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Complete ceramic crowns are the most esthetic fixed restoration as they resemble natural teeth in color and translucency without any visible metal. They are indicated for situations requiring high esthetics, proximal caries, endo-treated teeth with posts, or favorable load distribution. However, they are contraindicated when superior strength is needed, teeth are thin, load distribution is unfavorable, or insufficient tooth structure remains. Advantages include superior esthetics and conservative margins, while disadvantages comprise reduced strength compared to metal-ceramic crowns and being brittle. Jacket porcelain crowns are full coverage restorations made only of porcelain or combining porcelain over metal.
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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Role of Mukta Pishti in the Management of Hyperthyroidism
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- 1. Complete ceramic crown The most esthetic pleasing fixed restoration . because there is no metal understructure to block light transmission.it can resemble natural tooth in term of color and translucency than can any other restoration.
- 2. indication 1- high esthetic requirments 2- considerable proximal caries 3- endo-treated teeth with post and core 4- favorable distribution of occlusal load
- 3. Contra- indication 1- when superior strength required 2- thin teeth faciolingually 3- unfavorable distribution of occlusal load 4- insufficient coronal tooth structure for support. 5-edge to edge occlusion 6- bruxism
- 4. advantage 1- superior esthetic 2- good tissue response even for sub-gingival margin 3- more conservative of facial wall Disadvantage: 1- reduce strength compared to PFM 2- proper preparation extremely critical 3- among the least conservative preparation 4- brittle nature of the material.
- 5. Jacket porcelain crowns (PJC) Full coverage restorations, , it is an artificial non metallic restoration used to cover the all surfaces of the clinical crown. It is made only from porcelain, as, these are restorations used to restore the all surfaces of the clinical crown, classified according to the material used in their construction: 1. Metal crowns (or restorations). 2. Non-metal crowns (or restorations) Full veneer. 3. Combination of both of the two above crowns (constructed as a thin metal shell covered by layers of porcelain).