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
Indirect Sinus Lift
A sinus lift procedure is essentially done to increase bone height and density in the posterior maxilla.
Extremely effective in increasing bone height. for more details visit our website https://www.implantdentistindia.com/i...
Direct Sinus Lift
The direct sinus lift or the lateral window sinus elevation is a widely used technique when resorption of the alveolar bone which leads to insufficient bone height (No bone to place implant). for more details please visit https://www.implantdentistindia.com/d...
We will assure you of the best treatment in this area.
Experienced Implantologist -Dr. Sudhakar Reddy, a Maxillofacial surgeon by specialization has vast experience with such a surgical procedures and can make this surgery very simple.
Book an appointment now
Indirect Sinus Lift
A sinus lift procedure is essentially done to increase bone height and density in the posterior maxilla.
Extremely effective in increasing bone height. for more details visit our website https://www.implantdentistindia.com/i...
Direct Sinus Lift
The direct sinus lift or the lateral window sinus elevation is a widely used technique when resorption of the alveolar bone which leads to insufficient bone height (No bone to place implant). for more details please visit https://www.implantdentistindia.com/d...
We will assure you of the best treatment in this area.
Experienced Implantologist -Dr. Sudhakar Reddy, a Maxillofacial surgeon by specialization has vast experience with such a surgical procedures and can make this surgery very simple.
Book an appointment now
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
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.
Fixed partial dentures transmit forces through the abutments to the periodontium. Failures are due to poor engineering, the use of improper materials, inadequate tooth preparation, and faulty fabrication. Of particular concern to prosthodontist is the selection of teeth for abutments. They must recognize the forces developed by the oral mechanism, and resistance.
Successful selection of abutments for fixed partial dentures requires sensitive diagnostic ability. Thorough knowledge of anatomy, ceramics, the chemistry and physics of dental materials, metallurgy, Periodontics, phonetics, physiology, radiology and the mechanics of oral function is fundamental.
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.
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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
orthognathic surgery is very intresting and well knowing branch in oral surgery ....this presentation is dealing with jaw correction surgery in upper jaw.
Implant surgeries to overcome anatomic difficulties ii / dental implant cour...Indian dental academy
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
The Controlled Assisted Ridge Expansion Technique for Implant placement in An...Indian 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.
Implant surgeries to overcome anatomic difficulties / implant dentistry cour...Indian 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.
Pre prosthetic surgery /certified fixed orthodontic courses by Indian dental ...Indian dental academy
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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Fabrication of functional complete dentures for edentulous patients who have undergone hemimandibulectomy is a very arduous and demanding endeavor.
The most challenging situation encountered during this procedure is the deviation of the mandible to the resected side. The deviation of the mandible to the resected side is directly proportional to the loss of tissues in the area hemi-mandibulectomy has been performed.
In cases with Cantor and Curtis classes II, III, IV, and V, guide flange prosthesis would be a treatment modality. For guide flange prosthesis to be effective, the sufficient number of posterior teeth that are periodontally sound should be present in the opposite arch.
In patients where reconstruction is not done after resection of the mandible, scar tissue formation occurs over a period of time that stiffens the tissues and worsens prosthetic rehabilitation, leading to compromised treatment planning.
Diagnosis and treatment planning in implants 2. / dental implant courses by ...Indian dental academy
Description :
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
Pre prosthetic surgery 1 (nx power lite) /certified fixed orthodontic courses...Indian dental academy
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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This PowerPoint presentation delivers a technical analysis of the midface orthognathic procedure. Explore surgical techniques, anatomical considerations, and treatment objectives.
Diagnosis and treatment planning in implants/ cosmetic dentistry trainingIndian 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.
Diagnosis and treatment planning in implants / esthetic dentistry coursesIndian 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.
Similar to Ridge augmentation procedures /orthodontic courses by Indian dental academy (20)
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
You can complete the whole process in 3-4 months.Salary range for DH/DT is around 2500-3500 Pounds per month.
Eligibility / requirements-
1. An International English Language Testing System (IELTS) certificate
at the appropriate level.(Within 2 yrs of application date )
2: A recent primary dental qualification that has been taught and examined in English..(Within 2 yrs of application date )
3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
If you are interested Please contact us for more details.
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian 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.
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.
I –Aligners are made with FDA approved transparent thermoplastic materials using 3D scanning, 3D Printing and finally Trays with Pressure vacuum formers.
Dear Doctor,
Indian Dental Academy Now offers comprehensive online Orthodontics course.
