This document reviews the clinical application of orthodontic miniscrews. It begins by discussing the history and limitations of using dental implants and bone screws for orthodontic anchorage. It then describes the development of smaller miniscrews that address many of the disadvantages of larger implants. The document reviews various miniscrew systems and characteristics like diameter, length, head design. It discusses surgical placement and appropriate sites. Finally, it provides examples of common clinical applications like space closure, intrusion of teeth, and impacted tooth movement where miniscrews provide improved anchorage control.
Loading of implants /certified fixed orthodontic courses by Indian dental aca...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.for more details please visit
www.indiandentalacademy.com
loading protocols in dental implants about indications and contraindications of conventional , immediate,progressive and delayed loading of dental implants
Abstract: Corticotomy-assisted orthodontic treatment is an established and efficient orthodontic technique that has recently been studied in a number of publications. Corticotomy facilitated orthodontics have been employed in various forms over speed up orthodontic treatment It involves selective alveolar decortication in the form of decortication lines and dots performed around the teeth that are to be moved. It is done to induce a state of increased tissue turnover and a transient osteopenia, which is followed by a faster rate of orthodontic tooth movement. This technique has several advantages, including faster tooth movement, shorter treatment time, safer expansion of constricted arches, enhanced post-orthodontic treatment stability and extended envelope of tooth movement. The aim of this article is to present a comprehensive review of the literature, including historical background, contemporary clinical techniques, indications, contraindications, complications and side effects. Keywords: Corticotomy, decortication, review, orthodontic treatment
Over time, progressively shorter implants have been placed such that short implants are now available that are less than 6 mm in length. The viability and high success rates seen with short implants can be explained by osseointegration, the macro geometric design of the implant, as well as physics and the distribution of forces. This paper was aimed to review the stability and survival rate of short implants under functional loads. Numerical and clinical studies were reviewed. Keywords: Short dental implants, sinus augmentation, factors affecting bone regeneration in dental implantology
Loading of implants /certified fixed orthodontic courses by Indian dental aca...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.for more details please visit
www.indiandentalacademy.com
loading protocols in dental implants about indications and contraindications of conventional , immediate,progressive and delayed loading of dental implants
Abstract: Corticotomy-assisted orthodontic treatment is an established and efficient orthodontic technique that has recently been studied in a number of publications. Corticotomy facilitated orthodontics have been employed in various forms over speed up orthodontic treatment It involves selective alveolar decortication in the form of decortication lines and dots performed around the teeth that are to be moved. It is done to induce a state of increased tissue turnover and a transient osteopenia, which is followed by a faster rate of orthodontic tooth movement. This technique has several advantages, including faster tooth movement, shorter treatment time, safer expansion of constricted arches, enhanced post-orthodontic treatment stability and extended envelope of tooth movement. The aim of this article is to present a comprehensive review of the literature, including historical background, contemporary clinical techniques, indications, contraindications, complications and side effects. Keywords: Corticotomy, decortication, review, orthodontic treatment
Over time, progressively shorter implants have been placed such that short implants are now available that are less than 6 mm in length. The viability and high success rates seen with short implants can be explained by osseointegration, the macro geometric design of the implant, as well as physics and the distribution of forces. This paper was aimed to review the stability and survival rate of short implants under functional loads. Numerical and clinical studies were reviewed. Keywords: Short dental implants, sinus augmentation, factors affecting bone regeneration in dental implantology
Abstract: Immediate implant placement has been the acceptable procedure for the past two decades. Perhaps
the most important aspect of any implant surgery in accordance with the successful procedure is implant
surgery and bone to implant contact.The aim of this article is to describe a clinical case in which a fractured
maxillary canine was replaced by an immediately loaded postextraction implant using a simplified technique,
which permits a reduction of the number of implant components and consequently a lower cost of treatment,
while at the same time maintaining acceptable aesthetic and functional outcomes.
Key words: Immediate implant placement, Immediate loading, Immediate provisionalisation, Esthetics
Quinidine, Albino rats, Pentylenetetrazole, Gap junctionsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Crestal bone loss around dental implants after implantation of Tricalcium pho...Dr. Anuj S Parihar
Background and Aims: Bone loss around dental implants is generally measured by monitoring changes in marginal bone level using radiographs. After the first year of implantation, an implant should have <0.2 mm annual loss of marginal bone level to satisfy the criteria of success. However, the success rate of dental implants depends on the amount of the crestal bone around the implants. The main aim of this study was to evaluate and compare the crestal bone loss around implants placed with particulate β‑Tricalcium Phosphate Bone Graft and platelet concentrates. Methods: 50 individuals received hundred dental implants. Each individual received one dental implant in the edentulous site filled with β‑Tricalcium Phosphate Bone Graft along (β‑TCP) with Platelet‑ Rich Plasma (PRP)
(Group A) and another in edentulous site filled only with β‑Tricalcium Phosphate Bone Graft (Group B) in the posterior edentulous region. All the 100 implants were prosthetically loaded after a healing period of three months. Crestal bone loss was measured on mesial, distal, buccal and lingual side of each implant using periapical radiographs 3 months, 6 months and 9 months after implant placement. Results: The average crestal bone loss 9 months after the implants placement in Group A and Group B was 2.75 mm and 2.23 mm respectively, the value being statistically significant (P < 0.05). In both Group A and Group B, the average crestal bone loss was maximum on the lingual side followed by buccal, distal and mesial sides. Conclusion: β‑TCP is a promising biomaterial for clinical
situations requiring bone augmentation. However, the addition of PRP results in decreased bone loss around the dental implants.
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
Periodontally Accelerated Osteogenic Orthodontics with Piezoelectric Surgery...Abu-Hussein Muhamad
Piezosurgery has been applied in dentistry for many years. This paper reviews specifically the treatment applications that have been used in surgically assisted orthodontic treatment since the last decade. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a surgical technique which results in an increase in alveolar bone width, shorter treatment time, increase post-treatment stability, and decrease amount of apical root resorption. The aim of this case report is to compare the use of micro-motor and piezoelectric surgery unit during decortication in Periodontally Accelerated Osteogenic Orthodontics technique.
Key words: Piezoelectric surgery, piezosurgery, Periodontal regeneration , accelerated tooth movement
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
Implant Loading Protocols Journal Club-Comparative evaluation of the influenc...Partha Sarathi Adhya
This journal club deals with different loading protocols and comparative analysis among them. this basically deals with immediate and delayed loading protocols.
The greater treatment time is one of the major drawbacks associated with fixed orthodontic therapy.Micro-osteoperforation has proved to be effective in reducing the duration of conventional orthodontic treatment.
Micro implant anchorage in orthodontics /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
0091-9248678078
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
DENTAL AVULSION- IMMEDIATE REPLANTATION: 8- YEAR FOLLOW UP CASEAbu-Hussein Muhamad
Avulsion of permanent front teeth is a rare accident , mostly affecting children between seven and nine year s of age.
