Peizosurgery: A boon in modern periodonticsAnushri Gupta
Piezoelectricity is the electricity resulting from pressure. It is effective in precise bone cutting. It spares soft tissue and hence less blood loss is seen.
Peizosurgery: A boon in modern periodonticsAnushri Gupta
Piezoelectricity is the electricity resulting from pressure. It is effective in precise bone cutting. It spares soft tissue and hence less blood loss is seen.
The primary success metric of dental implants is achieving osseointegration, which is influenced by many factors including implant design, surface treatments, as well as treatment method. Implant drilling is also a major influential factor.
The biological fixation determines the longevity of dental implant treatment. It ensures the long term survival of dental implant. Better the osseointegration,higher will be the survival rate
A diplomate of the Board of Periodontology, Perry Westbrook, DMD, is also one of the nation’s first Kois Center Recognized Periodontist Specialists. Dr. Perry Westbrook has trained in piezosurgery, an advanced type of bone surgery, and holds a membership with the International Piezosurgery Academy.
In an age where every teeny tiny bit of electricity is valued, conservation is much talked about, can piezoelectricity be the messiah to ease the burden off the conventional energy sources?
Who says it cannot?
--
Presentation as a part of seminar coursework.
The primary success metric of dental implants is achieving osseointegration, which is influenced by many factors including implant design, surface treatments, as well as treatment method. Implant drilling is also a major influential factor.
The biological fixation determines the longevity of dental implant treatment. It ensures the long term survival of dental implant. Better the osseointegration,higher will be the survival rate
A diplomate of the Board of Periodontology, Perry Westbrook, DMD, is also one of the nation’s first Kois Center Recognized Periodontist Specialists. Dr. Perry Westbrook has trained in piezosurgery, an advanced type of bone surgery, and holds a membership with the International Piezosurgery Academy.
In an age where every teeny tiny bit of electricity is valued, conservation is much talked about, can piezoelectricity be the messiah to ease the burden off the conventional energy sources?
Who says it cannot?
--
Presentation as a part of seminar coursework.
Surgical procedures in fixed partial denture prostheses/ General orthodonticsIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Piezoelectric surgery definition
History
Indications
Mechanism of action
Types
Advantages
Disadvantages
Uses of piezoelectric device
Implant surgery in dentistry
This presentation has videos and more surgical aspects of recent advances in Implant dentistry.This is different from other presentations in this platform since it is stuffed with most recent articles and informations
Smoking is a major public health problem. Cigarette smoking acts as a nicotine delivery in humans, has found to produce profound changes in physiological architecture. Smoking’s as well as chronic pain are one of the major challenging health concerns faced in day to day life. During smoking nicotine is quickly absorbed into the blood stream within a time gap of 30 seconds it reaches the brain. It stimulates the brain to release various chemicals namely epinephrine which will give a pleasurable euphoric effect. It is a proven fact that smoking of tobacco will cause the production of Rheumatoid factors or anti-cyclic citrullinated peptide autoantibodies which is a risk factor for the development of Rheumatoid arthritis. There is a positive relation between smoking and depression and it has been seen smokers use more number of cigarettes when depressed and smoking also caused the individual who is depressed more prone to pain than a normal smoker. Quitting of smoking is quite difficult because of unpleasant withdrawal syndrome that consists of frustration, depression, anxiety, reduced heart rate, increased weight, depressed mood, difficulty in concentration. Because of all these withdrawal symptoms individuals who try to quit start up again very soon. Smoking is a health hazard, this is a well-known fact and the noxious effects are multiple so in management of pain in theseindividual’s, necessary steps has to be put forward in order to quit the habit. Cognitive behavioural therapy or antidepressant therapy in the management of pain of depressed patients who are smokers has shown good results in a rehabilitation centre on the course of the management of pain.
Taurodontism, a dental anomaly is defined as a change in tooth shape caused by the failure of
Hertwig’s epithelial root sheath to invaginate at the proper horizontal level. Enlarged and elongated
pulp chamber, apically shifted pulpal floor, and lack of constriction at the level of the cementoenamel
junction are the characteristic features. In performing root canal t
appreciate the complexity of the root canal system, canal obliteration, configuration, and the potential
for additional root canal systems. Careful exploration of the all orifices with the help of magnification,
ultrasonics and a modified filling technique are useful for its better management.
Smear layer is a controversial topic in the field of operative dentistry and endodontics. This presentation includes composition, concepts, structure, advantages, disadvantages, and removal methods of smear layer.
This presentation is all about restoration of endodontically treated teeth, prefabricated post and core, cast post and core, direct and indirect technique.
This presentation describes about evolution of nitinol (NiTi), its properties, manufacturing, metallurgy and various rotary systems in the field of endodontics.
About failures of root canal treatment and retreatment. This presentation describes about various techniques for gutta percha removal, posts removal, pastes removal, and removal of separated instrument
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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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
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.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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
2. Introduction
• One goal of endodontic surgery is to treat apical
periodontitis in cases in which healing has not
occurred after nonsurgical retreatment or, in
certain instances, after primary root canal
therapy.
