Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine, Al-Azhar University. Mandibular angle fractures account for 23% to 42% of all facial fractures. Fracture of mandibular angle can be classified as (A) Vertical favorable or unfavorable, (B) Horizontally favorable of unfavorable. Traditionally, mandibular angle fractures have been treated with either closed reduction and inter-maxillary fixation or open reduction and internal fixation with or without inter-maxillary fixation. Patients treated with inter-maxillary fixation have a restricted airway and loose excess weight. Rigid internal fixation and early return to function have eliminated the use of wire osteosenthysis and prolonged use of inter-maxillary fixation. The principal of rigid fixation, however, have inherent set of disadvantages including damage to the inferior alveolar nerve and the marginal mandibular branch of facial nerve. Postoperative malocclusion rates are also high. With the introduction of semi-rigid technique fracture of the mandibular angle could be treated according to Champy’s Ideal lines of osteosenthysis. The technique involves placement of a single monocortial miniplate on the superior border of the mandible. However, some studies suggested using a second miniplate along the inferior border. Wether one or two miniplates should be used is still debatable. The application of 3D plates may provide additional stability in 3 dimension and good resistance against torque forces.
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine, Al-Azhar University. Mandibular angle fractures account for 23% to 42% of all facial fractures. Fracture of mandibular angle can be classified as (A) Vertical favorable or unfavorable, (B) Horizontally favorable of unfavorable. Traditionally, mandibular angle fractures have been treated with either closed reduction and inter-maxillary fixation or open reduction and internal fixation with or without inter-maxillary fixation. Patients treated with inter-maxillary fixation have a restricted airway and loose excess weight. Rigid internal fixation and early return to function have eliminated the use of wire osteosenthysis and prolonged use of inter-maxillary fixation. The principal of rigid fixation, however, have inherent set of disadvantages including damage to the inferior alveolar nerve and the marginal mandibular branch of facial nerve. Postoperative malocclusion rates are also high. With the introduction of semi-rigid technique fracture of the mandibular angle could be treated according to Champy’s Ideal lines of osteosenthysis. The technique involves placement of a single monocortial miniplate on the superior border of the mandible. However, some studies suggested using a second miniplate along the inferior border. Wether one or two miniplates should be used is still debatable. The application of 3D plates may provide additional stability in 3 dimension and good resistance against torque forces.
Classification of Impaction and Methods & Techniques of Third molar/Manidibular impaction removal,Flap designs of impaction removal techniques and more
A well pictured presentation on Endodontic Instrumentation for UG students. Best for getting a good grip on the topic as a whole. Meant to supplement not substitute standard texts.
Classification of Impaction and Methods & Techniques of Third molar/Manidibular impaction removal,Flap designs of impaction removal techniques and more
A well pictured presentation on Endodontic Instrumentation for UG students. Best for getting a good grip on the topic as a whole. Meant to supplement not substitute standard texts.
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine
Al-Azhar University. Impacted teeth can be defined as those prevented from eruption at the expected time due to physical barrier. The etiology, frequency of impactions are given. Classification systems are based on the depth, angulation, and available space. Complications associated with lower third molar impaction are discussed and methods of treatment are explained. Comparison between maxillary third molar and mandibular one is given. Upper canine is the second most commonly impacted tooth after third molars. It form the foundation of an esthetic smile. The management of impacted canine is interdisciplinary management comprises of a team of an orthodontist, oral surgeon, and periodontist.
Impacted teeth - learn everything about it (classification - complications - indications of removal - contraindications for removal - operative and post operative complications - and more about it)
موضوع باوربوينت عن الاسنان المنحصرة : تتعلم فيها كل ما يتعلق عنها:
(الاعراض والاختلاطات - دواعي الازالة - موانع الازالة - اختلاطات المعالجة واختلاطات بعد المعالجة - والمزيد..)
Prepared by:
Dr.Basma Elbeshlawy
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
Mandibular molar impaction and related retrospective study finding incidence of impacted mandibular third molars in a population sample from Bosnia and Herzegovina
Retention,stability& support in dentures / dental implant 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.for more details please visit
www.indiandentalacademy.com
Third molar /certified fixed orthodontic courses by Indian dental academy 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
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.
This ia educative PPT for students and patients to help them understand the surgical removal of impacted third molar teeth.
