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
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
FUNCTIONAL ANALYSIS AND CEPHALOMETRIC ANALYSIS CRITERIA FOR FUNCTIONAL JAW O...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
This slide gives you ideas about functional matrix theory revisited by Melvin moss in a series of four articles which he tells the limitations of his first study and how he corrected it . this slide includes Functional matrix theory
Constrains of FMH,Functional matrix theory revisited
Articles,Reference
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Mode of action of functional appliances /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
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
FUNCTIONAL ANALYSIS AND CEPHALOMETRIC ANALYSIS CRITERIA FOR FUNCTIONAL JAW O...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
This slide gives you ideas about functional matrix theory revisited by Melvin moss in a series of four articles which he tells the limitations of his first study and how he corrected it . this slide includes Functional matrix theory
Constrains of FMH,Functional matrix theory revisited
Articles,Reference
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Mode of action of functional appliances /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
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
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
Muscle physiology /certified fixed orthodontic courses by Indian dental academy 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
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Growth relativity hypothesis1 /certified fixed orthodontic courses by India...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Fixed functional appliances /certified fixed orthodontic courses by Indian de...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
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
Growth rotations 2 /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Roth philosophy /certified fixed orthodontic courses by Indian dental academy 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
Activator /certified fixed orthodontic courses by Indian dental academyIndian 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
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
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
Muscle physiology /certified fixed orthodontic courses by Indian dental academy 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
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Growth relativity hypothesis1 /certified fixed orthodontic courses by India...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Fixed functional appliances /certified fixed orthodontic courses by Indian de...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
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
Growth rotations 2 /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Roth philosophy /certified fixed orthodontic courses by Indian dental academy 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
Activator /certified fixed orthodontic courses by Indian dental academyIndian 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
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
TMJ problems, Traumas, and many other conditions can result in severe muscular activity and contraction. These muscles appear tight, and rigid on palpation. This lecture identify the basics of prescribing muscle relaxants in dental practice
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
This lecture explain to undergraduate dentists the basics and most commonly used endodontic instruments in daily practice. It is not meant to be a complete observation, rather a simplified approach to define these basic instruments.
This lecture explain the basic of root canal preparation in endodontic treatment. It is not meant to be a comprehensive lecture, rather an preliminary one
Rapid maxilllary expansion in orthodontics / oral surgery coursesIndian 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
Modus operandi of functional appliances/cosmetic dentistry coursesIndian 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
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The 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
Neural mechnism and physiologic basis /certified fixed orthodontic courses by...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
Tissue reaction to dentofacial orthopedic appliances /certified fixed orthodo...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
Growth of maxilla /certified fixed orthodontic courses by Indian dental acad...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Muscle function in orthodontics /certified fixed orthodontic courses by Indi...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Theories of craniofacial growth in the postgenomic era123 /certified fixed or...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
Theories /certified fixed orthodontic courses by Indian dental academy 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
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
Activator therapy /certified fixed orthodontic courses by Indian dental acad...Indian dental academy
Welcome to 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 has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Similar to Modus operandi of functional appliances mallik /prosthodontic courses (20)
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
You can complete the whole process in 3-4 months.Salary range for DH/DT is around 2500-3500 Pounds per month.
Eligibility / requirements-
1. An International English Language Testing System (IELTS) certificate
at the appropriate level.(Within 2 yrs of application date )
2: A recent primary dental qualification that has been taught and examined in English..(Within 2 yrs of application date )
3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
If you are interested Please contact us for more details.
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
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.
I –Aligners are made with FDA approved transparent thermoplastic materials using 3D scanning, 3D Printing and finally Trays with Pressure vacuum formers.
Dear Doctor,
Indian Dental Academy Now offers comprehensive online Orthodontics course.
Course includes:
1.whiteboard lecture presentations
2.Case Discussions
3.with hundreds of pictures.
4.Demo on Models
5.Demo on Patients
6. subtitles in your own language
12 months unlimited access and support @350 USD only.
For Demo please visit :www.idalectures.com/preview/
For more details visit: www.idalectures.com
Please contact us for any clarifications:
idalectures@gmail.com
indiandentalacademy@gmail.com
Thanks & Regards
Indian Dental Academy
--
Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...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
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian 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
Properties of Denture base materials /rotary endodontic coursesIndian 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
Use of modified tooth forms in complete denture occlusion / dental implant...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
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
2. • Introduction.