Replanted and splinted, these teeth often develop inflammat ion, severe resorption or ankylosis affect ing alveolar bone
development and have to be extracted sooner or later . This repor t proposes a discussion on the var ious pecul iar ities of a
tooth avulsion case with immediate replantation, such as a long retent ion per iod, root canal fil ling with MTA, or thodontic
treatment.
A Clinical Study Resonance Frequency Analysis of Stability during the Healing...Abu-Hussein Muhamad
Implant stability plays a critical role for successful osseointegration, which has been viewed as a
direct structural and functional connection existing between bone and the surface of a load-carrying
implant. Achievement and maintenance of implant stability are prerequisites for successful clinical
Outcome. Therefore, measuring the implant stability is an important method for evaluating the success
of an implant.
The aim of this clinical study was to measure the implant stability quotient using a method called
resonance frequency analysis of dental implants during the healing period.
Material and methods: A number of 43 patients received 152 Shark AL-Technology implant
system either in the maxillary or in the mandibular arch. Implant stability was measured with an Osstell
Mentor device (Osstel, AB, Sweden) using the resonance frequency analysis at the time of implant
placement, 0, 2, 4, 8 and 12 weeks post insertion.
Results: The mean implant stability quotient for all implants placed was 72,18. The lowest value
of the implant stability quotient was at 2 weeks post insertion measuring 60,78.
Conclusions: In relation to the gender the implants placed in female patients showed a higher
mean value of the implant stability quotient. In relation to the location within the dental arch the implants
placed in the anterior areas had a higher implant stability quotient than the ones places in the posterior
areas of the arch.
Abstract: Immediate implant placement has been the acceptable procedure for the past two decades. Perhaps
the most important aspect of any implant surgery in accordance with the successful procedure is implant
surgery and bone to implant contact.The aim of this article is to describe a clinical case in which a fractured
maxillary canine was replaced by an immediately loaded postextraction implant using a simplified technique,
which permits a reduction of the number of implant components and consequently a lower cost of treatment,
while at the same time maintaining acceptable aesthetic and functional outcomes.
Key words: Immediate implant placement, Immediate loading, Immediate provisionalisation, Esthetics
Quinidine, Albino rats, Pentylenetetrazole, Gap junctionsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Crestal bone loss around dental implants after implantation of Tricalcium pho...Dr. Anuj S Parihar
Background and Aims: Bone loss around dental implants is generally measured by monitoring changes in marginal bone level using radiographs. After the first year of implantation, an implant should have <0.2 mm annual loss of marginal bone level to satisfy the criteria of success. However, the success rate of dental implants depends on the amount of the crestal bone around the implants. The main aim of this study was to evaluate and compare the crestal bone loss around implants placed with particulate β‑Tricalcium Phosphate Bone Graft and platelet concentrates. Methods: 50 individuals received hundred dental implants. Each individual received one dental implant in the edentulous site filled with β‑Tricalcium Phosphate Bone Graft along (β‑TCP) with Platelet‑ Rich Plasma (PRP)
(Group A) and another in edentulous site filled only with β‑Tricalcium Phosphate Bone Graft (Group B) in the posterior edentulous region. All the 100 implants were prosthetically loaded after a healing period of three months. Crestal bone loss was measured on mesial, distal, buccal and lingual side of each implant using periapical radiographs 3 months, 6 months and 9 months after implant placement. Results: The average crestal bone loss 9 months after the implants placement in Group A and Group B was 2.75 mm and 2.23 mm respectively, the value being statistically significant (P < 0.05). In both Group A and Group B, the average crestal bone loss was maximum on the lingual side followed by buccal, distal and mesial sides. Conclusion: β‑TCP is a promising biomaterial for clinical
situations requiring bone augmentation. However, the addition of PRP results in decreased bone loss around the dental implants.
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training
center with best faculty and flexible training programs for dental
professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
Periodontally Accelerated Osteogenic Orthodontics with Piezoelectric Surgery...Abu-Hussein Muhamad
Piezosurgery has been applied in dentistry for many years. This paper reviews specifically the treatment applications that have been used in surgically assisted orthodontic treatment since the last decade. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a surgical technique which results in an increase in alveolar bone width, shorter treatment time, increase post-treatment stability, and decrease amount of apical root resorption. The aim of this case report is to compare the use of micro-motor and piezoelectric surgery unit during decortication in Periodontally Accelerated Osteogenic Orthodontics technique.
Key words: Piezoelectric surgery, piezosurgery, Periodontal regeneration , accelerated tooth movement
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
Implant Loading Protocols Journal Club-Comparative evaluation of the influenc...Partha Sarathi Adhya
This journal club deals with different loading protocols and comparative analysis among them. this basically deals with immediate and delayed loading protocols.
The greater treatment time is one of the major drawbacks associated with fixed orthodontic therapy.Micro-osteoperforation has proved to be effective in reducing the duration of conventional orthodontic treatment.
Micro implant anchorage in orthodontics /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
0091-9248678078
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
DENTAL AVULSION- IMMEDIATE REPLANTATION: 8- YEAR FOLLOW UP CASEAbu-Hussein Muhamad
Avulsion of permanent front teeth is a rare accident , mostly affecting children between seven and nine year s of age.
Replanted and splinted, these teeth often develop inflammat ion, severe resorption or ankylosis affect ing alveolar bone
development and have to be extracted sooner or later . This repor t proposes a discussion on the var ious pecul iar ities of a
tooth avulsion case with immediate replantation, such as a long retent ion per iod, root canal fil ling with MTA, or thodontic
treatment.
A Clinical Study Resonance Frequency Analysis of Stability during the Healing...Abu-Hussein Muhamad
Implant stability plays a critical role for successful osseointegration, which has been viewed as a
direct structural and functional connection existing between bone and the surface of a load-carrying
implant. Achievement and maintenance of implant stability are prerequisites for successful clinical
Outcome. Therefore, measuring the implant stability is an important method for evaluating the success
of an implant.
The aim of this clinical study was to measure the implant stability quotient using a method called
resonance frequency analysis of dental implants during the healing period.
Material and methods: A number of 43 patients received 152 Shark AL-Technology implant
system either in the maxillary or in the mandibular arch. Implant stability was measured with an Osstell
Mentor device (Osstel, AB, Sweden) using the resonance frequency analysis at the time of implant
placement, 0, 2, 4, 8 and 12 weeks post insertion.
Results: The mean implant stability quotient for all implants placed was 72,18. The lowest value
of the implant stability quotient was at 2 weeks post insertion measuring 60,78.
Conclusions: In relation to the gender the implants placed in female patients showed a higher
mean value of the implant stability quotient. In relation to the location within the dental arch the implants
placed in the anterior areas had a higher implant stability quotient than the ones places in the posterior
areas of the arch.
