INTRODUCTION
DEFINITION
TYPES OF TRAUMA FROM OCCLUSION
GLICKMAN CONCEPT
WAERHAUG CONCEPT
STAGES OF TISSUE RESPONSE TO INJURY
CLINICAL AND RADIOGRAPHIC FEATURES OF TFO
CLINICAL DIAGNOSIS OF TFO
TFO AND IMPLANTS
TREATMENT OF TFO
CONCLUSION
REFRENCES
INTRODUCTION
DEFINITION
TYPES OF TRAUMA FROM OCCLUSION
GLICKMAN CONCEPT
WAERHAUG CONCEPT
STAGES OF TISSUE RESPONSE TO INJURY
CLINICAL AND RADIOGRAPHIC FEATURES OF TFO
CLINICAL DIAGNOSIS OF TFO
TFO AND IMPLANTS
TREATMENT OF TFO
CONCLUSION
REFRENCES
Necrotising periodontal diseases, Necrotising periodontal diseases as a manifestation of systemic diseases.
By Dr. Ritam Kundu, MDS PGT, Dr. R. Ahmed Dental College & Hospital, Kolkata, India.
Phase I periodontal therapy is the first in the chronologic sequence of procedures that constitute periodontal treatment. It is also referred to as cause related therapy or non-surgical periodontal therapy.
This presentation describes the gingival recession, its classifications and theories of pathogenesis and different etiological factors in its progression.
Necrotising periodontal diseases, Necrotising periodontal diseases as a manifestation of systemic diseases.
By Dr. Ritam Kundu, MDS PGT, Dr. R. Ahmed Dental College & Hospital, Kolkata, India.
Phase I periodontal therapy is the first in the chronologic sequence of procedures that constitute periodontal treatment. It is also referred to as cause related therapy or non-surgical periodontal therapy.
This presentation describes the gingival recession, its classifications and theories of pathogenesis and different etiological factors in its progression.
explaining about Periodontal disease
The term periodontal disease is used in a general sense to encompass all diseases of the periodontium.
The most common disease is initiated by plaque accumulation in the gingivodental area and is basically inflammatory in character, termed marginal periodontitis or more accurately chronic destructive periodontitis.
The periodontal tissues can also be involved by other nosologic entities and many of these fall into degenerative or neoplastic categories. They are considered as periodontal manifestations of systemic diseases
CHRONIC DESTRUCTIVE PERIODONTITIS
Periodontitis
Marginal periodontitis
Slowly progressing
Rapidly progressing
Refractory
Juvenile form of periodontitis
Generalized form
Localized form
Necrotizing Ulcerative Periodontitis
Trauma from occlusion*
Periodontal atrophy*
Presenile atrophy
Disuse atrophy
MARGINAL PERIODONTITIS
Clinical features: chronic inflammation of the gingiva, pocket formation, and bone loss. Tooth mobility and pathologic migration appear in advanced cases.
Etiology: dental plaque
Types: slowly progressing periodontitis, rapidly progressing periodontitis, refractory periodontitis
Presenile atrophy
reduction in the height of periodontium that is uniform throughout the mouth and without apparent cause
Disuse atrophy
Results when the functional stimulation for the maintenance of the periodontal tissues is markedly diminished or absent.
characterized by thinning of periodontal ligament, thinning and reduction in the number of periodontal fibers and disruption of fiber bundle arrangement, thickened cementum, reduction in height of alveolar bone, and osteoporosis
A periodontal pocket is a pathologically deepened sulcus: it is one of the important clinical features of periodontal disease.
SYMPTOMS:
Localized pain or a sensation of pressure after eating, which gradually diminishes
A foul taste in localized areas.
A tendency to suck material from the interproximal spaces.
Radiating pain “deep in the bone”
A “gnawing” feeling or feeling of itchiness in the gums.
Behavioral Management Technique For Patient With Special Needs DrGhadooRa
done by : ( ABCD'S &G )
alaa ba-jafar
abrar alshahranii
sahab filfilan
nada alharbi
shahd rajab
Ghadeer suwaimil
I hope that you enjoy and you benefit❤
done by : ( ABCD'S &G )
alaa ba-jafar
abrar alshahranii
sahab filfilan
nada alharbi
shahd rajab
Ghadeer suwaimil
I hope that you enjoy and you benefit❤
done by : ( ABCD'S &G )
alaa ba-jafar
abrar alshahranii
sahab filfilan
nada alharbi
shahd rajab
Ghadeer suwaimil
I hope that you enjoy and you benefit❤
done by : ( ABCD'S &G )
alaa ba-jafar
abrar alshahranii
sahab filfilan
nada alharbi
shahd rajab
Ghadeer suwaimil
I hope that you enjoy and you benefit❤
DENTAL BIOAEROSOL AS AN OCCUPATIONAL HAZARD IN A DENTIST’S WORKPLACE
NOTE : all this from my reading in some scientific website and articles
I hope that you enjoy and you benefit❤
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.