• History.
• Premise on which modus operandi of functional appliance
was built.
• Modus operandi of functional appliance – schools of
thought.
• Research findings.
- Cellular and bio molecular findings.
- Jaw muscle activity and and muscle fiber recruitment.
- Skeletal and dental changes.
• Conclusion.
Contents
www.indiandentalacademy.com
3. “Working with growth” has had been a term
which has been in for quite sometime now.
Its presence has not only given orthodontics
a huge credit but also promised a greater
working range for orthodontist. This
seminar would present claims and counter
claims on the working principles of
functional appliance and at present what to
expect out of it.
Introduction
www.indiandentalacademy.com
5. • European orthodontists have long been
aware of the role of peri-oral musculature in
orthodontic problems. They also recognized
the potential use of deforming forces to
eliminate these problems. These ideas have
been borrowed latter by the Americans.
www.indiandentalacademy.com
6. 1912
• The spark arose by Lischer’s theory, which
states that if compensatory, adaptive lip and
tongue function could exacerbate excessive
overjet in class-II type of malocclusion and
if abnormal swallowing and prolonged
finger sucking habits could create anterior
open bite and narrow arches, could not the
same muscles be used to correct these and
other problems.
www.indiandentalacademy.com
7. 1936 :
Andresen: working hypothesis
• Though Andresen working hypothesis was
not intended for “guiding growth" at that
time ,but only to eliminate the adverse
effects of abnormal function.
• Andresen was surprised to see that night
time wearing of the appliance not only had
eliminated the abnormal neuro-muscular
compensation but also produced a complete
saggital correction and significantly
improved the facial profile.
www.indiandentalacademy.com
8. 1967
• Findings concerning the biological peculiarities of
mammalian condyle cartilage, role of respiration on
craniofacial morphology and popular theories on
functional matrix hypothesis and epigenitics at that
time have helped fuel this understanding
• Petrovic and coworkers produced the first rigorous
demonstrations that the condylar cartilage’s growth
rate and amount can be modified using appropriate
functional and orthopedic appliances.
• Since then, many other clinicians and researchers
have inquired about possibility of modifying the
condylar cartilage’s growth ratewww.indiandentalacademy.com
9. Premise on which modus
operandi of functional appliances
was built
www.indiandentalacademy.com
10. Peculiarity of condylar cartilage:
• Unlike the primary cartilage found at other growth
sites, i.e. Epiphysis of long bones, Speno-occipital
syncondrosis, which are embryonic in origin, the
condylar cartilage originates separately during the
development and further more Stutzmann 1967
emphasized that in primary cartilage the dividing
cells, differentiated condroblasts, are surrounded by
cartilaginous matrix that isolates them from local
factors able to restrain or stimulate cartilage growth
whereas the secondary cartilage ;the dividing cells,
precondroblasts, are not surrounded by a
cartilaginous matrix and thus are not isolated from
local factor influence.
www.indiandentalacademy.com
12. Popularity of epigenetic theory
• The genome as providing a set of formal, prior,
intrinsic, and necessary causal factors which, when
combined with efficient, proximate, extrinsic, and
necessary casual factors, together are sufficient to
account for the regulation of development.
• The genetic theory views that the diploid genome, at
the moment of fertilization, contains all the
information necessary, “a blue print,” to regulate
skeletal size, Shape, and location – a blue print,
moreover, that merely requires a permissive
environment in which to express itself.www.indiandentalacademy.com
13. Various hypothesis on the modus
operandi of functional appliances
www.indiandentalacademy.com
14. • Five hypotheses based on neuromuscular
mechanisms have evolved to account for the
skeletal changes associated with functional
appliance therapy.
• In three of these concepts an increase in postural
and functional muscle activity is fundamental to
the proposed mode of action of the appliances and
thereby their design and the degree of vertical
opening used in the bite registration. This
increased activity is thought to result from either
an enhanced stretch (myotonic) reflex of the
masticatory muscle,
www.indiandentalacademy.com
15. or from "conditioning" of the patient that produces
an enhanced higher-brain-center drive of the
motor neurons supplying the muscles, even during
sleep (Myodynamic).
