Sunday, December 20, 2015

Ellis classification (Tooth fractures)

Ellis classification (Tooth fractures)

Ellis Class I
  • Enamel fracture: This level of injury includes crown fractures that extend through the enamel only. These teeth are usually nontender and without visible color change but have rough edges.

Ellis Class II
  • Enamel and dentin fracture without pulp exposure: Injuries in this category are fractures that involve the enamel as well as the dentin layer. These teeth are typically tender to the touch and to air exposure. A yellow layer of dentin may be visible on examination.

Ellis Class III
  • Crown fracture with pulp exposure: These fractures involve the enamel, dentin, and pulp layers. These teeth are tender (similar to those in the Ellis II category) and have a visible area of pink, red, or even blood at the center of the tooth.

Ellis Class IV
  • Traumatized tooth that has become non-vital with or without loss of tooth structure.

Ellis Class V
  • Luxation: The effect on the tooth that tends to dislocate the tooth from the alveolus.
  • Teeth loss due to trauma.

Ellis Class VI
  • Avulsion: The complete separation of a tooth from its alveolus by traumatic injury.
  • Fracture of root with or without loss of crown structure.

Ellis Class VII
  • Displacement of a tooth without the fracture of crown or root.

Ellis Class VIII
  • Fracture of the crown en masse and its replacement.

Ellis Class IX
  • Fracture of deciduous teeth.
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Saturday, October 3, 2015

The Ideal Teeth Access Cavity Preparations for RCT (Root Canal Treatment)



The correct access preparation for RCT is as follows:

Upper Teeth:
central Incisors : triangular
lateral Incisors: ovoid
canines: ovoid
first premolars: ovoid
second premolars: ovoid
first molars: triangle
second molars: triangle


Lower Teeth:
central Incisors: ovoid
lateral Incisors: ovoid
canines: ovoid
first premolars: ovoid
second premolars: ovoid
first molars: triangle or trapezoid
second molars: triangle or trapezoid


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Monday, August 4, 2014

Contraindications of Dental Implants (Absolute, Relative and Local)


1- ABSOLUTE CONTRAINDICATIONS

Implants can not be placed in these situations:

Heart:
• Heart diseases affecting the valves (valvulopathy)
• Recent infarcts
• Severe cardiac insufficiency, cardiomyopathy

Miscellaneous:
• Active cancer, certain bone diseases (osteomalacia, Paget’s disease, brittle bones syndrome, etc.),
• Certain immunological diseases, immunosuppressant treatments, clinical AIDS, awaiting an organ transplant,
• Certain mental diseases,
• Strongly irradiated jaw bones (radiotherapy treatment),
• Treatments of osteoporosis or some cancers by bisphosphonates

Age:
• Children: not before the jaw bones have stopped growing (in general 17-18 years).
On the other hand advanced age does not pose problems if the patient’s general condition is good.

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2- RELATIVE CONTRAINDICATIONS

The indication to place implants will be evaluated on a case-by-case basis, with the greatest caution:

• Diabetes (particularly insulin-dependent),
• Angina pectoris (angina),
• Seropositivity (absolute contraindication for clinical AIDS),
• Significant consumption of tobacco (read pdf)
• Certain mental diseases,
• Radiotherapy to the neck or face (depending on the zone, quantity of radiation, localisation of the cancerous lesion etc.),
• Certain auto-immunes diseases,
• Drug and alcohol dependency,
• Pregnancy.

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3- RELATIVE LOCAL CONTRAINDICATIONS

The indication to place implants will be evaluated on a case-by-case basis, with caution:

• An insufficient quantity of bone.
• Certain diseases of the mucous membranes of the mouth.
• Periodontal diseases (loosening of the teeth); it is necessary to clean up the gums and stabilise the disease first.
• Severe grinding or clenching of the teeth.
• An unbalanced relationship between the upper and lower teeth.
• Infections in the neighbouring teeth (pockets, cysts, granulomas), major sinusitis.
• Poor hygiene of the mouth and teeth.

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Sunday, July 27, 2014

Blue Sclera "Definition and Diseases"


Definition:
Blue sclera is characterized by localized or generalized blue coloration of sclera because of thinness and loss of water content, which allow underlying dark choroid to be seen.

Diseases and Disorders:

1. Associated with high urine excretion:A. Folling syndrome (phenylketonuria)
B. Hypophosphatasia (phosphoethanolaminuria)
C. Lowe syndrome (oculocerebrorenal syndrome; chondroitin-4-sulfate-uria)

2. Associated with skeletal disorders:A. Brachmann-de Lange syndrome
B. Brittle cornea syndrome (blue sclera syndrome)-recessive
C. Crouzon disease (craniofacial dysostosis)
D. Hallermann-Streiff syndrome (dyscephalia mandibulooculofacial syndrome)
E. Marfan syndrome (dystrophia mesodermalis congenita)
F. Marshall-Smith syndrome
G. McCune-Albright syndrome (fibrosus dysplasia)
H. Mucopolysaccharidosis VI (Maroteaux-Lamy syndrome)
I. Osteogenesis imperfecta (van der Hoeve syndrome)
J. Paget syndrome (osteitis deformans)
K. Pierre Robin syndrome (micrognathia-glossoptosis syndrome)
L. Robert syndrome
M. Silver-Russell syndrome
N. Werner syndrome (progeria of adults)

