This document summarizes a study that evaluated the outcome of using a titanium button with chain by Watted for orthodontic traction of 82 impacted maxillary canines in patients between 2006-2013. Following surgical exposure of the impacted teeth, an orthodontic traction hook with a titanium button and chain was bonded to each tooth. All teeth were successfully erupted with few complications. Forced orthodontic eruption using a well-bonded orthodontic traction hook and ligation chain in conjunction with surgery resulted in predictable orthodontic eruption of impacted maxillary canines.
Titanium Button With Chain by Watted For Orthodontic Traction of Impacted Ma...Abu-Hussein Muhamad
Abstract: Advances in bonding techniques and materials allow for reliable bracket placement on ectopically positioned teeth. This prospective study evaluates the outcome of forced orthodontic eruption of impacted canine teeth in both palatal and labial positions. Eighty-two impacted maxillary canines in 2200patients were included in the study and were observed for 2006 to 2013 ,in Center for Dentistry research and Aesthetics, Jatt/Israel after exposure. Following exposure by means of a palatal flap or an apically repositioned buccal flap, an orthodontic traction hook, with a Titanium Button with chain by Watted (Dentaurum) attached, was bonded to each impacted tooth using a light cured orthodontic resin cement. A periodontal dressing was placed over the surgical site for a period of time. All teeth were successfully erupted. Complications consisted of: failure of initial bond, at the time of surgery, which required rebonding; premature debonding at the time of pack removal and; debonding of brackets during orthodontic eruption. There was no infection, eruption failure, ankylosis, resorption or periodontal defect (pocket greater than 3 mm) associated with any of the exposed teeth. Forced orthodontic eruption of impacted maxillary canines with a well bonded orthodontic traction hook and ligation chain, used in conjunction with a palatal flap or an apically repositioned labial flap, results in predictable orthodontic eruption with few complications. Key Words: cuspid/surgery; orthodontics, corrective; tooth, impacted/therapy
Surgery of Labially Impacted Canine & Orthodontic Management – A Case ReportAbu-Hussein Muhamad
Maxillary canines are one of the most common teeth that are impacted among patients seeking orthodontic treatment. Depending on the position of these impacted teeth, various surgical techniques have been employed for their exposure. His primary goal of surgical phase is to provide the means for correct position of orthodontic anchorage. Additionally, the technique used must ensure favorable tissue anatomy that will permit long-term maintenance of periodontal health. In the present case, a labially impacted maxillary left canine was surgically exposed using an apically po
Clinical Management of Bilateral Impacted Maxillary CaninesAbu-Hussein Muhamad
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive
approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the
dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines
treated with surgical exposure and orthodontic treatment.
Material and Methods: A 15year-old female with various degrees of bilateral palatal impaction of maxillary canines were managed
by the described technique.
Results and Discussion: Autonomous eruption of the impacted canines after surgical uncovering was witnessed in all patients
without the need for application of a vertical orthodontic force for their extrusion.
Conclusion: The described method of surgical uncovering and autonomous eruption created conditions for biological eruption of the
palatally impacted canines into the oral cavity and facilitated considerably the subsequent orthodontic treatment for their proper alignment
in the dental arch.
Keywords: Impacted canines; Surgical; Tooth exposure; Orthodontic treatment
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines treated with surgical exposure and orthodontic treatment.
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines treated with surgical exposure and orthodontic treatment
Modern Treatment for Congenitally Missing Teeth : A Multidisciplinary Appro...Abu-Hussein Muhamad
The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisors using dental implants. Finally, the importance of interdisciplinary team treatment planning is emphasized as a requirement for achieving optimal final esthetics
PROSTHODONTIC EVALUATION FOR IMPLANT TREATMENT PLANNINGJehan Dordi
Prosthetic options in implant dentistry
Extra-oral evaluation
Smile line
TMJ evaluation
Lip lines
Intra-oral evaluation
Type of edentulism
Arch relationship
Arch form
Opposing and adjacent teeth at occlusal position
Available space for different prosthesis
Diagnostic casts
Diagnostic templates
Occlusal consideration
Available bone: Influence on prosthetic treatment planning
Bone density: Influence on prosthetic treatment planning
Conclusion
Surgery of Labially Impacted Canine & Orthodontic Management – A Case ReportAbu-Hussein Muhamad
Maxillary canines are one of the most common teeth that are impacted among patients seeking orthodontic treatment. Depending on the position of these impacted teeth, various surgical techniques have been employed for their exposure. His primary goal of surgical phase is to provide the means for correct position of orthodontic anchorage. Additionally, the technique used must ensure favorable tissue anatomy that will permit long-term maintenance of periodontal health. In the present case, a labially impacted maxillary left canine was surgically exposed using an apically positioned flap. Orthodontic extrusion was carried out further.
Titanium Button With Chain by Watted For Orthodontic Traction of Impacted Ma...Abu-Hussein Muhamad
Abstract: Advances in bonding techniques and materials allow for reliable bracket placement on ectopically positioned teeth. This prospective study evaluates the outcome of forced orthodontic eruption of impacted canine teeth in both palatal and labial positions. Eighty-two impacted maxillary canines in 2200patients were included in the study and were observed for 2006 to 2013 ,in Center for Dentistry research and Aesthetics, Jatt/Israel after exposure. Following exposure by means of a palatal flap or an apically repositioned buccal flap, an orthodontic traction hook, with a Titanium Button with chain by Watted (Dentaurum) attached, was bonded to each impacted tooth using a light cured orthodontic resin cement. A periodontal dressing was placed over the surgical site for a period of time. All teeth were successfully erupted. Complications consisted of: failure of initial bond, at the time of surgery, which required rebonding; premature debonding at the time of pack removal and; debonding of brackets during orthodontic eruption. There was no infection, eruption failure, ankylosis, resorption or periodontal defect (pocket greater than 3 mm) associated with any of the exposed teeth. Forced orthodontic eruption of impacted maxillary canines with a well bonded orthodontic traction hook and ligation chain, used in conjunction with a palatal flap or an apically repositioned labial flap, results in predictable orthodontic eruption with few complications. Key Words: cuspid/surgery; orthodontics, corrective; tooth, impacted/therapy
Surgery of Labially Impacted Canine & Orthodontic Management – A Case ReportAbu-Hussein Muhamad
Maxillary canines are one of the most common teeth that are impacted among patients seeking orthodontic treatment. Depending on the position of these impacted teeth, various surgical techniques have been employed for their exposure. His primary goal of surgical phase is to provide the means for correct position of orthodontic anchorage. Additionally, the technique used must ensure favorable tissue anatomy that will permit long-term maintenance of periodontal health. In the present case, a labially impacted maxillary left canine was surgically exposed using an apically po
Clinical Management of Bilateral Impacted Maxillary CaninesAbu-Hussein Muhamad
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive
approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the
dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines
treated with surgical exposure and orthodontic treatment.
