Surgical Considerations For Implant Placement

Surgical Considerations For Implant Placement
Nadia Rhebi, nar344@nyu.edu, 201–496–4914 12/7/14 3:16 PM
Indications and Surgical Considerations for Implant Placement in Maxillary Incisive Canal – a Case
Series
Rhebi, Nadia; Ochoa–Durand, Daniel; Suzuki, Takanori; Cho, Sang–Choon; Froum, Stuart
Introduction
Implant surgery in the edentulous premaxilla is often challenging because of esthetic, phonetic and
biomechanical considerations. In the maxilla, resorption following tooth extraction occurs mainly
within the first 3–12 months post–operatively (1). Bone resorption following tooth loss occurs in
both a lingual and apical direction, resulting in an edentulous maxilla that is narrower with a loss of
vertical height. This resorption is responsible for the edge–to–edge or reverses occlusal relation of
the residual crests that is often observed in patients with completely edentulous maxillae (2).
At times, ridge resorption in the maxilla is so severe that is necessary to augment the bone in order
to place an implant. In some cases, conventional ridge augmentation cannot build enough bone to
place implants, especially in fully edentulous cases. A number of bone augmentation methods have
been developed specifically for implant placement in the severely resorbed maxilla. These include
split ridge augmentation (3), distraction osteogenesis (4), ridge augmentation using guided bone
regeneration with various kinds of graft materials, and sinus augmentation (5). Most of these
procedures are not only technique–sensitive and
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Client Presentation Case Study
Client's general pigmentation is very light tan with deep yellow undertones. Client's skin is even and
consistent with genetic background. Client's facial expressions are symmetric and respond
accordingly to appropriate behavior or mood. Client's skin is intact with no obvious lesions. Client
expresses a relaxed and comfortable facial expression which accompanies his adequate vision.
(Jarvis, 2016, p. 293)
Client has no eyebrows.
Client's eyelids skin is intact without redness, swelling, discharge, or lesions. Client's eyelashes are
distributed evenly along the lid margins and curve outward. (Jarvis, 2016, p. 294)
Client's eyeballs are aligned in their sockets with no protrusion or sunken appearance. (Jarvis, 2016,
p. 294)
Client's right eye has red beefy–looking ... Show more content on Helpwriting.net ...
Client presents no cracking or lesions. (Jarvis, 2016, p. 363)
Client's teeth present no diseased, absent, loose, or abnormally positioned teeth. The client's teeth
are white, straight, evenly spaced and clean and free of decay. The client presents normal occlusion
in the back; is the upper teeth resting directly on the lower teeth; in the front the upper incisors
slightly override the lower incisors. The client's gum color is pink with a stippled surface. The gum
margins at the teeth are tight and well defined. The client presents no swelling, no retraction of
gingival margins, no spongy bleeding gums or discolored gums. (Jarvis, 2016, p. 364)
The client presents a pink and even color tongue. The dorsal surface appears roughened from the
papillae. The client's ventral tongue surface looks smooth and glistening and shows veins. The
client's U–shaped tongue presents no oral malignancies; white patches, lesions, nodules, or
ulcerations. Saliva is present. (Jarvis, 2016, p. 364–365)
The client's buccal mucosa is pink, smooth and moist. There are no brown patches and no swelling
in the client's buccal mucosa. (Jarvis, 2016, p.

Case Study Of Amelogenesis Imperfecta
Amelogenesis Imperfecta
Amelogenesis Imperfecta represents a group of conditions, genomic in origin, which affect the
structure and clinical appearance of the enamel of all or nearly all the teeth in a more or less equal
manner, and which may be associated with morphologic or biochemical changes elsewhere in the
body (1). AI is a developmental condition of the dental enamel characterised by hypoplasia and/or
hypomineralisation, which could be autosomal dominant, autosomal recessive, sex linked with
sporadic inheritance patterns.
The anatomic and histological features of the various phenotypes include either reduced enamel
hypoplasia or hypomineralization including hypomaturation and hy– pocalcification subtypes.(2)
Clinical features associated with AI include enamel defects, pulpal calcification, taurodontism, root
malformations, disturbances in tooth eruption, impaction of permanent teeth, progressive root and ...
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The multiple treatment phases can utilize considerable time, the long–term consequences, risks, and
benefits of the various treatmentoptions must be discussed with patients.
A correct treatment plan and the use of the new ceramic materials made it possible to obtain good
results both from a functional and esthetic point of view with a much more conservative approach
compared with the traditional one.
Recent long–term follow–up research on these new materials support their use in esthetic and
functional rehabilitations of this type. In addition, considering the young age of the patient, the
preservation of hard tissues and the complete non–interference of periodontal tissues will not
prejudice the possibility of any further dental