Course includes:
1.whiteboard lecture presentations
2.Case Discussions
3.with hundreds of pictures.
4.Demo on Models
5.Demo on Patients
6. subtitles in your own language
12 months unlimited access and support @350 USD only.
For Demo please visit :www.idalectures.com/preview/
For more details visit: www.idalectures.com
Please contact us for any clarifications:
idalectures@gmail.com
indiandentalacademy@gmail.com
Thanks & Regards
Indian Dental Academy
--
Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
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
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
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
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
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
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
Properties of Denture base materials /rotary endodontic coursesIndian dental academy
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
Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
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
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
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
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
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
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
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
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
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
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
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.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
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.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
3. Mandibular augmentation
Augmentation of the superior border of the mandible
Rib onlay graft
Iliac crest onlay graft
Pedicaled bone augmentation with graft supplementation
Horizontal osteotomy
Vertical/Visor osteotomy
Combined vertical and horizontal osteotomies
Augmentation of the inferior border of the mandible
Augmentation with synthetic graft material – Hydroxylapatite
Surgical technique for minor deficiencies ( Class I & II )
Surgical technique for major deficiencies ( Class III & IV )
Distraction osteogenesis
Conclusion
List of references
www.indiandentalacademy.com
4. RIDGE AUGMENTATIONRIDGE AUGMENTATION:: is a process of replacingis a process of replacing
the lost bone of the residual ridge by grafting natural orthe lost bone of the residual ridge by grafting natural or
synthetic material.synthetic material.
OBJECTIVES
• Functional Biological Platform
• Support Prosthetic Rehabilitation
• Without further bone or tissue loss
LIMITATIONS
• Physical condition of the patient
• Metabolism of the patient
• Nutritional deficiencies
• Availability of adequate soft tissue coverage
• Compliance of the patient for major surgerywww.indiandentalacademy.com
INTRODUCTION
5. GRAFT MATERIALS :
Cortical Bone Graft
Revascularization – Slow Cell Survival Rate - Less
Cancellous Bone Graft
Allogenic Bone : Genetically unrelated individuals
Ex: 1. Ileac crest graft – Provides cortical bone framework
and cancellous marrow – 30 – 50 %
2. Rib Graft : 5th
to 9th
Ribs
High initial resorbtion rate
Alloplastic materials :
Proplast, Hydroxyapatite, Tricalcium Phosphate.
Hydroxyopatite :
- Biocompatible, Nonresorbable and Nonosteogenic
- Similar to the structure of both bone and tooth.
Tricalcium Phosphate : Resorbable & Osteogenic
www.indiandentalacademy.com
6. Preoperative Evaluation
• Radiographs
• Diagnostic mounted cast
Inter arch space - 16-18 mm
Interocclusal relationship
AP Skeletal Deficiency
Technique to correct alveolar atrophy :
Over the Ridge
Graft Lower Border
Interposed / Pedicle
Preservation of original
mucoperiosteum bone
interface
www.indiandentalacademy.com
7. Factors affecting the success of the treatment :
Technique
Direct Transfer of the graft
Wound Closure
Post operative loading
Maxillary onlay graft :
Indications :
Cawood and Howell Class V
Implant Restoration
Large inter arch space
Maxillary lip length
Ccomplete arch edentulism
Absolute contraindications :
Inadequate inter arch space
Short upper lip
Partial edentulism
Soft tissue volume
Poor blood supply and loss of elasticity
Antral infection, complete loss of basal bonewww.indiandentalacademy.com
8. Procedure
Incision above the mucogingival
junction
Subperiosteal dissection to expose the
lateral piriform aperture, anterior floor
of the nose
Minimum reflection of palatal
mucoperiosteum
Catricocancellous blocks of iliac crest
Thick foil impression
Contouring and fitting the graft
Void filled
Interrupted and continuous mattress
sutures
Palatal pressure dressing
Implant placement in 2nd
stage procedure
www.indiandentalacademy.com
9. Ridge split osteoplastyRidge split osteoplasty
Indication - Knife edge alveolusIndication - Knife edge alveolus
Sub-periosteal flapSub-periosteal flap
Position of the buccal
fragment after osteotomy
Circumferential osteotomy
Buccal plate outfractured
to complete ridge split
Interpositional corticocancellous
and allogenic bone to maintain the
increased B L Dimensionwww.indiandentalacademy.com
10. The Lefort I maxillary osteotomy with interpositional bone
grafting :
•Amount of augmentation depends upon AP
relationship
Indications :
• Adequate palatal vault height with posterior
alveolar atrophy, resulting in an increased
inter arch space.
