This document discusses occlusion and its role in periodontics. It defines occlusion and describes ideal occlusion. It discusses differing occlusal schemes and questions regarding occlusion's role in periodontitis, dental implants, and abfraction. It covers trauma from occlusion, including classifications and tissue response. It reviews historical studies on occlusion's role and their shortcomings. Animal studies demonstrated that jiggling trauma can aggravate periodontal disease. Clinical studies provide some evidence occlusion may be a risk factor in disease progression. The role of occlusion in implant dentistry aims to protect implants from biomechanical overload.
This presentation describes the occlusion evaluation, its role in periodontal disease and occlusal therapy. Various diagnostic options and treatment options opted for occlusal correction.
The future of dentistry and periodontics lies in regeneration. The goals of periodontal therapy lies in not only the arrest of periodontal disease progression but also regeneration of the lost periodontal structures. This presentation provides a review of the current understanding of the regeneration of the periodontium and the procedures involved to restore the periodontal tissues around the teeth.
This presentation describes the occlusion evaluation, its role in periodontal disease and occlusal therapy. Various diagnostic options and treatment options opted for occlusal correction.
The future of dentistry and periodontics lies in regeneration. The goals of periodontal therapy lies in not only the arrest of periodontal disease progression but also regeneration of the lost periodontal structures. This presentation provides a review of the current understanding of the regeneration of the periodontium and the procedures involved to restore the periodontal tissues around the teeth.
Furcation involvement is a common sequela of severe chronic periodontal disease. Its effective management has a profound influence on the outcome of periodontal therapy.
A brief description of all topics to recent advances,SDD, host modulation and diabetes, host modulation in smokers, chemically modified tetracyclines, bisphosphonates
Furcation involvement is a common sequela of severe chronic periodontal disease. Its effective management has a profound influence on the outcome of periodontal therapy.
A brief description of all topics to recent advances,SDD, host modulation and diabetes, host modulation in smokers, chemically modified tetracyclines, bisphosphonates
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
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.
AGGRESSIVE PERIODONTITIS
PRESENTER
DR. REBICCA RANJIT
DEPT. OF PERIODONTOLOGY & ORAL IMPLANTOLOGY
Why is there localisation of disease to 1st molars and incisors in LAP?
Often subjects present with attachment loss that does not fit the specific diagnostic criteria (AP or chronic periodontitis).
Schenkein et al. 1995: cigarette smoking was shown to be a risk factor for patients with generalized forms of AgP.
Smokers with GAP had more affected teeth and greater mean levels of attachment loss than patients with GAP who did not smoke.
IgG2 serum levels as well as antibody levels against A.a. are significantly depressed in subjects with GAP who smoked.
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
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.
Talk about:
- Types of occlusal forces and Periodontal Response to External Forces
- Clinical & Radiographic
Signs of Trauma from Occlusion
- Therapy & Treatment Outcomes for this condition.
Traumatic Occlusion and Pathologic tooth migrationAyam Chhatkuli
description about traumatic occlusion and pathologic tooth migrations.its pathogenesis, changes in the forces exerted on tooth, its treatment and prevention.
*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.
Trauma from occlusion
In Periodontics
definition of trauma from occlusion by WHO (1978)
and many more definitions by different authors
Factors involved in the etiology of trauma from occlusion
which includes 1.) precipitating factors : such as Magnitude, Direction, Duration of force applied, Frequency of force applied
2.) Predisosing factors : intrinsic factors & extrinsic factors
# Terminologies which are used which have been used to describe occlusion trauma
Glickmans theory of co-destruction
occlusal forces during jaw movement
classification of trauma from occlusion which includes acute , chronic , primary secondary
Stages of tissue response to excessive occlusion forces
stage 1 INJURY
slightly excessive forces
greater then slightly excessive forces
severely high forces
stage 2: REPAIR
stage 3: ADAPTIVE REMODELLING OF THE PERIDONTIUM
Examination And Diagnosis of trauma from occlusion
signs of trauma from occlusion :
tooth mobility
tooth migration
wear pattern abfraction
V shaped or angled gingival recession
Buccal bone dehisence
fermitus test
SYMPTOMS OF TRAUMA FROM OCCLUSION
radiographic features of trauma from occlusion
effects of insufficent occlusal forces
reversibility of traumatic lesion
effects of excessive occlusion forces on dental pulp
Influence of trauma from occlusion on progression of marginal periodontitis
pathological migration
pathogenisis
management of trauma from occlusion
treatment of trauma from occlusion
conclusion
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
Risk assessment is the determination of quantitative or qualitative estimate of risk related to a well-defined situation and a recognized threat (also called hazard). Quantitative risk assessment requires calculations of two components of risk (R): the magnitude of the potential loss (L), and the probability (p) that the loss will occur. An acceptable risk is a risk that is understood and tolerated usually because the cost or difficulty of implementing an effective countermeasure for the associated vulnerability exceeds the expectation of loss."Health risk assessment" includes variations, such as risk as the type and severity of response, with or without a probabilistic context.