This will ease in understanding the complexity of surgical procedure.
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.
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
The increased availability of biomedical data, particularly in the public domain, offers the opportunity to better understand human health and to develop effective therapeutics for a wide range of unmet medical needs. However, data scientists remain stymied by the fact that data remain hard to find and to productively reuse because data and their metadata i) are wholly inaccessible, ii) are in non-standard or incompatible representations, iii) do not conform to community standards, and iv) have unclear or highly restricted terms and conditions that preclude legitimate reuse. These limitations require a rethink on data can be made machine and AI-ready - the key motivation behind the FAIR Guiding Principles. Concurrently, while recent efforts have explored the use of deep learning to fuse disparate data into predictive models for a wide range of biomedical applications, these models often fail even when the correct answer is already known, and fail to explain individual predictions in terms that data scientists can appreciate. These limitations suggest that new methods to produce practical artificial intelligence are still needed.
In this talk, I will discuss our work in (1) building an integrative knowledge infrastructure to prepare FAIR and "AI-ready" data and services along with (2) neurosymbolic AI methods to improve the quality of predictions and to generate plausible explanations. Attention is given to standards, platforms, and methods to wrangle knowledge into simple, but effective semantic and latent representations, and to make these available into standards-compliant and discoverable interfaces that can be used in model building, validation, and explanation. Our work, and those of others in the field, creates a baseline for building trustworthy and easy to deploy AI models in biomedicine.
Bio
Dr. Michel Dumontier is the Distinguished Professor of Data Science at Maastricht University, founder and executive director of the Institute of Data Science, and co-founder of the FAIR (Findable, Accessible, Interoperable and Reusable) data principles. His research explores socio-technological approaches for responsible discovery science, which includes collaborative multi-modal knowledge graphs, privacy-preserving distributed data mining, and AI methods for drug discovery and personalized medicine. His work is supported through the Dutch National Research Agenda, the Netherlands Organisation for Scientific Research, Horizon Europe, the European Open Science Cloud, the US National Institutes of Health, and a Marie-Curie Innovative Training Network. He is the editor-in-chief for the journal Data Science and is internationally recognized for his contributions in bioinformatics, biomedical informatics, and semantic technologies including ontologies and linked data.
Richard's entangled aventures in wonderlandRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
Professional air quality monitoring systems provide immediate, on-site data for analysis, compliance, and decision-making.
Monitor common gases, weather parameters, particulates.
Earliest Galaxies in the JADES Origins Field: Luminosity Function and Cosmic ...Sérgio Sacani
We characterize the earliest galaxy population in the JADES Origins Field (JOF), the deepest
imaging field observed with JWST. We make use of the ancillary Hubble optical images (5 filters
spanning 0.4−0.9µm) and novel JWST images with 14 filters spanning 0.8−5µm, including 7 mediumband filters, and reaching total exposure times of up to 46 hours per filter. We combine all our data
at > 2.3µm to construct an ultradeep image, reaching as deep as ≈ 31.4 AB mag in the stack and
30.3-31.0 AB mag (5σ, r = 0.1” circular aperture) in individual filters. We measure photometric
redshifts and use robust selection criteria to identify a sample of eight galaxy candidates at redshifts
z = 11.5 − 15. These objects show compact half-light radii of R1/2 ∼ 50 − 200pc, stellar masses of
M⋆ ∼ 107−108M⊙, and star-formation rates of SFR ∼ 0.1−1 M⊙ yr−1
. Our search finds no candidates
at 15 < z < 20, placing upper limits at these redshifts. We develop a forward modeling approach to
infer the properties of the evolving luminosity function without binning in redshift or luminosity that
marginalizes over the photometric redshift uncertainty of our candidate galaxies and incorporates the
impact of non-detections. We find a z = 12 luminosity function in good agreement with prior results,
and that the luminosity function normalization and UV luminosity density decline by a factor of ∼ 2.5
from z = 12 to z = 14. We discuss the possible implications of our results in the context of theoretical
models for evolution of the dark matter halo mass function.
Introduction:
RNA interference (RNAi) or Post-Transcriptional Gene Silencing (PTGS) is an important biological process for modulating eukaryotic gene expression.