3. Chromosome disorders:A. Trisomy syndrome
B. Turner syndrome

4. Ocular:A. Congenital glaucoma
B. Myopia
C. Repeated surgeries
D. Scleromalacia (perforans)
E. Staphyloma
F. Trauma

5. Miscellaneous:A. Ehlers-Danlos syndrome (fibrodysplasia elastica generalisata)
B. Goltz syndrome (focal dermal hypoplasia syndrome)
C. Incontinentia pigmenti (Bloch-Sulzberger syndrome)
D. Lax ligament syndrome
E. Minocycline-induced
F. Oculodermal melanocytosis (nevus of Ota)
G. Pseudoxanthoma elasticum (Grönblad-Strandberg syndrome)
H. Relapsing polychondritis

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Friday, July 25, 2014

Indications and Contraindications of the Maryland Bridge


Indications:
• Periodontal Splinting
• Replacement of missing teeth
• Prosthodontic splinting
• Combination with Removable Partial Denture
• Changes in Occlusal table
• Strengthening Natural Teeth

Contraindications:
• Sensitivity to base metal alloys
• Changes in facial esthetic of abutments (Long spans - Inadequate enamel for bonding)
• Poor quality enamel
• Short clinical crowns
• Narrow embrasures
• Incisors with thin buccal lingual dimensions
• Pathologic occlusion (i.e.- bruxism)
• Malocclusion
• High caries rate or high caries risk

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Saturday, July 19, 2014

Bronchial (Pharyngeal) Arches



:: 1st Pharyngeal Arch (also called "mandibular arch") ::


Muscular contributions
Muscles of mastication, anterior belly of thedigastric, mylohyoid, tensor tympani, tensor veli palatini

Skeletal contributions
Maxilla, mandible (only as a model for mandible not actual formation of mandible), the incus, and the malleus of the middle ear, also Meckel's cartilage

Nerve
Trigeminal nerve(V2 and V3)

Artery
Maxillary artery, external carotid artery

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:: 2nd Pharyngeal Arch (also called the "hyoid arch") ::
Muscular contributions
Muscles of facial expression, buccinator,platysma, stapedius, stylohyoid, posterior belly of the digastric 

Skeletal contributions
Stapes, temporal styloid process, hyoid (lesser horn and upper part of body), Reichert's cartilage 

Nerve
Facial nerve (VII)

Artery
Stapedial artery, hyoid artery

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:: 3rd Pharyngeal Arch ::
Muscular contributions
Stylopharyngeus

Skeletal contributions
Hyoid (greater horn and lower part of body), thymus, inferior parathyroids

Nerve
Glossopharyngeal nerve (IX)

Artery
Common carotid, internal carotid

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:: 4th Pharyngeal Arch ::

Muscular contributions
Cricothyroid muscle, all intrinsic muscles of soft palate (including levator veli palatini) except tensor veli palatini

Skeletal contributions
Thyroid cartilage, superior parathyroids, epiglottic cartilage
Nerve
Vagus nerve (X),superior laryngeal nerve

Artery
Right 4th aortic arch:subclavian artery
Left 4th aortic arch: aortic arch

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:: 6th Pharyngeal Arch ::

Muscular contributions
All intrinsic muscles of larynx except the cricothyroid muscle

Skeletal contributions
Cricoid cartilage, arytenoid cartilages, corniculate cartilage, cuneiform cartilages

Nerve
Vagus nerve (X), recurrent laryngeal nerve

Artery
Right 6th aortic arch: pulmonary artery
Left 6th aortic arch: pulmonary artery and ductus arteriosus


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Thursday, July 3, 2014

Muscles of the Face and Scalp

- Those muscles receive motor innervation from branches of the facial nerve (CN VII).

- Rather than inserting into bone, these muscles insert into the dermis of the skin, thus their orchestrated contractions convey various shapes to the face that we interpret as emotions.



Scalp

Muscle
Location
Origin
Frontalis
Forehead
Procerus, corrugator, orbicularis oculi
Occipitalis
Back of the head
Mastoid process and superior nuchal line
Temporoparietalis
Temple
Temporal fascia


Ear

Muscle
Location
Origin

Auricularis anterior
Anterior to ear
Temporal fascia
Auricularis superior
Above ear
Temporal fascia
Auricularis posterior
Behind ear
Mastoid process


Nose

Muscle
Location
Origin
Procerus
Nasalis
Depressor septi


Eye

Muscle
Location
Origin

Orbicularis oculi
Around the orbit
Nasal process of frontal bone, frontal process of maxilla, medial palpebral ligament, and lacrimal bone
Corrugator
Deep to the orbicularis oculi
Medial aspect of superciliary arch


Mouth

Muscle
Location
Origin
Levator labii superioris
Upper lip
Zygoma and maxilla just above infraorbital foramen
Levator labii superioris alaque nasi
Upper lip and side of nose
Maxilla, frontal process
Levator anguli oris
Corner of mouth
Canine fossa of maxilla
Zygomaticus major
Cheek and corner of mouth
Temporal process of zygoma
Zygomaticus minor
Cheek and corner of mouth
Maxillary process of zygoma
Risorius
Cheek
Masseteric fascia
Depressor labii inferioris
Lower lip
Oblique line of mandible
Depressor anguli oris
Corner of mouth
Oblique line of mandible
Mentalis
Chin
Incisive fossa of mandible
Orbicularis oris
Circumscribes the mouth
Muscles in the vicinity, maxilla, nasal septum, mandible
Buccinator
Cheek
Pterygomandibular raphe, alveola arches of mandible and maxilla


Neck

Muscle
Location
Origin
Platysma
Neck and chin
Pectoral and deltoid fascia



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