• True skeletal discrepancies
•Maxillary splint – Fixation aid
Mandibular splint – To interface
•Circumvestibular incision
•Lefort I osteotomy
•Maxilla repositoned inferiorly
•Interpositional iliac crest graft
•If insufficient three grafts
•Cortical surface facing nasal floorwww.indiandentalacademy.com
11. • Splint insert
• Graft stabilized – Interosseous
suture
• Horizontal mater suture
• Removal of splint – 6-8 weeks
• Definitive prosthesis after stabilitySinus lift and antral inlay grafting procedure :
Indication : Implant restoration
• Crestal incision
• Relieving incision
• Buccal full thickness flap
• Semilunar bone cut
• Schneiderian membrane not to be
perforated
The opening involves only the
anteroinferior quadrant of the antrum.
• Mobilization bone island
• Mucosa with the bone lifted of the antral
floorwww.indiandentalacademy.com
12. Coronal section - Position of
the bone graft
•Corticocancellous blocks
•Perforation – Collagen membrane
•GTR membrane
•Vertical mattress sutures
•Denture returned
Mandibular augmentation :
Indications : ↔
Severely atrophic mandible < 8mm & ↑ 5mm
Pt exhibit overclosed, age appearance high risk of pathologic fracture
Contra indications :
Inadequate inter arch space or short lip length.
www.indiandentalacademy.com
13. Augmentation of superior border of the mandible.
Rib onlay graft :
Donor consideration:
•Two rib segments – 16cms long
•Preservation of periosteum
•First rib - Kerfing by Devis in 1979
•Second rib - Pieces of 2 x 3 mm
Recipient site:
•Incision – Retromolar region avoiding mental N
•Plane of dissection → Lateral crest, periosteum
•Buccal lingual & labial flaps developed
•Longitudinal relaxing incisions
•Rib strut adjusted
•Wires through the internal oblique ridge & inferior aspect of the rib
•Anterior segment through rib & lingual cortex to secure the graft
•Ridge contouring & running horizontal mattress suture
•Graft maturation - 4 months, vestibuloplasty is performedwww.indiandentalacademy.com
14. Disadvantages :
• Donor site morbidity.
• Second surgical site necessary.
• Continued resorption of the grafted sites.
• Soft tissue dehiscence or limitation.
Iliac crest onlay grafts can also used.
Pedicled bone augmentation with graft supplementation:
Concept: Maintenance of lingual periosteum
1. Horizontal osteotomy - Ideal if reasonable amount of bone
above mandibular canal
2. Vertical/Visor osteotomy - If insufficient height with adequate
width (10-15mm)
www.indiandentalacademy.com
15. Horizontal osteotomy with interpositional graft :
•Incision retromolar pad just inferior to the crest of the ridge
•Buccolabial mucoperiosteal flap
•Mental nerves exposed
•Lingual tissue serve as vascular pedical
•Vertical tunnels
•Horizontal osteotomy
•Transosseous holes
•Corticocancellous struts
•Polyglycolic acid sutures
•3-0 Resorbable horizontal mattress suture
•Indresano – overextended stent
•Vestibuloplasty
•Advantages – Stable, shortened post operative period
•Disadvantages – Nerve trauma, paresthesia, fracture & flap dehiscence
www.indiandentalacademy.com
16. Modified interpositional technique :
Lekkas and Wes (1981) osteotomy is performed through a
combined intraoral and extraoral approach, and the inferior segment is
lowered rather than the superior portion being raised.