It is highly conserved process of posttranscriptional gene silencing by which double stranded RNA (dsRNA) causes sequence-specific degradation of mRNA sequences.
dsRNA-induced gene silencing (RNAi) is reported in a wide range of eukaryotes ranging from worms, insects, mammals and plants.
This process mediates resistance to both endogenous parasitic and exogenous pathogenic nucleic acids, and regulates the expression of protein-coding genes.
What are small ncRNAs?
micro RNA (miRNA)
short interfering RNA (siRNA)
Properties of small non-coding RNA:
Involved in silencing mRNA transcripts.
Called “small” because they are usually only about 21-24 nucleotides long.
Synthesized by first cutting up longer precursor sequences (like the 61nt one that Lee discovered).
Silence an mRNA by base pairing with some sequence on the mRNA.
Discovery of siRNA?
The first small RNA:
In 1993 Rosalind Lee (Victor Ambros lab) was studying a non- coding gene in C. elegans, lin-4, that was involved in silencing of another gene, lin-14, at the appropriate time in the
development of the worm C. elegans.
Two small transcripts of lin-4 (22nt and 61nt) were found to be complementary to a sequence in the 3' UTR of lin-14.
Because lin-4 encoded no protein, she deduced that it must be these transcripts that are causing the silencing by RNA-RNA interactions.
Types of RNAi ( non coding RNA)
MiRNA
Length (23-25 nt)
Trans acting
Binds with target MRNA in mismatch
Translation inhibition
Si RNA
Length 21 nt.
Cis acting
Bind with target Mrna in perfect complementary sequence
Piwi-RNA
Length ; 25 to 36 nt.
Expressed in Germ Cells
Regulates trnasposomes activity
MECHANISM OF RNAI:
First the double-stranded RNA teams up with a protein complex named Dicer, which cuts the long RNA into short pieces.
Then another protein complex called RISC (RNA-induced silencing complex) discards one of the two RNA strands.
The RISC-docked, single-stranded RNA then pairs with the homologous mRNA and destroys it.
THE RISC COMPLEX:
RISC is large(>500kD) RNA multi- protein Binding complex which triggers MRNA degradation in response to MRNA
Unwinding of double stranded Si RNA by ATP independent Helicase
Active component of RISC is Ago proteins( ENDONUCLEASE) which cleave target MRNA.
DICER: endonuclease (RNase Family III)
Argonaute: Central Component of the RNA-Induced Silencing Complex (RISC)
One strand of the dsRNA produced by Dicer is retained in the RISC complex in association with Argonaute
ARGONAUTE PROTEIN :
1.PAZ(PIWI/Argonaute/ Zwille)- Recognition of target MRNA
2.PIWI (p-element induced wimpy Testis)- breaks Phosphodiester bond of mRNA.)RNAse H activity.
MiRNA:
The Double-stranded RNAs are naturally produced in eukaryotic cells during development, and they have a key role in regulating gene expression .
Cancer cell metabolism: special Reference to Lactate PathwayAADYARAJPANDEY1
Normal Cell Metabolism:
Cellular respiration describes the series of steps that cells use to break down sugar and other chemicals to get the energy we need to function.
Energy is stored in the bonds of glucose and when glucose is broken down, much of that energy is released.
Cell utilize energy in the form of ATP.
The first step of respiration is called glycolysis. In a series of steps, glycolysis breaks glucose into two smaller molecules - a chemical called pyruvate. A small amount of ATP is formed during this process.
Most healthy cells continue the breakdown in a second process, called the Kreb's cycle. The Kreb's cycle allows cells to “burn” the pyruvates made in glycolysis to get more ATP.
The last step in the breakdown of glucose is called oxidative phosphorylation (Ox-Phos).
It takes place in specialized cell structures called mitochondria. This process produces a large amount of ATP. Importantly, cells need oxygen to complete oxidative phosphorylation.
If a cell completes only glycolysis, only 2 molecules of ATP are made per glucose. However, if the cell completes the entire respiration process (glycolysis - Kreb's - oxidative phosphorylation), about 36 molecules of ATP are created, giving it much more energy to use.
IN CANCER CELL:
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
Unlike healthy cells that "burn" the entire molecule of sugar to capture a large amount of energy as ATP, cancer cells are wasteful.
Cancer cells only partially break down sugar molecules. They overuse the first step of respiration, glycolysis. They frequently do not complete the second step, oxidative phosphorylation.