• Fourth view proposes that increased lip strength is
the prime force in alveolar bone remodeling
during functional appliance therapy.
• Fifth emphasizes the importance of viscoelastic
elements in the stretched masticatory muscles and
other orofacial tissue; these elements produce an
increase in "passive" muscle tension, which
provides the major force elicited by the appliance.
www.indiandentalacademy.com
16. Modus operandi of functional
appliances
• Melvin Moss school of thought (1962)
• Petrovic school of thought. (1972)
• Voudoris school of thought.(2000)
www.indiandentalacademy.com
17. Functional matrix hypothesis
• Claims that the origin, growth (i.e., changes in
size, shape, and location), and maintenance in
being of all skeletal tissues and organs (i.e.,
skeletal units) are always secondary,
compensatory, mechanically obligatory
responses to temporally and operationally
prior events or processes occurring in
specifically related non skeletal tissues,
organs, or functioning spaces (i.e., in
functional matrices, either capsular or
periosteal).
www.indiandentalacademy.com
18. Functional cranial component
Skeletal unit Functional matrices
Micro-
skeletal
unit
Macro
Skeletal
unit
Periosteal
matrices
Capsular
matrices
www.indiandentalacademy.com
19. • Moss stresses the dominance of non osseous
structures of the Cranio-facial complex over the
bony parts. He claims that the growth of the
skeletal components ,whether endocondrial or
intra membranous in origin is largely dependent
on the growth of functional matrices
www.indiandentalacademy.com
20. Petrovic school of thought
• Role of lateral pterigoid muscle (LMP) to
regulate in the control of the condylar cartilage
growth as shown by Petrovic, Stutzmann in
1972,1974,1975 was further confirmed by
McNamara in 1980’s
• Stutzmann et al in 1976 discovered that the
reterodiscal pad apparently has a mediator role
in the efforts of the LPM to control condylar
growth www.indiandentalacademy.com
21. Functional appliances
Increased contractile activity of lateral pterygoid
Intensification in reterodiscal pad iterative activity
Supplementation in growth stimulating factors
Enhancement of local mediators
Reduction of local regulators
Additional growth of the condylar cartilage
Additional subperiosteal ossification
Supplementary lengthening of the mandible
www.indiandentalacademy.com
22. Cybernetic model
• It is based on communication and information
theory.
• Petrovic 1977 was the first to promulgate a
cybernetic model to account for physiological
phenomenon involved in facial growth and the
method of operation of orthodontic and functional
appliance.
• Claims that the upper arch is the constantly changing
reference input and the lower arch is the controlled variable.
Servosystem
theory
www.indiandentalacademy.com
23. • STH or Testosterone blood level increases, the
supplementary lengthening of the mandible is greater than
that of the maxilla.
STH or Testosterone
Optimum occlusion Suboptimum occlusion.
No positional change Growth
or growth represented
Servo
system
Servo
system
www.indiandentalacademy.com
27. • Functional appliances that position the mandible
forward increase the condylar growth rate and
amount
• Wearing the postural hyperpropulsor everything
occurs as if the upper dental arch were in a more
anterior position than normal.
• The “operation of confrontation” of the two dental
arches then gives a deviation signal.
• During the growth period the saggital deviation
produced by the postural hyperpropulsor decreases
through the supplementary forward growth of the
mandible.
Postural hyperpropulsor
(Herbst, Frankle)
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28. • Periodic increase in thickness of the postural hyperpropulsor
produce increase in LPM activity and in the activity of the
retrodiscal pad as recorded electromyographically; these,
consequently, bring about increase in the rate and amount of
condylar cartilage growth.
• If the appliance is removed after the growth is completed, little or
no relapse is observed. If the appliance is removed before the
growth is completed, no significant relapse is detected if good
inter- cuspation is maintained however if good intercuspation is not
achieved, the comparator of the servosystem imposes an increase or
decrease condylar growth rate until a state of intercuspal stability is
established.