Dental Question Bank
1 1. For lower premolars, the purpose of inclining the handpiece lingually is to A. B. C. D. Avoid
buccal pulp horn Avoid lingual pulp horn Remove unsupported enamel Conserve lingual dentine 2.
For an amalgam Restoration of weakened cusp you should A. B. C. Reduce cusp by 2mm on a flat
base for more resistance Reduce cusp by 2mm following the outline of the cusp Reduce 2mm for
retention form 3. Before filling a class V abrasion cavity with GIC you should A. B. C. Clean with
pumice, rubber cup, water and weak acid Dry the cavity thoroughly before doing anything Acid itch
cavity then dry thoroughly 4. Which of the following statement about the defective margins of
amalgam restoration is true? A. The larger the breakdown, the greater ... Show more content on
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C. Start endodontic treatment Extraction of tooth 22. What is the main purpose of performing pulp
test on a recently traumatised tooth A. B. Obtain baseline response Obtain accurate indication about
pulp vitality 23. What is the main function of EDTA in endodontics A. Decalcification of dentine B.
Cleaning debris from root canal 24. Which is NOT TRUE in relation to the prescription of 5mg or
10mg of diazepam for sedation A. B. Patient commonly complain of post operative headache An
acceptable level of anxiolytic action is obtained when the drug is given one hour preoperatively C.
There is a profound amnesic action and no side affects D. Active metabolites can give a level of
sedation up to 8 hours post operatively E. As Benzodiazepine the action can be reversed with
Flumazepil 25. Which of the following is TRUE in regards to high risk patient A. 0.1ml of blood
from Hepatitis B carrier is less infective than 0.1ml of blood from HIV patient B. 0.1ml of blood
from Hepatitis B carrier is more infective than 0.1ml of blood from HIV patient C. Level of virus
are similar in the blood and saliva of HIV patient D. Level of virus in the saliva is not significant for
Hepatitis B patient E. The presence of Hepatitis B core Antigen in the blood means that active
disease is not present 26. Your employer in an attempt to update office sterilization procedures; what
would you recommend as the BEST method to verify that sterilization has occurred** A. Use spore
test

Development Of Early Childhood And Adolescent Patients
Throughout life, we as humans are continually developing and our cognitive, physical and
behavioural conditions may change as we go through different stages of our life. As future Oral
Health Therapists, this is especially important to recognize as our career serves people of all ages
and it is important to be able to understand the characteristics and stages of human development in
order to practice effectively. This report aims to aid in the management of early childhood and
adolescent patients through the explanation of their cognitive, behavioural/social and physical
development through the use of (INSERT THEORISTS HERE) theories. This will be done in two
main parts, which will both include the cognitive, behavioural and physical changes of both a five
year old patient and a fifteen–year–old patient. It will also give rise to some important milestones
for these age groups and why this can have an impact on patients opinions.... And behaviours
exhibited in a clinical condition and their general oral health. Part I Early childhood ranges from the
ages of two to six years and this age range tend to hold a number of generalised physical, cognitive
and socio–emotional developmental milestones. It is important for a clinician to understand
developmental stages of children and communicate effectively with children within this specific age
range to promote positive and successful appointments. Physical Development During the early
childhood phase there is a rapid amount of

Aesthetic Considerations For Complete Denture
Esthetic Considerations in Complete Denture
Prepared by Meghetie Ketchedjian–201500949
Submitted to Dr. Maria Reslan
Esthetic Considerations in complete denture
What would an edentulous patient wish for other than restoring back his teeth,smile and beauty?
Of course, when dealing with artificial teeth in complete dentures, many will be terrified of the idea
of their future artificial appearance and will think restoring old natural appearance is impossible, but
they have no idea that removable prosthodontics is the art branch of dentistry, and that it has in its
dictionary what we call " Denture esthetics: the cosmetic effect produced by a dental prosthesis
which affects the desirable beauty, attractiveness, character, and dignity of the individual. "
Denture esthetics combines and blends science and art, therefore it does not have any set rules, but
relies on the artistic view of the dentist, guided by his scientific knowledge.
Since the days of Hippocrates in the 5th century BC, till recently, many concepts were presented for
teeth selection and arrangement, each trying to add more natural aspect of an "artificial dentition".
After combining and summarizing most of these concepts, we can list some of the main points a
"dent–art–ist" follows to make his patient's face and mouth appear as natural as before.
Biological– physiological point of view
When facial musculature, and normal facial appearance are well understood, the dentist can
accordingly make the

Accident Fall are the Main Cause of Dental Trauma in India...
In developing countries like India, accident falls are the main cause of dental trauma and anterior
teeth are frequently affected10.The treatment options are decided by the position of the fracture line,
length of the remaining root segment and the presence or absence of a coronal segment. The chances
of healing with calcified tissue is poorest in cervical–third fractures.1,11 If the fracture line extends
below the level of the alveolar bone crest and the apical root segment has sufficient length, the
treatment alternatives are crown lengthening, orthodontic extrusion, reattachment, post crown and
extraction.
Crown lengthening is performed if the fracture line is not more than 1–2 mm below the alveolar
bone crest. This ... Show more content on Helpwriting.net ...
The bonding of the fractured tooth fragment provides a more resistant restoration to staining,
abrasion than composite reconstruction, hence implicating positive psychological, emotional and
social response from child as well as parents.
Composite resins are proved to have an irritating effect on periodontal tissues especially fibroblast17
, White Mineral Trioxide Aggregate was used in the present case to seal the fracture line enabling
lesser possibility of leakage of dual cure composite across the fracture line. Even enzyme–linked
immunosorbent assay (ELISA) has evidently demonstrated the stimulatory effect of Mineral
Trioxide Aggregate on the production of bone morphogenetic protein (BMP–2) and TGF–1 by
fibroblasts of human periodontium18 The present case report concluded that composite reinforced
fiber post used with white Mineral Trioxide Aggregate for reattachment of mobile coronal segment
was observed successful. The success of the treatment was again evaluated after one year which
reveals the coronal portion in position with good esthetics. The radiological signs of periodontal
health and