Material and Methods: A 15year-old female with various degrees of bilateral palatal impaction of maxillary canines were managed
by the described technique.
Results and Discussion: Autonomous eruption of the impacted canines after surgical uncovering was witnessed in all patients
without the need for application of a vertical orthodontic force for their extrusion.
Conclusion: The described method of surgical uncovering and autonomous eruption created conditions for biological eruption of the
palatally impacted canines into the oral cavity and facilitated considerably the subsequent orthodontic treatment for their proper alignment
in the dental arch.
Keywords: Impacted canines; Surgical; Tooth exposure; Orthodontic treatment
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines treated with surgical exposure and orthodontic treatment.
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines treated with surgical exposure and orthodontic treatment
Modern Treatment for Congenitally Missing Teeth : A Multidisciplinary Appro...Abu-Hussein Muhamad
The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisors using dental implants. Finally, the importance of interdisciplinary team treatment planning is emphasized as a requirement for achieving optimal final esthetics
PROSTHODONTIC EVALUATION FOR IMPLANT TREATMENT PLANNINGJehan Dordi
Prosthetic options in implant dentistry
Extra-oral evaluation
Smile line
TMJ evaluation
Lip lines
Intra-oral evaluation
Type of edentulism
Arch relationship
Arch form
Opposing and adjacent teeth at occlusal position
Available space for different prosthesis
Diagnostic casts
Diagnostic templates
Occlusal consideration
Available bone: Influence on prosthetic treatment planning
Bone density: Influence on prosthetic treatment planning
Conclusion
Surgery of Labially Impacted Canine & Orthodontic Management – A Case ReportAbu-Hussein Muhamad
Maxillary canines are one of the most common teeth that are impacted among patients seeking orthodontic treatment. Depending on the position of these impacted teeth, various surgical techniques have been employed for their exposure. His primary goal of surgical phase is to provide the means for correct position of orthodontic anchorage. Additionally, the technique used must ensure favorable tissue anatomy that will permit long-term maintenance of periodontal health. In the present case, a labially impacted maxillary left canine was surgically exposed using an apically positioned flap. Orthodontic extrusion was carried out further.
Overdentures can be either tooth or implant supported. Completely edentulous patients whose economic condition Thwarts them to invest in the expensive implant (number based) treatments should be motivated to have at least a two implant-supported overdenture since the prosthesis offers most of the advantages of conventional tooth-supported overdenture. We report a case of an elderly female patient who was reluctant toward surgery, but with moderate education was treated successfully with a two staged, two implant-supported overdenture using a ball abutment with o ring attachment.
Two Treatment Approaches for Missing Maxillary Lateral Incisors: A CaseAbu-Hussein Muhamad
Missing maxillary lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. The aim of the present study is to evaluate the clinical success of the transmucosal flapless implant placement and immediate loading of the implants to restore the agenic lateral incisors after completing the orthodontic treatment and during the retention period.
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
Patients with resorbed ridges often have difficulty retaining conventional dentures. An implant supported overdenture is a good alternative treatment to a conventional denture for patients with complaints about the retention and stability of their removable complete denture. . These complaints more often have to do with the mandibular than the maxillary denture. Implantsupported overdentures offer better results in the mandible than in the maxilla. The two implant overdenture in the mandible has since become standard for edentulous patients. This article describes a clinical procedure for an implant supported mandibular overdenture.
The management of impacted canines is important in terms of esthetics and function. Clinicians must formulate treatment plans that are in the best interest of the patient and they must be knowledgeable about the variety of treatment options. When patients are evaluated and treated properly, clinicians can reduce the frequency of ectopic eruption and subsequent impaction of the maxillary canine. The simplest interceptive procedure that can be used to prevent impaction of permanent canines is the timely extraction of the primary canines. This procedure usually allows the permanent canines to become upright and erupt properly into the dental arch, provided sufficient space is available to accommodate them. In the present article, an overview of the incidence and sequelae, as well as the surgical, periodontal, and orthodontic considerations in the management of impacted canines is presented.
Altered Cast Impression Technique for Fabrication of Maxillary Obturator- Jou...Dr. Prathamesh Fulsundar
An obturator is a maxillofacial prosthesis that is used to close an acquired tissue opening, primarily of the hard palate, and/or a contiguous alveolar or soft tissue structure that has been removed by surgery. (GPT-8)
This clinical report describes the prosthodontic rehabilitation andfabrication of an obturator used for a partially edentulous patient with anacquired unilateral maxillary defect.
The impression was made in 2 steps in a similar manner as the altered castimpression technique.
Precise impression of the resection defect despite trismus was possible, thus providing this patient an accurately fitting obturator prosthesis.
Aim: Dental impaction is a very frequent problem and the canine tooth is one of the most affected. Impacted canines result
in many complications and their early diagnosis by radiographic evaluation is imperative. The aim of the present study was
to determine the prevalence of impacted canines in the Arab population in Israel(48Arabs). Materials and Methods: The
panoramic radiographic records of 2200patients attending the Center for Dentistry Research and Aesthetics, Jatt/Israel ,
between June 2006 and December 2013 were examined for the study. The age of the patients ranged from 10.5 to
39,5years, with a mean of 16,2years. Results: The prevalence of canine impaction in males was 1,6% and 2,1% in
females.in maxillary,and 0,6%mandibular The overall prevalence was 4,3 %. Maxillary left canines were the most
frequently impacted Only 13 cases showed impaction of the mandibular canine. Unilateral impaction was seen in 0,5% of
the patients. Conclusion: Canines play a vital role in facial appearance, dental esthetics, arch development, and functional
occlusion. If signs of ectopic eruption are detected early, every effort should be made to prevent impaction and its
consequences. Early intervention eliminates the need for surgical intervention and complex 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
The management of impacted canines is important in terms of esthetics and function. Clinicians must formulate treatment plans that are in the best interest of the patient and they must be knowledgeable about the variety of treatment options. When patients are evaluated and treated properly, clinicians can reduce the frequency of ectopic eruption and subsequent impaction of the maxillary canine. The simplest interceptive procedure that can be used to prevent impaction of permanent canines is the timely extraction of the primary canines. This procedure usually allows the permanent canines to become upright and erupt properly into the dental arch, provided sufficient space is available to accommodate them. In the present article, an overview of the incidence and sequelae, as well as the surgical, periodontal, and orthodontic considerations in the management of impacted canines is presented.
Overdentures can be either tooth or implant supported. Completely edentulous patients whose economic condition Thwarts them to invest in the expensive implant (number based) treatments should be motivated to have at least a two implant-supported overdenture since the prosthesis offers most of the advantages of conventional tooth-supported overdenture. We report a case of an elderly female patient who was reluctant toward surgery, but with moderate education was treated successfully with a two staged, two implant-supported overdenture using a ball abutment with o ring attachment.