• Functional maxipropulsion involving periodic forward
repositioning appears to be the best procedure for eliciting a
supplementary lengthening of mandible.
www.indiandentalacademy.com
29. Frankel
• Fränkel's functional regulator is worn primarily in
the lingual and dental regions, and uses the vestibule
as the operational base in contrast to other
functional appliances. It is claimed that the system
of labial, lingual, and buccal pads and shields
directly affects the level of postural activity in the
facial and masticatory muscles by means of a
training effect. The buccal and labial shields placed
highly in the vestibule would also indirectly put
traction onto the periosteum. This traction would
stimulate bone growth in the apical subperiosteal
areas and provide a guidance of eruption for the
teeth. www.indiandentalacademy.com
30. • The basic components are
- Equilibrium theory.
- Bone deposition secondary to periosteal pull.
- Training of muscles (hypotonic or
hypertonic)
www.indiandentalacademy.com
31. Class II elastics
• Intermaxillary intra-oral elastics, placed bilaterally
for 14 hours daily, in rats between upper first molar
and lower third molar, are not only orthodontic
devices but also functional appliances capable of
stimulating the growth rate and amount of the
condylar cartilage
• Class II elastics don’t increase the contractile activity
of LPM as the hyperpropulsor .The stimulating effect
of class II elastics is primarily mediated through the
retrodiscal pad (metabolic pump)
www.indiandentalacademy.com
32. Herren (L.S.U.) Ativator
• The Herren activator, or the Louisiana state university
modification of it,is different form of postural
hyperpropulsor; it opens the construction bite well
beyond the postural rest position, similar to that
achieved by the Harvold – Woodside activator.
• Such construction bite do not bring about any increase
activity of the LPM. instead it has a two step effect.
when the appliance is worn ,it creates a new sensory
engram which stimulates reterodiscal pad. But the most
important action of this appliances is seen when the
appliance is not worn. This happen due to decreased
length of LPM which stimulates the condyle when the
appliance is not wornwww.indiandentalacademy.com
33. • Amidst the claims on the working
hypothesis of functional appliances as put
forward by Petrovec et al, John Voudouris
in 2000 proposed the concept of growth
relativity.
• He attributes the failure of earlier research
on the working hypothesis of functional
appliances due to earlier EMG methods,
which were transcutaneous, short term and
removable as described in 2003.
www.indiandentalacademy.com
34. Voudouris school of thought
• The theory of relatively essentially states that
bone growth modification occurs relative to 2
elements:
1. The reterodiscal tissues
are stretched reciprocally,
similar to a large elastic
band, between the fossa
and the displaced condyle
during the expansion of the
growing facial complexwww.indiandentalacademy.com
36. 2.This is followed by the
stretch of nonmuscular
viscoelastic tissues.
3.The transduction of these
nonmuscular forces has
been shown to be
effective at a significant
distance from the actual
physical soft tissue
www.indiandentalacademy.com
38. • The growth relativity concept describes a specific
set of reciprocal soft tissue forces that operate
during herbst treatment, when muscle
hyperactivity does not appear to to be the primary
cause of skeletal change. The displaced condyle
modifies in a radiating manner relative to the
fossa, and the fossa grows in a radiating fashion
relative to the condyle. The reterodiskal streached
between the displaced condyle and the fossa
contributes to the the formation of new bone in
each region. Further more, force referral or
transduction from the posterior retero discal
attachment to the condyle radiating along condylar
fibrocartilage has been implicated in causing
growth modification.
www.indiandentalacademy.com
39. Fixed vs. Removable functional
appliance
• There are innumerable number of advantages of fixed functional or
full time wear appliance over removable appliances .
• Previous EMG studies on removable functional appliances by
petrovic et al has been discredited because of the decrease in EMG
activity after appliance wear.
• Where as fixed functional appliances The mode of action of
functional appliance therapy has been linked to neuromuscular and
skeletal adaptations to altered function in the orofacial region. The
EMG studies as shown by Pancherz ,kharbanda showed that though
there was decrease in the EMG activity during the initial phase of the
treatment because the muscles were in the stage of adaptation and
from 3 months to 6 months there has been a continuous increase in
EMG activity due the continuous forward posturing unlike removable
functional appliances which do not allow the muscles to stabilize and
adapt. www.indiandentalacademy.com
40. • 1987 Linden et al.
