Melanin is the primary pigment that causes gingival pigmentation. It is produced by melanocytes located in the basal layer of the gingiva. There are several causes of gingival pigmentation including medications like minocycline, genetic conditions like hemochromatosis, and environmental factors like smoking. Treatment options for aesthetic or medical reasons include surgical techniques using a scalpel, cryosurgery, or lasers to remove the pigmented layer. Nd:YAG and Er:YAG lasers have been effectively used for gingival depigmentation due to their affinity for melanin.
Definition of periodontal pocket, classification, Histopathology of periodontal pocket, microflora involved, pathogenesis, periodontal pocket as a healing lesion, microtopography of root surface, treatment of periodontal pocket
A brief description of all topics to recent advances,SDD, host modulation and diabetes, host modulation in smokers, chemically modified tetracyclines, bisphosphonates
Definition of periodontal pocket, classification, Histopathology of periodontal pocket, microflora involved, pathogenesis, periodontal pocket as a healing lesion, microtopography of root surface, treatment of periodontal pocket
A brief description of all topics to recent advances,SDD, host modulation and diabetes, host modulation in smokers, chemically modified tetracyclines, bisphosphonates
REFERENCES TAKEN FROM CARRANZA'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND LINDHE'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND IMPLANT DENTISTRY. CONTAINS ENOUGH AND MORE DETAILS OF THIS TOPIC FOR BDS STUDENTS.HOPE THIS PRESENTATION WILL HELP U GAIN SOME KNOWLEDGE ABOUT PERIODONTAL PLASTIC AND ESTHETIC DENTISTRY.
The periodontal dressing is a physical barrier that is placed in the surgical site to protect the healing tissues from the forces produced during mastication, for comfort and close adaptation.
Certains medications have been associated with gingival enlargement.
the seminar gives a complete analysis of etilogy and pathogenesis involved in digo as well as sequlae of it
Periodontitis is a complex infection initiated by bacteria –tissue destruction.
Host: the organism from which a parasite obtains its nourishment/ an individual who receives a graft
Modulation: the alteration of function or status of something in response to a stimulus or an altered physical or chemical environment
mucogingival surgery or plastic surgery of muco-gingival tissue is a surgical procedure targeted to correct and eliminate anatomic, developmental and traumatic alterations of gingiva.
REFERENCES TAKEN FROM CARRANZA'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND LINDHE'S TEXTBOOK OF CLINICAL PERIODONTOLOGY AND IMPLANT DENTISTRY. CONTAINS ENOUGH AND MORE DETAILS OF THIS TOPIC FOR BDS STUDENTS.HOPE THIS PRESENTATION WILL HELP U GAIN SOME KNOWLEDGE ABOUT PERIODONTAL PLASTIC AND ESTHETIC DENTISTRY.
The periodontal dressing is a physical barrier that is placed in the surgical site to protect the healing tissues from the forces produced during mastication, for comfort and close adaptation.
Certains medications have been associated with gingival enlargement.
the seminar gives a complete analysis of etilogy and pathogenesis involved in digo as well as sequlae of it
Periodontitis is a complex infection initiated by bacteria –tissue destruction.
Host: the organism from which a parasite obtains its nourishment/ an individual who receives a graft
Modulation: the alteration of function or status of something in response to a stimulus or an altered physical or chemical environment
mucogingival surgery or plastic surgery of muco-gingival tissue is a surgical procedure targeted to correct and eliminate anatomic, developmental and traumatic alterations of gingiva.
'Oral Potentially Malignant Disorders' includes a variety of lesions with risk of progression to malignancy. It is widely prevalent in the Indian population, and early diagnosis and management is the need of the hour.
Here's a discussion of the same with methods of early diagnosis of such lesions.
This is a detailed presentation about the Exogenous Pigmentations of the Oral Cavity and its Etiology, Clinical Features, Oral Manifestations, and treatment plan.
Chronic periodontitis, formerly known as “adult periodontitis” or “chronic adult periodontitis” is the most prevalent form of periodontitis.
Chronic periodontitis has been defined as “an infectious disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment loss, and bone loss”.
This definition outlines the major clinical and etiological characteristics of the disease:
Microbial plaque formation.
Periodontal inflammation.
Loss of attachment and alveolar bone.
Flap surgery, also called pocket reduction surgery. Your periodontist makes cuts in your gums to carefully fold back the tissue. This exposes the tooth roots for more effective scaling and root planning. Because periodontitis often causes bone loss, the underlying bone may be reshaped before the gum tissue is stitched back in place. After you heal, it's easier to clean the areas around your teeth and maintain healthy gum tissue.
