This document defines and describes primary and secondary occlusal trauma, which are injuries to the periodontium resulting from excessive occlusal forces. Primary trauma occurs with normal bone and attachment levels, while secondary trauma occurs with bone or attachment loss. Histological studies in animals and humans show that occlusal forces can cause widening of the periodontal ligament space, bone remodeling, root resorption, and other changes depending on the force magnitude and direction. Clinical indicators include tooth mobility, occlusal prematurities, sensitivity, and radiographic changes like widening of the periodontal ligament space. Diagnosis involves examining history, teeth for attrition, decreased vertical dimension, and radiographs. Treatment may include extra
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
Periodontitis is a complex infection initiated by bacteria –tissue destruction.
Host: the organism from which a parasite obtains its nourishment/ an individual who receives a graft
Modulation: the alteration of function or status of something in response to a stimulus or an altered physical or chemical environment
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.
Systemic Peridoontology, link between systemic health and periodontology, diabetes and periodontology, Pregnancy and Peridotology,Nutrition and periodontology
In periodontology, classifications are widely used to categorize defects due to periodontitis according to their etiology, diagnosis, treatment and prognosis.
Several classifications have been proposed in the literature in order to facilitate the diagnosis of gingival recessions.
Periodontitis is a complex infection initiated by bacteria –tissue destruction.
Host: the organism from which a parasite obtains its nourishment/ an individual who receives a graft
Modulation: the alteration of function or status of something in response to a stimulus or an altered physical or chemical environment
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.
Systemic Peridoontology, link between systemic health and periodontology, diabetes and periodontology, Pregnancy and Peridotology,Nutrition and periodontology
In periodontology, classifications are widely used to categorize defects due to periodontitis according to their etiology, diagnosis, treatment and prognosis.
Several classifications have been proposed in the literature in order to facilitate the diagnosis of gingival recessions.
*RAMA DENTAL COLLEGE HOSPITAL AND RESEARCH CENTRE
DEPARTMENT OF PERIODONTOLOGY
TRAUMA FROM OCCLUSION
When occlusal forces exceed the adaptive capacity of the tissues, tissue injury results the resultant injury is termed as trauma from occlusion.
When occlusal forces exceed the adaptive capacity of the tissues, tissue injury results. The resultant injury is termed as trauma from occlusion.
TFO refers to tissue injury, not the occlusal force. An occlusion that produces such injury is termed as traumatic occlusion.
Trauma from occlusion in Periodontics.pptxSUBHRADIPKAYAL
Contents
1. Definitions
2. Introduction
3. Classification of Trauma from occlusion
4. Stages of tissue response
5. Clinical features
6. Radiological features
7. Trauma from occlusion and plaque associated periodontal disease
8. Treatment of TFO
9. References
Definitions
• When occlusal forces exceed the adaptive capacity of tissues, tissue injury results. The resultant injury is termed as trauma from occlusion. - Carranza 10th edition
• Trauma from occlusion is a term used to describe pathologic alterations or adaptive changes which develop in the periodontium as a result of undue force produced by the masticatory muscles. - Lindhe 6th edition
• Stillman (1917) as “a condition where injury results to the supporting structures of the teeth by the act of bringing the jaws into a closed position”.
• WHO (1978) defined trauma from occlusion as “damage in the periodontium caused by stress on the teeth produced directly or indirectly by teeth of the opposing jaw”.
• Injury resulting in tissue changes within the attachment apparatus as a result of occlusal force(s). - AAP Glossary of periodontal terms 2001; 4th Edition
Introduction
• The periodontal ligament has a cushioning effect on forces applied to teeth as means to accommodate forces exerted on the crown.
• When there is increase in occlusal forces, changes occur in the periodontium in order to accommodate such forces.
• Changes occur in magnitude, direction, duration and frequency of increased occlusal forces.
Increased magnitude of occlusal forces
• Widening of periodontal ligament space.
• An increase in number and width of periodontal ligament fibers.
• An increase in the density of alveolar bone.
Changes in direction of occlusal forces
• Reorientation of the stresses and strains within the periodontium.
• The principal fibers of the periodontal ligament are arranged so that they best accommodate occlusal forces along the long axis of the tooth.
• Lateral (horizontal) and torque (rotational) forces are more likely to injure the periodontium.
Duration and frequency of occlusal forces
• Constant pressure on the bone is more injurious than intermittent forces.
• The more frequent the application of an intermittent force, the more injurious the force is to the periodontium.
Classification
According to mode of onset
1. Acute
2. Chronic
According to the capacity of the periodontium to resist to occlusal forces
1. Primary
2. Secondary
Acute trauma from occlusion
• Acute trauma from occlusion results from an abrupt occlusal impact such as that produced by biting on a hard object. Restorations or prosthetic appliances that interfere with or alter the direction of occlusal forces on the teeth may also induce acute trauma.
• Clinical features
1. Tooth pain
2. Sensitivity to percussion
3. Tooth mobility
Chronic trauma from occlusion
• It is more common than acute trauma from occlusion and is of greater clinical significance.
Fenestration
Dehiscence: lack of cortical bone at the level of dental root, at least 4mm apical to the margin of interproximal bone, the measurement was per found by graduated probe.
Or: lowering the crestal bone margin to expose root surface.
Fenestration: localized defect in the alveolar bone that exposed the root surface usually the apical or the medium third but did not involve the alveolar margin.
Or: is isolated areas in which the root is denuded of bone and the root surface is covered only by periosteum and overlying gingiva.
Fenestration is a term derived from Latin ward fenestra, meaning window, describe area of alveolar process devoid of bone, creating a window exposing the root surface.
Gingival recession: is the apical movement of the marginal soft tissue surrounding the tooth exposing root surface.
