Presentation describing important values to be understood in periodontology. Helpful for dental graduate students and periodontology post graduate students and also for neet mds exams.
Furcation involvement is a common sequela of severe chronic periodontal disease. Its effective management has a profound influence on the outcome of periodontal therapy.
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.
Furcation involvement is a common sequela of severe chronic periodontal disease. Its effective management has a profound influence on the outcome of periodontal therapy.
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.
Surgical v/s Non surgical periodontal therapy Achi Joshi
Both surgical and nonsurgical therapy produced improvement in the periodontal health.
Treatment approach was based on the comfort level of the practitioner.
In the late 60’s and continuing into the 70’s and 80’s, many series of longitudinal studies were conducted, aimed to document the immediate and most importantly long term clinical results following several types of periodontal therapy.
Epidemiology of gingival & periodontal diseasesChetan Basnet
It is the “study of the distribution and determinants of health related states or events in a specified population, and the application of this study to control of health problems.”
-John M. Last(1988)
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.
This presentation displays causes and types of occlusal forces, also discusses the classification of trauma from occlusion and its effect on the periodontium clinically and radiographically.
Pathologic migration and its effect on the hard and soft tissues.
Surgical v/s Non surgical periodontal therapy Achi Joshi
Both surgical and nonsurgical therapy produced improvement in the periodontal health.
Treatment approach was based on the comfort level of the practitioner.
In the late 60’s and continuing into the 70’s and 80’s, many series of longitudinal studies were conducted, aimed to document the immediate and most importantly long term clinical results following several types of periodontal therapy.
Epidemiology of gingival & periodontal diseasesChetan Basnet
It is the “study of the distribution and determinants of health related states or events in a specified population, and the application of this study to control of health problems.”
-John M. Last(1988)
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.
This presentation displays causes and types of occlusal forces, also discusses the classification of trauma from occlusion and its effect on the periodontium clinically and radiographically.
Pathologic migration and its effect on the hard and soft tissues.
Periodontal plastic surgery is defined as the surgical procedures performed to correct deformities of the gingiva or alveolar mucosa. It includes widening of attached gingiva,
deepening of shallow vestibules, resection of the aberrant frena, depigmentation of gingiva.In all of these procedures, blood supply is the most significant concern and must be the underlying issue for all decisions regarding the individual surgical procedure.
Journal Club On Subepithelial Connective Tissue GraftAssociated with Apicoec...Shilpa Shiv
Journal Club On Subepithelial Connective Tissue GraftAssociated with Apicoectomy andRoot-End Fillings in the Treatment ofDeep Localized Gingival Recession withApex Root Exposure
Peizosurgery: A boon in modern periodonticsAnushri Gupta
Piezoelectricity is the electricity resulting from pressure. It is effective in precise bone cutting. It spares soft tissue and hence less blood loss is seen.
A periodontal flap is a section of gingiva and/mucosa that is surgically separated from the underlying tissue to provide visibility and the access to the bone and the root surface. The flap also allows the gingiva to be displaced to a different location in patients with mucogingival involvement.
In this PowerPoint presentation, the periodontal flap is described under the headings: indication, contraindications, classification of flaps, flap design, horizontal and vertical incisions and various flap technique such as modified widman flap, undisplaced flap, palatal flap, apically displaced flap, papilla preservation flap and distal molar surgery for maxillary and mandibular molars. It also contains healing after flap surgery.
A presentation describing relationship between peridontics and prosthodontics and their implications. Helpful for dental graduates and perio and prostho post graduate students.
A presentation on inter-relationship between periodontal and orthodontic events. Helpful for dental graduates and perio and ortho post graduate students.
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
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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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.
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
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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- Prix Galien International Awards Ceremony
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
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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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
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
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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.