Two Treatment Approaches for Missing Maxillary Lateral Incisors: A CaseAbu-Hussein Muhamad
Missing maxillary lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. The aim of the present study is to evaluate the clinical success of the transmucosal flapless implant placement and immediate loading of the implants to restore the agenic lateral incisors after completing the orthodontic treatment and during the retention period.
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
Patients with resorbed ridges often have difficulty retaining conventional dentures. An implant supported overdenture is a good alternative treatment to a conventional denture for patients with complaints about the retention and stability of their removable complete denture. . These complaints more often have to do with the mandibular than the maxillary denture. Implantsupported overdentures offer better results in the mandible than in the maxilla. The two implant overdenture in the mandible has since become standard for edentulous patients. This article describes a clinical procedure for an implant supported mandibular overdenture.
The management of impacted canines is important in terms of esthetics and function. Clinicians must formulate treatment plans that are in the best interest of the patient and they must be knowledgeable about the variety of treatment options. When patients are evaluated and treated properly, clinicians can reduce the frequency of ectopic eruption and subsequent impaction of the maxillary canine. The simplest interceptive procedure that can be used to prevent impaction of permanent canines is the timely extraction of the primary canines. This procedure usually allows the permanent canines to become upright and erupt properly into the dental arch, provided sufficient space is available to accommodate them. In the present article, an overview of the incidence and sequelae, as well as the surgical, periodontal, and orthodontic considerations in the management of impacted canines is presented.
Altered Cast Impression Technique for Fabrication of Maxillary Obturator- Jou...Dr. Prathamesh Fulsundar
An obturator is a maxillofacial prosthesis that is used to close an acquired tissue opening, primarily of the hard palate, and/or a contiguous alveolar or soft tissue structure that has been removed by surgery. (GPT-8)
This clinical report describes the prosthodontic rehabilitation andfabrication of an obturator used for a partially edentulous patient with anacquired unilateral maxillary defect.
The impression was made in 2 steps in a similar manner as the altered castimpression technique.
Precise impression of the resection defect despite trismus was possible, thus providing this patient an accurately fitting obturator prosthesis.
Aim: Dental impaction is a very frequent problem and the canine tooth is one of the most affected. Impacted canines result
in many complications and their early diagnosis by radiographic evaluation is imperative. The aim of the present study was
to determine the prevalence of impacted canines in the Arab population in Israel(48Arabs). Materials and Methods: The
panoramic radiographic records of 2200patients attending the Center for Dentistry Research and Aesthetics, Jatt/Israel ,
between June 2006 and December 2013 were examined for the study. The age of the patients ranged from 10.5 to
39,5years, with a mean of 16,2years. Results: The prevalence of canine impaction in males was 1,6% and 2,1% in
females.in maxillary,and 0,6%mandibular The overall prevalence was 4,3 %. Maxillary left canines were the most
frequently impacted Only 13 cases showed impaction of the mandibular canine. Unilateral impaction was seen in 0,5% of
the patients. Conclusion: Canines play a vital role in facial appearance, dental esthetics, arch development, and functional
occlusion. If signs of ectopic eruption are detected early, every effort should be made to prevent impaction and its
consequences. Early intervention eliminates the need for surgical intervention and complex 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
The management of impacted canines is important in terms of esthetics and function. Clinicians must formulate treatment plans that are in the best interest of the patient and they must be knowledgeable about the variety of treatment options. When patients are evaluated and treated properly, clinicians can reduce the frequency of ectopic eruption and subsequent impaction of the maxillary canine. The simplest interceptive procedure that can be used to prevent impaction of permanent canines is the timely extraction of the primary canines. This procedure usually allows the permanent canines to become upright and erupt properly into the dental arch, provided sufficient space is available to accommodate them. In the present article, an overview of the incidence and sequelae, as well as the surgical, periodontal, and orthodontic considerations in the management of impacted canines is presented.
Management of impacted teeth /certified fixed orthodontic courses by Indian d...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
00919248678078
Treatment concept by Watted for a controlled alignment of palatally impacted ...Abu-Hussein Muhamad
It is known that maxillary canines remain impacted more often than the mandibular canines, and the inclusion can be
buccal or palatal. The treatment focuses mainly on the exposure and on the orthodontic realignment of the impacted
tooth. There are situations when canines erupt spontaneously after their surgical discovery. The present paper has the
purpose of approaching aspects related to impacted upper permanent canines by a literature review, including
localization and treatment conducts.
Key words: Impacted canine, periodontal, surgical-orthodontic treatment.
The main purpose of our study is to present the corrective movement of impacted canines using various surgical-orthodontic techniques Materials and method: Eighty-two impacted maxillary canines in 2200patients were included in the study and were observed for 2006 to 2013 ,in Center for Dentistry research and Aesthetics, Jatt/Israel after exposure. Following exposure by means of a palatal flap or an apically repositioned buccal flap, an orthodontic traction hook, with a Titanium Button with chain by Watted (Dentaurum) attached, was bonded to each impacted tooth using a light cured orthodontic resin cement. For this study we used only the batch of patients who presented upper impacted canine. Depending on the clinical status, we used the following surgical techniques: repositioned flap, gingival translation flap, window flap method and local mesh application. After surgery for 39 patients we considered that canine traction with an orthodontic device was necessary in order to obtain a vertical position of the teeth. The orthodontic systems used were: fixed orthodontics, with a Titanium Button with chain by Watted (Dentaurum). Results and discussion: We used the repositioned flap for 39patients with deep impacted canines in order to uncover the teeth and to bond an auxiliary orthodontic device, the gingival translation flap for 27 patients with superficial impacted canines: 10cases with apical translation and 2 with lateral and apical translation. The window flap was used for 22 patients with palatal impaction. After surgery all patients continued orthodontic treatment in order to correct every dental malposition and to obtain a neutral occlusion with esthetical, functional and stabile results.
Esthetic Management of Congenitally Missing Lateral Incisors With Single Toot...Abu-Hussein Muhamad
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. Several treatment options exist for the replacement of congenitally missing lateral incisors.This case report addresses the fundamental considerations related to replacement of a congenitally missing lateral incisor by a team approach.
Esthetic Management of Congenitally Missing Lateral Incisors With Single Toot...Abu-Hussein Muhamad
Congenitally missing teeth are frequently presented to the dentist. Interdisciplinary approach may be needed for the proper treatment plan. Several treatment options exist for the replacement of congenitally missing lateral incisors.This case report addresses the fundamental considerations related to replacement of a congenitally missing lateral incisor by a team approach.
Clinical study of impacted maxillary canine in the Arab population in IsraelAbu-Hussein Muhamad
The objective of the present study was to determine the prevalence of impacted maxillary canine in patients in Arabs
Community in Israel (ARAB48,Israel) visiting our Center For Dentistry,Research & Aesthetics,Jatt,Almothalath,Israel,
4250 patients . This study comprises data from patients who attended the O.P.D.2200 patients between Jun. 2006 to Dec
2013. Patients were examined in order to detect the impacted maxillary canines by intraoral examination, palpation, dental
records and followed by radiographs. It was found that the prevalence of canine impaction was 0,8 % (N=4250), 1,6
(N=2200), 43,9 (N-82) in males and 1,1% (N=4250), 2,1 (N=2200), 56,1 (N-82) in females suggesting that prevalence of
impacted maxillary canines is more in females than males and it is statistically significant. The overall prevalence for
maxillary impacted canines was found to be 3,7 % (N=2200) which suggested that it is much higher than previous studies.