• Such cases include patients with persistent or
refractory intracanal infection after iatrogenic
changes to canal anatomy or those with
microorganisms in proximity to the constriction
and apical foramen.
3. • Other indications include extraradicular
infections, such as the presence of bacterial
plaque on the apical root surface or bacteria
within the lesion itself.
• Advantages of modern surgical endodontic
treatment include easier identification of root
apices; smaller osteotomies; and shallower
resection angles, which preserve cortical bone
and root length.
• Introduction of CBCT scanning is particularly
useful for both diagnosis and treatment
planning.
4. • It eliminates of the superimposition of
anatomic structures, such as the zygomatic
buttress, alveolar bone, maxillary sinus, and
other roots, and helps in detection of the
presence and dimensions of apical lesions and
changes in apical bone density.
• Although many published studies advocate
the use of modern approaches, limited
information is available on the applications of
piezosurgery (piezoelectric bone surgery) in
endodontic surgery.
5. • Piezosurgery is a meticulous and soft tissue–
sparing system for bone cutting based on
ultrasonic microvibrations.
• Vercellotti et al pioneered its application in
periodontal surgery.
• Selective cutting is the most innovative
feature of the piezoelectric surgery device.
• Although piezosurgery cuts mineralized tissues
such as bone, it does not cut soft tissues such
as blood vessels, nerves, and mucosa.
6. • Indications for the use of piezosurgery devices
are increasing in oral and maxillofacial surgery,
as in other disciplines, such as endodontics.
• Currently, piezoelectric instruments can be
used at most stages of endodontic surgery,
reducing the risk of damage to soft tissues.
7. Overview
• Ultrasound is sound energy with a frequency
above the range of human hearing, which is
20 kHz.
• It is usually achieved either by
magnetostriction or piezoelectricity.
• In magnetostriction electric current passes
through a wire coil in the handpiece, a
magnetic field is created around the stack or
rod transducer, causing it to constrict.
8. • Alternating current then produces an
alternating magnetic field that causes the tip
to vibrate.
• Piezoelectric scaler units are based on the
piezoelectric effect which was first described
as “some ceramics and crystals deform when
an electric current is passed across them,
resulting in oscillations of ultrasonic frequency
without producing heat.”
9. • The resultant vibration produces tip
movement that is primarily linear in
direction and generally allows only 2 sides
of the tip to be active at any time.
• Piezoelectric scaler units have some
advantages over earlier magnetostrictive units
because they offer more cycles per second.
• The tips of these units work in a linear, back-
and-forth, ‘‘piston-like’’motion, which is ideal
for endodontics.
10. • Piezosurgery was introduced as an alternative
to the traditional instrumentation used in oral
bone surgery.
• Piezosurgery is a new and innovative method
that uses piezoelectric ultrasonic vibrations to
perform precise and safe osteotomies.
• It was developed in 1988 by the Italian oral
surgeon Vercellotti to overcome the
limitations of conventional bone surgery.
11. • The vibrations obtained are amplified and
transferred to a vibration tip, which, when
applied with slight pressure to bone tissue,
results in a mechanical cutting effect that
occurs exclusively in mineralized tissue.
• Piezosurgery uses a specifically engineered
surgical instrument approximately 3 times as
powerful as a conventional ultrasonic
instrument (a piezoelectric scaler unit).
12. • The unique feature of the piezosurgery
technique is that cutting occurs when the tool
is applied to mineralized tissue but stops
when soft tissue is encountered.
• The light handpiece pressure and integrated
saline coolant spray of piezosurgery maintain
a low temperature and allow clear visibility of
the surgical site.
13. Bone-tissue Management
• Piezosurgery is useful when bone must be cut
close to important soft tissues, such as nerves,
vessels, and the dura mater, or when
mechanical or thermal injury must be avoided.
• Trauma to the mental nerve caused by blunt
dissection in this area can cause temporary
paresthesia but is less likely to leave
permanent injury.
14. • Schaeren et al concluded that direct exposure
of a peripheral nerve to piezosurgery, even in
the worst case scenario, does not dissect the
nerve.
• This makes piezosurgery a promising tool for
osteotomy procedures in close proximity to
nerves during endodontic surgery.
• The cutting characteristics of piezosurgery
depend on the degree of bone mineralization,
the design of the insert, the pressure applied
to the handpiece, and the speed of operation.
15. • Bone quality can be evaluated with CBCT and
the appropriate power level is selected.
• Piezosurgery requires only minimal pressure
unlike conventional microsaws or drills.
• Piezosurgery devices provide a clear surgical
site; they maintain a blood-free field during
bone cutting through an air-water cavitation
effect.
• Walmsley et al suggested that cavitation
fragments bacterial cell walls and therefore
has an antibacterial function.
16. • The Piezosurgery Insert
OTS7-4 (Mectron) is effective
for microsurgical
applications, including
osteotomy and root-end
resection.
• Convenient laser-etched
markings at 7, 8.5, and 10
mm inform the clinician of
the osteotomy depth.
19. Enucleation of Radicular Cysts
• One important application of piezosurgery is in
the enucleation of radicular cysts.