Dental Implants have changed the face of dentistry over the last 25 years. What are dental implants? What is the history of dental implants? And how are they used to replace missing teeth? This section will give you an overview of the topic of dental implants, to be followed by more detail in additional sections.
As with most treatment procedures in dentistry today, dental implants not only involve scientific discovery, research and understanding, but also application in clinical practice. The practice of implant dentistry requires expertise in planning, surgery and tooth restoration; it is as much about art and experience as it is about science. This site will help provide you with the knowledge you need to make informed choices in consultation with your dental health professionals.
Dental Implants
Dental illustration by Dear Doctor
Let’s start from the beginning: A dental implant is actually a replacement for the root or roots of a tooth. Like tooth roots, dental implants are secured in the jawbone and are not visible once surgically placed. They are used to secure crowns (the parts of teeth seen in the mouth), bridgework or dentures by a variety of means. They are made of titanium, which is lightweight, strong and biocompatible, which means that it is not rejected by the body. Titanium and titanium alloys are the most widely used metals in both dental and other bone implants, such as orthopedic joint replacements. Dental implants have the highest success rate of any implanted surgical device.
Titanium’s special property of fusing to bone, called osseointegration (“osseo” – bone; “integration” – fusion or joining with), is the biological basis of dental implant success. That’s because when teeth are lost, the bone that supported those teeth is lost too. Placing dental implants stabilizes bone, preventing its loss. Along with replacing lost teeth, implants help maintain the jawbone’s shape and density. This means they also support the facial skeleton and, indirectly, the soft tissue structures — gum tissues, cheeks and lips. Dental implants help you eat, chew, smile, talk and look completely natural. This functionality imparts social, psychological and physical well-being.
There is no question that given the current state of the art in dentistry, that dental implants are pretty much the best way to replace teeth; they are stand alone tooth replacement systems that look and function just like natural teeth. They do not attach to adjacent teeth like a fixed bridge and don't have to be taken in and out like removable partial dentures.
A dental implant is a tooth root replacement made of titanium, which has the unique property of being osteophilic (osteo-bone, philic-loving) and actually fuses to bone. A crown, the part of the tooth that you see in your mouth, is attached to the implant. And the great thing about implants is they are not susceptible to decay or periodontal (gum) disease in the same way that teeth are.
Now here are a few important pointers, which hold for implants generally and are especially important in your case when replacing a front tooth for an imminent event . Dr Harshavardhan Patwal
Non surgical management of gingival recession- Dr Harshavardhan PatwalDr Harshavardhan Patwal
Treatment of gingival recession has become an important therapeutic issue due to the increasing number of cosmetic requests from patients. The dual goals of mucogingival treatment include complete root coverage, up to the cemento-enamel junction, and blending of tissue color between the treated area and non-treated adjacent tissues. Even though the connective tissue graft is commonly considered the “gold standard” for treatment of recession defects, it may not always be the best surgical option for every case. Dr Harshavardhan Patwal , Under non-experimental conditions, all root coverage procedures may be effective in terms of complete root coverage and excellent esthetics. Careful analyses of patient- and defect-related factors, however, are key considerations prior to selecting an appropriate surgical technique.
Since the initial observations of oral bacteria within dental
plaque by van Leeuwenhoek using his primitive microscopes
in 1680, an event that is generally recognized as the
advent of oral microbiological investigation, oral microbiology
has gone through phases of “reductionism” and
“holism”. From the small beginnings of the Miller and
Black period, in which microbiologists followed Koch’s
postulates, took the reductionist approach to try to study
the complex oral microbial community by analyzing
individual species; to the modern era when oral researchers
embrace “holism” or “system thinking”, adopt new concepts
such as interspecies interaction, microbial community,
biofilms, poly-microbial diseases, oral microbiological knowledge
has burgeoned and our ability to identify the resident
organisms in dental plaque and decipher the interactions
between key components has rapidly increased, such
knowledge has greatly changed our view of the oral
microbial flora, provided invaluable insight into the
etiology of dental and periodontal diseases, opened the door
to new approaches and techniques for developing new
therapeutic and preventive tools for combating oral polymicrobial
diseases. Dr Harshavardhan Patwal
Like many other biological sciences, the study
of microbiology has gone through phases of
“reductionism” and “holism”. For a long time,
microbiologists took the reductionist approach to
study complex microbial communities by analyzing
individual bacterial species. The strategy was to
understand the whole by examining smaller components,
and has been the hallmark of much of the
industrial and scientific revolutions for the past
150 years. While reductionism has greatly advanced
microbiology, it was recognized that assembly of
smaller pieces cannot explain the whole! Modern
microbiologists are learning “system thinking” and
“holism.” From global gene regulation to “metagenomics”
to “biofilms”, microbiology is entering
an exciting new era with emphasis on revealing
and decoding the interactions of different elements
within a microbial community. The knowledge
obtained from “system thinking” is changing our
understanding of microbial physiology and our
ability to diagnose/treat microbial infections, and
will have great impact on oral microbiology as
well.