Oclusion And The Definition Of Occlusion
Occlusion: Occlusion can be defined very simply: "it means the contact between teeth". the concept
can be further refined by defining those contacts between the teeth when the mandible is closed and
stationary as the static occlusion, and those contacts between teeth when the mandible is moving
relative to the maxilla as the dynamic occlusion. [1]
there are few terms in occlusion which needs to be explained to understand occlusion in detail.
Static Occlusion: static occlusion is the contact of upper and lower dentition when mandible is not
moving.
Centric occlusion (CO): can be described as the occlusion the patient makes when they fit their teeth
together in maximum intercuspation. Also, known as maximum Intercuspation Position (ICP). It is
the occlusion that the patient nearly always makes when asked to close their teeth together, it is the
'bite' that is most easily recorded because it is the bite patient is accustomed to, i.e. Habitual bite [1]
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It is the position of the mandible to the maxilla, with the intra–articular disc in place, when the head
of the condyle is against the most superior part of the distal facing incline of the glenoid fossa [1]
Dynamic occlusion: Dynamic occlusion is the functional occlusion in which mandibular and
maxillary teeth move relative to each other. other than the muscles of mastication there are two
guidance systems which are the main determinates of functional

Advantages Of Orthodontic Treatment Planning
INTRODUCTION
As they say "What we measure shapes what we collectively strive to pursue– and what we pursue
determines what we measure". If u can make the diagnosis, the treatment is easy and the damage can
be reserved but making the diagnosis can be tricky. Successful orthodontic treatment is based on
comprehensive diagnosis and treatment planning. Orthodontic treatment planning poses significant
challenges for clinicians with their ability to provide the predictable results for a patient in effective
and safest manner.1. Similarly, orthodontists must objectively address the challenge of assessing
treatment results1. The tooth size specifically the mesiodistal width of the teeth is one of the basic
fundamentals with which the orthodontist has to deal2.
Space analysis is one of the main steps to be considered for successful treatment planning. It is
traditionally ... Show more content on Helpwriting.net ...
If you can't measure something, you can't understand it. If you can't understand it, you can't control
it. If you can't control it you can't improve it." In orthodontics, dental models measurements are an
integral part of armamentarium used for treatment planning and diagnosis traditionally, diagnostic
measurements has been obtained from plaster dental casts. An orthodontist should be skilled in
measuring mesiodistal teeth width accurately. Any flaws in this measurement may lead to errors
between total tooth material and arch length. Study models provide a three dimensional view of
maxillary and mandibular dental arches in all three planes of space i.e transverse, sagittal and
vertical. The consumer protection act 1987 (United Kingdom) for medico legal purposes, states that
it is necessary to retain all patient records not less than 11 years. The British association of
orthodontics recommends that study models should be kept for 11 years or until the patient is 26
years

Prosthetic Essay
Patient demand for optimal esthetics (1) has altered the practice of dentistry and major advances in
ceramics have allowed dentistry to satisfactorily meet those expectations (2). The field of removable
prosthodontics has also responded to those patient demands and manufacturers of denture teeth have
introduced artificial teeth with optimal esthetics in mind. (1)
In the 700BC, bone, ivory, pebble, animal or human teeth were the first documented materials used
for partial denture construction. (3) They were held in place with wires or copper bands that go
beneath the gingiva. (3) In the early 16th century, dentures were carved out of a single piece of
wood and were retained in the mouth by atmospheric pressure. In a few complete dentures ivory,
bone or human teeth were attached to the wooden denture base, which later were attached to the
enameled metal base. (3) In order to improve the mastication ... Show more content on
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To improve the wear resistance and other mechanical properties of PMMA, cross–linked agents
were incorporated in the chemical structure. (5) The three different types of artificial teeth currently
available are acrylic, porcelain, and composite resin. Each of these artificial teeth has its advantages
and disadvantages. The cross–linked high strength PMMA artificial teeth were more resistant to
wear as compared to the conventional PMMA artificial teeth. (6) Studies comparing the wear
resistance of Nanocomposite artificial teeth and four layered cross–linked acrylic PMMA artificial
teeth show that Nanocomposite is more resistant to wear as compared to the cross–linked PMMA
artificial teeth, but the difference is negligible in comparison to the cost of these teeth.