The results of this study were slightly different than other studies, while the dissimilarities may be attributed to the sample
selection, method of the study and area of patient selection, which suggest racial and genetic differences.
Eruptive anomalies are present in many routine orthodontic cases. The challenge in them is to diagnose them correctly
and manage them in a way so as to maintain the esthetic and functional harmony of the stomatognathic system [1]. The orthodontist must know how to correct these anomalies rather than extracting the malposed tooth as this would lead to poor occlusion and
loss of masticatory function [2]. This article presents an overview
on various anomalies seen due to impaction in daily orthodontic
practice along with step by step management of each
Eruptive anomalies are present in many routine orthodontic cases. The challenge in them is to diagnose them correctly
and manage them in a way so as to maintain the esthetic and functional harmony of the stomatognathic system [1]. The orthodontist must know how to correct these anomalies rather than extracting the malposed tooth as this would lead to poor occlusion and
loss of masticatory function [2]. This article presents an overview
on various anomalies seen due to impaction in daily orthodontic
practice along with step by step management of each.
Eruptive anomalies are present in many routine orthodontic cases. The challenge in them is to diagnose them correctly
and manage them in a way so as to maintain the esthetic and functional harmony of the stomatognathic system [1]. The orthodontist must know how to correct these anomalies rather than extracting the malposed tooth as this would lead to poor occlusion and
loss of masticatory function [2]. This article presents an overview
on various anomalies seen due to impaction in daily orthodontic
practice along with step by step management of each.
Prosthodontic-Orthodontic Treatment Plan with Two-Unit Cantilevered Resin-Bon...Abu-Hussein Muhamad
Abstract: Congenitally missing lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. Selecting the appropriate treatment option depends on many factors, such us the malocclusion, the anterior relationship, specific space requirements, bone volume, root proximity, the condition of the adjacent teeth, and esthetic prediction mainly when the canine must be reshaped.Resin bonded bridges were considered to be doomed owing to their very high decementation rate, have come alive once again because of newer resin based cements. This article will discuss the variety of treatment managements in case of space opening and treated with two 2-unit cantilevered resin-bonded fixed partial dentures supported by the cuspids. This conservative treatment plan was cost-effective without having any significant biological cost. Keywords: Agenesis, Resin- bonded fixed partial denture, interim prosthesis.
Tooth eruption involves the migration of the teeth from a nonfunctional position within the bone to a functional position in the jaw. In orthodontic practice, it is inevitable that one will encounter eruptive abnormalities such as impacted, ectopically erupting, transposed, congenitally missing, and supernumerary teeth..
Tooth eruption involves the migration of the teeth from a nonfunctional position within the bone to a functional position in the jaw. In orthodontic practice, it is inevitable that one will encounter eruptive abnormalities such as impacted, ectopically erupting, transposed, congenitally missing, and supernumerary teeth..
Tooth eruption involves the migration of the teeth from a nonfunctional position within the bone to a functional position in the jaw. In orthodontic practice, it is inevitable that one will encounter eruptive abnormalities such as impacted, ectopically erupting, transposed, congenitally missing, and supernumerary teeth..
Treatment of Extremely Displaced and Impacted Second Premolar in the MandibleAbu-Hussein Muhamad
The mandibular second premolar is one of the most frequently impacted teeth. The recommended treatment is to extract the second primary molar with or without removing the bone along the eruption path, to uncover the tooth surgically and move it into the arch by orthodontic treatment. The purpose of this article is to review the principles of case management of soft tissue impacted second premolars mandibular and to illustrate their potential to respond well to the treatment. Although the scope of treatment may depend on a varying range of factors, this case report demonstrates the inherent potential for good treatment outcome in cases of soft tissue impactions.
Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an
esthetic and functional restorative treatment. . Fixed prosthodontic and removable prostheses, resin bonded retainers, orthodontic movement of maxillary
canine to the lateral incisor site and single tooth implants represent the available treatment modalities to replace congenitally missing teeth. This case report
demonstrates the team approach in prosthetic and surgical considerations and techniques for managing the lack of lateral incisors. The aims of this case
report of replacement of bilaterally congenitally missing maxillary lateral incisors with dental implants.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations.
Impacted Maxillary Central Incisors: Surgical Exposure and Orthodontic Treat...Abu-Hussein Muhamad
The maxillary permanent central incisor develops early in life and forms part of an aesthetic smile. Disruption of the formation or eruption of the permanent
central incisor has multiple etiological factors. Treatment options depend to some extent on the cause of failure of eruption of the central incisor. Generally,
the earlier treatment is provided, the higher the likelihood of success and the less the complexity. Our results suggest that close monitoring and interdisciplinary
cooperation during the treatment phases led to a successful esthetic result, with good periodontal health and functional occlusion.
Excess of space in the dental arch is diagnosed as a
generalised spacing or a local divergence, often
observed in the maxillary anterior region, as a median
diastema, traumatic loss of central incisors, or
congenital absence of lateral incisors. Furthermore,
spacing is observed in aging individuals, due to
pathological migration of teeth caused by
periodontitis. Finally, adult individuals with partial
edentulous jaws demand pre-prosthetic orthodontic
treatment from functional aspects. Thus, indication for
orthodontic treatment in subjects with spacing of teeth
exists for aesthetic reasons, but also for facilitating
prosthetic restorations with optimal occlusalstability.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting
cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically
induced failures, since low primary implant stability, low bone density, short implants and overload have been
identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a
successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations
Orthodontic tooth movement is basically a biologic response towards a mechanical force. Osteoclast and osteoblast cells mediate bone resorption and apposition, which eventually produces tooth movement. Researches showed that the rate of orthodontic tooth movement can be altered by certain drugs locally or systemically. The Objective of this article is to discuss the current data concerning the effect of drugs on orthodontic tooth movement.
Multidisciplinary Approach in the Rehabilitation of Congenitally Maxillary C...Abu-Hussein Muhamad
Objective: This case report describes the multidisciplinary
approach to treat a congenitally missed maxillary canine, how to
improve patient’s smile using orthodontic fixed appliance, endosseous
dental implant, and porcelain veneer to achieve the treatment results of
function and esthetic.
Materials and procedures: Unilateral agenesis of the permanent
maxillary canines in healthy individuals is extremely rare. This
paper presents the case of a female patient diagnosed with congenital
unilateral agenesis of the permanent maxillary canines as well as
occlusal abnormalities in the form of left-side crossbite. To restore the
proper aesthetics and function, interdisciplinary therapeutic treatment
was implemented. In the case presented in this paper, the aim of
oral rehabilitation was to restore a functional balance by obtaining
proper skeletal relationships, creating optimal occlusal conditions and
obtaining arch continuity.