This results in only 2 molecules of ATP per each glucose molecule instead of the 36 or so ATPs healthy cells gain. As a result, cancer cells need to use a lot more sugar molecules to get enough energy to survive.
introduction to WARBERG PHENOMENA:
WARBURG EFFECT Usually, cancer cells are highly glycolytic (glucose addiction) and take up more glucose than do normal cells from outside.
Otto Heinrich Warburg (; 8 October 1883 – 1 August 1970) In 1931 was awarded the Nobel Prize in Physiology for his "discovery of the nature and mode of action of the respiratory enzyme.
WARNBURG EFFECT : cancer cells under aerobic (well-oxygenated) conditions to metabolize glucose to lactate (aerobic glycolysis) is known as the Warburg effect. Warburg made the observation that tumor slices consume glucose and secrete lactate at a higher rate than normal tissues.
2. Treatment of Mandibular 3rd molar impaction
with complications
Treatment of Maxillary 3rd molar impaction
with complications
Treatment of Maxillary and Mandibular
Canine impactions in
i. Class 1 position
ii. Class 2 position
iii. Class 3 position
iv. Class 4 position
v. Class 5 position
3. HISTORY
› Patients might be asymptomatic
› when symptomatic- pain, swelling of the face, trismus
› Symptoms of acute pulpitis or abscess
› In denture wearers if denture no longer fits & at the same time show the
symptoms of pericoronitis.
› General medical history & assessment of physical condition
EXAMINATION
Clinical
Extra oral
Intra oral
Radiographs
DECISION
Diagnosis
Treatment planning – type of anesthesia
- surgical procedure
4. Local Examination
EXTRA ORAL:
• Signs of swelling & redness of the cheek
• LN’s - enlargment & tenderness,
• TMJ
• Anesthesia or paraesthesia of lower lip,
INTRA ORAL:
• Mouth opening & any evidence of trismus
• State of eruption of tooth, signs of pericoronitis
• Condition of 1st & 2nd molars
• Space present b/w 2nd M & ascending ramus
• Elasticity of oral tissues
• Size of tongue
11. Interpretation
1. Assessing Access
2. Assesing Position and Depth:
o WAR LINES
o White line, Amber Line, Red Line
1. Asses Roots
o Length
o Fusion of roots
o Curvature of roots
o Width of roots
o Roots of 2nd molar
1. Asses Bone Texture
2. Asses Relationship with Inferior Alveolar
Nerve
12. 7 Radiological Signs (Howe and Poyton
1960)
1. Darkening of roots
2. Deflected root
3. Narrowing of the Roots
4. Dark and Bifid roots
5. Interruption of the white lines
6. Diversion of Inferior Alveolar Canal
7. Narrowing of the inferior alveolar canal
26. Factors affecting
Type and Degree of impaction
Amount of Soft tissue exposure
Amount and technique of bone removal
Odentectomy
27.
28. Anesthesia
LA : nerve block of the Inferior alveolar,
lingual, and long buccal nerve
GA: indicated if tooth is situated deep inside
the jaw, when more than 2 impacted molars
are to be removed
29. Mucoperiosteal Flap
Ideal Requirements:
Adequate Exposure
Base of flap Wide
Expose entire site of operation
No overextension of flap
Incision should not damage vital anatomic
structures
30.
31. MUCOPERIOSTEAL FLAP
Incision – 3 parts: Anterior, posterior & intermediate limb
Not to be extended too distally-
Bleeding from buccal vessels & other arteries
Postoperative trismus – temporalis muscle damage
Herniation of buccal fat pad
Damage to lingual nerve (lingual extention)
32. Planned Ward’s Incision
Anterior release incision made including the
interdental papilla distal to 37. the incision
extends downwards at 35 degree angle to
the long axis of 36 extending 5 mm beyond
the Mucogingival Junction taking care that
the anterior limit of the incision does not
cross the mesial line angle of 37 to avoid
encountering facial artery
33. Crevicular incision or interdental bevel
incision is done in relation to 38
Distal release incision is made from the
distobuccal line angle of 38 buccolaterally to
avoid encountering lingual nerve
34. Types of Flaps
L – shaped flap
(2nd molar para
marginal Flap with
vestibular extension)
Envelope flap
(2nd molar
sulcus incision)
Bayonet – shaped flap
(2nd molar sulcus incision
With vestibular extension)
37. Buccal mucoperiosteal flap is raised staring
the elevator frm the base of the falp at
vestibular ( labial) mucosafor easy
identification of the subperiosteal plane
Buccal mucoperiosteal flap is raisedincluding
the interdental papilla
Complete elevation of the buccal
mucopriosteal flap exposing the impacted 38
38. Raising of the lingual mucoperiosteal flap
Complete exposure of the impacted 38 and
surrounding bone
39.