Non Carious Teeth Lesions
Non–carious teeth lesions is the deficiency of tooth structure by another factors instead of caries.
There is a lot of factors can be considered as a non–carious teeth lesions like:
Attrition
Abrasion
Enamel hypoplasia
Enamel hypocalcification
Teeth Discoloration
Malformation
Dental Fluorosis
Attrition: which can be caused physically duo to frictional forces between contacting teeth. (Figure
1)
Treatment: by restorative options, such as direct composite restorations, bonded cast metal
restorations and after that polishing sharp edges. ] Figure1[: ... Show more content on
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)Figure 2)
Treatment: by restorative options, eg. direct composite restorations. ]Figure2:[ Toothbrush Abrasion
Enamel hypoplasia: it is defect in enamel occurs during enamel formation duo to injury of
ameloblast. )Figure 3)
Treatment: treatment consists of bonding a tooth colored material to the tooth in order to protect it
from any wearing or sensitivity. ]Figure3:[ Enamel Hypoplasia
Enamel hypocalcification: damaged enamel, the porous dentin underneath is exposed. )Figure 4)
Treatment: composite resin restoration can be placed, or full metal crown.
]Figure4:[ Enamel Hypocalcification
Teeth Discoloration: it is changing of the tooth's color or its

Transitions Of Reptiles To Mammals Essay
Transitions of Reptiles to Mammals      A long long time ago, in a
galaxy not too far away, was a little blue planet called Earth, and on this world not a single mammal
lived. However a lot of time has past since then and we now have lots of furry creatures that are
collectively called mammals. How did they get their? Where did they come from? These are the
kinds of questions that led me to my subject of choice. I will endeavor to provide examples, using
specific transitional fossils, to show that mammals have evolved from a group of reptiles and were
simply not placed here by unknown forces.      Before I begin, I
would like to define some terms so that nobody gets left in the dust. ... Show more content on
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Primitive therapsids are present as fossils in certain Middle Permian deposits; later forms are known
from every continent except Australia but are most common in the Late Permian and Early Triassic
of South Africa.      The several features that separate modern
reptiles from modern mammals doubtlessly evolved at different rates. Many attributes of mammals
are correlated with their highly active lifestyle; for example, efficient double circulation of blood
with a completely four–chambered heart, anucleate and biconcave erythrocytes (blood cells), the
diaphragm, and the secondary palate (which separates passages of food and air and allows breathing
during mastication (chewing) or suckling). Hair for insulation correlates with endothermy (being
warm–blooded), the physiological maintenance of individual temperature independent of the
environmental temperature, and endothermy allows high levels of sustained activity. the unique
characteristics of mammals thus would seem to have evolved as a complex interrelated system.
Transitions to New Higher Taxa      Transitions often result in a
new "higher taxon" (a new genus, family, order, etc.) from a species belonging to
different, older taxon. There is nothing magical about this. The first members of the new group are
not bizzare, they are simply a new, slightly different species, barely different from the parent
species. Eventually they give rise to

Aesthetic Management of a Mesio Labially Rotated Maxillary...
"Aesthetic Management of a Mesio Labially Rotated Maxillary Lateral Incisor with Type I Palatal
Talon Cusp – a Minimally Invasive Approach" Introduction:
Talon cusp is a rare dental anomaly in the shape of the tooth. It is a well delineated cusp like
structure projecting from either lingual or facial surface of anterior teeth. The prevalence of talon
cusp was reported to be between 1 to 8% [1,2]. Hattab et al [3] classified talon cusp into three types
based on its size as Type I (Talon / true talon) – extends at least half the distance from cemento–
enamel junction to the incisal edge Type II (Semi talon) – extends less than half the distance from
cement–enamel junction to the incisal edge and Type III (Trace talon) enlarged or prominent cingula
and their variations like conical, bifid or tubercle like. Palatal talon causes functional discrepancies
like occlusal interference, periodontal problems due to excessive occlusal forces and temporo–
mandibular joint pain where as a facial talon creates unaesthetic appearance. Treatment of talon cusp
should be as conservative as possible depending on clinical problem encountered. We present
esthetic correction of palatal type–1 talon on a mesio labially rotated maxillary left lateral incisor.
Case Report: A 20 year old female patient reported to the Department Of Conservative Dentistry
with a chief complaint of unpleasant appearance of an upper front tooth. Medical history was
noncontributory. Intra

Genetic Disorders: Beta Thalassemia
Orofacial characteristics of β –thalassemia major patients among the UAE population
Introduction
Beta thalassemia is a genetic disorder in which the gene for the production of beta globin chain is
defective. The name thalassemia is derived from a combination of two Greek words: thalassa
meaning the sea, i.e. the Mediterranean, and anaemia ("weak blood"). Therefore it is also known as
Mediterranean anemia. Another name for beta–thalassemia is Cooley's anemia, named after Prof.
Thomas Cooley, a pediatrician in the USA who first described the clinical characteristics of this
disorder in patients of Italian origin in 1925.
There are three types of beta thalassemia: beta thalassemia major which is the most severe and
patients require ... Show more content on Helpwriting.net ...
Classification Frequency Percentage
Class 1 10 52.6
Class 2 7 36.8
Class 3 2 10.5
Table 2: Frequency and percentage of each dental classification in the control group.
Classification frequency percentage
Class 1 30 83.33
Class 2 5 13.89
Class 3 1 2.78
There was a highly significant difference between control and thalassemic group regarding:
shorter inter–incisal distance in the maxilla and mandible
shorter inter–molar distance in the mandible
shorter arch depth in the maxilla
shorter right and left anterior arch length in the maxilla
shorter left posterior arch length maxilla
shorter posterior arch length mandibular
As shown in Table 4, a high correlation is present between the Inter–incisal, inter–premolar and
inter–molar distance in the Maxilla.
Table 3– Means, standard deviations (SDs) and difference between means of the width and length of

the lower and upper dental arch in tthalassaemia major and unaffected control groups. Thalassemic
patients Control group
Variable Mean SD Mean SD Difference between means P–Value
Inter–incisal distance maxillary 24.68 4.96 28.16 2.86 3.48 0.002**
Inter–incisal distance mandibular 19.78 3.9 22.5 1.71 2.71 0.001**
Inter–canine distance maxillary 34.52 2.98 34.8 2.85 0.27 0.735
Inter–canine distance mandibular 29.15 2.69 28.51 3.55 –0.64 0.493
Inter premolars distance maxillary 44.57 3.67 46.39 4.46 1.81

