CONSIST OF INDTRODUCTION, PAIN DEFINITION , MECHANISM OF PAIN, THEORIES OF PAIN, PATHOPHYSIOLOGY OF PAIN, THORIES OF DENTIN HYPERSENSTIVITY , TREATMENT
CONSIST OF INDTRODUCTION, PAIN DEFINITION , MECHANISM OF PAIN, THEORIES OF PAIN, PATHOPHYSIOLOGY OF PAIN, THORIES OF DENTIN HYPERSENSTIVITY , TREATMENT
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
Brief notes on the inflammation of Alveolar bone that surrounds a tooth that has recently been extracted. It occurs as a complication of tooth extraction.
ORN is an inflammatory condition of bone that occurs after the bone has been exposed to therapeutic doses of radiation usually given for a malignancies.
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.
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
Brief notes on the inflammation of Alveolar bone that surrounds a tooth that has recently been extracted. It occurs as a complication of tooth extraction.
ORN is an inflammatory condition of bone that occurs after the bone has been exposed to therapeutic doses of radiation usually given for a malignancies.
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.
Premalignantlesions and conditions by Dr. Amit T. Suryawanshi, Oral Surgeon,...All Good Things
Hi. This is Dr. Amit T. Suryawanshi. Oral & Maxillofacial surgeon from Pune, India. I am here on slideshare.com to share some of my own presentations presented at various levels in the field of OMFS. Hope this would somehow be helpful to you making your presentations. All the best.
abscess advanced trauma life support anterio advanced trauma life support antibiotics apically repositioned flap dental diseases dr dr shabeel drshabeel’s face eye trauma lidocaine anodontia management medical medicine misuse and abuse orthodontics teeth braces pharmacy pn preparation dental students for community based ed presentations s abscess abscess tooth active orthodonti shabeel shabeel"s shabeel’s shabeelpn trends of antimicrobial usage in dental practice View all
’s abscess abscess advanced trauma life support anterio abscess tooth active orthodontics adolescent advanced trauma life support aesthetic dentistry airway management alignment of teeth amalgam anesthesia in dentistry anesthetics in dentistry anterior open bite antibiotic resistanace antibiotics antibiotics and leukopenia aphthous ulcers apically repositioned flap apicoectomy appliances arch dental arch form orthodontics braces arch length orthodontics braces arch wire orthodontist braces ayurvedha baby teeth bloger boil books braces braces teeth cancer canker sore pain cavity preparation children community based learning congenitally missing teeth cosmetic dentistry csf leaks dental dental anesthetics dental restorations dental teeth dento alveolar fractures disease
This is a PPT of Trigeminal neuralgia for Masters students . take an idea from it...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Facial neuropathology Maxillofacial SurgeryLama K Banna
Lecture 4 facial neuropathology
Maxillofacial Surgery
Dental Students Fifth Year second semester
Al Azhar University Gaza Palestine
Dr. Lama El Banna
https://twitter.com/lama_k_banna
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
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.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
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.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
7. A-history:
1-Chief complaint.
2-History of present illness.
Pain Characteristics
Intensity
Quality
Location
Onset
Associated events at onset
Duration and timing of pain
Course of symptoms since onset
Activities that increase pain
Activities that decrease pain
Associated symptoms (eg, altered sensation, swelling)
Previous treatments and their effects
Referral
8. 3-Past medical history
-Connective tissue disease.
-Demylination disorder.
-Metastatic disease.
-Ischemic heart disease.
4-Social history:
-History of traumatic event prior to onset of pain.
-Change in work, or problem regarding marital
state.
9. B-physical examination:
1. Inspection of the head and neck skin,
2. Palpation of masticatory muscles,
3. Assessment and measurement of the range of
mandibular movement.
4. Palpation of soft tissue .
5. Palpation of the temporomandibular joint
6. Palpation of cervical muscles and assessment of
cervical range of motion.
7. Cranial nerve examination.
8. General inspection of the ears, nose, and
oropharyngeal areas.
9. Examination and palpation of intraoral soft tissue.
10. Examination of the teeth and periodontium (including
occlusion.
10. Methods of pain measurement:
1-visual analog scale (VAS)
0 -----------------------------------10
no pain
worst possible pain
2-Descriptive rating scales (eg, no pain, mild,
moderate, severe pain).
3-Faces rating scale.
4-The McGill Pain Questionnaire (MPQ) .
11.
12. -Used to confirm the diagnosis or rule out
serious disease.
-Extent of an identified disorder.
-Most OFP not produce abnormality.