Conclusion: Interdisciplinary treatment combined of orthodontics,
implant surgery, and prosthodontics was useful to treat a nonsyndromic
oligodontia patient. Especially, with the new strategy, implantanchored
orthodontics, which can facilitate the treatmentand make it
more simply with greater predictability.
The multifactorial factors influenc cleft Lip-literature review Abu-Hussein Muhamad
Congenital cleft-Lip and cleft palate have been the subject of many genetic
studies, but until recently there has been no consensus as to their modes of
inheritance. In fact, claims have been made for just about every genetic
mechanism one can think of. Recently, however, evidence has been
accumulating that favors a multifactorial basis for these malformations. The
purpose of the present paper is to present the etiology of cleft lip and cleft palate
both the genetic and the environmental factors. It is suggested that the genetic
basis for diverse kinds of common or uncommon congenital malformations may
very well be homogeneous, whilst, at the same, the environmental basis is
heterogeneous.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically induced failures, since low primary implant stability, low bone density, short implants and overload have been identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field
Over time, progressively shorter implants have been placed such that short implants are now available that are less than 6 mm in length. The viability and high success rates seen with short implants can be explained by osseointegration, the macro geometric design of the implant, as well as physics and the distribution of forces. This paper was aimed to review the stability and survival rate of short implants under functional loads. Numerical and clinical studies were reviewed. Keywords: Short dental implants, sinus augmentation, factors affecting bone regeneration in dental implantology
Porcelain laminate veneers are among the most esthetic means of creating a more pleasing and beautiful smile. Porcelain veneers within reason allow for the alteration of tooth position, shape, size and color. They require a minimal amount of tooth preparation, approximately 0.5 mm to 0.7mm of surface enamel reduction. This study describes the use of ceramic veneers without tooth wear, reinforcing the concept that minimally invasive porcelain laminate veneers could become versatile and conservative allies in the fi eld of esthetic dentistry. Keywords: Ceramics, dentin-bonding agents, esthetics
Immediate Restoration of Single Implants Replacing Lateral Incisor Compromis...Abu-Hussein Muhamad
Today, the diagnosis of internal root resorption is significantly improved by the three-dimensional imaging. Furthermore, the CBCT’s superior diagnosis accuracy resulted in an improved management of the resorptive defects and a better outcome of Implant therapy of teeth with internal resorption.Implant has become a wide option to maintain periodontal architecture. Diagnosis and treatment planning is the key factors in achieving the successful outcomes after placing and restoring implants placed immediately after tooth extraction. The purpose of this clinical update is to report on the success and survival of Immediate restoration of single implants replacing right lateral incisor compromised by internal resorption.
Immediate Implant Placement And Restoration With Natural Tooth In The Maxilla...Abu-Hussein Muhamad
Anterior tooth loss and restoration in the esthetic zone is a common challenge in dentistry today. The prominent visibility of the area can be especially distressing to the patient and requires a timely and esthetically pleasing solution. Immediate single-tooth implantation followed by immediate provisionalization is becoming an increasingly desirable treatment that offers numerous benefits over conventional delayed loading. Provisionalization for immediately-placed implants using the patient’s existing tooth can enhance the final aesthetic outcome if certain steps are
followed. If the natural tooth is intact and can be used as a provisional, the emergence profile can be very similar to the preoperative condition. This article outlines a technique to use the patient’s natural tooth after extraction to provisionalize an implant.
“One-Piece” Immediate-Load Post-Extraction Implant In Maxillary Central IncisorAbu-Hussein Muhamad
Abstract: This case report describes extraction of a fractured left maxillary central incisor tooth, followed by immediate placement of an one-piece implant in the prepared socket and temporization by a bonded restoration.
Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted.
Results: The atraumatic operating technique and the immediate insertion of the one-piece Implant resulted in the preservation of the hard and soft tissues at the extraction site.
Conclusion: The “One-piece” dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues. The one-piece implant design resulted in a high cumulative implant survival rate and beneficial marginal bone levels.
Single Visit Replacement of Central Maxillary Using Fiber-Reinforced Composi...Abu-Hussein Muhamad
Fiber reinforced composites are high strength filling materials composed of conventional composites and glass fibres. They exhibit extensive applications in different fields of dentistry. This clinical report present a case where FRC technology was successfully used to restore central maxillary incisor edentulous area in terms of esthetic-cosmetic values and functionality.
Zirconium Dental Implants And Crown for Congenitally Missing Maxillary Latera...Abu-Hussein Muhamad
Zirconia implants were familiarized into dental implantology. Zirconia appears
to be an appropriate implant material due to its low plaque affinity, tooth like color, biocompatibility and mechanical properties. The following a case presentations will show how the acid-etched zirconia Implant can be used to functionally and aesthetically replace congenitally missing left lateral incisor tooth germ in the maxilla, and achieve optimal soft tissues and health.
Taurodontism is a rare dental anomaly in which the involved tooth has an enlarged and elongated body and pulp chamber
with apical displacement of the pulpal floor. Endodontic treatment of a taurodont tooth is challenge to a clinician and
requires special handling because of the proximity and apical displacement of the roots. The present article describes the
diagnosis and management of hypertaurodontism by endodontic treatment in a left mandibular second molar.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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.
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.
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.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
Titanium Button With Chain by Watted For Orthodontic Traction of Impacted Maxillary Canines
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 2 Ver. I (Feb. 2015), PP 00-00
www.iosrjournals.org
DOI: 10.9790/0853-142XXXXX www.iosrjournals.org 1 | Page
Titanium Button With Chain by Watted For Orthodontic
Traction of Impacted Maxillary Canines
1
Prof. Dr. Nezar Watted, 2
Dr. Muhamad Abu-Hussein, 3
Dr. Obaida Awadi,
4
Dr. Borbély Péter
13
Center for Dentistry research and Aesthetics, Jatt/Israel
2
Department of Pediatric Dentistry,University of Athens,Greece
4
University of Debrecen, Hungary
Abstract: Advances in bonding techniques and materials allow for reliable bracket placement on ectopically
positioned teeth. This prospective study evaluates the outcome of forced orthodontic eruption of impacted
canine teeth in both palatal and labial positions. Eighty-two impacted maxillary canines in 2200patients were
included in the study and were observed for 2006 to 2013 ,in Center for Dentistry research and Aesthetics,
Jatt/Israel after exposure. Following exposure by means of a palatal flap or an apically repositioned buccal
flap, an orthodontic traction hook, with a Titanium Button with chain by Watted (Dentaurum) attached, was
bonded to each impacted tooth using a light cured orthodontic resin cement. A periodontal dressing was placed
over the surgical site for a period of time. All teeth were successfully erupted. Complications consisted of:
failure of initial bond, at the time of surgery, which required rebonding; premature debonding at the time of
pack removal and; debonding of brackets during orthodontic eruption. There was no infection, eruption failure,
ankylosis, resorption or periodontal defect (pocket greater than 3 mm) associated with any of the exposed teeth.