Dr. Decker 's For Restorative Treatment
Mrs. Perdaris is a patient who comes to Dr. Decker's for restorative treatment. She needs many
dental procedures to repair her deteriorating oral health, including bone loss, receiving partial
dentures of both maxillary and mandibular arches, as well as extraction of #7, 8, 9, and 10 (all
permanent maxillary incisors). As a temporary solution, a provisional splint is added to allow the
teeth to garner support from neighboring ones during which time periodontal treatment and surgery
can be performed. She ends up postponing the needed periodontal treatment and fractures her splint
on several occasions. Mrs. Perdaris requests that Dr. Decker makes a more durable and esthetic
splint while she deals with personal issues that will keep her away ... Show more content on
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Doing the periodontal therapy would insure that the patient is going to achieve her optimal oral
health status again. If the patient did not follow the proposed treatment plan, her periodontal health
would only continue to be compromised and deteriorate further with time. Furthermore, if such
progression continued, it would not be appropriate to do crowns on the patient. In a jeopardized
periodontal situation, any crowns Mrs. Perdaris would receive are bound to fail. She will end up in a
worse oral health status than she started out.
The next principle to discuss is the principle of autonomy. Not only is this one of the core values in
the hierarchy model, but also one of the five principles mentioned in ADA's Code of Ethics.
According to the ADA, patient autonomy matters just as much as the dentist's patterns of practice.
However, Dr. Decker should focus on what is going to be best for the patent in long term. In the
Dental Ethics at Chairside textbook, the dentist is mentioned to be the expert in dental treatment.
The patient has every right to dictate their treatment under the principle of autonomy, but ultimately
the patient lacks the knowledge what all entails each dental treatment plan option. This idea is
expressed in the Guild Model which idealizes the foundation of placing the decision making in the
sole hands of the dentist. In this model, the

Deciduous Teeth Research Paper
Just like humans, dogs are born without any teeth. Then around two or three weeks old the
deciduous teeth, or baby teeth, pop through the gums. Around 4 months old the puppy will have full
grown deciduous teeth and at that time they will have 28 teeth total, 6 incisor teeth on top and
bottom, 2 canines on top and bottom, 3 premolars on top and bottom, and no molars at this time.
Also like humans these puppies go through two sets of teeth throughout their life. When they
become around six to seven months old, they will have 42 adult teeth. These adult teeth consist of, 6
incisor teeth on top and bottom, 2 canines on top and bottom, 4 premolars on top and bottom, and 2
molars on the top and 3 molars on the bottom "Retained Deciduous Teeth (Baby ... Show more
content on Helpwriting.net ...
Any deciduous teeth should be removed as soon as possible. Do not wait, owners should check the
puppies teeth at least once a week to make sure the deciduous teeth are coming out and new ones are
growing in correctly. If they puppy has a retained tooth or teeth, radiographs should be taken to see
the how much the root is reabsorbed "Retained Puppy Teeth User". The treatment of choice is
usually extraction unless they deciduous tooth is moveable. If extracted early enough the adult tooth
can grow into its proper place. Extraction should be scheduled right away. General anesthesia will
be required for the procedure "Retained Deciduous Teeth (Baby Teeth) in Dogs". Extraction can be
difficult since the walls of the baby tooth are thin. By looking at the radiographs the veterinarian
should be able to easily removed, they will be able to see how much is reabsorbed and be able to see
the roots clearly "Retained Puppy Teeth

Disadvantages And Disadvantages Of Skeletal Expression...
The appliances using this type are oral screen, lip bumper, Frankel appliance, anterior and posterior
raised bite. Advantages and disadvantages Skeletal anchorage devices have become popular adjuncts
in clinical orthodontics because they offer several advantages, including  The primary advantage is
that implants provide skeletal anchorage, which is sure more predictable and stable than methods
requiring patient compliance.  Serving as a means of increasing orthodontic anchorage. 
Virtually eliminating patient compliance issues with regard to wearing of appliances.  Decreasing
overall treatment time.  Sufﬁcient anchorage for noncompliant patients.  Simplicity of insertion
and removal.  Relatively low cost, and –versatility in clinical applications.  The ability to obtain
absolute anchorage through bone–anchored devices has enabled orthodontists to eliminate the
unwanted side effects associated with conventional approaches and to correct malocclusions that
previously required complicated biomechanics or orthognathic surgery. (5,9) Disadvantage 
Unintentional detachment of the headgear during sleep.  Lack of patient's co– operation, potential
psychological concerns.  Anchorage assembly is bulky & externally visible.  Decrease in the
number of hours for which the anchorage assembly is worn, so affects quality of result achieved.
(using headgear)  Potential risks of root injury.  four types of complications: – The
complications during insertion involve

