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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Canine Impaction and Its Importance in OrthodonticsAnalhaq Shaikh
Canine Impaction, Its Importance in Orthodontics, Etiology, Diagnosis and Management.
by Dr Analhaq Shaikh, 2nd year Postgraduate student, Sharavathi Dental College and Hospital, Shimoga, Karnataka
Canine Impaction can also be termed as Shy Canine.
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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Canine Impaction and Its Importance in OrthodonticsAnalhaq Shaikh
Canine Impaction, Its Importance in Orthodontics, Etiology, Diagnosis and Management.
by Dr Analhaq Shaikh, 2nd year Postgraduate student, Sharavathi Dental College and Hospital, Shimoga, Karnataka
Canine Impaction can also be termed as Shy Canine.
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
Introduction
Incidence
Development of canine
Eruption of canine
Etiology of canine impaction
Sequelae of canine impaction
Classification of canine impaction
Diagnosis
Radiographic Prediction
Prognosis
Prevention of maxillary impaction
Extraction of impacted canine
Treatment alternatives
General principles of mechanotherapy
Methods of gaining space
Anchorage considerations
Surgical Methods
Surgical exposure for natural eruption
One step vs two step
Types of flaps
Attachments
Methods of traction
Mandibular canine impaction
Canine impaction and resorption
Canine impaction and periodontium
Retention
Complications of treatment
Complications of untreated impacted canine
Conclusions
References
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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Slow maxillary expansion /certified fixed orthodontic courses by Indian dent...Indian 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
Maxillomandibular elastics (or intermaxillary elastics) are commonly used because of their simplicity; however, a lack of understanding of their force system can lead to many serious problems.
Elastics are usually classified by the direction of the force (eg, Class II or Class III elastics).
Sometimes force magnitude is considered, but point of force application is left out. Therefore, many different types of Class II elastics can be applied. There are short or long elastics.
Often too many elastics are used when a single resultant elastic at the correct location would work better. However, sometimes more than a single elastic is needed when the attachment point is not directly accessible.
All maxillomandibular elastics and their actions should be analyzed in three dimensions.
Frankel ortodontic appliance by thomas /certified fixed orthodontic courses ...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
00919248678078
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
Introduction
Incidence
Development of canine
Eruption of canine
Etiology of canine impaction
Sequelae of canine impaction
Classification of canine impaction
Diagnosis
Radiographic Prediction
Prognosis
Prevention of maxillary impaction
Extraction of impacted canine
Treatment alternatives
General principles of mechanotherapy
Methods of gaining space
Anchorage considerations
Surgical Methods
Surgical exposure for natural eruption
One step vs two step
Types of flaps
Attachments
Methods of traction
Mandibular canine impaction
Canine impaction and resorption
Canine impaction and periodontium
Retention
Complications of treatment
Complications of untreated impacted canine
Conclusions
References
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
Slow maxillary expansion /certified fixed orthodontic courses by Indian dent...Indian 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
Maxillomandibular elastics (or intermaxillary elastics) are commonly used because of their simplicity; however, a lack of understanding of their force system can lead to many serious problems.
Elastics are usually classified by the direction of the force (eg, Class II or Class III elastics).
Sometimes force magnitude is considered, but point of force application is left out. Therefore, many different types of Class II elastics can be applied. There are short or long elastics.
Often too many elastics are used when a single resultant elastic at the correct location would work better. However, sometimes more than a single elastic is needed when the attachment point is not directly accessible.
All maxillomandibular elastics and their actions should be analyzed in three dimensions.
Frankel ortodontic appliance by thomas /certified fixed orthodontic courses ...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
00919248678078
surgical and orthodontic management of impacted canines- jcDr. mahipal singh
After the third molar most common impaction is maxillary canines.
This article help to how to treat impacted maxillary canines by surgical and orthodontic.