Soft tissue grafts. When you lose gum tissue, your gumline gets lower, exposing some of your tooth roots. You may need to have some of the damaged tissue reinforced. This is usually done by removing a small amount of tissue from the roof of your mouth or using tissue from another donor source and attaching it to the affected site. This can help reduce further gum loss, cover exposed roots and give your teeth a better appearance.
Bone grafting. This procedure is performed when periodontitis destroys the bone around your tooth root. The graft may be made from small bits of your own bone, or the bone may be made of artificial material or donated. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.
Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special type of fabric between existing bone and your tooth. The material prevents unwanted tissue from growing into the healing area, allowing bone to grow back instead.
Tissue-stimulating proteins. Another approach involves applying a special gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue.
Host modulatory therapy does not shut off the normal defence mechanism of inflammation instead, they ameliorate excessive or pathologically elevated inflammatory process to enhance the opportunities for wound healing and periodontal stability.
Pharmacological agents are used to stop the progression of periodontitis by intervention of the pathogenic mechanism.
It is used as an adjunct with conventional periodontal disease treatment.
It offers the opportunity for modulating or reducing destruction by treating chronic inflammatory response.
The concept was introduced by William and Golub in 1990.
Initially adjunctive therapies were solely anti-microbial such as use of antibiotics and antiseptics.
New approaches include modulation of host response.
Host modulatory therapy is considered as a BENCH-MARK in the treatment of patients with periodontal diseases.
Also, Useful in the following patients :
Diabetes & immunocompromised situations
peri-implant dis-ease (local and systemic efficiency of host modulatory therapy are used as an adjunct to conventional local disinfection treatment)
Although the efficacy and usefulness of host modulating agents have improved the treatment in several folds still, more research is required to make treatment response faster and to increase periodontal stability.
In the 18th century CAROLUS LINNAEUS called Carl von Linné, revolutionized the field of natural history by introducing a formalized system of naming organisms, what we call a taxonomic nomenclature.
He divided the natural world into 3 kingdoms and used five ranks : Class, Order, Genus, Species & Variety.
FROM 1977 TO 1989, THE AMERICAN ACADEMY OF PERIODONTOLOGY (AAP) WENT FROM 2 MAIN PERIODONTAL DISEASE CATEGORIES TO 5.
The 1989 Classification Had It’s Short-comings Including :
Lack of a category for strictly gingival diseases
Overlap between disease categories
Difficulty in fitting certain patients into any of the existing categories.
Similarity of microbiological and host response features.
A New Periodontal Disease Classification System Was Recommended By The 1999 International Workshop For A Classification Of Periodontal Disease And Conditions.
Periodontal abscesses, combined periodontic-endodontic problems, mucogingival deformities and occlusal trauma all remain unchanged except that they have been ordered in the classification system.
NUG and NUP were combined under the category of necrotizing periodontal diseases with no changes to their definitions.
One of the most significant changes included the addition of a detailed section on gingival diseases and lesions. Another important change was the discontinuation of terms related to age of presentation and rate of progression of the diseases.
The criteria for chronic periodontitis remain similar to those used for adult periodontitis but the age-dependent terminology has been removed.
All syndromes and systemic diseases which predispose a patient to periodontal disease would be classified under the category of “PERIODONTITIS AS A MANIFESTATION OF SYSTEMIC DISEASE”
Refractory periodontitis (low plaque scores and low responsiveness to periodontal therapy) is no longer considered a specific disease.
The 1999 classification system has been approved by the AAP, is now official terminology for that organization, and will be used in accredited graduate periodontal programs and board examinations.
The Parameters of Care approved by the AAP have adopted the new classification and future publications will use it as their standard. Since many of the 1999 workshop participants were from Europe and Asia as well as North America, it is anticipated that the proposed classification will be adopted in most parts of the world.
All of my Lectures are based on information purposes.
It is based on the viva explanation and understanding basis.
Basically for 4th BDS Professional Year.
All of my Lectures are based on information purposes.
It is based on the viva explanation and understanding basis.
Basically for 4th BDS Professional Year.
All of my Lectures are based on information purposes.
It is based on the viva explanation and understanding basis.
Basically for 4th BDS Professional Year.
