficulties with eating and speech, loss of soft-tissue support, and altered facial appearance. These problems are a challenge for the prosthodontist and surgeon. In this case report, patient with resorbed edentulous mandible was successfully rehabilitated using two dental implants placed in the interforaminal region with ball abutments opposing conventional maxillary complete denture. Key Words: dental implants; dental prosthesis, implant-supported; resorption,
Prosthodontic-Orthodontic Treatment Plan with Two-Unit Cantilevered Resin-Bon...Abu-Hussein Muhamad
Abstract: Congenitally missing lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. Selecting the appropriate treatment option depends on many factors, such us the malocclusion, the anterior relationship, specific space requirements, bone volume, root proximity, the condition of the adjacent teeth, and esthetic prediction mainly when the canine must be reshaped.Resin bonded bridges were considered to be doomed owing to their very high decementation rate, have come alive once again because of newer resin based cements. This article will discuss the variety of treatment managements in case of space opening and treated with two 2-unit cantilevered resin-bonded fixed partial dentures supported by the cuspids. This conservative treatment plan was cost-effective without having any significant biological cost. Keywords: Agenesis, Resin- bonded fixed partial denture, interim prosthesis.
Overdentures can be either tooth or implant supported. Completely edentulous patients whose economic condition Thwarts them to invest in the expensive implant (number based) treatments should be motivated to have at least a two implant-supported overdenture since the prosthesis offers most of the advantages of conventional tooth-supported overdenture. We report a case of an elderly female patient who was reluctant toward surgery, but with moderate education was treated successfully with a two staged, two implant-supported overdenture using a ball abutment with o ring attachment.
Similar to full mouth rehabilitation of partially and fully edentulous patient with crown lengthening procedure: case report 1 (20)
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
full mouth rehabilitation of partially and fully edentulous patient with crown lengthening procedure: case report 1
1. DOI:10.4047/jap.2010.2.2.50
50
J Adv Prosthodont 2010;2:50-3
INTRODUCTION
A short clinical crown is defined as any tooth with less
than 2 mm of sound, opposing parallel walls remaining after
occlusal and axial reduction. The common causes of short clin-
ical crown include caries, erosion, tooth malformation, frac-
ture, attrition, excessive tooth reduction, eruption disharmo-
ny, exostosis and genetic variation.1
When restoring a short clin-
ical crown, the clinician may attempt to gain length by plac-
ing a subgingival margin. However, deep subgingival margins
that encroach upon the biologic width jeopardize the periodontal
tissue and are therefore not desirable.1,2
Davarpanah et al.1
and
Assif et al.3
suggest the therapeutic modalities which include
surgical lengthening of clinical crowns, forced eruption of teeth,
altering tooth preparation design and foundation restorations.
However, the short clinical crown cannot be evaluated by visu-
al inspection alone. A thorough examination that includes clin-
ical examination, radiographic examination, and diagnostic cast
analysis is essential for successful rehabilitation of severely com-
plicated oral dentition. Inadequate diagnosis and improper treat-
ment plan may not ensure a satisfactory result. Visualization
of the desired result is a prerequisite of successful therapy.1
Average biologic width consists of epithelial attachment
(0.97 mm) plus connective tissue attachment (1.07 mm).
This gives an average value of 2 mm. When this biologic width
is violated by a restoration, as a defense mechanism, inflam-
matory response accelerates bone loss to provide space for new
connective tissue attachment, which results in increased
pocket depth.2
Therefore, impingement of a restoration on the
biologic width will trigger loss of bone, connective tissue and
epithelial attachment.