• During the first phase of functional treatment,
reflexes in jaw muscles are transiently brought
into a state of imbalance. This phase of
imbalance could act as a trigger for the mandible
to attain a new functional position, which
subsequently leads to morphologic changes.
www.indiandentalacademy.com
41. • Full-time wearing of the appliance is of
importance in this respect since a continuous
anterior functioning might elicit the muscle
response more rapidly than a discontinuous one.
In view of these considerations, functional
appliances that are worn full-time (Herbst
appliance) or nearly full-time (eg, Fränkel's
functional regulator, Bionator) could be
expected to have a greater net result than those
worn only part-time (eg, activator)
www.indiandentalacademy.com
43. • The mechanism of action of functional
appliance in growth modification has been
basically targeted toward the changes at the
condyle and the gleniod fossa but there are
other effects . It wouldn't be justified and
the M.O.A would be in complete without
bringing them to light
www.indiandentalacademy.com
44. • Effect on palatal plane
• Restraining effect on the maxilla Vargervik and
Harvold found that the activator inhibited the
horizontal growth of the maxilla by 2 mm;
Pancherz found it was restricted by 1.7 mm.
• Relative intrusion of the dentoalveolar segment
Do you know how much teeth erupt from age of 8
years to 15 years of age?
www.indiandentalacademy.com
45. • Maxillary teeth at the molars erupt by 6.3
mm and incisors erupt 6mm Mandibular
incisors erupt by 5 mm and molar erupts by
5.7 mm in boys and 3.7 mm and 4.4 mm in
girls.
• If u can relatively intrude or hold on the
teeth vertically and prevent eruption by 5
mm the mandible will auto rotate by 12
degrees and net A-P gain would be helpful
in converting a borderline vertical
malocclusion case with in the domain of
orthodontics
www.indiandentalacademy.com
46. Petrovic vs. Voudoris
• Petr : EMG studies showed hyperactivity of
LPM
• Voud : EMG studies were short term and
transcutaneous
• Voud : Most of the EMGs on a long term
showed in contrary reduced activity of LPM
• .
www.indiandentalacademy.com
47. • Petr : It was believed that upper lateral pterygoid
muscle was attached to the articular disk and the
condyle
• Voud : It has been shown that only few fibers
from the upper lateral pterygoid are attached to the
fibrocarilage of the condyle through lateral
pterygoid tendon
• Petr : Condylar cartilage cell failed to proliferate
in homoautotransplant due to absence of LPM
activation
• Voud : It was thought that resection of LPM
compromised the blood supply and there fore cell
proliferation
www.indiandentalacademy.com
50. • Electromyography of the condylar cartilage
show that cell to cell cytoplasmic junctions
between skeletoblasts become quantitatively
reduced. Consequently, possibilities of
inhibitory inter cellular communications are
cut down; i.e., the cell division rate increases.
Simultaneously, the rate of differentiation of
the skeletoblasts into precondroblasts also
increases Petrovic (1982).
www.indiandentalacademy.com
51. • Characteristic and consistent transmembrane ion flux
variations can be detected : intra cellular Na++
concentration is raised, intracellular K+
concentration is very slightly lowered, and discharge
of H+ from both skeletoblast and precondroblast is
increased, leading to a rise of intracytoplasmic PH.
Intracytoplasmic Ca++ concentration decreases.
• Calmodulin as well as [Ca++ ,Mg++ ] – ATPase and
[H] – ATPase activities are promoted,where as
cAMP, fibronectin, [Na/K] – ATPase activity,cell
trans glutaminase are reduced. The cell division
process is initiated through the momentry surge of
cytoplasmic Ca++ and endogenous cAMP
www.indiandentalacademy.com
52. • The local coupling mechanism include:
a) An open loop part of the control system having a
stimulating effect on the cell multiplication and comprised
of growth hormone ,testosterone, estrogen, insulin,,
glucagon, parathormone, calcitonin, prostaglandin F2, as
well as other mitogenic peptides that corresponds to,
operationally, to fibroblast growth factor which convert
the cell from quiescent to a new cycle stage
b) A feed back part of the control system having an
inhibiting effect on the cell multiplication and comprising
regulators of local origin: a skeletoblast or precondroblast-
multiplication restraining signal of un known nature.