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.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
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.
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.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
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
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.
1. Necrotizing Ulcerative Gingivitis Necrotizing ulcerative periodontitis
Definition
A microbial disease of the gingiva in the context of an
impaired host response. It is characterized by the death
and sloughing of gingival tissue and presents with
characteristic signs and symptoms.
May be an extension of NUGinto the periodontal
structures, leading to periodontal attachment and
bone loss.
Clinical
Features
NUG often undergoes a diminution in severity without
treatment, leading to a subacute stage with milder clinical
symptoms. Thus patients may have :
o a history of repeated remissions and
exacerbations
o Edematous interdental papillae
o Crateriform lesions, most commonly in the
anterior incisor and posterior molar regions
o Erythema
o Spontaneous gingival hemorrhage
o Necrosis with formation of a grayish
pseudomembrane over affected area
o Pain with rapid onset
o Halitosis
o Blunted gingivae between the teeth (normally
cone-shaped)
o Often accompanied by fever, malaise, and
lymphadenopathy
o Often associated with immunosuppression,
o clinical cases of NUP are defined by necrosis
and ulceration of the coronal portion of the
interdental papillae and gingival margin, with a
painful, bright red marginal gingiva that bleeds
easily . Show gingival crater on interdental
papillae. NUP characterized by destructive
progression
o NUP distinguished by :
the destructive progression of the
disease that includes periodontal
attachment and bone loss.
Deep interdental osseous craters
demonstrate periodontal lesions of NUP.
Gingival lesion destroys the marginal
epithelium and connective tissue,
resulting in gingival recession.
Periodontal pockets are formed because
the junctional epithelial cells remain
viable and can therefore migrate apically
to cover areas of connective tissue loss.
2. tobacco use, and physical or emotional stress;
the vernacular name 'trench mouth' came from
large outbreaks in the World War I trenches.
The disease is also seen in college dormitories
and other stressful crowded living conditions,
but there is no evidence that acute necrotizing
ulcerative gingivitis is communicabl
Tooth mobility Ultimately tooth loss.
NUP patient may present with : Oral
malodor ( foul odor ) Fever Malaise
lymphadenopathy
Microscopic
Findings
Surface epithelium is destroyed and replaced by a meshwork
of fibrin, necrotic epithelial cells, polymorphonuclear
leukocytes (PMNs, neutrophils), and various types of
microorganisms individual cells exhibit varying degrees of
hydropic degeneration.
Commonly similar to NUG 1 - surface biofilm
composed of a mixed microbial flora with different
morphotypes and a subsurface flora with dense
aggregations of spirochetes ( bacterial zone ).
2 - Dense aggregations of PMNs ( neutrophil-rich
zone ) .
3 - N ecrotic cells ( necrotic zone ).
4 - S pirochetal infiltration zone.
5 - High levels of yeasts and herpes-like viruses
were observed
Etiology
Build-up of bacterial plaque on the teeth, adjacent
gingivae, and pockets between teeth and gums,
releasing toxins that cause an inflammatory response
(most common species involved are Gram-negative
anaerobic bacteria—Actinobacillus
Etiology of NUP Generally as NUG:
1- Bacteria role: NUP in HIV-positive patients
demonstrated significantly greater numbers
of the opportunistic fungus Candida albicans
and a higher prevalence of A.
actinomycetemcomitans , P. intermedia , P.
gingivalis , Fusobacterium nucleatum , and
3. actinomycetemcomitans and Porphyromonas gingivalis)
Build-up of calculus contributes to the chronicity of
periodontal disease; if plaque is not removed, it forms
a hard mass commonly called 'tartar,' which traps
bacteria that cause gingivitis. Toxins released from
the bacteria stimulate an immune response (via
cytokines) that increases production of collagenase.
Untreated, this has a destructive effect on the
connective tissue, which renders the teeth less
secure, leading to periodontal disease and tooth loss
Smoking tobacco
Faulty dental prosthesis
Malocclusion
Breathing through the mouth
Local trauma (eg, an overly aggressive toothbrushing
technique)
Dry mouth: because of loss of protective effect of
Campylobacter species compared with HIV-negative
controls . L ow or variable level of
spirochetes , which is inconsistent with the
flora associated with NUG .