Several studies have also shown that 2 to 3 mm band of
attached gingiva is preferable to maintain the restored tooth suc-
cessfully. Since the resecting nature of this procedure, there is
a risk of reducing the width of attached gingiva. For this
reason, it is important to diagnose and evaluate the attached gin-
giva when planning surgical crown lengthening procedure.2
In company with the short clinical crown length, the prob-
ability of the combination syndrome was also anticipated in this
case. A patient wearing a maxillary complete denture opposed
by mandibular anterior teeth and a distal extension removable
partial denture can easily show the combination syndrome, which
was coined by Kelly.4
He described following five characteristic
changes: loss of bone from the anterior part of the maxillary
ridge, overgrowth of maxillary tuberosity, papillary hyperplasia,
extrusion of the lower anterior teeth, and bone loss under the
partial denture bases. The anterior part of the maxilla is the weak-
est part to resist stress and when the mandibular anterior
Full mouth rehabilitation of partially and fully
edentulous patient with crown lengthening procedure:
a case report
Hyon-Woo Seol, DDS, Jai-Young Koak, DDS, MSD, PhD, Seong-Kyun Kim, DDS, MSD, PhD,
Seong-Joo Heo*, DDS, MSD, PhD
Department of Prosthodontics, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
BACKGROUND. In order to restore severely attrited teeth properly, surgical intervention in the form of a crown-lengthening procedure may
be required. And also, proper diagnosis and treatment sequencing is critical to obtain a successful results. Adequate diagnostic wax-up ensures
good esthetics and healthy periodontal tissue. CASE DESCRIPTION. This clinical case report describes a diagnostically based protocol for
restoration on mandibular anterior teeth with crown lengthening procedure and the treatment of partially edentulous mandible combined with
an edentulous maxilla. In addition, the effort to prevent the combination syndrome was described. CLINICAL IMPLICATION. An interdisciplinary
diagnosis and examination through visualization of the desired results ensure conservative and more predictable outcome. [J Adv
Prosthodont 2010;2:50-3]
CASE REPORT
Corresponding author: Seong-Joo Heo
Department of Prosthodontics, School of Dentistry, Seoul National University
275-1 Yeongeon-Dong, Jongno-Gu, Seoul, 110-768, South Korea
Tel, +82 2 2072 2661: e-mail, heosj@snu.ac.kr
Received May 11, 2010 / Last Revison May 20, 2010 / Accepted May 24, 2010
KEY WORDS. Surgical crown lengthening, Diagnostic wax up, Full mouth rehabilitation, Combination syndrome
ⓒ 2010 The Korean Academy of Prosthodontics
This is an Open Access article distributed under the terms of the Creative Commons
Attribution Non-Commercial License (http://creativecommons.org/licenses/by-
nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction
in any medium, provided the original work is properly cited.
2. 51J Adv Prosthodont 2010;2:50-3
teeth occlude anterior to the basal support, trauma is inevitable.4,5
In addition, according to Palmqvist et al.6
, loss of estab-
lished posterior occlusal contacts can be attributed not only to
bone resorption under mandibular distal extension bases, but
also to wear of the artificial denture teeth as well as changes
in position of the anterior mandibular teeth. Such changes in
occlusion facilitate the clenching activity and thereby increase
the pressure on the maxillary anterior alveolar bone. Kelly4
dis-
cussed various possibilities to avoid combination syndrome,
including the use of the roots of anterior mandibular teeth and
endodontic implant to support the overdenture.
This clinical report demonstrates the treatment sequence includ-
ing the determination of the required length of crown and visu-
alization of desired results through diagnostic wax up and thor-
ough examinations. In addition, the effort to prevent the
combination syndrome was also described.
CASE REPORT
In this case, 66 year old woman patient visited the clinic com-
plaining of discomfort of the dentures.
She had undergone a heart valve surgery twice in 1968
and 1998 and was under warfarin medication. Following
problem lists were detected. The mandibular anterior teeth showed
extremely short clinical crown length. The reverse compensating
curve of the old prostheses, overgrowth of mandibular sym-
physis area, and bone resorption of mandibular posterior
region were observed. The possibility of combination syndrome
was anticipated due to the recent extraction of maxillary
anterior teeth (Fig. 1 and 2). As Davarpanah et al.1
suggested,
a thorough examination was performed. In radiographic
examination, any periapical radiolucency was not detected even
though the dentin was exposed to oral cavity. The periodon-
tal ligament was within normal limit. The crown-to-root ratio
was about 1:3. In clinical examination, attached gingival
band was 4 to 5 mm width, and periodontal pocket depth was
3 mm or less. Neither periodontal problem nor tooth mobili-
ty was detected. On the properly mounted diagnostic cast exam-
ination, the imaginary line from retromolar pad 2/3 point to
mandibular premolar tip was drawn. The distance between the
imaginary line and the mandibular incisor’s tip was 4 to 5 mm.
The clinical crown was 2 mm height. According to Ash and
Nelson7
, the diagnostic wax up was undertaken to allow the
crown to be 9 mm length. Supposing the height of coping, porce-
Full mouth rehabilitation of partially and fully edentulous patient with crown lengthening procedure: a case report Seol HW et al.
Fig. 1. Initial intraoral photograph. Fig. 2. Initial intraoral photograph.
Fig. 3. Analysis of diagnostic cast. Determination of the length of sur-
gical crown lengthening.
Fig. 4. Diagnostic wax-up.
3. 52 J Adv Prosthodont 2010;2:50-3
lain and the amount of subgingival margin position were 1.5
mm, 2.5 mm and 1 mm respectively, the required additional
crown length was calculated as 2 mm (Fig. 3 and 4).
Treatment plan
Based on the examination as mentioned above, the treatment
plan was established. The mandibular anterior teeth were
planned to have a surgical crown lengthening procedure of 2
mm extension as determined by diagnostic wax-up. Complete
denture for maxilla and removable partial denture with linguoplate
for mandible were planned. As mentioned by Langer et al.8
,
linguoplate was planned to prohibit the extrusion of mandibu-
lar anterior teeth and minimize the force upon the premaxil-
la. Mandibular anterior teeth were planned to be fabricated as
single crowns. Bilateral balanced occlusion scheme was
applied to the distal extension of the mandibular removable par-
tial denture. The patient was suggested the implant installation
at the second molar area to supplement the support of denture,
but she denied the suggestion on account of economic prob-
lem.