Oxidative stress reflects an imbalance between the systemic manifestation of reactive oxygen species and a biological system's ability to readily detoxify the reactive intermediates or to repair the resulting damage. Disturbances in the normal redox state of cells can cause toxic effects through the production of peroxides and free radicals that damage all components of the cell, including proteins, lipids, and DNA. Oxidative stress from oxidative metabolism causes base damage, as well as strand breaks in DNA. Base damage is mostly indirect and caused by reactive oxygen species (ROS) generated, e.g. O2− (superoxide radical), OH (hydroxyl radical) and H2O2 (hydrogen peroxide).Further, some reactive oxidative species act as cellular messengers in redox signaling. Thus, oxidative stress can cause disruptions in normal mechanisms of cellular signaling. Dr Harshavardhan Patwal , Chemically, oxidative stress is associated with increased production of oxidizing species or a significant decrease in the effectiveness of antioxidant defenses, such as glutathione.The effects of oxidative stress depend upon the size of these changes, with a cell being able to overcome small perturbations and regain its original state. However, more severe oxidative stress can cause cell death and even moderate oxidation can trigger apoptosis, while more intense stresses may cause necrosis.
Production of reactive oxygen species is a particularly destructive aspect of oxidative* stress. Such species include free radicals and peroxides. Some of the less reactive of these species (such as superoxide) can be converted by oxidoreduction reactions with transition metals or other redox cycling compounds (including quinones) into more aggressive radical species that can cause extensive cellular damage.Most long-term effects are caused by damage to DNA
The periodontium is the specialized tissues that both surround and support the teeth, maintaining them in the maxillary and mandibular bones. The word comes from the Greek terms περί peri-, meaning "around" and -odont, meaning "tooth". Literally taken, it means that which is "around the tooth". Periodontics is the dental specialty that relates specifically to the care and maintenance of these tissues. It provides the support necessary to maintain teeth in function. It consists of four principal components, namely:
Gingiva
Periodontal ligament (PDL)
Cementum
Alveolar bone proper
Dr Harshavardhan Patwal explains the diffrent cell matrix interactions with emphasis on each components is distinct in location, architecture, and biochemical properties, which adapt during the life of the structure. For example, as teeth respond to forces or migrate medially, bone resorbs on the pressure side and is added on the tension side. Cementum similarly adapts to wear on the occlusal surfaces of the teeth by apical deposition. The periodontal ligament in itself is an area of high turnover that allows the tooth not only to be suspended in the alveolar bone but also to respond to the forces. Thus, although seemingly static and having functions of their own, all of these components function as a single unit .
Porphyromonas gingivalis belongs to the phylum Bacteroidetes and is a nonmotile, Gram-negative, rod-shaped, anaerobic, pathogenic bacterium. It forms black colonies on blood agar.
It is found in the oral cavity, where it is implicated in certain forms of periodontal disease, as well as in the upper gastrointestinal tract, the respiratory tract, and the colon. It has also been isolated from women with bacterial vaginosis. Collagen degradation observed in chronic periodontal disease results in part from the collagenase enzymes of this species. It has been shown in an in vitro study that P. gingivalis can invade human gingival fibroblasts and can survive in them in the presence of considerable concentrations of antibiotics.P. gingivalis also invades gingival epithelial cells in high numbers, in which cases both bacteria and epithelial cells survive for extended periods of time. High levels of specific antibodies can be detected in patients harboring P. gingivalis. Dr Harshavardhan Patwal , explains the various enzymes enzyme peptidyl-arginine deiminase, which is involved in citrullination.[4] Patients with rheumatoid arthritis have an increased incidence of periodontal disease, and antibodies against the bacterium are significantly more common in these patients.