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 maxillary canine is the second most impaction of the oral cavity and this presentation I describe some etiology the interfere of normal eruption path of the maxillary canine.
done by : ( ABCD'S &G )
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I hope that you enjoy and you benefit❤
Maxillary canine impaction / oral surgery courses /certified fixed orthodon...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
00919248678078
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
Management of impacted teeth /certified fixed orthodontic courses by Indi...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
00919248678078
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
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.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Tests for analysis of different pharmaceutical.pptx
Impacted teeth by DR luma
1. Management of impacted teeth
Done by : Dr Luma Najada
Supervised by : Dr Ahmad Tarawneh
Dr Jumana Tbaishat
Dr Bashar Momani
Dr Anwar Rahamneh
2. Contents :
1. Impacted upper canines
2. Impacted upper central insicors
3. Impacted lower second premolars
3. Impacted upper canines
• Impacted tooth : is a tooth that is prevented
from erupting into its normal functional
position by bone,
tooth or fibrous tissue.
• Impacted canines is a frequently encountered
clinical problem. If orthodontic treatment is
not started, there is always a risk of retention
and also of resorption of the roots of the
permanent incisors.
4. Eruption
• Calcification start at 4-5 months after birth.
• Has long path of eruption from the infra-
orbital place along the roots of upper laterals
causing ugly duckling space which resolve
later, and then pass along the buccal surface
of the C.
• Upper canine erupts at 11-12yrs, lower at 9-10
yrs.
• 3's palpable in buccal sulcus by 8-10 yrs.
5. Prevalence
• Developmentally absent 3's: 0.08% (Brin et al, 1986)
• Impacted 3's: 2% (Ericsson, 1986)
• F:M = 70%:30%
• Unilateral: bilateral = 4:1
• Palatal: 61%; in line of arch: 34%; buccal: 4.5%
(Mandal, 2000, Brin et al, 1986)
• Associated with peg lateral incisors (Brin et al 1986)
• High incidence associated with CI II div 2 malocclusions
(Moosy, 1994)
6. Complications
• 1. Nothing
• 2. May erupt in a Labial / lingual malposition
• 3. If the C lost, then Migration of neighbouring teeth
and loss of arch length
• 4. Internal or external root resorption of teeth adjacent
to impacted canine.
• 5. Resorption of canine itself can also occur.
• 6. Dentigerous cyst formation and infection with
referred pain
• 7. Damage to adjacent teeth during surgery
• 8. Ankylosis
7. Etiology
1. Long eruptive path
2. Trauma with displacement of tooth bud.
3. intra-alveolar obstruction :
- Retained deciduous teeth
- Supernumerary tooth or odontome
- Pathology (dentigerous cyst)
- Thickened mucosa following early extraction of deciduous teeth
- Dental crowding
8. Theories of impaction
• Two main theories have been proposed :
• A ) Guidance theory :
• underlines a role of the lateral incisor root in guiding
the erupting canine crown in the proper direction
towards the dental arch.
• Evidences:
• • With small or developmentally absent lateral incisors,
the incidence are three times (Becker)
• • Associated with peg lateral incisors (Brin et al 1986)
• • High incidence associated with CI II div 2
malocclusions (Moosy, 1994)
9. • B) Genetic theory: (Peck et al., 1994, 1995),
• The palatal displacement of the canine is genetically determined.
• This theory is supported by other dental anomalies frequently
occurring in patients with the ectopically erupting canines, so-called
microsymptoms (e.g. small teeth, enamel hypoplasia, aplasia of
second premolars, infraocclusion of primary molars, etc.)
• Occurrence with specific race
• Occurrence in family
• Occurrence in female more than male
• Occurrence with specific syndrome
• Occurrence unilateral: bilateral is 4:1
10. Diagnosis
• A) Inspection
Clinical signs of impacted 3s :
• Delayed eruption.
• Asymmetrical eruption.
• Prolonged retained of C.
• Absence of buccal bulge at age of 10 years.
• Presence of palatal buldges.
• Angulated or flared laterals.
• Change colour of centerls or laterals .
11. • B) Palpation and percussion :
• Palpation of the upper canines is a vital step in
assessing the developing dentition.
• Deciduous canines or adjacent permanent
teeth should be checked for mobility,
tenderness and vitality.