The Replacement Of A Single Tooth
Introduction:
The replacement of a single tooth lost due to dental caries or trauma can be challenging for a
clinician. Traditionally several options are indicated in order to restore the edentulous space
including implant/crown, fixed partial dentures (FPD) or removable partial denture (RPD). However
economic factors, occlusal disturbances, lack of adequate bone support or excessive removal of
healthy dental structure are some of the limiting factors in the traditional treatment modalities.
One approach that is overlooked and may serve as a good treatment modality is the Fiber Reinforced
Composite Bridge (FRCB). FRCBs are minimally invasive and economic treatment modalities that
can be utilized to replace of a missing tooth and restore an edentulous space.
The ideal site for a conservative FRCB is an edentulous space spanning one to two teeth. Other
considerations include occlusion or the bite relation, periodontal status, oral hygiene, and the status
of abutment teeth.
It should be noted that this modality of treatment is the not the most ideal modaility of treatment
however, it does provide an alternative approach if the ideal modality (Implant/Crown, FPD, RPD)
is not accepted or acceptable. Patient accepting this treatment modality should be aware that there is
a risk of aspiration. Retention with FRCB cannot reach the level of FPDs; more conservative
preparations and bonded nature FRCBs are two reasons worth noting. Patients should exercise care
chewing directly

En Masse Retraction
ENMASSE RETRACTION WookHeo, Dong–SeokNahm, and Seung–HakBaek (2007)32performed
study to compare the amount of anchorage loss of the maxillary posterior teeth and amountof
retraction of the maxillary anterior teeth between en masse retraction and two–step retraction of the
anterior teeth.30 female adult patients with Class I malocclusion and lip protrusion were included in
the study. The sample was subdivided into group 1 (en masse retraction) and group 2 (two–step
retraction). Lateral cephalograms were taken before (T1) and after treatment (T2). Nine skeletal and
10 anchorage variables were measured, and independent t–test was used for statistical analysis.The
amount of horizontal retraction of the maxillary anterior teeth was not different between the two
groups, there was mild labial movement of the root apices of the upper incisors in group 2 at T2. No
significant difference in the degree of anchorage loss of the maxillary posterior teeth was observed
between the two groups. Bodily and mesial movements of the upper molars occurred in both groups.
A 4 mm of the retraction of the upper incisal edges resulted from 1 mm of anchorage loss in the
upper molars in both groups. ... Show more content on Helpwriting.net ...
Fifty–two patients were included in study. On panoramic radiographs, root shortening of the
maxillary and mandibular incisors was evaluated. Radiographs were taken before and after space
closure, and were measured in millimeters. Special metal rods ligated to brackets were used to
correct distortion of measurements caused by panoramic radiographs. It was observed that there is
no difference in the amount of root shortening between two space closure

Buccal Cavity Research Paper
The name of the above diagram is called the Buccal Cavity. I am going to talk about each labelled
structure in detail.
The buccal cavity is the entrance of the digestive system. It surrounded by the cheeks and is formed
by both soft and hard plate, teeth and tongue. The main function of the buccal cavity it to break
down food in to small boluses and allow it to be swallowed for digestion to take place (Kent, 2013).
Now I am going to talk about the different structures inside the buccal cavity and their functions.
The Lips
The lips are flesh covered by a thin layer of skin externally and covered by a mucous membrane
internally. Lips are used for eating by opening and allowing food to enter. Another function of the
lips is that they hold ... Show more content on Helpwriting.net ...
It is the organ of taste. The tongue has different taste buds, these are also called the gustatory
receptors. The tongue also has an extrinsic and intrinsic muscles. The intrinsic muscles are located
in the connective tissues inside the tongue. The intrinsic muscles change the shape and size of the
tongue, this motion is done to assist with speech and swallowing. The extrinsic muscle is outside the
tongue, the muscle allows the tongue to move from side to side, in and out also to move food that is
being chewed in the mouth and transforms it in to bolus. The bolus is then moved with the tongue to
the back of the soft palate to the pharynx in order to fit in to the oesophagus. For all of the above to
happen salivation plays a huge role in assisting all the tongue muscles to move appropriately as it
acts similar to a lubricant. (Tortora et al., 2002).
Central Incisor
Central incisors are at the front of the teeth. These teeth are the ones tht are more visible when you
eat or smile. The main functions of the central incisors are that they slice and cut food
Second Molars
The second molars are also called the maxillary second molars they are located towards the back of
the jawline. Functions of the maxillary second molar are to crush and grind food into small particles
which are created in to boluses, this process enables food to be chemically digested. The maxillary
second molar like every other tooth has its own nerves and blood supply, this creates sensitivity
around the tooth. This type of tooth has three roots and four