• The intensification in meniscotemporocondylar ligament
activity is associated with an increase in blood and lymph
flow and decrease in cell catabolite concentration and in
negative feed back factors.www.indiandentalacademy.com
53. Proliferative cells
SOX 9
Differentiation Condroblasts
Cartilage matrix/
condrocytes
SOX 9Regulates type
II collagen synthesis
Hypertrophic cartilage
Precedes on set of EO
Secretes
Type x
collagen
express
VEGF
New blood
vesselsRecruits
Osteoprogenator
Mesenchymal cells
Osteoblasts
osteocytes
Endocondrial
ossification
Condylar growth
Differentiation
osteogenisis
www.indiandentalacademy.com
54. Effect of hyperpropulsor on the precondroblastic cells count
• The following data are from the study of periodic forward
repositioning of the mandible (12 male rats in each
experimental group, sacrificed at day 48 )
• Number of H- methyl-thymidine- labelled cells in condylar
cartilage for various thickness of postural hyperpropulsor.
• Group 1 (control) at 0 mm thickness - 876 cells – 13.5 mm
• Group 2 at 0.5 mm thickness - 1049 cells – 14.9 mm
• Group 3 at 1.0 mm thickness - 1316 cells - 15.2 mm
• Group 4 at 2.0 mm thickness - 1499 cells - 15.4 mm
• Group 5 at 3.0 mm thickness - 818 cells - 13.5 mm
www.indiandentalacademy.com
55. Effect of various functional appliances on the growth
of the rat mandible
• H- methyl-thymidine- labeled cells in condylar cartilage for
various appliances
• Bionator and frankel
• No appliance – 859 cells – 14.2 mm
• Bionator (end to end) – 988 cells – 14.6 mm
• Bionator (1mm) - 1199 cells – 15.2 mm
• Frankel (lip pad) - 1236 cells – 15.2 mm
• Postural hyperpropulsor and intra oral elastics
• No appliance - 878 cells – 13.9 mm
• P H (0.5 mm) - 1049 cells – 14.8 mm
• PH (1mm) - 1316 cells – 15.25 mm
• Elastics - 1336 cells – 15.26 mmwww.indiandentalacademy.com
56. Study to identify and quantify the temporal Sequence of,
replicating mesenchymal cells during natural growth and
mandibular advancement in the condyle and the
glenoidfossa . Rabie et.al., (Ajo 2003.)
www.indiandentalacademy.com
57. • The number of mesenchymal cells in anyone is
genetically controlled. Heritable influences were
found to contribute up to 90%. Nongenetic
factors were still appreciable and account for
approximately 3.6%.
• A most interesting finding in the present study is
that resident mesenchymal cells in the condyle
contributed to bone formation in response to
forward mandibular positioning, whereas
resident mesenchymal cells in the glenoid fossa
contributed less to growth modification.
www.indiandentalacademy.com
58. •Human mesenchymal cells can be harvested, purified, and
grown in vitro to increase their numbers and, when
reimplanted, they can still differentiate into bone-making cells
and lead to a significant increase in bone formation — a
principle that should be seriously considered for managing
patients with hemifacial microsomia and other craniofacial
anomalies requiring growth modification.
•The number of replicating mesenchymal cells, which is
genetically controlled, influences the growth potential of the
condyle and the glenoid fossa. Mandibular protrusion leads to
an increase in the number of replicating cells in the
temporomandibular joint. Individual variations in the
response to growth modification therapy could be a result of
the close correlation between mesenchymal cell numbers and
growth. www.indiandentalacademy.com
59. • BMP-2 is characterized by an ability to induce
ectopic cartilage and bone in soft tissues.
• A recent report showed that the lack of
expression of Sox 9 leads to campomelic
displasia in humans, a disease affecting all
cartilage-derived skeletal structures, resulting in
bowing and angulation of long bones, vertebral
abnormalities, small thoracic cages, craniofacial
defects with macrocephaly, micrognathism, and
cleft palate. Rabie, Urban Hagg (Am J Orthod
Dentofacial Orthop 2003;123:40-8)
www.indiandentalacademy.com
60. Photomicrograph showing positive immunostaining of VEGF
expression (®) in the posterior (P) and middle (M) regions of
the mandibular condyle with forward mandibular positioning
on Day 14. During normal growth on Day 14.