According to some studies that irreversible recession can be caused by fixed appliances for 1.3% to 10.0% of treated cases.
We can use CBCT to measure the labial and lingual thickness of the bone related to roots.
ABT: apical buccal thickness. MBT: middle buccal thickness. CBT: cervical buccal thickness.
ALT: apical lingual thickness. MLT; middle lingual thickness. CLT: cervical lingual thickness.
== naturally occurring alveolar bone dehiscence and fenestration are common finding in different type of malocclusion especially in anterior region of class III.
== fenestration and dehiscence may lead to gingival recession and additional bone loss during orthodontic treatment in addition to large amount of labial inclination such as decompensation in class III malocclusion may pose a greater risk of periodontal complication such as:
Alveolar dehiscence, fenestration, gingival recession.
Clinically gingival recession, is always accompanied by alveolar bone dehiscence whether underlying bone dehiscence is developed before or parallel to gingival recession.
N:B- gingival recession; is described as exposure of root surface by an apical shift in the position of gingiva.
Factors affect recession increase:
1- Difficulty of plaque control due to fixed appliances
2- Proclination of teeth.
3- Coronally attached Frenum.
4- Muscle attachment.
5- Abnormal tooth position.
6- Overhanging restoration or crowns.
7- Fenestration and dehiscence.
** Classification of fenestration according to their apicocoronal location in relation to root length to:
1- At the level of the apical third of the dental root 48% all in maxilla.
2- At the level of the middle third of dental root 28% in maxilla and mandible.
3- At the level of the coronal third of the dental root 19% all in mandible.
4- Extending from the apical to the middle third of the dental root 4.3% of them located in maxilla.
** Etiology of dehiscence:
1- Ectopically positioned teeth which are outside of the bony limits of the alveolus are often lacking the normal amount of bone on the overlying facial surface.
2- Roots of the toot
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
Dentist in pune.(BDS) MDS- OMFS - Dr. Amit T. Suryawanshi.. Mandibular fractu...All Good Things
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Eruptive anomalies are present in many routine orthodontic cases. The challenge in them is to diagnose them correctly
and manage them in a way so as to maintain the esthetic and functional harmony of the stomatognathic system [1]. The orthodontist must know how to correct these anomalies rather than extracting the malposed tooth as this would lead to poor occlusion and
loss of masticatory function [2]. This article presents an overview
on various anomalies seen due to impaction in daily orthodontic
practice along with step by step management of each
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
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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.
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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
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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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.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Occlusal trauma
1.
2. Definition:
Occlusal trauma :- injury resulting in tissue
changes within the attachment apparatus as a
result of occlusal force (s).
3. Primary occlusal trauma :- injury resulting in
tissue changes from excessive occclusal forces
applied to a tooth or teeth with normal support.
It occurs in the presence of:1- normal bone level
2- normal attachment level
3- excessive occlusal force (s).
4.
5. Secondary occlusal trauma :- injury resulting in
tissue changes from normal or excessive
occlusal forces applied to a tooth or teeth with
reduced support . it occurs in the presence of :1- bone loss.
2- attachment loss.
3- normal / excessive occlusal force(s).
6.
7. Histological studies :
The histological features of occlusal trauma have been studied extensively in animal
. and human autopsy materials
Alteration of the periodontium that have been associated with occlusal trauma will
vary with the magnitude & direction of applied force and location (pressure versus
tension).
These changes many include:, widening / compression of the periodontal ligament
( , bone remodeling (resorption /repair
,hyalinization-necrosis
, increased cellularity
,vascular dilatation / permeability , thrombosis
root resorption
and cemental tears
8.
9.
10. Despite isolated reports of apical migration of
junction epithelium accompanying excessive
occulsal forces , studies generally have failed to
disclose associated pocket formation while
demonstration remarkable stability of the
sharpey,s fiber and periodontal fibers coronal to
the alveolar bone.
In the absence of existing inflammation , it was
noted that bony changes accompanying occlusal
trauma may be reversed by discontinuing
offending occlusal force.
22. 1-history:
a-teeth which are sensitive (not related to
recession,caries,or broken fillings).
b-muscle pain
c-problems with TMJ (clicking,limitation in
opening,or deviation).
23. 2-examination:
a- attrition of teeth
there are 2 different types of bruxism(clenching,grinding).
b-decrease in vertical dimension.
The functional attrition is normally compensated by continuous deposition of
cementum in the apical area which differs from bone in that it has no resorption.
c-some teeth with edges chipped.
d-broken restorations.
e-mobility of teeth(without periodontal disease or bone lesion).
f-changes in position of teeth
g-signs &symptoms of pulpal hyperemia or pulpitis without any obvious
This could develop to pulpal necrosis then develop to peri apical lesion.
cause.
25. 4- occlsal analysis
a-impression-cast-bite registration-mounted on fully
adjustable articulater.the analyze occlusion and
determine area of premature contact.
b-occlusion indicater
26. Treatment;
not every trauma from occlosion require treatment
just keep these patient under observation.
We should not change the pattern of occlusion
unless we are sure that pattern is causing the
problem.
For example; sometimes the cause is the
muscles[uncoordinated] so no matter how much
we trim the teeth we wont solve the problem.
27.
28.
29. Treatment;
1-interfering hopeless tooth-extraction.
2-new restoration of interfering teeth.
3-diminshed occlusal table require placement [bridge,partial denture….]
4-bite plane,night guard,now called [inter-occlusal appliance]
a-prevent teeth from fully interdigitating.
b-help in preventing or minimizing isomeric contraction of muscles.
c-abolish the effect of mechanoreceptors.
5-exercise for more harmonious occlusion.
6-portable electromyography contain warning system[feed back] measures the electric potential on the
muscles.