14. Myofascial
pain
diffuse poorly localized periauricular pain.
May associated with parafunctional habits .
the pain may be severe in morning.
the pain is more severe during periods of
tension and anxiety.
the range of mandibular movement decrease .
"trigger points," where muscles have taut,
palpable band regions that twitch when
manually percussed.
15. -Education of patient and explanation .
-Self care to eliminate oral habit such as gum
chewing , clenching of teeth.
-thermal therapy(U/S, laser ).
-Intraoral appliance.
-Pharmacotherapy:
-NSAID.
-Muscle relaxant drugs ,
-Antianxiety drugs.
-TCAs.
Botox injection.
Trigger point block therapies, using local anesthetic in
combination with corticosteroid.
16. Pain
on palpation directly over TMJ.
Limitation in joint range of motion.
Deviation on opening.
Joint noises consistently associated
with pain.
Joint crepitus.
Mahan sign (+ve in Wilkes II,III and IV).
20.
Rare pain disorder characterized by
continuous lancinating like pain in site of
previous tooth extraction.
Usually in lower 3rd molar region.
Pain not interfere with sleep.
Radiographically appear as moth eaten or
soap bubbles in site of previous extraction.
Treated by resection of bone area with
pain ,
22. Definition :
usually unilateral sever
brief sudden stabbing
pain in distribution of
one or more of branches
of trigeminal nerve.
23.
TN divided to primary and secondary(symptomatic)
the primary TN are result of vascular
compression of trigeminal nerve near its entry
into the pons (superior cerebellar artery).
Secondary TN causes include :multiple sclerosis,
tumors ,basilar artery eneurysim or actasia.
24.
It presents as episodic ,recurrent unilateral
facial pain, described as sudden high intensity
stabbing or electric like shock.
lasts for a few seconds to minutes ,
Pain is frequently triggered by trivial stimulation:
such as touching of face, washing ,shaving ,
chewing and talking.
25. It occurs mostly after 5th decade.
Clinical examination of face is nearly always
normal.
If sensory loss is present a mass lesion is more likely
In young patients with TN, multiple sclerosis should
be considered.
26.
Diagnosis depend on history and
clinical examination.
A careful search for ipsilateral
dental pathology should be
undertake
MRI and MRA and performed if
there is suspicion of underlying
pathology.
28. 1- Medical treatment:
Carbamazepine 200 mg _ 1600mg bid .(effective
in 75% as first line of treatment)
Oxcarbazepine 600mg _3000mg It used in patients
who are sensitive to Carbamazepine.
Baclofen 15mg _80mg tid.
Gabapentine 900mg _3600mg tid.
Lamotrigine 25mg _300mg.
Clonazepam 1.5 mg _ 6mg
Phenytoin 300 mg
Valproate sodium 500mg _1500mg
29. 2- Surgical treatment(invasive):
indicated If medical treatment (carbamazepine) has
been ineffective after 4 weeks at maximum
tolerated dose .
Surgical treatment divided into 3 groups:
a)
peripheral procedures :include alcohol injection, cryosurgery
,nerve avulsion
a)
Percutaneous ganglion procedure: include radiofrequent
thermocoaglation ,glycerol injection , balloon
compression,Gamma knife.
Open operations : microvascular decompression ,trigeminal
root section,
b)
31. Post-herpetic neuralgia
-Pain is typically aching,buring,or shock
like.
-Potential sequela of infection with
herpes zoster.
Pain persist longer than one month after
healing vesicle classified as PHN.
32.
-Antiviral and corticosteroids after
presentation of rash reduce incidence of
postherptic neuralgia.
-Anticonvulsant drugs
-Local anesthesia injected to painful site.
33. Glossopharangeal neuralgia
Clinical features :
Pain similar to character of TN.
Affect tonsil ,tongue base, ear,and intra articular
area.
Patient often point just to behind mandible angle.
Triggered by yawing and swallowing.
may be associated with a vasovagal reflex,
The application of a topical anesthetic to the
pharyngeal mucosa eliminates glossopharyngeal
nerve pain.
34. Glossopharangeal neuralgia
Etiology:
The most common causes of glossopharyngeal
neuralgia areintracranial or extracranial tumors and
vascular abnormalities that compress CN IX.
Management:
-Anti convulsion drugs,carbamezipine.
-Vascular decompression.
-Percutaneous R.F. at the jugular foramen.
-Intracranial or extra cranial neuroectomy.
35.
presents as a paroxysmal stabbing pain in the
distribution of the greater or lesser occipital nerves.