P. gingivalis is divided into K-serotypes based upon capsular antigenicity of the various types.
Influence of systemic disorders on periodontal diseases is well established. However, of growing interest is the effect of periodontal diseases on numerous systemic diseases or conditions like cardiovascular disease, cerebrovascular disease, diabetes, pre-term low birth weight babies, preeclampsia, respiratory infections and others including osteoporosis, cancer, rheumatoid arthritis, erectile dysfunction, Alzheimer's disease, gastrointestinal disease, prostatitis, renal diseases, which has also been scientifically validated. This side of the oral-systemic link has been termed Periodontal Medicine and is potentially of great public health significance, as periodontal disease is largely preventable and in many instances readily treatable, hence, providing many new opportunities for preventing and improving prognosis of several systemic pathologic conditions. in this power point Dr Harshavardhan Patwal , highlights the importance of prevention and treatment of periodontal diseases as an essential part of preventive medicine to circumvent its deleterious effects on general health.
ggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) is a Gram-negative, facultative nonmotile, rod-shaped oral commensal often found in association with localized aggressive periodontitis, a severe infection of the periodontium, although it is also associated with nonoral infections. Its role in periodontitis was first discovered by Danish-born periodontist Jørgen Slots, a professor of dentistry and microbiology at the University of Southern California School of Dentistry.
'Bacterium actinomycetem comitans' was described by Klinger (1912) as coccobacillary bacteria isolated together with Actinomyces from actinomycotic lesions of man. It was reclassified as Actinobacillus actinomycetemcomitans by Topley & Wilson (1929) and as Haemophilus actinomycetemcomitans by Potts et al. (1985). The species has attracted attention because of its association with localized aggressive periodontitis. is explained here by Dr Harshavardhan Patwal
T-cells is explained with a emphasis with humoral and adaptive immunity . And the diffrent subsets of t cells are well explained by Dr Harshavardhan Patwal here .
Here saliva as a diagnostic biomarker has been explained via this powerpoint . extraction of saliva and diagnostic equipments and techniques are explained here by Dr Harshavardhan Patwal
explained here is bone loos and patterns of bone loos in alveolar bone to various insults . Dr Harshavardhan pawal also gives emphasis on rate on bone loss and radius of action .
contains descriptive and other studies on genetics and epigenetics and whole gene concepts from central dogma to future concepts . Dr Harshavardhan Patwal
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
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.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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.
Follow us on: Pinterest
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. McNeil defines Occlusion as the
“Functional relationship between
components of the Masticatory system,
including the Teeth and the Supporting
tissues, Neuromuscular system,
Temporomandibular Joints and the
Craniofacial Skeleton.”
4. Ideal Occlusion (Dawson)
• Stable centric stops on all teeth when the
condyles are in the most superior and posterior
position
• An anterior guidance that is in harmony with
the border movements of the envelope of
function
• Disclusion of all posterior teeth in protrusive
movements
• Disclusion of all posterior teeth in non working
side
• Non interference of all posterior teeth on the
5. • Centric Relation: The position of the
mandible when the condyles are in an
orthopedically stable position
• Centric Occlusion: The position of the
mandible when there is maximum
interdigitation and occlusal contact between
maxillary and mandibular teeth
8. Questions that need
answers
• Is occlusion a risk factor for periodontitis
?
• What role does occlusion play in the
maintenance of a successfully osseo-
integrated dental implant?
• Do occlusal schemes differ between
natural dentitions and implant included
dentitions?
• Does increased occlusal force cause
Abfraction?
9. Trauma From Occlusion
• Trauma From Occlusion ( TFO ):
When occlusal forces exceed the adaptive
capacity of the periodontal tissues, the
resultant tissue injury is trauma from
occlusion
11. Classification of Trauma
from Occlusion
• Acute TFO : Results from an abrupt
increase in the amount of forces
• Chronic TFO : Results from gradual
changes in occlusion produced by tooth
wear, drifting movement, extrusion of
teeth, combined with parafunctional
habits such as Bruxism and Clenching
12. Classification of Chronic
Trauma from Occlusion
• Primary TFO : Periodontal Tissue
Injury resulting from excessive occlusal
forces applied to a tooth or teeth with
normal support.
• Secondary TFO : Periodontal tissue
injury resulting from normal or excessive
forces bing applied to tooth or teeth with
reduced support
14. Factors that determine
whether an Occlusion is
Traumatogenic
• Magnitude
• Direction
- Parallel to the Long Axis
- Lateral (Horizontal ) / Torque
• Duration
• Frequency
Criterion that determines if the occlusion is
traumatic is whether it produces periodontal injury,
not how it occludes.