40. Guttering of the mesial, buccal, and distal
bone of 38 closest to the tooth ( Moore-
Gillbe collar Technique)
41.
42. Initiation of dontectomy along long axis of
the tooth midway at the bifurcation
Odontectomy performed uptill 2/3rd of the
buccolingual width of the tooth using rotary
instruments
43.
44. Completion of odontectomy using straight
elevator
The working end of the elevator is engaged
into created groove and rotated clockwise to
complete odontectomy
47. Thorough debridement of the socket by Periapical curettage.
Smoothening of sharp bony margins by Bone file / burs.
Thorough irrigation of the socket Betadine solution + Saline .
Initial wound closure is achieved by placing 1stsuture just
distal to 2ndmolar, sufficient number of sutures to get a
proper closure.
48.
49.
50. Aim
1. To expose the crown by removing the bone overlying it.
2. To remove the bone obstructing the pathway for
removal of the impacted tooth.
Types
1. By consecutive sweeping action of bur (in layers).
2. By chisel or osteotomy cut (in sections).
How much bone has to be removed?
1. Bone should be removed till we reach below the height of contour,
where we can apply the elevator.
2. Extensive bone removal can be minimized by tooth sectioning
51. - Conventional tech of using bur.
- Rosehead round bur no.3 is used to create a gutter along the
buccal side & distal aspect of tooth.
- A point of elevation is created with bur.
- Amount of bone sacrificed is less.
- Can be used in old patient.
- Convenient for patient.
52. - Quick & clean tech
- Reduces the size of blood clot by means of saucerization
of socket.
- Decreased risk of damage to the periodontium of the second
molar.
- Less risk of inferior alveolar nerve damage.
- Decreased risk of socket healing problems
- Can use regional anaesthesia but endotracheal anaesthesia is
preferred one.
- Only suitable for young adults whose bone is elastic
- Inconvenience to patients due to chisel useage.
53. Incision Vertical stop cut
Split of Disto
lingual bone
Horizontal cut
Removal of distal
& buccal bone
Removal of disto
lingual bone
Elevation
Closure
54. Pressure pack – 1hr
Ice application
Soft diet –1st two days
1st dose of analgesic should be taken before the anesthetic
effect of LA wears off.
Avoid strenuous exercises for 1st 24 hrs.
Avoid gargling / spitting / smoking / drinking with straw.
Warm water saline gargling after 24 hrs + mouth wash
regularly thereafter.
Suture removal on 5th POD.
55. Intra Operative
1. During incision
a. Injury to facial artery
b. Injury to lingual nerve
c. Hemorrhage – careful history
56. 2. During bone removal
a. Damage to second molar
b. Slipping of bur into soft tissue &
causing injury
c. Extra oral/ mucosal burns
d. Fracture of the mandible when
using chisel & mallet
e. Subcutaneous emphysema
57. 3. During elevation or tooth removal
a. Luxation of neighbouring tooth/ fractured
restoration
b. Soft tissue injury due to slipping of elevator
c. Injury to inferior alveolar neurovascular bundle
d. Fracture of mandible
e. Forcing tooth root into submandibular space or
inferior
alveolar nerve canal
f. Breakage of instruments
g. TMJ Dislocation – careful history
58. Nerve Injuries
0.6-5% of all the third molar surgeries are involved with nerve
damages of which 0.2% are irreversible
IAN: immediate disturbance - 4-5% (1.3-7.8%)
permanent disturbances - <1% (0-2.2%)
Lingual N: immediate - 0.2-22%
permanent - 0-2%
96% IAN injuries show spontaneous recovery within 9 months,
better than lingual nerve which is about 87%
Beyond 2yrs recovery is unlikely
60. Dry Socket
20% of extraction of mandibular 3rd molar
2% of routine extraction
Moderate-severe pain develops generally on 3rd/4th day.(with no signs of
infection)
Dull aching pain usually radiates to ear
Empty socket
Bad odor & taste
Management
Gentle irrigation with warm saline followed by superficial suctioning.