Clinical procedure
The patient was referred to the department of periodon-
tology for surgical crown lengthening procedure, and visited
our department 2 months after operation. The planned amount
of crown length was gained enough (Fig. 5). The walls of the
anterior teeth were prepared as parallel as possible. The indi-
vidual trays were fabricated. One sheet of baseplate wax
(Dae-dong industry, Daegu, Korea) was covered for relief and
tray resin (Quicky, Nissin Dental Products Inc., Kyoto, Japan)
was adapted to the cast. By using the individual trays, functional
impressions were registered both in maxilla and in mandible.
Maxillary wax rim was fabricated as a general method. The ver-
tical dimension of the patient and the amount of anterior
exposure were maintained equal to previous old denture.
Mandibular recording base and wax rim were fabricated,
and then the resin cap made of DuraLay resin (Reliance
Dental Mfg. Co., Worth, IL, USA) was attached to the record-
ing base for stabilization during interocclusal registration,
as described by Chang et al.9
(Fig. 6). Facebow transfer was
followed by mandibular teeth wax up, coping fabrication
and porcelain-fused-to-gold crown fabrication. After the
Full mouth rehabilitation of partially and fully edentulous patient with crown lengthening procedure: a case report Seol HW et al.
Fig. 5. After surgical crown lengthening procedure. Fig. 6. Recording base and resin jig.
Fig. 7. Definitive prosthesis. Fig. 8. Recall check - 4 months later.
4. 53J Adv Prosthodont 2010;2:50-3
mandibular anterior teeth were delivered to the patient,
mandibular functional impression was taken. Framework
and wax rim were fabricated as a general method. Interocclusal
record was taken again, and artificial teeth were arranged to
have a scheme of bilateral balanced occlusion. The definitive
denture was delivered to the patient without any problem
(Fig. 7). Implant placement was recommended again, but
the patient hesitated over for economic problem. However, she
had agreed to recall check for every six months. After 4
months, on the recall check, the gingiva and periodontum were
healthy (Fig. 8). She had been satisfied with the prostheses for
esthetic and functional aspects.
DISCUSSION
The complications with the short clinical crown demand a cir-
cumspect treatment plan and proper sequencing of therapy to
ensure an optimal result for both the patient and the clinician.
Proper treatment sequencing is critical when a patient requires
multiple fixed restorations in conjunction with a removable par-
tial and complete denture. The vertical dimension, centric rela-
tion, and occlusal plane must be determined first, followed by
a diagnostic wax up which is essential for fixed prosthesis. An
accurate diagnostic and interdisciplinary approach is necessary
for obtaining improved, conservative and predictable results
in esthetically compromised areas, such as the anterior
mandibular dentition. Periodontal health is of paramount
importance for all teeth, both sound and restored. Thus, this pro-
cedure, as an adjunct to a restorative treatment, can produce
predictable results, while ensuring good esthetics and main-
taining periodontal health.
As Langer et al.8
emphasized the importance of the posterior
support in conjunction with the combination syndrome, the treat-
ment plan should be designed to provide posterior occlusal sup-
port and to minimize occlusal pressure in the anterior maxil-
la. Hence, the level of the incisal edges of the mandibular ante-
rior teeth should be assessed in comparison of the proposed pos-
terior occlusal plane. The mandibular removable partial den-
ture should be supported anteriorly by cingulum rest with a lin-
guoplate as the major connector. The linguoplate delays the overe-
ruption of the mandibular teeth, and also facilitates accurate
positioning the removable partial denture during relining
procedures. Posteriorly, maximum support is obtained by
extending the denture base. Maximum occlusal support pos-
teriorly with no contact anteriorly in centric occlusion and a
balanced articulation in eccentric movements further reduce
pressure on the anterior maxillary ridge. Posterior occlusal con-
tact must be maintained by constant relining of the distal
extension denture base to compensate for its resorption.
Every effort should be made to avoid the potentially destruc-
tive occlusal forces exerted on the anterior maxillary residual
ridge.
In conclusion, proper treatment plan should be established
before clinical procedures. With the aim of it, a thorough
examination including clinical examination, radiographic
assessment and diagnostic wax up are essential. In this case report,
visualization of the desired results has guaranteed the outstanding
surgical and prosthodontic outcomes. In addition, the treatment
modality was determined by the apparent potential to devel-
op the combination syndrome, and every effort was exerted on
fabricating properly designed removable partial denture that
distributes occlusal forces evenly.
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