15. Stages of Tissue Response
to Increased Occlusal
Forces
1) Injury
2) Repair
3) Adaptive Remodelling
16. Stage 1 - Injury
• Periodontal tissue injury occurs due to
increased occlusal forces
• Under forces of occlusion the tooth rotates
around a fulcrum, creating areas of pressure
and tension on opposing sides of the fulcrum
• Slightly excessive pressure stimulates bone
resorption
• Slightly excessive tension causes elongation of
PDL fibres and apposition of alveolar bone
17. Stage 1 Injury (cont’d)
• With greater Pressure, the compression of PDL
fibres produces areas of Hyalinization.Further
injury causes Necrosis of areas of PDL.
• Vascular changes, starting with vasostasis
within 30 minutes, which may eventually lead
to fragmentation of blood vessels in 1 – 7 days
• Associated with increased resorption of bone
(undermining resorption)
• Greater Tension leads to
thrombosis,hemorrhage, tearing of PDL and
resorption of alveolar bone.
18. Stage 2 - Repair
• The damaged tissues are removed and new
connective tissue cells, fibers, bone and
cementum are formed to restore the injured
periodontium
• Forces are traumatic only as long as the
damage exceeds the reparative capacity.
• Buttressing bone formation
19. Stage 3 – Adaptive
Remodelling
• If the repair process cannot keep pace with the
destruction caused by the Occlusion, the
periodontium is remodeled in an effort to
create a structural relationship in which forces
are no longer injurious to the tissues
• This results in a thickened periodontal
ligament which is funnel shaped at the crest
and angular defects in the bone with no pocket
formation
20. Role of occlusion in
Periodontal Disease –
Historical review
• Karolyi Effect ( 1901 )
• Stillman’s definition of TFO ( 1917 )
• Stones and Box – Experiments on sheep and
monkeys ( 1938 )
• Orban ( 1939 ) – Based on autopsy and animal
experiments described changes occurring to teeth
when excessive forces were applied – describing
changes that occur to sides with tension and sides
with pressure.
21. Shortcomings of Early
Studies
• These early studies had the following
shortcomings
• They were primarily based on individual
observations and opinions
• They lacked proper controls
• The design of these studies did not justify the
conclusions drawn
26. Glickman’s Hypothesis
• TFO may alter the pathway of inflammation to
the underlying tissues.
• Inflammation may then proceed to the
periodontal ligament rather than to the bone.
• Resulting bone loss would then be angular and
pockets could be intrabony
27. Glickman’s Conclusions
• Trauma from occlusion is an integral part of
the disease periodontitis rather than an
unrelated disease entity and is an etiologic
factor in the formation of infra bony pockets
and angular or crater like osseous defects.
• Considered TFO a Co-Destructive factor in the
etiology of periodontal disease
• Occlusal Adjustment is to be considered as
inherent part of periodontal therapy
28. Waerhaug’s Plaque Front
Hypothesis
• Measured the distance between subgingival
plaque and the periphery of associated
inflammatory cell infiltrate and the surface of
the adjacent alveolar bone.
• He suggested that angular bony defects and
Infrabony pockets occur when the sub gingival
plaque of one tooth reaches a more apical level
than plaque on an adjacent tooth
30. Waerhaug’s Plaque Front
Hypothesis
• Connective tissue attachment and resorption of
alveolar bone around teeth was exclusively the
result of inflammation associated with plaque.
• Angular defects result due to the difference in
the apical migration of plaque.
31. Problems with Early studies
Initial studies introduced forces that
were continuous or intermittent that
were in one direction
Created Orthodontic type of forces
Also lot of the early studies were on
autopsy specimens
Did not create Jiggling trauma that is
seen when TFO is present in human
33. Studies with Orthodontic
Forces
• Studies by Steiner (1981) and Wennstrom
(1987) however demonstrated that
orthodontic forces producing bodily or
tipping movement of teeth may result in
Gingival Recession with loss of connective
tissue attachment
• This occurred at sites with gingivitis, and
when in addition the tooth was moved
through the alveolar proceess.