• For enucleation of a lateral periodontal cyst, the
Piezosurgery Retrosurgical Kit is available, which
is specifically designed for endodontic surgery.
• Diamond-coated inserts can be used to remove
the bone lamina over the cyst, whereas dull,
bellshaped inserts can be used for the dissection
of the cyst epithelium from the bone.
20. • The use of piezosurgery in the treatment of jaw
cysts is a new development, and few cases have
been reported.
• Atraumatic handling of soft tissues is required for
the complete removal of cystic lesions and is
technically comparable to handling the sinus
membrane during sinus bone grafting.
• The main advantage of enucleation is that it
facilitates a pathologic examination of the entire
cyst.
• Another advantage is that total excisional biopsy
treats the lesion appropriately.
21. • Yaman and Suer evaluated the performance
of piezosurgery in removing odontogenic
cysts.
• They concluded that piezosurgery increased
operation time but also markedly increased
visibility in the operating field.
• In cases in which cyst enucleation is necessary
in difficult areas requiring delicate
manipulation, the use of piezosurgery carries
a lower risk of damage to vital structures, such
as neurovascular tissues.
22. Dull – Bell Shaped Insert
Dissection of cyst epithelium
From bone
Complete enucleation of cystCyst Removal
23. Root-end Resection
• Minimization of the bevel angle during root
resection is one of the most important
developments in endodontic microsurgery.
• The traditional technique uses a bevel angle of
45–60 to facilitate access and visibility when
using large surgical instruments.
• The modern technique uses a shallow bevel
angle of 0–10 to expose fewer dentinal
tubules.
24. • Several authors have shown that the type of
instrument and cutting angle used directly
relate to apical surface roughness and dentinal
tubule exposure after root-end resection.
• A Brazilian company developed chemical
vapor deposition (CVD)-coated diamond tips
adaptable for use with conventional
ultrasound devices and marketed under the
brand name CVDentus System.
25. • Bernardas et al compared an ultrasonic CVD-
coated tip with high- and low-speed carbide
burs for apicoectomy, evaluating resection
time and analyzing root-end surfaces using
SEM.
• They concluded that ultrasonic root-end
resection using the CVD-coated tip took longer
and resulted in rougher surfaces than carbide
burs at both high and low speeds.
26. • Some lasers can also be used for root-end
resection and offer many advantages,
including reduced discomfort and vibration,
risk of contamination, and risk of trauma to
adjacent tissues.
• Moreover, the ‘‘no-touch’’ characteristic of
laser methods results in a loss of tactile
feedback to the operator, rendering it difficult
to maintain conservative preparations.
27. • The piezosurgery insert OTS7-4 can also be
used for root-end resection.
• Few published studies have evaluated the use
of both ultrasound and piezosurgery
instruments for apicoectomy.
• Further studies are necessary to determine
the influence of root end resection techniques
on apical healing after endodontic surgery.
29. Root-end Cavity Preparation
• Conventional root-end cavity preparation
using rotary burs in a microhandpiece poses
several problems for the clinician, such as
difficult access to the root end, the inability to
establish preparations parallel to the canal,
and the risk of lingual perforation of the root.
• Ultrasonic retrotips have shown many
advantages over the traditional handpiece.
30. • The long axis of the tooth can be followed,
thus preserving canal morphology, and apical
cavities can be shaped more easily, safely, and
with greater precision than with conventional
handpieces.
• Several studies on the use of ultrasonic
retrotips also report improved cleaning of
cavity walls compared with conventional
instruments and reduced smear layer volume
after root canal preparation.
32. • Diamond-coated retrotips produce quality
root-end preparations faster and more
effectively than stainless steel tips.
• Comparisons of diamond-coated and smooth
ultrasonic tips for root-end preparation by
Peters et al revealed that a shorter
preparation time was required with diamond-
coated retrotips than with stainless steel tips.
33. • Recently, a new ultrasonic tip, JETip,
has been introduced that features
micro projections on its stainless steel
surface.
• Liu et al reported that JETip facilitated the rapid
production of regular root end preparations.
• several studies have shown the occurrence of
dentinal cracks on resected root ends after
retrograde preparation with ultrasonic
retrotips.
34. • However, these in vitro studies had
limitations.
• Cadaveric studies have been undertaken to
overcome these problems.
• They showed that, when the pizoelectric tip
oscillated with a constant vibration, the power
level did not affect the incidence or type of
dentin cracks.
35. Conclusions
• Piezosurgery is a bone-cutting modality with
rapidly increasing indications in different
surgical fields, including endodontic surgery.
• The main advantages of piezosurgery include
protection of soft tissues, optimal
visualization, decreased blood loss, reduced
vibration and noise, increased comfort for the
patient, and protection of tooth structures.
36. • Some disadvantages of piezosurgery include
the initial financial burden, the long duration
of the surgical procedure, and the fact that
the instruction manuals of many piezoelectric
units discourage use of these devices in
patients with implanted cardiac pacemakers.
• Further studies are necessary to determine
the long-term success rate of this novel
technique.