12. • C) Diagnostic imaging of unerupted teeth
• Features of ectopic maxillary canines that should be
determined by radiographs:
1. Presence or absence of the canine
2. Overall stage of dental development
3. Local anatomic considerations
4. Size of the follicle
5. Inclination of the long axis of the tooth
6. Relative buccal and palatal positions
7. Relative superior-inferior positions
8. Amount of the bone covering the tooth
9. 3D proximity and resorption of roots of adjacent teeth
10. Condition of adjacent teeth
13. Radiographical techniques
1. Right angle technique
• The use of two radiographs taken at right angles to one another allows
three dimensional localisation of the canine :
• Lateral and posterio-anterior cephalometric films
• Occlusal vertex film with OPT
• Mand occ and opt or ceph for lower canines
- this technique need additional film for fine details.
Disadvantages associated with the vertex occlusal radiograph:
1. large radiation exposure since the brain, the pituitary, salivary glands,
thyroid, and the lenses of both eyes receive unnecessary exposure.
2. The film is usually difficult to interpret.
Because of these disadvantages the British Orthodontic Society guidelines
for radiography state that there are very few indications for a vertex
occlusal view in any patient even when taken with rare earth intensifying
screens/cassette.
14. 2. Magnification technique
• Chaushu and Becker (1999) have described a method of localising
maxillary canines using only a panoramic radiograph.
• Sensitivity of this technique is 80%
• This depends on the fact that objects nearer the x-ray source ( and further
from the film) project a larger image than objects closer to the film and
further from the x-ray source. So palataly positioned canine looks larger
than adjacent or normal contralateral if present.
• Not precise technique.
15. 3. Parallax technique (image/tube shift method, Clark’s rule, buccal object
rule).
- It is first described by Clark in 1909
• parallax is the apparent displacement of an image relative to the reference
object caused by an actual change in the angulation of the x-ray beam.
• First they used 2 PA radiographs
• Then 2 occ radiographs
• Then OPT+occ at 70degree (Jacobes 1999 in order to increase the effect of
parallax)
• The horizontal shift in the horizontal parallex is 10-20 degree
• Armstrong 2003 fond horizontal better than vertical parallex.
16. 4. CT spiral scanning
5. Cone beam volumetric tomography (CBCT)
• indicate if there is a possible resorption which cannot be seen by
conventional radiograph, Birnie recommend that CBCT would be indicated
in 30% of cases.
17. • Classification of radiographical feature of impacted canine, Power & Short
1993 :
• 1. Angulation
• Grade 1=0-15 degree,
• Grade2=16-30,
• Grade 3= more than 30
• 2. Vertical height
• Grade 1=below CEJ,
• Grade 2=above CEJ but less than half of root,
• Grade 3= more than half but less than full root,
• Grade4=above apex
18. • 3. AP position of root apex
• Zone 1=at area of 3,
• zone 2=above 4,
• Zone3=above5
• 4. Coronal overlap
• Sector 1=before lateral,
• Sector 2= before long axis of 2,
• Sector 3 = after long axis but before central,
• Sector 4=over the central). The same had been used by Kurol and Ericsson
1987.
• 5. Labio-palatal position of crown and root
• 6. Resorption
19.
20. Treatment options According to
RCSEng 2016 Husain and McSherry
• 1 ) No active treatment/leave and observe
Indications :
1. Patient does not want treatment
2. Canine very displaced, ie high and above roots of incisors
3. No evidence of resorption of adjacent teeth or other pathology
4. Ideally good contact between lateral incisor and first premolar wih good
aesthetics
5. Good prognosis for the deciduous canine
• Radiographic monitoring should take place to rule out cystic formation
(frequency unknown), migration, resorption etc
21. • Disadvantages :
• 1. Not guarantee
• 2. Trauma to child
• 3. Loss of space
22. • 2) Interceptive treatment by extraction of the primary canine in selected
cases , where the ectopic permanent canine is not severely displaced ,
there is some evidence that interceptive extraction of the adjacent
primary canine can result in an improvement in position of an ectopic
permanent canine.