34. Animal Experiments-Jiggling
Trauma
Rochester Group
• Used squirrel monkeys
• Trauma induced by repetitive interdental
wedging
• Mild to Moderate gingival inflammation
was introduced
• Experiments were carried on upto 10
weeks
35. Animal Experiments-Jiggling
Trauma
Univ. of Gothenburg Group
• Used Beagle dogs
• Produced jiggling trauma by placing cap
splints and orthodontic appliances
• Induced severe gingival inflammation
• Experimental times were upto one year
40. Conclusions of Experiments
Jiggling Trauma superimposed
on Teeth with Experimental
Periodontitis
• The Rochester Group concluded that
Trauma superimposed on teeth with
Suprabony or Infrabony Pockets
a) Caused increased loss of alveolar bone
b) Failed to produce additional loss of
connective tissue attachment
41. Photomicrograph of teeth with
and without Jiggling Trauma
superimposed on teeth with
Infrabony Pockets
42. Jiggling Trauma superimposed on
Teeth with Experimental
Periodontitis-Gothenburg Group -
Conclusions
• TFO that allows adaptive alterations to
develop in pressure/tension zones of the
periodontal ligament will not aggravate a
plaque associated periodontal disease
• In TFO were adaptation did not occur the
Zone of Co-Destruction merged with the
Zone of Irritation resulting in apical
migration of the dento-gingival epithelium
and Aggravation of Periodontal Disease
43. Animal studies – Yoshinaga 2007
Distribution of RANKL in rat periodontium
during Lipopolysaccharide induced
inflammation with and without Occlusal
Trauma
44. Yoshinaga 2007
• Lipopolysaccharide(LPS) was injected rat
gingiva to induce inflammation. Occlusal
trauma was introduced by the placement of
gold inlays.
• The study found significantly more RANKL+ve
cells in the LPS and in the LPS + trauma
groups
• There was significantly more RANKL+ve cells
in the LPS + trauma group than the other two
45. Yoshinaga 2007
• This report demonstrated that LPS induced
inflammatory bone resorption with traumatic
occlusion, is more than destruction induced by
LPS or traumatic occlusion alone.
• The study also hinted that occlusal trauma
influenced the spread of LPS induced
inflammation to the furcation region .
46. Stress induced regulation of
mRNA Expression of
Osteoprotegerin
• Tsuji in 2004 reported that the combination
of LPS and mechanical stress reduced the
expression of Osteoprotegerin in
periodontal ligament cells in vitro
• These studies seem to indicate that occlusal
stress in association with LPS induced
inflammation upregulates factors that
promote increased bone resorption
47. Clinical Studies - Ethical
Issues
• Problems associated with non treatment of
Diagnosed Periodontal Diseases
• Therefore difficulties in formatting a RCT
World Workshop of Periodontics 1996 recognized
that “ Prospective studies on the effects of occlusal
forces on progression of periodontitis are not
ethically acceptable”
Therefore most studies in humans have been
Descriptive or Retrospective
48. Meta analysis
Systematic reviews
In vitro
research
Animal research
Ideas, editorials, opinions
Case reports
Case control studies
LEVELS OF CLINICAL EVIDENCE
Randomized
controlled trials
Cohort studies
1
2
3
4
5
49. Clinical Trials – Philstrom
1986
• Studied the association between TFO and
Periodontitis by assessing a series of clinical and
radiographic features of Maxillary 1st molars
• They concluded that teeth with increased
mobility and widened periodontal ligament
space had in fact, deeper pockets, moe
attachment loss and less bone support than
teeth without these symptoms
50. Clinical Trials – Burgett
1992
• Studied the effect of Occlusal Adjustment in
treatment of Periodontitis
• 50 patients following examination at baseline
were treated with Root Debridement and Flap
Surgery, out of whom 22 received
Comprehensive Occlusal Therapy.
• On re-examination those with Occlusal
Therapy had on average 0.5 mm greater
Attachment Gain than those who did not
receive occlusal therapy
51. Effects of Occlusal Discrepancies
on the Progression of Periodontal
Disease
• Nunn and Harrel in a series of studies published
in 2001 and 2004 reported that two specifically
defined occlusal parameters consisting of either
an occlusal discrepancy between centric
relation occlusion and centric occlusion and/or
a non working side contact.
• These studies reported that these occlusal
discrepancies are an independent risk factor
for the progression of periodontal disease with
periodontal treatment resulting in improved
52. Association of Occlusal Contacts
with Pocket Depths –Nunn &
Harrel 2009
• The following associations of deeper pocket depth
with occlusal prematurity was noted
• In CRO (0.89mm, p < 0.0001)
• Post. Protrusive contact( 0.51mm,p<0.0001)
• Balancing contacts ( 1.01mm,p<0.0001)
• Combining balancing &working side contacts
(1.13mm,p<0.0001)
53. Nunn & Harrel 2009
• Multiple types of Occlusal prematurities were
shown to be associated with deeper probing
pocket depths and an increased assignment of
a less than “Good” prognosis
• They suggested that treatment of Occlusal
Discrepancies as a routine part of periodontal
treatment may be indicated
54. Contradicting Studies
• Rosling et al (1976) – Infrabony pockets
associated with hypermobile teeth exhibited the
same degree of healing as adjacent firm teeth
• Jin and Cao (1992) – Concluded that there were
no significant differences in probing depth,
clinical attachment levels or alveolar bone
height, when comparing teeth with and without
abnormal occlusal contacts
55. Contradicting Studies
• Bernhardt et al (2006) investigated the potential
associations between dynamic occlusal
interferences and signs of periodontal disease
in posterior teeth
• They demonstrated a weak relationship
between non working side contacts and
increased probing depth and attachment loss.