Dental Articulator Essay
1) Introduction:
The information which is obtained from the master cast, occlusal rims and bases may be termed
static information. But as we know that the mouth is a dynamic system, and the static information is
converted from the laboratory. So this process is done by mounting the casts on an specific
instrument which is called DENTAL ARTICULATOR.
2) Definition:
 Mounting: It's a procedure of attaching the upper and the lower cast to an dental articulator or
similar instrument. This procedure is mainly produce in the laboratory.
 Articulator: An dental articulator is an instrument especially a mechanical instrument that
represents the temporomandibular joints (TMJ) ... Show more content on Helpwriting.net ...
 To stimulate the jaw hinge movements (opening and closing the jaws).
 To produce the border movements (extremely lateral and protrusive movements).
 To act as a patients in the absence of the patients.
 It can simulate, but they cannot duplicate the all possible mandibular movements.
 Articulator mount dental cast for diagnosis the case of the occlusion in both: opposing natural
teeth and for the relationship dentition and also mount dental cast for treatment planning.
 To aid in the fabrication of occlusal surfaces for dental restorations and prothodontic
replacements.
 To the arrangement of artificial teeth for removable complete and parital dentures.
 Dental articulator rectificate and modify completed restoration. 4) Advantages of Dental
Articulator:
The operator or the technician can see the patient's occlusion more obviousness especially from the
lingual aspect. The operator or the technician can make their jobs in comfortable way. The patients

appointment time and the considerable chair time too is saved. And the most important things that
the saliva, blood, tongue, and cheeks are not factors during the process in the

Dental Caries: Tooth Decay
Introduction Dental Caries is becoming a real major concern for public health professionals.
Globally, around 60–90% of school children and 100% of adults have dental caries (1). Dental
Caries commonly known as tooth decay can be defined as a transmissible bacterial disease caused
mainly by bacteria producing acids and dissolving tooth minerals(2). Prevalence of tooth decay
showed that the mandibular central incisors have the lowest percentage to experience tooth decay,
while maxillary and mandibular molars showed the highest incidence rate for caries. Caries also
showed surface specificity in which occlusal surfaces in molars and proximal surfaces of incisors,
canines and premolar have greater number of tooth decay compared to other sites ... Show more
Unidentified factors is a possibility due to the observational study design. Questionnaires in several
studies requires the guardian to recall some necessary data, which might lead to inaccurate
information depending on the memory of the guardian leading to a bias in results (6,9,11). It should
be noted that in multiple studies there was variations in defining and assessment of dental caries as
some used dft, DMFS and DMFT or a combination, which might lead to indifference in caries
identification (6). Further studies is needed to accurately identify the risk factors by having a
specific defined research including longitudinal studies to identify factors influencing both pathways
of obesity and dental caries.(9) It is recommended that more effective health programs are made to
educate the community on how to prevent both dental caries and obesity and what is the proper way
to treat them if they occur. Objective Prevalence of Dental Caries in Saudi children. Prevalence of
Obesity in Saudi children. Examine the potential association between Dental Caries and Obesity in
Saudi children. Education and parent counseling about the importance of healthy diet and on both
oral health and physical health and fluoride

Dental Care: Prolonged Baby Bottle Feeding: a Health Risk...
Dental Care:
Prolonged Baby Bottle Feeding: A Health Risk Factor
Abstract
Deysi is a 2–year–old girl who lives with her parents in a one–bedroom apartment. Her mother and
father work outside of the home, approximately 10 hours/day. Child care is provided by a network
of women who include licensed home–based providers and a variety of friends and extended family
members. On most evenings, Deysi's father picks her up from the child care site and gives her a
fresh bottle of chocolate–flavored milk for the 45– minute trip home. She usually falls asleep while
drinking it; Deysi's parents see this routine as a comfort for their daughter that usually results in a
most welcomed, quiet car ride home at the end of a busy day. ... Show more content on
Helpwriting.net ...
Nutrition has recommended that children should not go to sleep with bottles (AAP, 1998). The
American Academy of Pediatric Dentistry has recommended that an infant oral health evaluation
should be performed within 6 months of the eruption of the primary tooth but no later than 12
months of age (AAPD, 1999).
From the viewpoint of nurses who examine children in primary care settings, the history of baby
bottle use and the physical examination can provide important clues. In particular, Beaulieu and
DuFour (2000) point out that evidence suggestive of BBTD is the presence of a dull, white band of
demineralized enamel along the gingival margin, usually found on the central incisors. Often all 4
maxillary anterior teeth are involved simultaneously.
The white band is a marker for a rapidly progressing process that leads to overt caries. The white
band signals the destruction of tooth enamel that is subsequently replaced by yellow or brown areas
of decay. The pathological process for BBTD includes the presence of Streptococcus mutans. This is
a bacterium that may occur in infant saliva. It facilitates the conversion of the sugar in fermentable
carbohydrate liquids, such as milk, formula, and juice to an acid that, in turn, penetrates the
protective layer of enamel on affected teeth. The identification of early demineralization requires
immediate

Traumatic Dental Injury
Traumatic dental injuries are the most common of all the facial injuries and majorly involve
maxillary incisors because of its position in the arch (4). Luxation injuries occur commonly in the
primary dentition and mainly due to the resiliency of the alveolar bone (5). Treatment decisions for
primary teeth are based on the degree of displacement, root formation and the ability of the child to
cope with the emergency situation. Immediate repositioning and stabilization of laterally luxated
teeth in their anatomic position are essential for the healing of periodontal ligament and to maintain
esthetics and functional integrity (6, 7). Indications for extraction are severe injury or if the tooth is
nearing exfoliation. In the present case, maxillary