Forced orthodontic eruption of impacted maxillary canines with a well bonded orthodontic traction hook and
ligation chain, used in conjunction with a palatal flap or an apically repositioned labial flap, results in
predictable orthodontic eruption with few complications.
Key Words: cuspid/surgery; orthodontics, corrective; tooth, impacted/therapy
I. Introduction:
The orthodontic treatment of impacted maxillary canine remains a challenge to today's clinicians. The
treatment of this clinical entity usually involves surgical exposure of the impacted tooth, followed by
orthodontic traction to guide and align it into the dental arch. Bone loss, root resorption, and gingival recession
around the treated teeth are some of the most common complications.[1,2,3]
Early diagnosis and intervention could save the time, expense, and more complex treatment in the
permanent dentition. Tooth impaction can be defined as the infraosseous position of the tooth after the expected
time of eruption, whereas the anomalous infraosseous position of the canine before the expected time of
eruption can be defined as a displacement. Most of the time, palatal displacement of the maxillary canine results
in impaction.[3,4,5,6]
Incidence of maxillary canine impactions vary from 0.92% - 1.7%.1,2 Impactions are twice as common
in females(1.17%) than males(0.51%). Impacted canines are found palatally in 85% of the cases, with labial
position in 15% of cases.[1,4,5,6]
Etiology of impacted maxillary canine is obscure and most likely it is multifactorial. In general, the
causes for impacted canine may be generalized or localized.[1,7,8,9,10,11]he most common causes for canine
impactions are usually localized and might be the result of any of the combinations. (a)Tooth size-arch length
discrepancies (b) Prolonged retention or early loss of deciduous canine (c) Abnormal position of the tooth bud
(d) The presence of an alveolar cleft (e) Ankylosis (f) Cystic or neoplastic formation (h) idiopathic condition
with no apparent cause.[9,10,11,12,13]
Other suggested cause of palatal impaction is trauma to the maxillary anterior region at an early stage
of development.[11 ]Also studies have shown that the presence of lateral incisor root with the right length,
formed at the right time is an important variable to guide the mesially erupting canine in a more favourable
distal and incisal direction. An increase of 2.4 times in the incidence of palatally impacted canines adjacent to
missing lateral incisors as compared with the general population was noted.[12,13,14]
A genetic predisposition was shown in some studies; the relatives of patients with palatal canines are
likely to exhibit palatally displaced canines and anomalous lateral incisors.13 Peck et al concluded that palatally
displaced canines appear to be a product of polygenic multifactorial inheritance.[14]Also Prinin et al found that
palatally impacted canines are genetic and related to incisor premolar hypodontia and peg shaped lateral
incisors.[15]
2. Titanium Button with chain by Watted for Orthodontic Traction Of Impacted Maxillary Canines
DOI: 10.9790/0853-142XXXXX www.iosrjournals.org 2 | Page
Internal or external root resorption of teeth adjacent to canine is the most common sequelae. It is
estimated that 0.7% of the children in the 10 to 13 year old age group have permanent incisors resorbed, as a
result of canine ectopia. Resorption of lateral incisor root is more common than the central incisor. Lateral
incisors are more commonly resorbed palatally and at the midroot level than at the cervical or apical
regions.[16]
Late resorption of the unerupted canine itself can occur. Loss of vitality and cystic degeneration is an
uncommon sequelae and the prevalence is not known. Orthodontic treatment is not without risks which include
root resorption, decalcification, periodontal damage and failure to complete treatment. Surgical risks include
damage to adjacent teeth and need for re-exposure sometimes.[4,5,13,15,16]
Localization of the unerupted canine involves inspection, palpation and radiographic evaluation. The
position of the crown of the lateral incisor can give a clue as to the position of the unerupted canine; that is the
crown of the lateral incisor may be proclined if the canine is lying on the labial aspect of the lateral incisor
root.[17]
Often the crown of the unerupted canine can be palpated either in buccal position or in palatal position
.There is a possibility of ectopic or impacted canine, if the canine is not palpable in the buccal sulcus by the age
of 10- 11 years or if the palpation indicates an asymmetrical eruption pattern. Ericson and Kurol recommend
inspection and palpation in canine region annually from 8 years for early identification of impacted canine.[3]
In selected cases, computerized tomograms are helpful in accurately assessing the location and
identifying root resorption of adjacent teeth however this method is rarely used because of the high cost of the
equipment.[2,3,8,9]
After mandibular third molars, the maxillary canines are the second most commonly impacted teeth
[1], with palatal impactions prevailing over buccal impactions [2, 3]. Treatment approaches are aimed at the
canines’ correctocclusion, as well as function and esthetics of the dentition and can be divided into preventive
and surgical. The preventive approach involves diagnosing the early signs of palatal displacement of permanent
canines and early extraction of primary canines in order to achieve self- correction of the improper eruption [4].
If diagnosis is belated and prevention of impaction is impossible surgical- orthodontic treatment should be
performed.
Various surgical techniques for exposing palatally impacted canines exist [4,5]): 1. technique of open
eruption; 2. technique of closed eruption; 3. open eruption through a window; 4. tunnel extrusion, etc. Within
the different approaches there exist two main options for the subsequent eruption of the impacted teeth [6]:
natural autonomous eruption and forced eruption under orthodontic traction.
The choice of a surgical approach still remains a question of personal preference for the surgeon and
orthodontist because the scientific literature lacks satisfactory evidence in favor of one of the techniques [7, 8,
]). Additional studies comparing directly the various methods and their advantages as regards the periodontal
status of the impacted teeth are needed [10, 11]
II. Materials and Methods
This study included 82ortho-dontic patients (46female, 36 male) who were followed for 18-21 months
after the surgical exposure of canines. The patients were 10 to 39 years old (mean . A total of 82 impacted
maxillary canines were treated according to a standard protocol. 65 (80%) teeth were palatally impacted and
17(20%) teeth were labially impacted. At the time of surgical exposure, all the teeth had at least one-third to
two-thirds of root formation completed. All the crowns of the impacted teeth were covered by bone.
Prior to surgery, the position of the impacted tooth was determined clinically (by palpation),
radiographically (panoramic, lateral cephalogram, two periapicals and maxillary occlusal films) and Cone Beam
Computerized Tomography.
For bilateral palatally impacted canines, a full thickness mucope-riosteal flap was raised from the
mesiopalatal aspect of the second premolars. In unilateral cases, the flap extended to the mesiopalatal aspect of
the contralateral lateral incisor.
For labially impacted canines, a full thickness mucoperiosteal flap was raised, initially without vertical
incisions, from the mesiobuccal aspect of the second premolar to the distolabial aspect of the lateral incisor.