56. What do we Know?
• Trauma from occlusion does not initiate
gingivitis or periodontitis
Literature review though not unambiguous
seems to suggest the following:
• Occlusion may be a risk factor in the
progression of periodontal disease
• Healing following surgical treatment of
periodontal disease may be more advantageous
in Non-mobile Teeth than in Mobile teeth
57. Evidence Based Approach for
Decision
Making
Newman et al : Ann Periodontol 2003
• Is Objective
• Is Scientifically Sound
• Is Patient Focussed
• Incorporates Clinical Experience
• Is Thorough and Comprehensive
• Uses Transparent Methodology
60. Occlusal Considerations –
Implant Dentistry
• Main difference between a tooth and implant is the
lack of Periodontal Ligament
• There are no proprioceptive nerve endings
• The Blood Supply is less
• Implants have very limited capacity to displace
axially ( 3 – 5 µm)
61. Consequences of Biomechanical
Overload
• Early Implant Failure
• Early Crestal Bone Loss
• Intermediate - Late bone loss & implant failure
• Screw loosening/Un-cementation
• Component/Porcelain Fracture
• Peri Implantitis (from crestal bone loss)
62. Implant Protective
Occlusion
• No premature occlusal contacts/inteferences
• Influence of Surface Area
• Mutually Protected Occlusion
• Implant body angle to occlusal load
• Cusp angle to crown
• Cantilever – Horizontal/vertical Offset
• Implant Crown Contour
• Protect the weakest component
63. Proprioception in
Implants
• Teeth identify inteferences at approximately
20µm.
• An implant opposing a natural tooth detects an
interferences at 48µm
• An implant opposing an implant detects an
interference at 64µm
• When a tooth opposes an implant supported
overdenture the awareness is at 108µm
65. Occlusion on Natural Teeth
and Implants
Implants do not display Immediate Horizontal Mobility. With Heavier
Forces mobility ranges from 10 to 50µm.
66. Axis Of Implant To The
Load
• Non – Axial / Off Axis loading is harmful
• Cantilevered Loading is harmful
• Control the Horizontal Force with Cusp
Incline
• Reduce the area of the Occlusal Table
67. Occlusion and Abfraction
• Abfraction – Coined from two Latin words
Ab – Away
Fractio – Breaking
ie. Breaking Away
Term coined by John Grippo in 1991
68. Abfraction
• Definition: The Pathological loss of tooth
substance caused by Biomechanical
Loading Forces that result in flexure and
failure of enamel and dentine at a
location away from Loading
69. Abfraction - History
• In the early ‘80s McCoy questioned the role of
tooth brush abrasion in what had previously
been considered cervical abrasion
• He postulated using Engineering Studies that
tensile stress from mastication and
malocclusion broke the Hydroxyapatite
chemical bonds making them susceptible to
toothbrush abrasion and chemical erosion
74. •There is a tendency to think of occlusal
adjustment
solely in a negative sense.
•Equally important purpose is to provide
Functional
•Stimulation necessary for the preservation of
Periodontal Health.
75. Relationship between Occlusal
Force and progression of
Periodontal Disease – Takeuchi
2010
• Prognosis of teeth in maintenance phase was
significantly affected by Low Occlusal Forces ( p
< 0.006)
• Suggested that Low Occlusal Forces might be
possible Risk Factor for Periodontal Disease
Progression
76. Biologic Basis of Occlusal
Function
• Physiologic Occlusion is present when no signs
of Dysfunction or Disease are present and no
treatment is indicated
• Non-Physiologic Occlusion is associated with
Dysfuction or disease due to tissue injury
Criterion that decide whether the occlusion is
traumatic is whether it produces periodontal
tissue injury, not how the teeth occlude
77. Terminologies
• Intercuspal Position
• Muscular Contact Position
• Excursive Movement
• Laterotrusive Side
• Mediotrusive Side
• Protrusion
• Retruded Position
• Guidance
• Interference
78. Guidelines for Therapeutic
Occlusion
Natural Dentition
1. ICP –
2. RCP –
3. Vertical Stops – Stable multiple contacts on the
posterior teeth providing individual tooth stability.