Photomicrograph showing positive PAS
staining of new bone formation (B) in
the posterior region of the mandibular
condyle during forward mandibular
positioning on Day 30..www.indiandentalacademy.com
61. Mechanical stimuli
(static or dynamic)
Deform EM & bone cell
Reception Transduction Transmission
Ionic Mechanical
Multicellular
Bone cell response
CCN MMCCytoskeleton
(connectin)
(actin)
Nuclear membraneOsteocytic
genome
Ca++
Frankel
www.indiandentalacademy.com
62. Effect of functional appliances on
the jaw muscle activity and type of
muscle fibers recruited
www.indiandentalacademy.com
63. Muscle fibers
• Muscle fibers can be characterized by type according
to the amount of myoglobin; fibers with higher
concentration of myoglobin are deep red in color and
capable of slow but sustained contraction. They have
well developed aerobic metabolism and there fore
resistant to fatigue
• Fibers with low concentration of myoglobin are
whiter and are called fast muscle fibers; they have
fewer mitochondria and relay more on anaerobic
activity for function. Fast fibers are capable of quick
contraction but fatigue more rapidly
• Type I and Type IIa are slow twitch fibers.
• Type II b is fast twitch fibers
www.indiandentalacademy.com
65. Functional appliance
Muscle
fatigue
Excessive muscle
function
Lateral pterygoid
Type IIb
Type I & IIa
Accumulation
Of
Lactic acid
Lateral pterygoid
Type I & IIa
Type IIb
Excessive muscle
function
Accumulation
Of
Lactic acid
S A D
Continuous
Muscle
activity
www.indiandentalacademy.com
66. • Adaptations of masticatory muscles to a hyperpropulsive
appliance in the rat by Reggiani 1996
• The plasticity of masticatory muscles, i.e., their ability to
change their properties in relation to loading conditions,
represents a potentially important determinant of structure
and function of the mouth and the teeth. The effects of
changes of the masticatory loading conditions have been
described by Kiliaridis by comparing two groups of rats fed
with a hard diet and with a soft diet. In the two muscles
examined (deep masseter and anterior belly of digastric), the
soft diet was associated with a higher proportion of fast and
easily fatiguable IIB fibers.
www.indiandentalacademy.com
67. • A series of studies was carried out by Petrovic and by
other workers to test the hypothesis that protrusion
muscles, and particularly lateral pterygoid, can
influence the growth of condylar cartilage. Interestingly
wearing a protrusive appliance induced fiber
transformation in pterygoideus lateralis and superficial
masseter. The proportions of slow fibers and of fatigue-
resistant type I & IIA fibers increased in pterygoideus
lateralis, whereas only an increase in IIA fibers
occurred in the superficial masseter muscle.
www.indiandentalacademy.com
68. • Adaptation of the lateral pterygoid and superficial masseter
muscles to mandibular protrusion in the rat - Easton and
Carlson 1990
• The experimental rats wore bonded protrusive-type
appliances for 2 weeks. Histochemically, the lateral
pterygoid muscle in the experimental group exhibited a
significantly greater area occupied by type I fibers at the
expense of type llb fibers. The superficial masseter muscle
exhibited a significantly greater percentage of areas for both
type lla and type llb fibers in the experimental group.
Contraction time (TPT) increased in both muscles; that is,
the muscles became slower. The histochemical and
contractile-properties data indicate that the protrusive
appliance caused the lateral pterygoid muscle to become
more active with respect to tonic (postural) activity, whereas
the superficial masseter muscle became more active
phasically. www.indiandentalacademy.com
69. • 1990 Woodside et. al.