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
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Important values to remember in periodontology.pptx
1. ImportantValues to
remember in
Periodontology
Dr Aishwarya Pandey
MDS, IMS, BHU
https://www.linkedin.com/in/dr-aishwarya-pandey-63095b1aa
https://instagram.com/conundrums_of_life?igshid=OGQ5ZDc2ODk2Z
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2. • Ideal depth of gingival sulcus= 0 mm
• Histologic depth of gingival sulcus=1.8 mm (as
determined by histologic sections of gingival sulcus)
• Clinical probing depth = 2-3 mm (the estimation of the
distance of apical penetration by a periodontal probe
with as measured from gingival margin)
Clinical probing depth
Values important from clinical perspective
5. • Critical probing depth
• This concept was given by Lindhe et al, 1982.
• The critical probing depth represents a baseline probing-depth
value above which the outcome of a therapy will result in
attachment gain and below which the outcome of therapy will
result in clinical attachment loss.
• The critical probing depth for nonsurgical therapy (scaling
and root planing) is 3 mm (2.9 mm).
• For the access flap therapy, the critical probing depth is 5.4
mm.
• This, means that flap surgery is indicated predominantly with a
probing depth of 5.4 mm, while between 2.9 mm and 5.4 mm,
nonsurgical therapy is to be preferred.
6.
7. • Biologic width = 2 mm (the physiologic dimension of the
junctional epithelium and connective tissue attachment)
*peri-implant biologic width= 4 to 4.5 mm
8. • Infringement on the biologic width by the placement of a
margin of a restoration within its zone may result in gingival
inflammation, pocket formation, and alveolar bone loss.
• So, it is recommended that there be at least 3 mm between
the gingival margin and bone crest.
• This allows for adequate biologic width when the restoration is
placed 0.5 mm within the gingival sulcus.
9. Greater than 3 mm of soft tissue
between the bone and gingival
margin, with adequate attached
gingiva, allows crown lengthening by
gingivectomy
With less than 3 mm of soft tissue
between the bone and gingival margin,
or less-than-adequate attached gingiva, a
flap procedure and osseous
recontouring are required for crown
lengthening.
Crown Lengthening
10. • Restoration Margin Placement
• Rule 1: If the sulcus probes 1.5 mm or less, place the
restoration margin no more than 0.5 mm below the
gingival tissue crest. (Most common)
• Rule 2: If the sulcus probes more than 1.5 mm, place the
margin no more than half the depth of the sulcus below
the tissue crest.
• Rule 3: If a sulcus greater than 2 mm is found,
gingivectomy to be performed to lengthen the teeth and
create a 1.5-mm sulcus. Then the patient can be treated
using rule 1.
11. • Surgical Blades
• The #12D blade = to engage narrow, restricted areas with
both pushing and pulling cutting motions. (*has cutting
edges on both the sides, beak shaped)
• The #15 blade = for thinning the flaps and is also used for
general purposes.
• The #15C blade= for making the initial, scalloping-type
incision. (narrower version of the #15 blade)
12. • Gracey curettes
1. Gracey #1-2 and #3-4 Anterior teeth
2. Gracey #5-6 Anterior teeth and
premolars
3. Gracey #7-8 and #9-10 Posterior teeth,
facial and lingual
4. Gracey #11-12 Posterior teeth,
mesial
5.
Gracey #13-14
Posterior teeth,
distal
13. Blade angulation.
(A) 0 degrees: correct angulation for blade insertion.
(B) 45 to 90 degrees: correct angulation for scaling and root planing.
(C) Less than 45 degrees: incorrect angulation for scaling and root planing.
(D) More than 90 degrees: incorrect angulation for scaling and root planing,
but correct angulation for gingival curettage.
14. • Important frequencies
• Electrosurgery =1.5 to 7.5 million cycles per second
(megahertz).
• Sonic =2000 to 6500 cycles per second (Hertz)
• Ultrasonic =18,000 to 50,000 cycles per second (Hertz)
• Piezoelectric primary ultrasonic frequency 24-36 kHz
secondary sound frequency 30-6- Hz
15. • The objective of sharpening is to restore the fine, thin, linear
cutting edge of the instrument.
• India and Arkansas oilstones are examples of natural
abrasive stones. Carborundum, ruby, and ceramic stones are
synthetically produced.