Multidisciplinary approach in the rehabilitation of congenitally missing late...Abu-Hussein Muhamad
Agenesis, the absence of permanent teeth, is a common occurrence among dental patients. The total incidence of tooth agenesis is about 4.2% among patients that are seeking orthodontic treatment and with the exception of third molars, the maxillary lateral incisors are the most common congenitally missing teeth with about a 2% incidence. The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisor using dental implants. The paper discusses the aspects of pre-prosthetic orthodontic diagnosis and the treatment that needs to be considered with conservative and fixed prosthetic replacement.
Dental Transposition of Mandibular Canine and Lateral IncisorAbu-Hussein Muhamad
Dental transposition is a form of ectopic eruption with change in position of normal adjacent teeth. Its prevalence is very low in general population and could be frequently missed on oral examination. This article reports a case of early orthodontic treatment of a rare unilateral mandibular right lateral incisor – canine transposition
Tooth Agenesis in Orthodontic Patients at Arab Population in IsraelAbu-Hussein Muhamad
Non-syndromic tooth agenesis has been occasionally described in literature and data available for its prevalence is rare in Arabs population in Israel. The purpose of the present retrospective radiographic study was to provide data concerning the prevalence of non-syndromic hypodontia in patients reporting to the Center for Dentistry,Research & Aesthetics, Jatt, Almothalat, Israel
Combined orthodontic and prosthetic therapy special considerations.(52)Abu-Hussein Muhamad
Agenesis, the absence of permanent teeth, is a common occurrence among dental patients. The total incidence of tooth agenesis is about 4.2% among patients that are seeking orthodontic treatment and with the exception of third molars, the maxillary lateral incisors are the most common congenitally missing teeth with about a 2% incidence. The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisor using dental implants. The paper discusses the aspects of pre-prosthetic orthodontic diagnosis and the treatment that needs to be considered with conservative and fixed prosthetic replacement.
Managing congenitally missing lateral incisors with single tooth implants Abu-Hussein Muhamad
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. Several treatment
options exist for the replacement of congenitally missing lateral incisors. These options include canine substitution, resin bonded fixed partial dentures, cantilevered
fixed partial dentures, conventional fixed partial dentures and single tooth implants. Depending on which treatment option is chosen, a specific criterion has to be
addressed. Interdisciplinary treatment plays a vital role to achieve an excellent, esthetic result for a most predictable outcome. This paper describes the therapeutic use
of osseointegrated implants to replace congenitally missing upper lateral incisors. Highlighting the importance of the Orthodontic/Restorative interface.
Position of the Mental Foramen in a Northern Regional Palestinian PopulationAbu-Hussein Muhamad
Background: The mental foramen is one of important anatomical features frequently encountered
in maxillofacial surgical procedures in premolars area. Its position has been shown to vary according to
race. In this study researchers aim to study the position, shape, and appearance of the mental foramen,
as seen on panoramic radiographs of Palestinians, and to compare our findings with international
values.
Materials and methods: A randomly selected panoramic radiographs (368 with 736 sides)
from the records of dental patients attending three dental services in north of Palestine, the mental
foramina’s anterior–posterior position, shape, and radiologic appearance were subjected to analysis.
Results: The most frequent anterior–posterior position was in the area between the long axes of
first and second mandibular premolar teeth. The most frequent appearance was the continuous type
and majority of foramina were rounded in shape.
Conclusion: The position of the mental foramen on panoramic radiographs in this selected group
of Palestinians was most commonly between the mandibular premolars. The continuous type and
rounded shape of the mental foramen was founded in majority of cases. These results are similar to
previous findings in Caucasian populations.
Tooth agenesis is the most prevalent craniofacial congenital anomaly in humans. The term refers to an isolated disorder in the absence of non-dental phenotypes but is also used to describe the manifestation of missing teeth in syndromes. The affected individuals suffer from compromised masticatory functions and have decreased quality of life. Discerning the genetic etiology of tooth agenesis not only improves our understanding of normal tooth development but also provides a fundamental basis for developing potential therapeutic strategies for this anomaly. To date, MSX1, Pax9, Axin2, Eda, And Wnt10a have been established as candidate genes associated with non-syndromic tooth agenesis.This article reviews the recently discovered genes involved in dental agenesis , and provides an update on the aetiological factors underlying this common malformation.
OpenText SlideShare – Mitigate Compliance Risks through secure information ex...OpenText
Business organizations around the world exchange information on 24/7/365 basis. This needs to be secure to meet certain legal, regulatory and corporate compliance requirements. In addition to being complaint, certain industries need to meet audit requirements
This SlideShare discusses the challenges around compliance, what are some of the governance requirements and the options to overcome the compliance and governance risks through secure information exchange solutions. Visit OpenText http://www.opentext.com/campaigns/infoexchange to discover more
Elasticsearch, Logstash, Kibana. Cool search, analytics, data mining and more...Oleksiy Panchenko
In the age of information and big data, ability to quickly and easily find a needle in a haystack is extremely important. Elasticsearch is a distributed and scalable search engine which provides rich and flexible search capabilities. Social networks (Facebook, LinkedIn), media services (Netflix, SoundCloud), Q&A sites (StackOverflow, Quora, StackExchange) and even GitHub - they all find data for you using Elasticsearch. In conjunction with Logstash and Kibana, Elasticsearch becomes a powerful log engine which allows to process, store, analyze, search through and visualize your logs.
Video: https://www.youtube.com/watch?v=GL7xC5kpb-c
Scripts for the Demo: https://github.com/opanchenko/morning-at-lohika-ELK
Surgery of Labially Impacted Canine & Orthodontic Management – A Case ReportAbu-Hussein Muhamad
Maxillary canines are one of the most common teeth that are impacted among patients seeking orthodontic treatment. Depending on the position of these impacted teeth, various surgical techniques have been employed for their exposure. His primary goal of surgical phase is to provide the means for correct position of orthodontic anchorage. Additionally, the technique used must ensure favorable tissue anatomy that will permit long-term maintenance of periodontal health. In the present case, a labially impacted maxillary left canine was surgically exposed using an apically po
“One-Piece” Immediate-Load Post-Extraction Implant In Maxillary Central IncisorAbu-Hussein Muhamad
Abstract: This case report describes extraction of a fractured left maxillary central incisor tooth, followed by immediate placement of an one-piece implant in the prepared socket and temporization by a bonded restoration.
Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted.
Results: The atraumatic operating technique and the immediate insertion of the one-piece Implant resulted in the preservation of the hard and soft tissues at the extraction site.
Conclusion: The “One-piece” dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues. The one-piece implant design resulted in a high cumulative implant survival rate and beneficial marginal bone levels.
Reconstruction of a facial defect is a complex modality either surgically or prosthetically, depending on the site, size, etiology, severity, age, and the patient’s expectation. The loss of an auricle, in the presence of an auditory canal, affects hearing, because the auricle gathers sound and directs it into the canal.