Tempromandibular Case Studies
A 44–year Caucasian man with Down syndrome was referred to the graduate prosthodontic clinic at
the Indiana University School of Dentistry by his periodontist with a chief complaint of an inability
to chew and the unpleasant smile. His medical history included a diagnosis of controlled type II
diabetes mellitus, hypercholesterolemia and obstructive sleep apnea. There was no history of
allergic reactions to medication, local anesthetics or food. The patient is moderately intellectual
disable and he interacts well with dentists in general. However, the patient is afraid of any pain
induced dental treatment. His dental history disclosed that he had dental extractions and
prophylaxis. The patient regularly visits his dentist and the hygienist every six months. The patient
claimed that he has severe gag reflex and has some difficulty in breathing in a supine position.
Extraoral examination revealed no palpable nodes. The patient had no symptoms of any
tempromandibular joint discomfort or masticatory muscle pain. Examination of the
tempromandibular joints revealed no clicking, pain or crepitus at rest or in function. He had a full
range of mandibular movement with a maximum opening of 50mm with no deviation on opening or
closing. The patient presented with square face and concave lateral profile (Fig1,2). Intra–oral
examination revealed a negative cancer ... Show more content on Helpwriting.net ...
The artificial teeth were arranged by using denture teeth (Trubyte Portrait IPN, TP; SR Vivodent
DCL, SR) and Type II baseplate wax (TruWax Baseplate Wax; Dentsply International Inc, York, PA)
(Fig 14). The trial maxillary IAORPD was tried–in and esthetic and phonetic were evaluated. The
prosthesis was processed with heat–polymerized acrylic resin, Lucitone 199 (Dentsply International
Inc., New York, PA). The occlusion was adjusted after deflasking procedures, and the prosthesis
were finished and

The Native American Graves Protection And Repatriation Act...
The following writing sample is an excerpt from the second chapter of my departmental honors
thesis "The Reliability of Five Commonly Used Ancestral Techniques and their Implications
Regarding the Native American Graves Protection and Repatriation Act of 1990 and Minnesota
Statute 307.08". Chapter II Review of Techniques Interorbital Features Method Over the years,
several techniques involving the analysis of human skeletal remains for the purposes of ancestral
classification have been developed. Many of the earliest techniques involved the visual comparison
of different morphoscopic traits and subsequent classification based on the anthropologist's
subjective opinion. Although many of these non–metric techniques have been shown to be ... Show
more content on Helpwriting.net ...
1979), it performs poorly in correctly classifying Native Americans, especially those from the
Northwestern Plains, Central Plains, and Southwest (Gill et al. 1988). Of particular concern is the
incorrect classification of Native Americans from the Northwestern Plains, which has been shown to
occur 70% of the time when using this technique (Gill and Gilbert 1990). Hoping to address the
shortcomings of the Giles and Elliot technique (1962) with regard to Native American populations,
the interorbital features method was developed by Gill in 1984 with particular attention paid to
accurately distinguishing between individuals of European and Native American descent. The
interorbital features method utilizes a specialized coordinate caliper called a simometer (see
Appendix I for image) and involves a set of six measurements taken from the midfacial skeleton,
followed by computation of three indices: maxillofrontal, zygoorbital, and alpha. The three indices
are calculated by dividing three breadth measurements into their corresponding subtense
measurements, then multiplying by 100 (Gill et al. 1988). The six measurements as described by
Gill et al. (1988) are summarized in detail below, and images of the technique follow (Figure 1). 1.
Maxillofrontal breadth: The breadth between the left and right maxillofrontale, where the
maxillofrontale is defined as "the intersection of the frontomaxillary suture and the medial edge of
the eye orbit"

Advantages And Disadvantages Of Articulators
Beirut Arab University
Articulators
Submitted by: Yara Hassan Ismail
Submitted to: Dr. Ghada Ayyash
Date: Mon., Nov. 16th, 2015
Fundamentals of Occlusion
Content:
1. Introduction
2. Definition
3. Objectives or uses of articulators
4. Types of articulators
Relationships of Maxilla to Mandible
Before tackling the topic of articulators, the maxillomandibular relationship must first be introduced
as it provides the bases upon which dental prosthesis are fabricated and must be maximally
duplicated to ensure the success of a denture or restoration.
The temporomandibular joint involves the condylar head which moves along the petrous part of
temporal bone that makes up the mandibular/glenoid fossa. These condyles move the ... Show more
In addition, although it is unmovable unlike the mandible, the maxilla is in a fixed position relative
to the temporomandibular joint or the reference positions when the mandible has to function against
the maxillary teeth. This anatomical relationship, know as orientation relation, mandates its
recording when dealing with prosthesis or else it would lead to disharmony of occlusion and
eventually harming supporting and associated tissues.
In addition to the normal maxilla and mandibular positions discussed individually, the
maxillomandibular relationship must also be taken into consideration in the field of prosthodontics
and restorative dentistry. The maxillomandibular relationship accounts for the registration of any
positional relationship of the mandible with respect to the maxilla. The maxillomandibular relation
records are:
1. Orientation Relation Record: Relation of the maxilla to the intercondylar axis/temporomandibular
joint axis, an imaginary axis passing the condyles.

Anteriorly, the maxillary occlusal plane is adjusted to be parallel to the interpupillary line and
posteriorly it should be parallel to the Ala–tragus

Surgical Considerations For Implant Placement

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