• Angle between sharpening stone and face of the blade=
100-110° (angle between the face of the blade and the lateral surface of
any curette is 70 to 80 °)
Instrument sharpening
16. • Dental Implant considerations
• Implant should be placed buccolingually so there is at least 2 mm
of bone circumferentially around it
• Distance between implant and natural tooth= 1.5 mm
• Inter-implant distance=3 mm
• Violation of biologic width around an implant can lead to bone
loss. Improperly spaced implants invariably lead to chronic
inflammation and periimplantitis.
• Implants that are placed too close to each other or to natural
teeth can be difficult to restore.
• Implant placed at an excessive distance from an adjacent tooth or
implant may require prosthetic compensation in the form of
mesial or distal cantilevers, which can predispose the implant to
biologic (i.e., bone loss) and mechanical (i.e., screw loosening,
screw fracture, and implant fracture) complications and
difficulties with hygiene.
17. • Apicocoronally, the implant should be placed so the platform is
about 3 mm apical to the gingival margin of the anticipated
restoration
• Implant platform is placed too far coronally= there will not be
sufficient room to develop a natural-looking emergence
profile; unaesthetic appearance; exposure of implant collar
• At or above the level of the gingival margin= metal collar or
implant exposure can occur.
• Too far apical= a long transmucosal abutment will be necessary
to restore the implant.This can lead to a deep pocket and
difficult hygiene access for the patient and clinician.
18. • Wavelength of Lasers commonly employed (nm)
The wavelengths of light used for LLLT (low level laser therapy) = 600–1070
nm
(It is referred to as “low level” because the density of light energy is low
compared with other lasers; promote wound healing by reducing inflammation,
enhancing epithelialization, fibroblast proliferation, and matrix synthesis, as
well as neovascularization)
*Exposure of bone to temperatures ≥47°C =cellular damage and osseous
resorption.
≥60°C = tissue necrosis
20. • Radius of Action
• Garant and Cho suggested that locally produced bone
resorption factors may need to be present in the proximity
of the bone surface to exert their action.
• Page and Schroeder, postulated a range of effectivenessof
about 1.5 mm to 2.5 mm in which bacterial biofilm can
induce loss of bone.
21. • Chronic periodontitis
• Localized form: 30% of teeth involved
• Generalized form: >30% of teeth involved
• Mild: 1 to 2 mm clinical attachment loss (CAL)
• Moderate: 3 to 4 mm CAL
• Severe: ≥5 mm CAL
22. • Healing after Gingivectomy
A. Connective tissue components
• The initial response = formation of a protective surface blood
clot. (occurs within minutes)
• The clot is then replaced by granulation tissue in next few hours.
• In 24 hours= an increase occurs in new connective tissue cells,
which are mainly angioblasts beneath the surface layer of
inflammation and necrotic tissue.
• By the third day, numerous young fibroblasts are located in the
area.
• Vasodilation and vascularity begin to decrease after the fourth
day of healing, and they appear to be almost normal by the 16th
day.
• Complete repair of the connective tissue = 7 weeks
23. B. Epithelial components
• 12 to 24 hours= epithelial cells at the margins of the wound begin
to migrate over the granulation tissue, thereby separating it from
the contaminated surface layer of the clot. (The epithelial cells
advance by a tumbling action, with the cells becoming fixed to
the substrate by hemidesmosomes )
• Epithelial activity at the margins reaches a peak after 24 to 36
hours.
• After 5 to 14 days= completion surface epithelialization
• Complete epithelial repair takes about 1 month.
24. • 24 hours= a thick connection between the flap and the
tooth or bone surface is established by a blood clot
• 1- 3 days after flap surgery= the space between the flap
and the tooth or bone is thinner. Epithelial cells migrate
over the border of the flap, and contact the tooth at this
time.
• One week after surgery= an epithelial attachment to
the root has been established by means of
hemidesmosomes and a basal lamina. The blood clot is
replaced by granulation tissue derived from the gingival
connective tissue, the bone marrow, and the periodontal
ligament.
• Two weeks after surgery= collagen fibers begin to
appear parallel to the tooth surface.
• One month after surgery= a fully epithelialized gingival
crevice with a well-defined epithelial attachment is
present.