Surgical reconstruction is preferable but prosthetic approach may be necessary in some circumstances such as the presence of complex or large defects, requirement of the recurrence control, local or general contraindications of surgery, damaged neighboring tissues due to the radiotherapy, general poor health, failed reconstructive attempts previously made, refusal of the surgery by the patient, high esthetic demands, the desire for a quick recovery and palliatively operated patients.
Nowadays, craniofacial implants are used to support and retain such prostheses. Studies have shown successful retention and stability of auricular prostheses anchored to the temporal bone with titanium implants.
Short Implants and their role in prosthetic replacement of missing toothSivaRaman Sms
This is an seminar on short implants related to implant dentistry .
This gives the insight on what has happened since the evolution of short implants and its role in implantology .Their role as replacement of missing tooth in the atrophied maxillary and mandibular posterior regions
Immediate Implant Placement And Restoration With Natural Tooth In The Maxilla...Abu-Hussein Muhamad
Anterior tooth loss and restoration in the esthetic zone is a common challenge in dentistry today. The prominent visibility of the area can be especially distressing to the patient and requires a timely and esthetically pleasing solution. Immediate single-tooth implantation followed by immediate provisionalization is becoming an increasingly desirable treatment that offers numerous benefits over conventional delayed loading. Provisionalization for immediately-placed implants using the patient’s existing tooth can enhance the final aesthetic outcome if certain steps are
followed. If the natural tooth is intact and can be used as a provisional, the emergence profile can be very similar to the preoperative condition. This article outlines a technique to use the patient’s natural tooth after extraction to provisionalize an implant.
IMMEDIATE LOADING WITH MINI DENTAL IMPLANTS IN THE FULLY EDENTULOUS MANDIBLEAbu-Hussein Muhamad
Mini dental implants (MDI) have become increasingly popular in the past decade and have been approved for many long-term uses in dentistry. There are many advantages of the use of mini dental implants from both a practitioner and patient perspective. For the general dentist starting out in implant dentistry, their placement can be more challenging than conventional implants. It requires a different skill set, but one which can be learned with proper guidance and practice.In the study are presented clinical cases with mini implants with spherical joints for retention of removable overimplant mandibular dentures.
Key words: mini dental implants, immediate loading implants Prosthetics, overdenture
Overdentures can be either tooth or implant supported. Completely edentulous patients whose economic condition Thwarts them to invest in the expensive implant (number based) treatments should be motivated to have at least a two implant-supported overdenture since the prosthesis offers most of the advantages of conventional tooth-supported overdenture. We report a case of an elderly female patient who was reluctant toward surgery, but with moderate education was treated successfully with a two staged, two implant-supported overdenture using a ball abutment with o ring attachment.
Atrophied Edentulous Mandible with Implant-Supported Overdenture; A 10-year f...Abu-Hussein Muhamad
Abstract: Severe atrophy of the inferior alveolar process and underlying basal bone often results in problems with a lower denture. These problems include insufficient retention of the lower denture, intolerance to loading by the mucosa, pain, difficulties with eating and speech, loss of soft-tissue support, and altered facial appearance. These problems are a challenge for the prosthodontist and surgeon. In this case report, patient with resorbed edentulous mandible was successfully rehabilitated using two dental implants placed in the interforaminal region with ball abutments opposing conventional maxillary complete denture. Key Words: dental implants; dental prosthesis, implant-supported; resorption,
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Similar to Miniscrews: Clinical Application of Orthodontic. Abu-Hussein Muhamad1*, and Watted Nezar2 (20)
Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an
esthetic and functional restorative treatment. . Fixed prosthodontic and removable prostheses, resin bonded retainers, orthodontic movement of maxillary
canine to the lateral incisor site and single tooth implants represent the available treatment modalities to replace congenitally missing teeth. This case report
demonstrates the team approach in prosthetic and surgical considerations and techniques for managing the lack of lateral incisors. The aims of this case
report of replacement of bilaterally congenitally missing maxillary lateral incisors with dental implants.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations.
Impacted Maxillary Central Incisors: Surgical Exposure and Orthodontic Treat...Abu-Hussein Muhamad
The maxillary permanent central incisor develops early in life and forms part of an aesthetic smile. Disruption of the formation or eruption of the permanent
central incisor has multiple etiological factors. Treatment options depend to some extent on the cause of failure of eruption of the central incisor. Generally,
the earlier treatment is provided, the higher the likelihood of success and the less the complexity. Our results suggest that close monitoring and interdisciplinary
cooperation during the treatment phases led to a successful esthetic result, with good periodontal health and functional occlusion.
Excess of space in the dental arch is diagnosed as a
generalised spacing or a local divergence, often
observed in the maxillary anterior region, as a median
diastema, traumatic loss of central incisors, or
congenital absence of lateral incisors. Furthermore,
spacing is observed in aging individuals, due to
pathological migration of teeth caused by
periodontitis. Finally, adult individuals with partial
edentulous jaws demand pre-prosthetic orthodontic
treatment from functional aspects. Thus, indication for
orthodontic treatment in subjects with spacing of teeth
exists for aesthetic reasons, but also for facilitating
prosthetic restorations with optimal occlusalstability.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting
cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically
induced failures, since low primary implant stability, low bone density, short implants and overload have been
identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a
successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations
Orthodontic tooth movement is basically a biologic response towards a mechanical force. Osteoclast and osteoblast cells mediate bone resorption and apposition, which eventually produces tooth movement. Researches showed that the rate of orthodontic tooth movement can be altered by certain drugs locally or systemically. The Objective of this article is to discuss the current data concerning the effect of drugs on orthodontic tooth movement.
Multidisciplinary Approach in the Rehabilitation of Congenitally Maxillary C...Abu-Hussein Muhamad
Objective: This case report describes the multidisciplinary
approach to treat a congenitally missed maxillary canine, how to
improve patient’s smile using orthodontic fixed appliance, endosseous
dental implant, and porcelain veneer to achieve the treatment results of
function and esthetic.
Materials and procedures: Unilateral agenesis of the permanent
maxillary canines in healthy individuals is extremely rare. This
paper presents the case of a female patient diagnosed with congenital
unilateral agenesis of the permanent maxillary canines as well as
occlusal abnormalities in the form of left-side crossbite. To restore the
proper aesthetics and function, interdisciplinary therapeutic treatment
was implemented. In the case presented in this paper, the aim of
oral rehabilitation was to restore a functional balance by obtaining
proper skeletal relationships, creating optimal occlusal conditions and
obtaining arch continuity.
Conclusion: Interdisciplinary treatment combined of orthodontics,
implant surgery, and prosthodontics was useful to treat a nonsyndromic
oligodontia patient. Especially, with the new strategy, implantanchored
orthodontics, which can facilitate the treatmentand make it
more simply with greater predictability.