It may be caused by trauma,
Palpation below the superior nuchal line may
reveal a tender spot .
Treatment has included occipital nerve block,
neurolysis, C2 dorsal root gangionectomy ,
36. Its caused by Trigeminal nerve injuries may result
from facial trauma or from surgical procedures,
such as the removal of impacted third molars, the
placement of dental implant
Clinical Manifestations: The pain may be persistent
or occur only in response to a stimulus, such as a
light touch.
Patients with nerve damage may experience
anesthesia , paresthesia, allodynia , or
hyperalgesia .
37. Treatment:
may be surgical ,nonsurgical, or both,
Systemic corticosteroids a when administered
within the first week after a nerve injury.
TCAs
Anticonvulsant drugs, Gabapentin.
Topical capsaicin .
38.
chronic pain conditions that develop as a result of
injury.
patients suffer from allodynia, hyperalgesia, and
spontaneous pain that extends beyond the
affected nerve dermatome.
it accompanied by motor and sweat
abnormalities, atrophic changes in muscles and
skin, edema,
39. Types of CRPs :
1- CRPS I was previously termed reflex sympathetic
dystrophy (RSD),
2- CRPS II was previously termed causalgia.
Etiology and Pathogenesis:
believed to result from changes after trauma that
couples sensory nerve fibers with sympathetic
fibers.
40. Treatment:
physical therapy.
block of regional sympathetic ganglia or regional
intravenous blockades with guanethidine
,reserpine, or phenoxybenzamine,
Bisphosphonates such as alendronate or
pamidronate.
41. Nervous Intermedius (Geniculate)
Neuralgia
Paroxysmal pain of facial nerve, may result of
herpes zoster of geniculate ganglion.
-Clinical features:
-Pain at the ear, anterior tongue, soft palate.
-Not intense like T.N.
- Ramsay-hunt syndrome may develop(Facial
paralysis ,vesicle ,tinnitus & vertigo)
42. Management:
-High dose of steroid for 2-3weeks.
-Acyclovir is significant in reduce the
duration.
-Anti convulsion ,Carbamezipine.
-Surgery: section of nerve intermedius.
43.
Condition secondary to damage caused by
a cerebrovascular accident .
its is characterized by constant or paroxysmal
pain accompanied by sensory abnormalities ,
44. Treatment:
anticonvulsant ( Lamotrigine,Gabapentine)
sodium channel blocker(Mexiletine).
TCAs (Amitriptyline).
Short-term relief may be obtained with intra
venous lignocaine or propofol .
Note: the anticonvulsants are preferred
45.
In about 50% of patient with Bell's palsy,
pain occur in or near the ear but sometimes
spreading down the jaw, either precedes or
develops at the same time as the facial
palsy.
Treatment: prednisolone 60-80 mg per day,
acyclovir.
46.
Constant dull aching pain , deep ,diffuse
variable intensity in absence of identifiable
organic disease.
Its more common in female .
Most patient middle age and elderly .
47. Clinical features:
Often difficult for patients to describe their symptoms .
Most frequently described as deep , constant ache or
burning .
Doesn't awake patient.
Doesn't follow anatomical pattern and may be
bilateral.
Affect maxilla more than mandible.
Often initiated or exacerbated by dental treatment .
Examination entirely normal .
Often have other complaints such as IBS ,dry mouth
and chronic pain syndrome .
48. Treatment :
Often rewarded with limited response.
Tricyclic antideprssant drugs have some
effect in some patients .
30% of patient respond to Gabapentine
Cognitive behavior therapy
49. Atypical odontalgia(phantom)
occurs most frequently in women in the fourth and
fifth decades of life,
constant dull, aching pain without an apparent
cause that can be detected by examination ,
it occur after dental extraction or endodontic
treatment ,
Period of pain free after secondary dental
management.
51. Burning mouth syndrome
Burning sensation of oral mucosa , usually
tongue, in absence of any identifiable
clinical abnormality or cause.
Epidemiology: 5 per 100,000 ,higher in
middle age and elderly, affect female
more than male .
Causes: unknown but hormonal factors ,
anxiety ,and stress have been implicated.
52.
Complain of dry mouth with altered or
bad taste.
Burning sensation affecting tongue ,
anterior palate and less common lips.
May be aggravated by certain foods.
Usually bilateral.
Doesn't awake patient . But may present at
awaking
Examination entirely normal .
53. Investigation: FBC ,haematinics ,swab for
Candida .
Treatment:
Reassurance .
Avoidance of stimulating factors.