No buccal – lingual thrust or impact to any tooth in
closure to ICP.
4. Laterotrusive Excursions – Smooth movement with
diclusion controlled by canine and first premolar
on thelaterotrusive side .No contacts on
79. Guidelinesfor
TherapeuticOcclusion
Natural Dentition – Cont’d
5. Protrusive Excursions – Smooth movements with
multiple contacts bilaterally distributed on the
anterior teeth
6. Interfernces – Freedom from non working side
contacts. Freedom from posterior contacts on
protrusive excursions. Freedom from single
tooth molar contacts on any excursion.
7. Acceptable free way space – The normal range is
1-4mm . If the free way space measures more
and there are symptoms it must be treated
80. Guidelines for Occlusion in
Dental Treatment
Subjective to response to occlusion
• Lack of unpleasntness or untoward
awarness concerning in dental occlusion.
• Acceptable
- Freeway space
- Speech articulation
- Chewing ability
- Mandibular position
81. Recommended Materials for
Identifying and Making Tooth
Contact and Contact Movement
Products
• Occlusal registration strips
• Occlusal wax indicator
• Marking ribbion ,red,green
• Articulating paper, Blue
83. Occlusal Adjustment
Grooving
• Entails restoring the depth of devolopmental
grooves ; Done with tapered cutting tool until
its desired depth is attained.
84. Occlusal Adjustment
Spheroiding
• Consists of reducing the supracontact while
restoring the original tooth contour;Effort made
to preserve the occlusal height of the cusps.
86. Schedule of Coronoplasty
1. Remove retrusive prematurities and eleminate
the deflective shift from RCP to ICP.
2. Adjust ICP to achieve stable ,simultaneous,
multipointed, widely distributed contacts.
3. Test for excessive contact (fremitus) on the
incisor teeth.
4 Remove posterior protrusive supracontacts and
establish contacts that are bilaterally
distributed on the anterior teeth.
87. Schedule of Coronoplasty
5. Remove or lessen mediotrusive interferences.
6. Reduce excessive cusp steepness on the
laterotrusive contacts.
7. Eliminate gross occlusal disharmonies.
8. Recheck tooth contact relationships.
9. Polish all rough tooth surfaces.
90. Group Function Guidance
• Most favorable alternative to canine
guidance
• Several teeth on the working side contact
during laterotrusive movement
• Most desirable consists of the canine,
premolars and sometimes mesio – buccal
cusp of first premolar
91. Mutually Protected
Occlusion
• A mutually protected occlusion is an
occlusal scheme in which the anterior
teeth protect the posterior teeth, and vice
versa.
• Anterior guidance of an implant should
be as shallow as practical
• On lateral excursions the posterior teeth
are discluded by anterior segment of jaws
93. Maxillary Stabilization
Appliance
• Remains the most universal and effective long
term means of interfering with the effects of
bruxism.
• Aim of the appliance is to protect the tooth
surface and dissipate forces built up in the
mucoskeletal system through bruxism.
• Appliance results in an immediate reduction of
masseter and temporalis muscle activity levels.
94.
95. Criteria for Maxillary
Stabilization Appliance
Occlusal Criteria
• Appliance : stable
• RCP,ICP : stable ,multipointed , widely
distributed contacts.
• ICP: Posterior vertical steps in firm
contact;incisor teeth in slight infracontact.
• RCP-ICP relationship : in the same sagittal
plane.
• Smooth gliding contact in all excursions.
• MCP : stable , repeatable.
99. Conclusions
• There is no scientific evidence to show that trauma
from occlusion causes gingivitis or periodontitis or
accelerates the progression of gingivitis to
periodontitis.
• The periodontal ligament physiologically adapts to
increased occlusal loading by resorption of the
alveolar crestal bone resulting in increased tooth
mobility. This is Trauma from Occlusion and is
reversible if the Occlusal force is reduced.
100. Conclusions
• Trauma from Occlusion may be a co-factor which
can increase the rate of progression of an existing
periodontal disease.
• There is a place for Occlusal therapy in the
management of periodontitis,
• Occlusal therapy is not a substitute for
conventional methods of resolving plaque-induced
inflammation.
101. Conclusions
• A Comprehensive Knowledge of the
Dynamics of Occlusal Loading Forces on
Peri-Implant tissues is the most significant
factor in the successful rehablitation of
patients with Implants