The multifactorial factors influenc cleft Lip-literature review Abu-Hussein Muhamad
Congenital cleft-Lip and cleft palate have been the subject of many genetic
studies, but until recently there has been no consensus as to their modes of
inheritance. In fact, claims have been made for just about every genetic
mechanism one can think of. Recently, however, evidence has been
accumulating that favors a multifactorial basis for these malformations. The
purpose of the present paper is to present the etiology of cleft lip and cleft palate
both the genetic and the environmental factors. It is suggested that the genetic
basis for diverse kinds of common or uncommon congenital malformations may
very well be homogeneous, whilst, at the same, the environmental basis is
heterogeneous.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically induced failures, since low primary implant stability, low bone density, short implants and overload have been identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field
Porcelain laminate veneers are among the most esthetic means of creating a more pleasing and beautiful smile. Porcelain veneers within reason allow for the alteration of tooth position, shape, size and color. They require a minimal amount of tooth preparation, approximately 0.5 mm to 0.7mm of surface enamel reduction. This study describes the use of ceramic veneers without tooth wear, reinforcing the concept that minimally invasive porcelain laminate veneers could become versatile and conservative allies in the fi eld of esthetic dentistry. Keywords: Ceramics, dentin-bonding agents, esthetics
Immediate Restoration of Single Implants Replacing Lateral Incisor Compromis...Abu-Hussein Muhamad
Today, the diagnosis of internal root resorption is significantly improved by the three-dimensional imaging. Furthermore, the CBCT’s superior diagnosis accuracy resulted in an improved management of the resorptive defects and a better outcome of Implant therapy of teeth with internal resorption.Implant has become a wide option to maintain periodontal architecture. Diagnosis and treatment planning is the key factors in achieving the successful outcomes after placing and restoring implants placed immediately after tooth extraction. The purpose of this clinical update is to report on the success and survival of Immediate restoration of single implants replacing right lateral incisor compromised by internal resorption.
Clinical Management of Bilateral Impacted Maxillary CaninesAbu-Hussein Muhamad
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive
approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the
dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines
treated with surgical exposure and orthodontic treatment.
Material and Methods: A 15year-old female with various degrees of bilateral palatal impaction of maxillary canines were managed
by the described technique.
Results and Discussion: Autonomous eruption of the impacted canines after surgical uncovering was witnessed in all patients
without the need for application of a vertical orthodontic force for their extrusion.
Conclusion: The described method of surgical uncovering and autonomous eruption created conditions for biological eruption of the
palatally impacted canines into the oral cavity and facilitated considerably the subsequent orthodontic treatment for their proper alignment
in the dental arch.
Keywords: Impacted canines; Surgical; Tooth exposure; Orthodontic treatment
Single Visit Replacement of Central Maxillary Using Fiber-Reinforced Composi...Abu-Hussein Muhamad
Fiber reinforced composites are high strength filling materials composed of conventional composites and glass fibres. They exhibit extensive applications in different fields of dentistry. This clinical report present a case where FRC technology was successfully used to restore central maxillary incisor edentulous area in terms of esthetic-cosmetic values and functionality.
Zirconium Dental Implants And Crown for Congenitally Missing Maxillary Latera...Abu-Hussein Muhamad
Zirconia implants were familiarized into dental implantology. Zirconia appears
to be an appropriate implant material due to its low plaque affinity, tooth like color, biocompatibility and mechanical properties. The following a case presentations will show how the acid-etched zirconia Implant can be used to functionally and aesthetically replace congenitally missing left lateral incisor tooth germ in the maxilla, and achieve optimal soft tissues and health.
Surgery of Labially Impacted Canine & Orthodontic Management – A Case ReportAbu-Hussein Muhamad
Maxillary canines are one of the most common teeth that are impacted among patients seeking orthodontic treatment. Depending on the position of these impacted teeth, various surgical techniques have been employed for their exposure. His primary goal of surgical phase is to provide the means for correct position of orthodontic anchorage. Additionally, the technique used must ensure favorable tissue anatomy that will permit long-term maintenance of periodontal health. In the present case, a labially impacted maxillary left canine was surgically exposed using an apically positioned flap. Orthodontic extrusion was carried out further.
Taurodontism is a rare dental anomaly in which the involved tooth has an enlarged and elongated body and pulp chamber
with apical displacement of the pulpal floor. Endodontic treatment of a taurodont tooth is challenge to a clinician and
requires special handling because of the proximity and apical displacement of the roots. The present article describes the
diagnosis and management of hypertaurodontism by endodontic treatment in a left mandibular second molar.
Management of Open Apex in Permanent Teeth with BiodentineAbu-Hussein Muhamad
Biodentine is new calcium silicate based cement that exhibits physical and chemical properties similar to those described for certain Portland cement derivatives. This article demonstrates the use of the newer material, Biodentine as an apical matrix barrier in root end apexification procedure. This case reports present apexification and successful healing with the use of Biodentine as an apical barrier matrix.
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
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.
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.
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.
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.
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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.
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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
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.
Miniscrews: Clinical Application of Orthodontic. Abu-Hussein Muhamad1*, and Watted Nezar2
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RESEARCH AND REVIEWS: JOURNAL OF DENTAL SCIENCES
Miniscrews: Clinical Application of Orthodontic.
Abu-Hussein Muhamad1*, and Watted Nezar2.
1123 Argus Street, 10441 Athens, Greece.
2Arab American University, School of Dentistry, Department of Orthodontics, Jenin, Palestine.
Review Article
Received: 29/05/2014
Revised : 13/06/2014
Accepted: 23/06/2014
*For Correspondence
123 Argus Street, 10441
Athens, Greece.
Keywords: Miniscrews, Mini-
implant, Orthodontics,
Anchorage.
ABSTRACT
The incorporation of miniscrews into orthodontic treatment
planning has allowed for predictable anchorage control and has
increased the ability to correct severe skeletal and dental
discrepancies. Various minicsrews systems are now available for
clinical use and abundant reports and studies are being published,
dealing with different aspects of their applications (biology, surgical
procedures, placement sites, complications, success rate). The aim
of this article is to review the actual considerations regarding their
mechanical properties, surgical considerations, risks and
complications as well as their success rate and failure reasons.
INTRODUCTION
The concept of skeletal anchorage is not new. Basal bone anchorage was suggested more than 60
years ago as an alternative to increasing the number of teeth to achieve conventional anchorage. Because
of the limitations of headgear, clinicians sought other means of anchorage [1]. For example, orthopedists
have used stainless steel bone screws for leg lengthening since before 1905.In 1945, research into the
concept of using a pin or screw attachment to the ramus was initiated not only for moving teeth, but also
for "exerting a pull on the mandible [2].
One study involved placing Vitallium screws(Dentsply) in dogs. Using basal bone for anchorage,
tooth movement was successful; however, it was found that an effective force could be maintained for no
longer than 31 days[1,3]. The loss of all screws was attributed to infection from communication between
the Vitallium screw and the oral cavity. Nonetheless, the authors concluded that "anchorage may be
obtained for orthodontic movement in the future [3].