Some patients may respond to TCA, SSRIs
topical clonazepam, sucking and spitting 1
mg three times daily for 2 weeks.
2-month course of 600 mg daily alfa-lipoic
acid.
Cognitive behavior therapy.
54. a series of symptoms caused by an elongated
styloid process (more than 3 c.m) and/or the
ossification of part or the entire stylohyoid
Ligament.
55. 1-Classic :
the symptoms are persistent pharyngeal
pain aggravated by swallowing and
frequently radiate to the ear , with sensation
of foreign body within pharynx , This pain
arise following
tonsillectomy
due to
development of scar tissue around the tip of
the styloid process.
56. 2- stylo-carotid artery syndrome(vascular):
Attributed to impingement of the carotid artery by
the styloid process This can cause a compression
when turning the head resulting in a transient
ischemic accident or stroke.
3-Traumatic Eagle syndrome:
in which symptoms develop after fracture of a
mineralized stylohyoid ligament.
57.
58. (1)clinical manifestations,
(2) digital palpation of the process in the tonsillar
fossa,
(3) radiological findings .
(4) lidocaine infiltration test.
Treatment:
COSERVATIVE: involves injecting steroids
or long-lasting anesthetics into the lesser cornu of
the hyoid or the inferior aspect of the tonsillar fossa
I,NSAID
Surgical: intra oral or extra oral styloidectomy
59. Migraine
Before puberty , female more than
male .
Aura may developed before headache
in 40%.
It may be triggered by foods such as
nuts, chocolate, and red wine ; stress;
sleep deprivation; or hunger.
60. A-classic migraine (start with prodromal aura
occurring over 20-30 minutes )
Flashing lights
Scotoma (localized area of vision depression )
Sensitivity to light
Sensory and motor deficit
Aura is followed by severe unilateral throbbing pain.
Headaches may last for hours or up to 2 or 3 days.
B-common migraine (not preceded by aura)
Severe unilateral throbbing pain
Sensitivity to light and noise
Nausea and vomiting
61.
30-50 years of age.
Pain last for minutes to hours and recurs several
times per week.
Throbbing pain of neck and jaw.
Patients often seek dental consultation,
Tenderness of carotid artery
D-Basilar migraine :
The symptoms are primarily neurologic and
include aphasia,temporary blindness, vertigo,
confusion, and ataxia.
may be accompanied by an occipital
headache.
63. Clinical Manifestations:
80%of patients with CH are men.
The attacks are sudden, unilateral, and stabbing
,causing patients to pace, cry out, or even strike
objects. Some patients exhibit violent behavior
during attacks.
pain as a hot metal rod in or around the eye.
Each attack lasts from 15 minutes to 2 hours and
recurs several times daily.
A majority of the painful episodes occur at night,
often awaking the patient from sleep.
64. Clinical Manifestations:
The pain is associate nasal congestion and tearing
Sweating of the face, ptosis, increased salivation,
and edema of the eyelid.
Cluster headache produce pain in posterior
maxilla that mimic dental pain.
Trigger by alcohol.
65. Treatment:
An acute attack:
100% oxygen (its effectiveness is diagnostic), Injection
of sumatriptan or sublingual or inhaled ergotamine
Prophylaxis : lithium, ergotamine, prophylactic
prednisone, and calcium channel blockers.
66. is believed to be a form of CH that occurs
predominantly in women between the ages of 30
and 40 years.
The episodes of pain tend be shorter, but attacks
of 5 to 20 minutes’ duration can occur up to 30
times daily.
It responds dramatically to therapy with
indomethacin , which stops the attacks within 1to 2
days.
67. -Its inflammation(vasculitis) of cranial arterial
tree.secondary to giant cell granulomatous.
Clinical features:
most frequently affects adults above the age of
50 years.
Dull aching or throbbing temporal pain.
accompanied by generalized symptoms ,
including fever, malaise, and loss of
appetite.
Jaw claudication during mastication.
68. Diagnosis:
elevated ESR 50-100 .
elevated CRP.
Biopsy.
-Treatment:
high dose of steroid(prednisolone) 60 -100mg
daily.
the steroid is tapered once the signs of the disease
are controlled.
Patients are maintained on systemic steroids for 1
to 2 years after symptoms resolve.
69. References
1-Burket,s oral medicine.
2-Neville , Oral & Maxillofacial PATHOLOGY
3-Fonseca Oral and Maxillofacial surgery.
4- Booth Oral & Maxillofacial surgery.
5-Lecture notes in oral and maxillofacial surgery.
6- Orofacial pain ,from basic to management