A MAGNIFICENT ORTHODONTIC TREATMENT CAN BE DESTROYED BY POOR PERIODONTAL SUPPORT. EVALUATION AND MAINTENANCE OF PERIODONTAL HEALTH BEFORE, DURING AND AFTER TREATMENT IS VERY IMPORTANT.
Dr. Abhishek Gaur
BDS, MDS
Some of the slides may appear Blank/White/Black, those are the Videos that I added in the presentation.
Kindly Ignore those slides.
Dental Calculus: Short Presentation
Dr. Abhishek Gaur
BDS, MDS
Some of the slides may appear Blank/White/Black, those are the Videos that I added in the presentation.
Kindly Ignore those slides.
Dr. Abhishek Gaur
BDS, MDS
Some of the slides may appear Blank/White/Black, those are the Videos that I added in the presentation.
Kindly Ignore those slides.
Reconstructive periodontal therapy
Some of the slides may appear Blank/White/Black, those are the Videos that I added in the presentation.
Kindly Ignore those slides.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
3. Introduction
Pigmentation :
➢The natural coloring of animal or plant tissue;
➢Abnormal coloring of person’s skin, typically
resulting from diseases.
Gingival Pigmentation is a discoloration of
oral mucosa or gingiva due to the wide
variety of lesions and conditions.
4. Most pigmentation is caused by 5 primary pigments
:
1. Melanin
2. Melanoid
3. Oxy-Hemoglobin
4. Reduced Hemoglobin
5. Carotene
Other agents :
1. Bilirubin
2. Iron
5. Melanin
Melanin (Greek: µέλας - melas, "black, dark") is a
broad term for a group of natural pigments found in most
organisms (arachnids are one of the few groups in which it
has not been detected).
Melanin is produced by the oxidation of the amino
acid tyrosine.
The pigment is produced in a specialized group of
cells known as melanocytes.
6. There are three basic types of melanin:
1. eu-melanin (most common)
2. pheo-melanin (Brown & black, red hair)
3. neuro-melanin (Brain)
8. • Melanin is produced by
Melanocytes
• Location : Basal layer.
• Round Nucleus
• Clear Cytoplasm
• Lack Desmosomes
9. Melanoid
• Location : stratum lucidum and stratum corneum.
• Initially, it was assumed that melanoid was a
degradation product of melanin but more recently it
has been shown that such a relationship is highly
improbable.
• Melanoid imparts a clear yellow shade to the skin.
The Journal of Contemporary Dental Practice, Vol. 4 No.3 Aug. 15, 2013
13. • Gingiva : Pigmented intraoral tissue.
• Microscopically : melanoblasts are normally
present in basement (basal) layers of the lamina
propria.
• Location : Attached gingiva.
• The total number of melanophores in the attached
gingiva was approximately 16 times greater than in
the free gingiva.
14. • Shades of pigmented gingiva :
1. Very Dark brown to Black
2. Brown
3. Light-Brownish Yellow
• No Medical Problem.
• Esthetic problems.
16. Causes of Pigmentation :
1. Systemic Causes
2. Local Causes
Many systemic & local factors are responsible for causing
gingival Pigmentation.
Some of the very important factors are :
1. Amalgam Tattoo
2. Pigmented Nevi
3. Oral Melanotic Macules
4. Melanoma
5. Smoker’s Melanosis
6. Heavy Metals
7. Minocycline
8. Hemochromatosis
17. Amalgam Tattoo
✓The pigmentation of the oral mucosa membrane by tooth
restoration material (amalgam) is a common finding in
dental practice.
✓Amalgam pigmentation is generally called “Amalgam
Tattoo”.
✓The lesions represents embedded amalgam particles &
usually manifests itself as an isolated bluish or black
macule in various areas of the mucosa.
✓Color : Black, Blue, grey or a combination of these.
18.
19. Pigmented Nevi
• Uncommon.
• The Pigmented Nevi are classified as intramucosal,
junctional compound or Blue according to their
histological features.
• Nevi are seen mostly on the vermillion border of the lips
& the gingiva.
• Color : Grey, Brown, or bluish macules and are typically
asymptomatic.
22. Melanoma
• Cancerous condition of the
melanocytes.
• Melanocytes are found
among the basal cells of the
epidermis.
• Great majority : On the
palate, upper gingival &
alveolar mucosa.
23. Smoker’s Melanosis
• Benign focal pigmentation of oral mucosa &It tends to increase with
tobacco consumption.
• Clinically : Multiple brown pigmented macules.