Since 1969, when Branemark et al5 introduced dental implants for tooth replacement and
prosthetic rehabilitation, osseointegration has remained the singular goal. In the last 25 years, dental
implants have been used successfully in combined management of orthodonticrestorative patients,
particularly in partially edentulous adults (FIG. 01a-i). Osseointegrated dental implants are used for
orthodontic anchorage and then later serve as abutments for tooth replacement. This type of anchorage is
very effective in treating patients with hypodontia, congenially missing teeth, or periodontal disease, who
lack sufficient teeth for conventional anchorage. Additionally, implants have been used for presurgical
tooth movement, space opening/closing, and generally as a means to achieve better functional, biologic,
and esthetic results in multidisciplinary treatment [3.4].
In 1978, Sherman3 placed six vitreous dental implants into the extraction sites of mandibular
third premolars in dogs and loaded them with orthodontic forces. Only two of the six implants were
considered successful. Later on, Roberts and co-workers4 investigated the osseous adaptation of rigid
endosseous implants to continuous loading: titanium implants with an acid-etched surface were screwed
into the femur of rabbits and were found to be useful as a source of firm osseous anchorage for
orthodontics and dentofacial orthopaedics. They concluded that endosseous implants could be used as a
firm osseous anchorage for orthodontics and dentofacial orthopaedics [1,4,5].
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Figure 01 a-i: Osseointegrated dental implants are used for orthodontic anchorage and then later serve as
abutments for tooth replacement
Orthodontic miniscrew implants have been designed to circumvent the limitations posed by
restorative dental implants. These smaller bone screws are significantly less expensive, are easily placed
and removed, and can be placed in almost any intra-oral region, including between the roots of the teeth.
Some basic questions remain, however, concerning the limitations of miniscrews. Specifically, what is the
maximum amount of lateral or shear force that can be applied to these miniscrews before they fail? How
does a force that is applied immediately after the miniscrew is placed affect the maximum holding power
of the implant? To what extent does the total length literature. of screw engaged in bone affect the
maximum shear force the implant can withstand? These are questions ? [3,5,6].
For orthodontic purposes, however, standard implants of 3.25 to 7.0 mm in diameter were less
than ideal. They required multiple-stage surgical procedures and a waiting period of 4 to 6 months for
osseointegration before orthodontic loading could be activated. Lack of adequate bone to place the large-
diameter dental implants restricted their use in some patients. In others, anatomic limitations (soft tissue,
sinus, nerves, unerupted teeth inchildren, etc) were problems. Another disadvantage of osseointegrated
implants involved the need to place them in edentulous areas, retromolar regions, along the palatine
suture, or pterygoid areas.6-8 Finally, dental implant surgical protocols were invasive, expensive,
uncomfortable for patients, and lengthy, and they excluded children under the age of 16 years [6].
In preparation for implant placement, good orthodontic records (panoramic, periapical, and
cephalometric films, casts, etc) are required along with clinical findings and a definitive orthodontic
treatment plan to determine the optimal position for implant placement. Site selection is critical and
requires careful consideration of the hard and soft tissues, accessibility, patient comfort, and
biomechanical needs. The actual implant placement is atraumatic, nonpainful, and requires minimal
anesthesia [6,7].
All types of skeletal anchorage (including miniscrews) are, by definition, implants. It is important,
however, to differentiate miniscrews from typical dental implants [1,3,5].
More than 30 different terms for skeletal temporary anchorage screws are in use in the
international literature. The most common of these are mini-implant, mini-pin, miniscrew, or TAD
(temporary anchorage device) ( FIG. 2). The term “miniscrew” appears to provide the most accurate (and
most palatable) description of these “miniature screws,” especially when discussing their use with
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prospective patients . There are also more than 30 manufacturers of miniscrew systems , with the number
of different screws offered per system ranging from two to 154. It can be an overwhelming and perplexing
process to sort through all of these options and select those devices that are needed for daily practice. The
following is an overview of the most important decision-making criteria for choosing a miniscrew system
[1,3,5,6].
Figures 02: Types of Miniscrews
The stability of a miniscrew in the bone depends primarily on its diameter, and not on its length.
The diameter of available miniscrews varies between 1.2 mm and 2.3 mm. In this case, “diameter” is the
outside diameter of the threads. For safe and secure primary mechanical stabilization, a minimum amount
of bone is required around the shank of the miniscrew . Although there is no definitive answer as to the
amount of bone required, it appears that from between 0.5 mm to 2 mm is necessary for stabilization to
reduce premature loss. The amount of bone between the roots of teeth, therefore, defines the maximum
diameter of screw that can be used in a particular site. In short, the total distance between roots should be
at least 1 mm greater than the diameter of the chosen miniscrew to provide adequate bone support [5,7,8].
The length of the various miniscrews on the market ranges from 5 mm to 14 mm. Typically, the
length of the miniscrew refers only to the shaft or shank (the threaded section) (FIG. 03). As with the
diameter, the selection of the length of a miniscrew is dependent upon the amount of bone available.
Depending on the region, the total thickness of the alveolus is between 4 mm and 16 mm [5,7,8,9].
Figure 03: Orthodontic Miniscrew, Description
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The length of a screw, however, is of secondary importance when it comes to secure anchorage—
the diameter is much more critical. Various investigations have shown that the thickness of the cortical
plate plays the most important role in miniscrew stability.For example, FEM analyses have demonstrated
that the typical orthodontic load is applied only in the region of the cortical bone [7.9,10].
When selecting the length of a miniscrew, the depth of the gingiva must also be considered. The
average depth of the gingiva is about 1.25 mm except in a few locations such as the retromolar region. The
ratio between the length of the head (the part of the miniscrew outside the bone) and the length of the
threaded shaft (the part of the screw inside the bone) should be at least 1:1. Consequently, Poggio et al
recommended miniscrews lengths of 6 mm to 8 mm, and Costa suggested that miniscrews should be from
6 mm to 10 mm. On the basis of these investigations, it would appear that longer screws are unnecessary
except in unusual circumstances. This has also been confirmed by numerous, anecdotal clinical
experiences [8,10,11,12].
Color-coding of miniscrews for different lengths or diameters helps to facilitate the selection
process. This color-coding is accomplished by an anodized surface coating . This oxide layer also appears
to enhance retention of the miniscrew [11.12].
Some suppliers have a special head variation for every potential orthodontic application including:
Hook Tops;
Ball-Shaped Heads;
Eyelets;
Simple Slots;
Cross-Shaped Slots; and
Universal Heads.
The screw head must be very small and compact (low profile) to ensure that the patient experiences
minimal discomfort and tissue irritation . On the other hand, the head must also be large enough so that
the coupling elements (such as coil springs, wire segments, auxiliaries, and elastic chains) can be easily
and securely fastened [13,14].