Pack iodoform gauze socked with medications change every day for 3-6 days.
Intra-alveolar medicaments(controversial)
-with eugenol
-topical LA
-antifibrinolytic agents.
Analgesics.
61. Indications
1. Pain
2. Overeruption of the upper 3rd molar
3. 3rd molar errupting towards cheek
4. Exacerbation of pericoronitis of lower 3rd
molar
5. Complete Maxillary denture
62. Clinical
1. State of erruption
2. Buccolingual displcement
3. Impaction against 2nd molar
4. Mouth opening
5. Space around 3rd molar
65. 1. Maxillary Sinus approximation
2. 3rd molar within or above roots of 2nd molar
3. Fusion of roots with 2nd molar
4. Abnormal root curvature
5. Hypercementosis
6. Extreme bone density: elderly patients
7. Follicular space filled with bone
8. Inability t open mouth widely
66. Same as that of mandibular molars bt
difference in choice of elevators and forceps
1. Upper molar forcep
2. Miller and Potts elevator
3. BP- no 12
67. Step 1: Incision and Flap
1. Incision beyond the tuberosity in the hamular
notch
2. Mucous Membrane incised from the distal most
portion anteriorly
3. Incision is continued buccally around the neck
of 2nd molar to the interproximal space os 1st
molar and the towards mucobuca fold at 45
degree angle
4. Last incision using no 15 BP blade
68.
69. Step 2:Elevation and Bone removal
1. Overlying bone is not dense and can be
readily removed with a chisel
2. Elevator is inserted at the height of contour
using buccal plate as fulcrum
3. Extreme care must be taken not to
inadvertently drive tooth into maxillary sinus
or Pterygomaxillary space
70.
71. Step 3: Wound Toilet and Closure
1. Debridement of socket and smothening of
bone margins before wound is closed
2. Sutures are placed
72. Intraoperative
1. Fracture of tuberosity
2. Dislodgement into maxillary sinus
3. Dislodgement of tooth into maxillary sinus
4. Damage to adjacent 2nd molar
76. A. Age
B. Stage of tooth development
C. Position of tooth
D. Evidence of root resorption of adjacent
permanent teeth
77. 1. No treatment
2. Surgical removal of unerupted canine
3. Surgical exposure of crown with or without
orthodontic treatment
4. Surgical repositioning
5. Surgical transplantation
78. Indications for Surgery
i. No other methord possible to retain tooth
ii. Tooth is located very far from occlusal plane
iii. Pt unwilling to undergo ortho treatment
iv. Resorption of adjacent tooth
v. Cystslike infection, cyst formation
vi. Required space does not exist
vii. When repositioning is unfavorable
80. 1. Proximity to adjacent teeth
2. Proximity to the antral and nasal cavity
3. Formation of oroantral fistulas leading to
acute sinusitis
81. Removal of Canine in Class 1 position
(Maxillary)
1. Soft tissue flap
No 12 BP blade used
Incise tissuse around neck of teeth from lingual
side of central incisor
90. Flap is compressed onto the palatal bone
with a gauze palatal packing placed for 4 hrs
Alternatively a compound stent may be used
to prevent hematoma collection
91. Labially placed impacted canine can be
exposed by
1. Trapezoidal flap- 2 vertical limbs
2. Semilunar flap- no vertical limb
3. Triangular flap- one vertical limb
92. 1. Mucoperiosteal flap
2. Bone removed by chisel
3. Labial cortical plate as fulcrum luxate tooth
4. Wound debridement and closure
93.
94. A. Crown in palatal bone root on buccal side
1. Semilunar flap
2. Circumferential bone removal
3. Root is sectioned
4. Palatal flap outlined and mucoperiosteal flap
reflected
5. Blunt instrumentation used to elevate
6. Wound closure
95. B. Maxillary cuspid lying in line of arch along
alveolar crest
1. Trapezoidal flap
2. Bone removal with chisel and mallet
3. Buccal mucoperiosteal flap
4. Removal of tooth in sections or toto
5. Primary wound closure