• Location : Attached labial-anterior gingival and the interdental
papilla of the mandible.
24. Heavy Metal Pigmentation
A b s o r b e d s y s t e m i c a l l y f r o m
therapeutic use or occupational
environments may discolor gingiva,
and other areas of the oral mucosa.
Metals :
1. Bismuth
2. Arsenic
3. Mercury : Blackish Blue color of
the gingiva.
4. Lead : Bluish red or deep Blue.
5. Silver : Violet marginal line or
Bluish grey discoloration.
Lead Poisoning
25. Minocycline Pigmentation
• Causes discoloration of
Bones & teeth, but also
r e s p o n s i b l e f o r
discoloration of gingival
mucosa.
• Color : Brown.
• Mostly seen as Brownish
melanin deposits on the
hard palate, gingiva,
mucous membrane and the
tongue.
26. Hemo-chromatosis
• Also k/a Bronze Diabetes.
• Characterized by the deposition
of excess iron in the body
tissues, resulting in fibrosis and
functional insufficiency of the
involved organ.
• Hyper-pigmentation may appear
on both skin & mucosa
membranes.
28. Techniques Employed for Gingival
Depigmentation
Surgical Method :
1. Scalpel Surgical Technique
2. Cryosurgery
3. Electro surgery
4. Lasers :
a. Nd:Al:Yttrium-Gamet
b. Erbium-YAG Lasers
c. Carbon Di-Oxide Lasers
Methods Aimed at masking the Pigmented Gingiva with Grafts from Less Pigmented
Areas :
1. Free Gingival Grafts
2. Connective Tissue Grafts
3. Acellular Dermal Matrix Allografts.
29. Scalpel Surgical Technique
PROCEDURE :
• Local Anesthesia
• CEJ determined by probing around the labial and lingual
surfaces of each tooth.
• Bleeding points created by the pocket marker taken as
reference points for placing the external Bevel Incision.
• Knife : Kirkland Knife
• Incision made : From the attached gingiva to a level just
apical to the pocket margin.
44. Lasers
The use of LASERs has also been proposed for the
management of oral melanin pigmentation.
The Nd:YAG LASER with an invisible, near-infra-red light
(wavelength of 1,064 nm) has a high affinity for dark
pigments, making it particularly suited for depigmentation.
45. CLASSSIFICATION OF LASERS
Gas lasers-
• Argon
• Carbon dioxide laser
Solid state lasers-
1. Nd:YAG Laser
2. Ho:YAG Laser
3. Er:YAG Laser
4. DIODE Laser
46. Mechanism of Laser on Soft
Tissues
A highly focused laser beam vaporizes the
soft tissue with the high water content. Laser can make very
small incisions when the beam is focused on the tissue.
When the beam is defocused, the intensity of the
laser light on the tissue diminishes, and it can be used for
cauterization of small blood vessels and lymphatics, therefore
decreases post-operative swellings.
Probably most important, the laser decreases
post-operative pain by sealing nerve endings.
47. Surgical laser systems are differentiated not
only by the wavelength, but also by the light delivery
system: flexible fiber or articulated arm, as well as by other
factors.
Soft-tissue laser surgery is differentiated from hard-
tissue laser surgery (bones and teeth in dentistry) and Laser
Eye Surgery (eyesight corrective surgeries) by the type of
lasers used in a particular type of laser surgery.
A laser scalpel is a scalpel for surgery, cutting
or ablating living biological tissue by the energy
of laser light.
In soft tissue laser surgery, a laser beam ablates or vaporizes
the soft tissue with high water content.
48. Advantages
1. Dry surgical field and better visualization.
2. Tissue surface sterilization and reduction in bacteria.
3. Decreased swelling, edema and scarring.
4. Decreased pain.
5. Faster healing response.
6. Increased patient acceptance.
7. Minimal mechanical trauma.
8. Negotiates folds in tissues.
Naik VK, Sangeetha S & Victor DJ (2010), Journal of Dental Sciences 1, 91-8.
49. Disadvantages
1. Expensive.
2. Require specialized training.
3. Dental instruments mainly used are both side and end
cutting thus; a modification of clinical technique is
required.
4. No single wavelength will optimally treat all dental
disease.
5. There is inability to remove metallic and cast-porcelain
defective restorations.
6. Harmful to eyes and skin.
Coluzzi DJ & Swick MD http://www.henryschein.com/usen/images/Dental/ CEHP/LaserinDentistry.pdf (accessed 14 March 2013)