CLINICAL APPLICATIONS
Clinicians must observe basic surgical techniques to prevent infection. Instruments and materials
such as handpieces, hand screwdrivers, bone twist drills, and titanium mini-implants should be sterilized
before surgery.
After disinfection of the placement site, infiltration anesthesia should be injected into a movable
membrane.[15].
The surgical incision depends on the particular situation, as mucosal tissue can be caught in the
bone twist drill. A pilot hole should be drilled before placement of a selftapping type screw. A self-drilling
screw can be inserted into the bone by using a hand screwdriver, without a pilot hole (FIG. 04).
Figure 04: Screw selection
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Miniscrews might be used in different steps of orthodontic treatment and in different dental and
occlusal situations. Although their use cannot be theoretically limited, typical applications include the
following:
Anchorage control in space closure
Whether closing space is present from extracted or missing teeth or created as a result of molar
distalization, the use of miniscrew anchorage provides a good control (FIG. 05a-c).
Figure 05a-c: Anchorage control in space closure
Intrusion of over-erupted teeth
In the past, intrusion of such teeth was virtually impossible. The use of miniscrew anchorage
allows troublefree intrusion of these problematic teeth (FIG. 06a-d).
Figure 06a-d: Intrusion of over-erpted teeth
Traction of impacted teeth
In many instances, the precarious position of an impacted teeth, especially canines, can limit the
ability to safelyand effectively bring them on dental arch. Miniscrew anchorage allows force vectors that
are otherwise hardly attainable (FIG. 07).
Uprighting of mesially tipped molars (FIG. 08a, b).
Correction of canted occlusal planes:
These cases have conventionally been accepted, ignored, or referred for correction with
orthognathic surgery. Miniscrew anchorage can now be effectively used to correct asymmetries and
canting of occlusal plane (FIG. 09).
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Table 1: Traction force and tooth movement. : Center of resistance (CR) of the
dental arch. Red arrow: orthodontic traction force; Black arrows: direction
of tooth movement. Parallel translation in the posterior direction is seen
when the force vector is directed through the CR and remains parallel to the
occlusal plane.
Mini-implants are frequently placed in upper buccal alveolar bone between the second bicuspid
and first molar in bicuspid extraction cases. Sung et al. simulated en-masse movement of the anterior
segment using finite element analysis [16,17]. They hypothesized the center of resistance (CR) of the anterior
segment and measured distortion of the archwire and tipping movement of the anterior teeth. However,
this simulation calculated initial behavior immediately after force application [18]. Clinically, anterior and
posterior teeth move and wire distortion would be cancelled over time when continuous, stiff archwire is
used; the entire dental arch can be hypothesized as a massive structure. The present author then
hypothesized the CR of the entire dental arch and attempted to simulate long-term behavior [19,20,21]. In
bicuspid extraction, movement of the entire upper dental arch can be vertically controlled by alteration of
the orthodontic force vector. If we posit a condition in which the anterior and posterior segments are rigidly
fixed by inserting a stiff archwire into the bracket slots, the CR of the entire dental arch can be
approximated around the root of the bicuspid, asshown in Tabe1 to 3. When we intend to produce bodily
movement of the anterior segment in patients with a mesiofacial pattern, the force vector should be
parallel to the occlusal plane, as shown in Table 1. In patients with adoicofacial pattern and excessive
overbite, who require counterclockwise rotation of the mandible by depressing the entire maxillary dental
arch, the force vector should be directed as shown in Table 2, so that it passes through the CR of the upper
dental arch and the force is directed in a posterosuperior direction [22,23,24]. In a patient with a dolicofacial
pattern and anterior open bite who is expected to depress the posterior teeth, it is effective to direct the
force vector to pass inferior to the CR, as shown in Table 3 [23,25].
Table 2: Parallel translation in the posterosuperior direction is seen when the force
vector passes through the CR and is directed in a posterosuperior direction.
Anchorage in Orthodontics
The attainment and control of anchorage is fundamental to the successful practice of orthodontics
and dentofacial orthopedics. According to Newton’s well-known law of physics, action and reaction forces
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are equal and opposite. In orthodontics, anchorage is used to describe resistance to reaction forces.Teeth
are the usual source of anchorage and, in the typical orthodontic biomechanical situation, are pitted
against one another to produce tooth movement. The teeth serving as the anchorage unit, by virtue of their
number, position, size and number of roots, intend to offer resistance to movement so as to bring about
the movement of the other teeth. A threshold value of force to initiate tooth movement has not
Table 3: Depression of molars and distal movement of the anterior teeth is expected when the force vector is directed
inferior to the CR.
been identified, but appears to be very low. For example, tooth movement has been detected with as little
as 4 gm of force. Considering this principle, is has been concluded that the practice of pitting more teeth
with a larger root surface area against fewer teeth with less surface area in intra-arch mechanics may not
be sufficient to prevent movement of anchor teeth. Therefore, in order to achieve increasedanchorage
control, a supplemental form of anchorage is often required. Traditionally, headgear and intermaxillary
elastics have been used as forms of supplemental anchorage. While this form of supplemental mechanics
may be effective in increasing anchorage, effectiveness depends upon the cooperation of the patient.
Consequently, orthodontic anchorage control has historically been contingent on patient compliance. Due
to the inconsistent nature of such compliance,orthodontists often note the unfavorable reciprocal
movement of the intra-arch and inter-arch “anchor” teeth [3,8,12,17,18,22,23,24].
Orthodontists have recognized that stability of reactive anchorage units could be significantly
increased if orthodontic anchorage could be provided by the skeletal bone itself,and in the 1940s began to
conduct research on the subject. An early study by Bernier and Canby suggested that surgical vitallium
bone screws were inert and stable in bone.However, when Gainsforth and Higley attempted to use these
screws as a source of orthodontic anchorage they were largely unsuccessfully [23,24,25].
Surgical Principles
Surgical procedures for implantation of orthodontic miniimplants should be based on the following
principles:
Aseptic principle
Atraumatic procedures
Thorough preoperative examination and precise implant positioning
Premedication for pain control
Standardized procedures
Implants and instruments should be used under aseptic conditions. The driver tip is a female type,
so blood and saliva can gather easily in the driver tip. The driver tip should be cleaned with a smooth brush
and a neutral detergent as soon as possible following the conclusion of the procedure. Recycling of
implants is prohibited by law and is also unfavorable from the viewpoint of stability, because the surfaces
of implants are treated to increase biocompatibility; when in contact with body fluid, the surface changes
continuously from the initial state. If there is even a small amount of surface contamination, the implant
can be used after cleaning with an ultrasonic cleaner and autoclaving. However, repeated autoclaving has
adverse effects on the biocompatibility of the surface [11,14,19,26].
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To minimize surgical trauma, the surgical procedure should be performed with well-sharpened
drills used at an appropriate speed under flowing saline coolant.2-5 Appropriate cooling is needed to
minimize damage from the heat generated during the insertion procedure. If insertional torque seems to
increase abruptly, further attempts at insertion are undesirable because increased torque may be a sign
that adjacent bone tissue is overstressed.