Advantage: Used in mandible < ↑ 6mm
To avoid mandibular canal – Lip anesthesia or paresthesia
Disadvantage: Extra oral scar
Vertical or Visor osteotomy with graft supplement :
Harle, modified by Peterson & Slade
•Insufficent vertical mandibular bone height
•Buccolabial mucoperiosteal flap
•Narrow vertical lingual subperiosteal tunnels
•Sagittal cut, in molar region angled laterally
www.indiandentalacademy.com
17. •Lingual section elevated
•Cancellous bone graft
•Trans-osteal wires – 3-4 months
•Disfavour unavoidable nerve
trauma
Combined vertical and horizontal osteotomies for mandibular
augmentation :
•Anterior horizontal osteotomy
•Vertical osteotomy
•The combined procedure
- Repositioning of the pedicle segment
to correct AP ridge discrepancy
- Less chance of fracture
- A more stable pedicle bone flap
www.indiandentalacademy.com
18. Modified three-piece osteotomy
Outline of osteotomies designed to
Avoid damage to the inf alv N
Anterior segment is held by bone
struts and midline circummand wire
which pulls the fragment forward
•Posterior segment rotated horizontally
•Interposition of the cancellous bone graft
•Gap over the mental foramen is filled with chips
www.indiandentalacademy.com
19. Inferior border augmentation : Sanders and Cox
Bur holes drilled
Entire specimen is
fixed rigidly using
screw fixation
•Preexisting prosthesis
•Increased stabilization of the mandible
•Nochange in vertical dimension
•Nodirect masticatory forces
•Extraoral scar
•Sensory or motor nerve deficiencies
•Submadibular incision
•Inferior border exposed
•Cadeveric mandibular adjustment – Scalloped
tray to incorporate autogenous bone
www.indiandentalacademy.com
20. Ridge augmentation with synthetic graft materials :
Hydroxylapatite:
Nonresorbable ceramic bone substitutes – Calcium phosphate,
radioopque, sterilized
HA – Bone mixture (1:1) Loaded in a syringe to facilitate
its placement in graft site
Classification alveolar ridge deficiency :
Class I: Inadequate width, undercut areas → HA
Class II: Deficient in Height & width, knife edge → HA
Class III: Resorbed to the level of basilar bone,
concave form → HA/HA-bone
Class IV: Resorption of the basilar bone → HA-Bonewww.indiandentalacademy.com
21. Surgical Technique for Minor Deficiencies (Class I & II )
•For complete augmentation ridge crest or single midline
vertical incision
•For only posterior aspects ridge crest or bilateral vertical
incision in cuspid areas
•Periosteum is elevated only in the area of augmentation
•Traction sutures
•Filling of HA from posterior ends bilaterally to these incision
•Denture or Splint
www.indiandentalacademy.com
22. Surgical Technique for Major Deficiencies ( Class III & IV )
Maxillary Augmentation
Vertical midline incision with
combined submucosal dissection
and subperiosteal reflection
Periosteum is cut at
crestal tissue junction
Incising anterior
bulbous tissue
www.indiandentalacademy.com
23. Large pocket is
produced
Injection of
HA or HA with bone
Enlargement of flat
maxilla with HA
just before splint is fixed
www.indiandentalacademy.com
24. Maxillary augmentation with custom titanium mesh tray :
Indication :
•Maxillary atrophy with Sever V & H Bone loss
•Enlarged maxillary sinus
Repositioning of lateral
wall and reflection of
the antral lining
HA-Bone injected
Tray in place with graft beneath
•Horizontal running suture
•Two weeks after denture relined placed for
esthetic use onlywww.indiandentalacademy.com
25. Mandibular augmentation :
Combined mandibular mucosal dissection
with periosteal reflection and detachment
of developed large pocket
Inferior alveolar nerve arising from crest of
severely resorbed Class IV mandible. Placement
of HA frequently required in lateral nerve
repositioning with bone grafting
Delivery of HA particles on a Class IV
mandible after circummandibular sutures
are placed to secure a splint
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26. Denture can be placed at one month, in cases augmented with HA only
and in six to eight weeks, in cases with HA-Bone
Postoperative complications
1. Dehiscence with extrusion of particles
2. Abrasion through the mucosa
3. Infection
4. Abnormal colour
5. Mental nerve neuropathy
Advantages :
1. Local augmentation
2. Composite grafting in severe Class III & IV
3. No donor site
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27. Alveolar distraction osteogenesis :
Pincipal : “Law of tension – stress”
Force → Bone cut → Widening the gap → Bone + Soft tissue
regeneration
Atrophic mandible in preparation
for alveolar ridge distraction
Distraction device in place
Bony regenerate at the distraction site is
visible at the time of device removal
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28. • Peterson’s principle of oral and maxillo facial surgery second
edition Vol 1.
• Reconstructive preposthetic oral and maxillofacial surgery-Fonseca
and Davis, 2nd edition.
• Text Book of oral and maxillofacial surgery V:2 by Daniel. M.
Laskin
• Text Book of oral and maxillofacial surgery by Gustav. D. Kruger
• Preprosthetic oral surgery by Thomas. J. Starshak
• Essentials of complete denture prosthodontics by Sheldon Winkler
• Prosthodontic treatment for edentulous patients by Boucher
• Syllabus of complete dentures by Charles. M. Heartwell, Jr.
Arther. www.indiandentalacademy.com
CONCLUSION