• the patient should be aged between 10-13 years
23. • Ericson and Kurol : suggested that removal of
the deciduous canine
• before the age of 11 years will normalize the position of the ectopically
erupting permanent canines in 91% of the cases if the canine crown is
distal to the midline of the lateral incisor. On the other hand, the success
rate is only 64% if the canine crown is mesial to the midline of the lateral
incisor
26. • 3) Surgical exposure and orthodontic alignment
• interceptive treatment fails .
• The patient should be well motivated
• No pathology
• Favourable position of 3.
• Available space for 3
• Disadvantage :
• 1. Root resorption
• 2. Pulp obiltarion
• 3. Necrosis of teeth
• 4. Ankylosis
• 5. Fenestration and PD problems
• 6. Discontinuation of treatment
27. • Types of attachment:
• Many types of attachments can be placed on the tooth . These include the
cast-gold inlay, the ligature wire around the cervical part of the tooth, the
direct bonded attachment , a screw cemented in the crown , the
placement of a wire in a filling , or a hole in the tip of the crown through
which to pass a ligature wire.( Andre Fournier 1982 )
• Position of attachment:
• The position of attachment on the crown is very important because it
determines, in part, the direction and especially the type of movement
the traction will induce . The more horizontally the canine lies, the more
occlusal the attachment must be to assure a proper tipping of the tooth to
a vertical position. In another spatial plane the proper placement of the
attachment ( more mesial or distal , buccal or lingual ) can help rotate a
tooth. ( Andre Fournier 1982 )
28. • 4) Surgical removal of the ectopic permanent canine:
• Indication
• 1. Pathology of 3
• 2. Good contact bet 2 and 4
• 3. Good c
• 4. Sever impaction
• 5. Poor compliance
• Disadvantages
• 1. Surgery can further compromise prognosis of C
• 2. Poor esthetic
• 3. Loss of canine eminence
• 4. Alveolar bone loss
29. • Mechanics of subsequent orthodontic
treatment in canine substitution
• 4 as a replacement for 3, apply;
• 1. mesiopalatal rotation
• 2. buccal root torque
• 3. grinding the 4 palatal cusp
30. • 5) Transplantation
• Where interception has failed and grossly
malpositioned canine.
• ideally with open apex at 13-14 yrs. to aid vitality.
• optimal development stage for auto transplantation is
when the root is 50-75% formed = half to three-
quarters complete .
• The prognosis should be good for the canine tooth to
be transplanted with no evidence of ankylosis .
•
31. II) Impacted maxillary central incisors
• Delayed eruption of the permanent maxillary incisor teeth can be
considered in the following circumstances:
• a. eruption of the contralateral incisor occurred more than 6 months
earlier.
• b. the maxillary incisors remain unerupted more than one year after the
eruption of the mandibular incisors.
• c. There is a significant deviation from the normal eruption sequence (for
example, lateral incisors erupting prior to the central incisor).
• Incidence : 0.13 %
• the maxillary central incisor is the third-most commonly impacted tooth
after third permanent molars and maxillary canines.
32. • Causes of delayed eruption:
• General causes :
• Hereditary gingival fibromatosis .
• down syndrome .
• Cleidocranial dystosis .
• CLP.
• Localized causes :
• Crowding .
• Delayed exfoliation of primary tooth.
• Supernumerary tooth .
• Dilacerations.
• Abnormal position of crypt .
34. III) Impacted lower second premolar
• • The mandibular second premolar is one of the most frequently
impacted teeth.
• • The recommended treatment is to extract the second primary
molar with or without removing the bone along the eruption path,
to uncover the tooth surgically and move it into the arch by
orthodontic treatment.
• • The prevalence of impacted premolars has been found to vary
according to age . the overall prevalence in adults has been
reported to be 0.5%.
• • Premolar impactions may be due to local factors such as mesial
drift of teeth arising from premature loss of primary molars; ectopic
positioning of the developing premolar tooth buds; or pathology
such as inflammatory or dentigerous cyst.
• • They may also be associated with over retained or infraocclusal
ankylosed primary molars or with syndromes such as cleidocranial
dysostosis .
36. • Referrences
• Clinical Management of Impacted Maxillary Canines Samir E. Bishara
• Maxillary incisor impaction and its relationship to canine displacement
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