Vertical releasing incisions were placed mesially and distally. Sufficient bone was removed from around the
crown in order to place a bonded orthodontic appliance. An apically positioned flap was fashioned if the tooth
was coronally place. For deeper impactions, a closed eruption technique was employed.
Currently the most common procedure is bonding of an attachment directly to the enamel surface of the
impacted tooth at the time of surgery.
A curved base bracket is used, with a soft wire ligated to the attachment before bonding. The wire
protrudes through the palatal tissue with a pig tail hook for attachment of the elastic.
The oral surgeon should expose enough of the canine to prevent the infiltration of the granulation
tissue, but the position of the canine will determine whether the orthodontist can isolate, etch, and bond with a
3. Titanium Button with chain by Watted for Orthodontic Traction Of Impacted Maxillary Canines
DOI: 10.9790/0853-142XXXXX www.iosrjournals.org 3 | Page
conventional composite resin. Most of the tough impactions are up far enough, that bonding is rendered rather
difficult by the proximity of the adjacent tissues and the lack of really good moisture control.
The enamel was etched for 20 seconds using 37% phosphoric acid. At this point the field was kept as
dry as possible using suction and gauze or bone wax. A light cured orthodontic resin cement (Unitek, Transbond
XT) was used for bonding (light cured at 470 nm for 40 seconds). The appliance used was a bonded orthodontic
traction hook with a Titanium Button with chain by Watted (Dentaurum) ligation chain .
If the primary canine was present, it was extracted and the wire was passed through the extraction
socket The Titanium Button with chain by Watted (Dentaurum) was wrapped around the existing labial
archwire, or held in place within the periodontal dressing until the orthodontic appliance was placed .
The flap was then repositioned. Labial flaps were apically repositioned ensuring that the full amount of
keratinized gingiva was maintained cervical to the crown. Palatal flaps were repositioned to their original site
and windows were placed in the mucoperiosteum, for the more medially placed palatal canines, to allow for
passage of the wire. Flaps were held in place by means of resorbable sutures.
Subsequently, a light cured periodontal dressing was placed over the area The dressing assured
patency of the window, aided flap immobilization, and provided protection and comfort for the patient.
Patients were then evaluated 7-14 days after surgery, when the dressing and sutures were removed.
Clinical evaluation included assessment of bracket attachment, eruption status, gingival tissue response,
recession, periodontal pocket depth and infection. A radiographic examination with one standard periapical film
was performed to assess the status of adjacent structures, as well as the presence of root resorption, ankylosis or
periodontal defects.
The patients then had orthodontic traction forces activated within seven to 21 days. At subsequent
orthodontic appointments, the same clinical examination was performed with radiological evaluation occurring
every three months. Progress was noted and complications were recorded
III. Results And Discussion
Of the 82 cases treated in this study, none came seeking treatment for the impacted canine as all
patients were not aware of the presence of any abnormality. Accidental discovery of the impaction was through
routine screening in the Center for Dentistry research and Aesthetics, Jatt/Israel.
Thirty-six (54.5%) cases had the canines bucally situated while thirty (45.5%) were palatally impacted.
Intraoral examination revealed that 65 cases were unilaterally impacted while bilateral impaction was present in
only one case. Forty cases (60.6%) showed retained deciduous canines. As a prominent clinical finding, there
was a bulge of the mucosa either labial or palatal that determined the position of the impaction[17,18,19]n.
Although this was not a common finding, it was, more often than not, accurately determined radiographically. In
those cases which could not be detected by palpation or by the presence of a bulge, lateral cephalometrics
helped in locating the impacted canine Intraoral occlusal films were merely confirmatory to the
cephalometrics[20].
Different devices can be applied to the crown of an impacted canine, including a wire, pins, crown
formers and orthodontic bracket. For many years, cervical neck wires (lasso) were a popular technique to secure
a tooth, but such wires injured the root of the tooth. Securing pins into the tip of the canine damaged the crown
of impacted tooth. Crown forms snapped or cemented over the crown of an impacted tooth was also popular for
many years. The crown forms act as a foreign body, causing erosion of overlying tissue with ultimate exposure
of the impacted tooth[19,20,21].
The device of choice is an orthodontic bracket. Once the orthodontic attachment has been placed on
impacted canine, orthodontic traction is applied to move the canine into proper alignment. Various methods
have been described for applying traction, these usually include the use of fixed appliances with a transpalatal
bar and or headgear to control vertical anchorage. The maintenance of adequate space in the canine area is
essential prior to application of traction[21,22,23].
Application of force can be in the form of elastic or wire traction. "The ballista spring" system for
impacted teeth has been described by Harry Jacoby. It employs a wire loop constructed using a 0.014", 0.016"
or 0.018" round wire[20].
Robert Harry and Harridane described a sectional approach to maxillary canine using transpalatal arch
for anchorage. They used a 0.017" x 0.025"TMA sectional archwire from first molar to canine providing low
force over a long range[20].
Cantilever mechanics for treatment of impacted canines has been described by Fischer et
al.[21]Australian helical archwire for assisting eruption of impacted canine was described by Hauser et al.26 It
comprises of three helices bent in 0.016" special plus Australian wire. The Australian wire is bent with helices
that serve as stops against the brackets of adjacent teeth to maintain space for erupting canine. An additional
incisal helix increases the resilience of the system and anchors the stainless steel ligature running to the canine
4. Titanium Button with chain by Watted for Orthodontic Traction Of Impacted Maxillary Canines
DOI: 10.9790/0853-142XXXXX www.iosrjournals.org 4 | Page
attachment. K-9 spring for alignment of impacted canines was described by Varun Kalra, it comprises of a
spring made of 0.017 x 0.025 inch TMA wire[20,21,22].
Bowman and Carano designed monkey hook as well as kilroy spring for guiding the eruption of
impacted tooth., [24] They described two types of kilroy springs. Kilroy I applies lateral and vertically directed
forces to direct the impacted tooth. Kilroy II spring was designed to produce more vertical eruptive forces for
eruption of buccally impacted tooth[24]. Magnetic forces have also been advocated by some authors to align
impacted tooth. Regardless of the method of traction used, the direction of applied force should initially move
the impacted tooth away from roots of the neighbouring teeth. In addition, Bishara recommends - a) use of light
force(< 60gms) to move the impacted tooth b) creation and maintenance of sufficient space within the arch c)
the use of base archwire of sufficient stiffness (0.018"x0.022") to resist deformation by the tractional forces
applied[24]
The purpose of our study in Center for Dentistry research and Aesthetics, Jatt/Israel was to
analyze the indications of surgical methods according to the clinical status of each Case.
In deep impactions, because the gingival tissue cannot be positioned in the vestibule in order to
uncover the tooth and to bond the auxiliary orthodontic device, it is recommended the use of muco-periostal
repositioned flap with passive guidance of the impacted canine. The apical translation flap has the purpose of
assuring the uncovering of the teeth and provides the amount of periodontal tissue for the repositioned canine.