2- Immunocompromised Status : Clearly, both
NUG and NUP lesions are more prevalent in
patients with compromised or suppressed
immune systems. Commonly in HIV-positive
and AIDS patients.
3- Psychologic Stress Stress increases
systemic cortisol levels , and sustained
increases in cortisone have a suppressive
effect on the immune response by
microcirculation in gingiva and altered
phagocytic functions. Some researchers: F
ound that urinary levels of 17-
hydroxycorticosteroid were higher in
subjects with NUG than in all other subjects
diagnosed with periodontal health , gingivitis
, or periodontitis
4- Malnutrition Direct evidence of the
relationship between malnutrition and
necrotizing periodontal disease is limited to
descriptions of necrotizing infections in
severely malnourished children. M any of the
host defenses , including phagocytosis; cell-
4. saliva
Vitamin deficiency, especially of vitamin C
mediated immunity ; and complement,
antibody , and altered cytokine production ,
are impaired in malnourished individuals
5- Reduction of nutrients to cells and tissues
results in immunosuppression and disease
susceptibility. Malnutrition can predispose
an individual to opportunistic infections or
intensify the severity of current oral
infections
6- Other factors - Smoking - Plaque and other
local factors e.g. calculus
Predisposing
factors
Preexisting gingivitis, injury to the gingiva, smoking ,
nutritional deficiency; fatigue caused by chronic sleep
deficiency; other health habits (e.g., alcohol or drug
abuse), and systemic disease (e.g., diabetes, debilitating
infection).
Poor oral hygiene, preexisting periodontal
disease, smoking, viral infections,
immunocompromised status, psychosocial stress,
and malnutrition
Complication
And
comorbidities
If oral hygiene is poor, plaque accumulates and can form
calculus; both harbor toxin-releasing bacteria around the
gum line. Eating carbohydrate-containing foods promotes an
acid environment in the mouth that encourages bacterial
growth
Crowns or fillings that are poorly contoured provide traps
for food particles
Smoking has a significant effect on overall dental health
Gangrenous (necrotic) stomatitis :
extensive necrotic process to adjacent
gingival mucosa (check, palate, tongue,
floor of m., lips)
5. Coexisting diseases such as diabetes mellitus Down
syndrome, and HIV infection render a patient more
susceptible to the inflammatory process
Degenerative disease of the connective tissue such as
rheumatoid arthritis, systemic lupus erythematosus, and
CREST syndrome (calcinosis, Raynaud phenomenon,
esophageal dysfunction, sclerodactyly, and telangiectasia)
may make a person more susceptible to periodontal disease
Sjögren syndrome or xerostomia can cause dryness of the
mouth, which increases the likelihood of oral pathology
Steroid medication may increase a patient's susceptibility
to bacteria
Ill-fitting dentures or restorations should be properly
fitted
Noma ( cancrum oris ): serious (fatal )
form of necrotic stomatitis that lead to
exposure of bone and perforation of
check & nasal cavity
Treatment
Treatment usually is divided into the acute phase and the
maintenance phase. The primary concern in the acute phase is
pain control. For the maintenance phase, treatment is directed
toward reducing the burden of potential pathogens, preventing
further tissue destruction, and promoting healing.
For uncomplicated NUP or NUG, the primary care
provider should prescribe an antimicrobial rinse ,
antibiotic therapy , medications for pain management,
and nutritional supplementation; the patient should be
referred to a dental health care professional.
The treatment is mostly similar to NUG
1- Lavage of necrotic tissue and pseudomembrane
under local anesthesia.
2 - Correction of the systemic condition as possible
and consultation with patient’s physician .
3- Periodontal debridement ( scaling and root
planing ).
4- Local and systemic antibiotics
5- Antiseptic mouth wash ( chlorhexidine )
6. Chlorhexidine gluconate rinse (0.12%) twice daily after
brushing and flossing (an alcohol-free preparation is
preferred).
Antibiotic therapy (preferably narrow spectrum, to leave
gram-positive aerobic flora unperturbed).
Refer to a dentist for the following:
Removal of plaque and debris from the site of
infection and inflammation.
Debridement of necrotic hard and soft tissues,
with a 0.12% chlorhexidine gluconate or
povidone-iodine lavage
6 - Antifungal and antiviral drugs
7- Good nutrition and enhancement the psychic
status.
8 - Oral hygiene instruction and patient
motivation to control dental plaque.
9 - Maintenance recall visits to evaluate periodontal
health and observe the recurrence of lesions.