• Effect of functional appliances on jaw muscle activity - The
electromyographic (EMG) activity of masticatory muscles was
monitored longitudinally with chronically implanted EMG electrodes
to determine whether functional appliances produce a change in
postural EMG activity of the muscles. Preappliance and postappliance
EMG levels in four experimentals that had been fitted with functional
appliances were compared against the background of EMG levels in
controls without appliances. The insertion of two types of functional
appliance to induce mandibular protrusion was associated with a
decrease in postural EMG activity of the superior and inferior heads
of the lateral pterygoid, superficial masseter, and anterior digastric
muscles; the decrease in the first three muscles was statistically
significant. This decreased postural EMG activity persisted for
approximately 6 weeks, with a gradual return toward preappliance
levels during a subsequent 6-week period of observation. Progressive
mandibular advancement of 1.5 to 2 mm every 10 to 15 days did
not .prevent the decrease in postural EMG activity.
www.indiandentalacademy.com
70. • The action of the types of functional appliances on the
activity of the masticatory muscles Camilo Yamin- ajo
1997
• Three commonly used functional appliances; namely, the
Herbst, Frankel, and a simulation of the Clark twin block
appliances were used to test the lateral pterygoid muscle
hypothesis. The electromyographic (EMG) activity of the
masseter, digastric, superior, and inferior heads of the lateral
pterygoid muscles was monitored with chronically inserted
EMG electrodes, in nonhuman primates. The insertion of
these three appliances was associated with a decrease in
functional EMG activity of the four muscles. This decrease
was statistically significant in all muscles 3 and 6 weeks
after appliance insertion. In view of the fact that the animals
showed large skeletal changes in the temporomandibular
facial area, this study could not support the lateral pterygoid
muscle hypothesis. www.indiandentalacademy.com
71. • An electromyographic study was performed on 10
young growing girls in the age group of 9 to 12
years with Class II Division 1 malocclusion and
retruded mandible, who were under treatment with
Twin-block appliances. Bilateral EMG activity of
elevator muscles of the mandible (ie, anterior
temporalis and masseter) was monitored
longitudinally with bipolar surface electrodes to
determine changes in postural, swallowing, and
maximal voluntary clenching activity during an
observation period of 6 months.
www.indiandentalacademy.com
72. • The changes were noted at the start of treatment (0 month),
within 1 month of Twin-block insertion, at the end of 3
months, and at the end of 6 months. The results revealed a
significant increase in postural and maximal clenching
EMG activity in masseter and a numeric increase in anterior
temporalis activity during the 6 month period of treatment.
The increased electromyographic activity can be attributed
to an enhanced stretch (myotatic) reflex of the elevator
muscles, contributing to isometric contractions. The main
force for Twin-block treatment appears to be provided
through increased active tension in the stretched muscles
(motor unit stimulation) and from initiation of myotatic
reflex activity and not through passive tension (viscoelastic
properties) of jaw muscles. The results of this study reaffirm
the importance of full-time wear for functional appliances to
exert their maximum therapeutic effect by way of
neuromuscular adaptation. Ajo 1999 Preeti Aggarwal, .
Kharbanda,,
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73. Skeletal and dental effects of
functional appliances
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74. • Kevin O Brien et al conducted a multicentric,
randomized, controlled trial evaluated the
effectiveness of early orthodontic treatment
with the twin block appliance for class II
division 1 malocclusion
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75. Over jet correction
6.93 mm 100%
Dental
5.05mm 73%
Skeletal
1.88mm 27%
MAX
3.03 mm
44%
MAND
1.00mm
14%
MAND
2.03mm
29%
MAX
0.88mm
13%
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76. Molar correction
4.59 mm 100%
Dental
2.71mm 59%
Skeletal
1.88mm 41%
MAX
1.19 mm
26%
MAND
1.00mm
22%
MAND
1.52mm
33%
MAX
0.88mm
19%
Kevin O’ Brien et al ajo-2003
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77. • Most of the studies on the functional
appliances claim that the small changes that
occur in the skeletal relation ship might not
be considered clinically significant or
functional appliances accelerates growth
ahead of time. Hence may be effective in
reducing the skeletal dysplasia earlier and
interception of exacerbation of
malocclusion and has psychological benefit.
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78. Conclusion
• Functional appliances or rather Dentofacial orthopedics
has been a lurking mirage in orthodontic literature and
has had enough victims, disappointments and limited
long term success, but no wonder the quest is still on,
hoping that there are still ways to communicate with
various cell populations of the condylar cartilage with
mechanical stimuli which remain to be learned. The
answer to whether mandible can be grown in excess
beyond the whelms of genetics or it’s a barren field,
lies with time.
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