Thus, reverse rotation should be used to relieve stress on the adjacent bone. However, reverse
rotation should never be used during insertion of the last 2.0 mm of an implant, because, otherwise,
sufficient primary stability cannot be obtained [12,17,19,24,27].
The clinician should minimize unnecessary injuries to the anatomic structures by attaining a full
awareness of the anatomy of the insertion area. More specifically, if the movement of teeth adjacent to an
implant is planned, precise positioning of implants should be performed to ensure enough available space
[18,19,20].
Pain control is very important to secure the patient's compliance. If the implant loosens,
reinsertion is necessary, but the patient's experience with the first surgical placement of implants can
greatly influence compliance with the second placement. For efficient pain control, premedication with
analgesics 1 hour prior to or at surgery is recommended. In general, the prescription of systemic
antibiotics, either preventatively before surgery or after surgery, is not necessary [19.20,21].
Although the new type of implant has a structur designed to minimize the influence of the
operator's deterity, the abilities and experience of the operator may stiinfluence the success rate [25,27]
.
Placement technique
Prior to placing the implant an intra-oral peri-apical or a panoramic radiograph of the region is
essential to evaluate the inter-radicular space available; ideally, a minimum of 2 mm is required .
Radiographic stents or guides such as twisted brass wire can be used as an aid to positioning . However,
they only give a two-dimensional image, which indicates the correct implant insertion point, but offer no
guidance to the drilling angle. This is best determined by direct vision as drilling proceeds [3,7,18,28,29].
A minimal amount of dental anaesthetic (about0.3 ml) is given into the mucosa adjacent to the
proposed implant placement site. The underlying bone has no innervation and profound anaesthesia of
theadjacent teeth and periodontal ligaments (PDL) is contra-indicated. Any approximation of the drill or
implant to the PDL will elicit pain, which will, in turn, alert the dentist to redirect the implant. This important
feedback from the patient would not be possible with profound anaesthesia [29,30].
Wherever possible, the implant head should protrude through the attached gingiva and not the
unattached alveolar mucosa. Insertion through alveolar mucosa tends to create more bleeding, is more
traumatic and requires an initial incision to be made through the mucosa with a scalpel to prevent
entanglement of the bur (FIG. 10a). For this reason and in order to take advantage of the increased apical
inter-radicular space, the implant is placed at an angle of about 45u to the buccal/labial bone [13,17,29,30,31].
The implants come in various lengths (5–12 mm) and diameters (1.2–2 mm). It is the authors’
experience that 1.5 mm is the optimal diameter to use. Thinner implants risk breakage and thicker
implants make root contact more probable. In the mandible, where the bone is generally denser, a 6–8
mm length is optimal, while in the maxilla an 8–10 mm length is preferred.
To prevent the pilot twist drill slipping on the surface of the cortical bone, first pierce the cortical
bone at right angles with a #2 round bur and then change the inclination of the drill to 45u to allow oblique
drilling with the pilot drill. The pilot hole is drilled with a 1.2 mm twist drill, generally supplied with the
implant kit, at y600 rpm to just short of the implant length. Self-drilling implants are available, although in
our opinion the risk of going off course during placement is higher. While some clinicians prefer the self-
drilling screw, we believe that the force required to place a self-drilling screw in bone reduces the tactile
feel for the operator and may increase the risk of root contact. A gently drilled pilot hole, in our experience,
offers better tactile feedback and placement precision. However, as yet there is no scientific evidence to
support either technique [31,32].
The sterile implant is removed from its package with the handpiece driver attached to the
handpiece. It is carried to the mouth without being touched by hand, placed into the pilot hole and driven,
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with the handpiece at y??? r pm, three-quarters ofthe way and, if access permits, it driven to its full depth
with a hand driver. Using a hand driver to do the final tightening of the implant offers better tactile
feedback as to the tightness and stability of the implant (FIG. 10a-e). The implant needs only to be
tightened to a torque value of 7–10 Ncm, which is achieved with mild finger tightening; achieving primary
stability is essential. A post-operative radiograph should be taken to assure correct positioning of the
implants [3.5,9,15,17,29,30].
COMPLICATIONS
Accurate miniscrews placement should be performed with a thorough understanding of soft and
hard tissue anatomy, surgical response, and healing to reduce per and post-operative complications. Only
fewere reported in the literature:
- Infection of the insertion site if it is not kept absolutely clean; the infection is also associated with
repeated drilling during placement.
- Inflammation around the implant. Screws placed in the attached gingiva without incisions are less
likely to develop infection and inflammation. A mild swelling occurs with screws placed without a
flap.
- Heat generation during drilling.
- Screw breakage because of an increased bone density or a decreased miniscrew diameter.
- Injury of anatomic structures such as nerves, blood vessels, roots and maxillary sinus. Some
regions in both jaws do not allow a safe insertion for miniscrews like around sinus region or in the
maxillary tuberosity basal bone in the mandible close to the dental nerve. In some situations,
required width of inter-radicular bone is not enough and presence of permanent dental germs
close to placement site will create surgical challenge to avoid teeth damage.Finally, the majority of
authors agree that screws in the midpalatal area are not suitable for growing patients and have a
low rate of success in adults. This is where a dental implant works better than screws.
- Pain and discomfort are among the unwanted outcomes of orthodontic MI use . When compared
tooth extraction and fixed appliance insertion procedures, studies show less pain experience with
MI than with any of them, and that patients tend to overestimate the pain anticipated in MI
placement [31,32,33,34].
CONCLUSIONS
The incorporation of dental implants into dental treatment plans has had a tremendous impact on
virtually the entire field of dentistry. With the increased interest in the area of implantology has come a
great deal of credible research exploring the use of dental implants. Indeed, evidence-based dentistry is
the basis for sound clinical decision making and treatment planning modalities. Whereas the conventional
use of dental implants has been studied for some time now, the use of implants and implantable devices
as described in this article is relatively new by comparison. Therefore, the literature is limited in clinical
trials and other more rigorous evaluation methods. At this time, the body of research associated with this
subject is composed largely of case reports and a few small time limited trials in animals. There is no doubt
that this area will continue to be explored and researched and will probably become an indispensable part
of contemporary orthodontic therapy in the future. Purely as a matter of opinion, it seems that the extent to
which the use of implants or implantable devices is accepted by the field of orthodontics on a broad basis
will depend on a few specific factors. It seems that the devices themselves will continue to evolve but will
probably move in a direction that supports the best combination of ease of placement (able to be placed by
orthodontist), least invasive procedure, and best physical design properties to deliver optimum mechanical
forces. Perhaps the use of dental implants will prove to be as useful to the field of orthodontics as it has
been for other areas of dentistry.
ACKNOWLEDGEMENTS
The author is very grateful to the clinicians who spent great deal of time filling in survey forms for
this study.
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