Due to the fact that the lower margin of the flap is positioned in direct contact with the tooth, this method
contributes to periodontal restoration[20,21,24].
The window flap used in palatal impaction avoids extensive decollation of the mucosa, allows the
attachment of orthodontic devices and minimizes the trauma to the marginal periodontal tissue.Periodontal
follow-up 6 month after surgery shows that in the cases in which we used the repositioned flap, apical
translation flap and window flap there were no periodontal recessions or dental mobility which could
compromise the treatment. Conversely, in the cases in which we used the lateral and apical translation method
and meshing, the periodontal tissue was damaged and it needed surgical restoration[20,21,22,23,24].
IV. Conclusions
We recommend conservatory surgical orthodontic treatment due to its role in alveolar bone formation
during the movement of an impacted tooth, with restoration of the periodontium with esthetical and functional
implications.
When the treatment was finished, positive changes were achieved by performing the orthodontic
traction of the upper right canine and positioning it correctly in the dental arch. In doing so, canine class I was
achieved and we improved arch form, the overjet and the overbite as well as the profile and the incisor’s
inclination.
The radiographic characteristics prior to treatment assessed in the panoramic radiographs are useful
indicators for the duration of the orthodontic traction but they are not valid predictors for the final periodontal
status of the orthodontically repositioned impacted canine.
Complete fixed appliances are a commonly used alternative in combination with traction applied to the
center of the alveolar process and the use of a Titanium Button with chain by Watted and tied to the rigid
arch wire. This technique ensures a good control system.
Bibliography
[1]. Moyers RE: Handbook of Orthodontics 4th ed. Chicago,IL, Year book Medical Publisher 1988.
[2]. Becker A., Smith P, Behar R. The incidence of anomalous maxillary lateral incisors in relation to palatally-displaced cuspids. Angle
Orthod. 1981 Jan;51(1):24-29.
[3]. Mcnamara C.M.: Orthodontic Management Of An Impacted Maxillary Canine With An Abnormal Premolar Root: J.C.O. 2000;
34(12) : 709-711.
[4]. Ericson S, Kurol J. Radiographic examination of ectopically erupting maxillary canines. Am J Orthod Dentofacial Orthop 1987
Jun;91(6):483-492
[5]. Ericson S, Kurol J. Early treatment of palatally erupting maxillary canines by extraction of the primary canines. Eur J Orthod 1988
Nov;10(4):283-245. 6.Weaver B, Hornbrook R And Ngan P.: Early Timely Management of Ectopically Erupting Maxillary
Canines: Seminars In Orthodontics. 2005; 11(3):152-163.
[6]. Bedoya M., Park JH. A review of the diagnosis and management of impacted maxillary canines. J Am Dent Assoc. 2009
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[7]. Kokich VG Preorthodontic uncovering and autonomous eruption of REFERENCES:palatally impacted maxillary canines.
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mouth. Cochrane Database Syst Rev.2008 Oct 8;(4):CD006966.
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Tijdschr Tandheelkd. 2007Oct; 114(10): 416-22
[10]. Shafi I. No evidence to support one surgical technique over the other for the management of palatally displaced canines. Evid Based
Dent. 2008;9(4):111.
[11]. Aghaloo T, Felsenfeld, A.L.: Surgical Exposure of Impacted Teeth : Oral & Maxillofacial Surgery Clinics Of North America. 2002;
14(2): 187-199.
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[12]. Schmidt AD, Kokich VG.Periodontal response to early uncovering, autonomous eruption and orthodonticalignment of palatally
impacted maxillary canines. Am J Orthod Dentofacial Ortho2007 Apr;131(4):449-455
[13]. Frank CA., Long M. Periodontal concerns associated with the orthodontic treatment of impacted teeth. Am J Orthod Dentofacial
Orthop 2002 Jun;121(6): 639-49.
[14]. Magnusson H. Saving impacted teeth. J Clin Orthod. 1990; 24(4): 246-249..
[15]. Coulter J, Richardson A. Normal eruption of the maxillary canine quantified in three dimensions. European Journal of orthodontics
1997;18:449-456.
[16]. Ferguson JW. Parvizi F. Eruption of palatal canines following surgical exposure:a review of outcomes in a series of consecutively
treated cases. Br J Orthod 1997;24(3)203-207.
[17]. Kokich VG,Mathews DP. Surgical and orthodontic management of impacted teeth. Dent Clin North Am 1993;37(2):181-204.
[18]. Jacoby H. The Ballista spring system for impacted teeth. Am J Orthod 1979;75(2):1143-151.
[19]. Roberts-Harry D, Harridane N. A sectional approach to the alignment of ectopic maxillary canine. Br J Orthod 1995;22:67-70.
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FIG.
Table 1
Impacted Canine: N=82
Male Palatally 25
Male Buccally 11
Female Palatally 40
Female Buccally 6
Total 82
Fig. 1: Distribution of retention by gender and location
Table 2
Impacted Canine: N=82
Male Unilateral Left 16
Male Unilateral Right 6
Male Bilateral 14
Female Unilateral Left 20
Female Unilateral Right 16
Female Bilateral 10
Total 82
6. Titanium Button with chain by Watted for Orthodontic Traction Of Impacted Maxillary Canines
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Fig1(a)
Fig1(b)
Fig1(c)
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Fig2(a)
Fig2(b)
Fig2(c)
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Fig2(d)
Fig2(e)
Fig2(f)
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Fig2(g)
Fig2(h)
Fig2(i)
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Fig3(a)
Fig3(b)
Fig3(c)
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Fig3(d)
Fig3(e)
Fig3(f)
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Fig3(g)
Fig. 2a-c: Bilateral palatally impacted canine: Cone Beam Computerized Tomography shows an accurate
visualization of what the surgical field will look like, when the exposure is undertaken.
Fig.3a: a patient before the treatment The Orthopantomogram shows the displacement and retention of tooth 13
and 23 with persistence of the tooth 53 and 63
Fig. 3b: Clinical situation of the upper dental arch
Fig. 3c: Formation of a Mucoperiosteal flap and expose the crown of an impacted canine with substantial
protection of the bone.
Fig. 3d: titanium chain by Watted (DENTAURUM).
Fig. 3e: the full flap is now re-sutured into its former place and the titanium chain may be seen through the flap.
Fig. 3f-h: Clinical situation after the treatment
Fig. 3i: Orthopantomogram at the end of treatment.
Fig. 4a,b: Bilateral impacted canine. a: Palatally impacted , b: Buccally impacted
Fig. 4c-g Fixation of the attachment by means of light-curing resin after etching technique and repositioning of
the flap (closed elongation). –
Fig. 5: Distribution of retention by gender, side and location
20%
7%
17%
24%
20%
12%
Impacted Canine: N=82
Male Unilateral Left
Male Unilateral Right
Male Bilateral
Female Unilateral Left
Female Unilateral Right
Female Bilateral