Thursday, October 23, 2014
Diagnosis and Management of Oral Lesions and Conditions: A Resource Handbook for the Clinician
This handbook has the goal of providing a short and objective approach to the diagnosis and management of common oral lesions and conditions likely to be encountered in the daily practice of dentistry by the general practitioner. Each of the lesions/conditions will be grouped based on their nature, inflammatory or infectious, benign or malignant, variants of normal, bony lesions, etc. The individual lesion/condition will be described based on common clinical signs and symptoms, differential diagnosis, best approach for diagnostic confirmation, and brief management strategy. One of the chapters is dedicated to oral hygiene and oral health maintenance recommendations.
Wheeler's Dental Anatomy, Physiology and Occlusion-CD
By Major M. Ash, Stanley Nelson,
Publisher: Saunders
Number Of Pages: 520
Publication Date: 2002-12-24
Sales Rank: 158862
ISBN / ASIN: 0721693822
EAN: 9780721693828
Binding: Hardcover
Manufacturer: Saunders
Studio: Saunders
Average Rating: 2.5
Total Reviews: 10
The updated 8th edition of this classic reference provides a visually-oriented presentation of dental macromorphology and evidence-based chronologies of the human dentitions, while reflecting definitive shifts in modern dental practice. New features include an enhanced reader-friendly approach, new color illustrations, and a greater emphasis on clinical applications. A new, interactive CD-ROM offers three-dimensional animations of masticatory movements - including tooth contact relationships and temporomandibular joint movements - that bring the text's illustrations to life. Plus, an interactive mock examination mimics the National Board exam for outstanding review and practice.
http://rapidshare.com/files/3931324/DAy.part1.rar
http://rapidshare.com/files/3976175/DAy.part2.rar
http://rapidshare.com/files/4029345/DAy.part3.rar
http://rapidshare.com/files/4039640/DAy.part4.rar
password
www.ALLISLAM.net
total size is =318 MB
size after Extraction=389
Gray's Anatomy: The Anatomical Basis of Clinical Practice 39th Edition
Publisher: Churchill Livingstone
Number Of Pages: 1600
Publication Date: 2004-11-24
ISBN-10 / ASIN: 0443071683
ISBN-13 / EAN: 9780443071683
Binding: Hardcover
Book Description:
Not since it first published in 1858 has Gray's Anatomy introduced so much innovation to the world of anatomical references. A team of renowned clinicians, anatomists, and basic scientists have radically transformed this classic resource to incorporate all of the newest anatomical knowledge reorganized it by body region to parallel clinical practice and added many new surface anatomy, radiologic anatomy, and microanatomy images to complement the exquisite artwork that the book is known for. Although there are now many books called "Gray's Anatomy," only this 39th Edition carries on the true lineage of the original text. And, only this 39th Edition delivers so much pragmatic, clinically indispensable information. The result is, once again, the world's definitive source on human anatomy..
Number Of Pages: 1600
Publication Date: 2004-11-24
ISBN-10 / ASIN: 0443071683
ISBN-13 / EAN: 9780443071683
Binding: Hardcover
Not since it first published in 1858 has Gray's Anatomy introduced so much innovation to the world of anatomical references. A team of renowned clinicians, anatomists, and basic scientists have radically transformed this classic resource to incorporate all of the newest anatomical knowledge reorganized it by body region to parallel clinical practice and added many new surface anatomy, radiologic anatomy, and microanatomy images to complement the exquisite artwork that the book is known for. Although there are now many books called "Gray's Anatomy," only this 39th Edition carries on the true lineage of the original text. And, only this 39th Edition delivers so much pragmatic, clinically indispensable information. The result is, once again, the world's definitive source on human anatomy..
Comparative Dental Morphology: Selected Papers of the 14th International Symposium on Dental Morphology
T. Koppe, G. Meyer, K. W. Alt, A. Brook, M. C. Dean, "Comparative Dental Morphology: Selected Papers of the 14th International Symposium on Dental Morphology, August 27-30, 2008, Greifswald, Germany (Frontiers of Oral Biology)"
Publisher: S. Karger AG (Switzerland) | ISBN 10: 3805592299 | 2009 | PDF | 202 pages | 2.3 MB
Publisher: S. Karger AG (Switzerland) | ISBN 10: 3805592299 | 2009 | PDF | 202 pages | 2.3 MB
Teeth and their surrounding structures are exceptional sources for addressing significant questions in numerous disciplines. In this publication, an international, multidisciplinary team of researchers addresses important issues on current aspects of dental morphology research from evolutionary, anatomical, clinical and archaeological perspectives. In combining leading-edge methods of data acquisition and analyses, such as molecular analyses and highly advanced non-destructive imaging technologies, the book demonstrates how information about various aspects of dental morphology can be used to explore the evolution of vertebrate life histories, a subject most relevant to our own species. The chapters provide profound discussions on dental evolution, dental morphology, dental tissues, dental growth and development, as well as on clinical aspects of dental morphology. As a special feature, the publication provides new information about the role of teeth as tools in reconstructing the nature and behaviour of past populations.
This book will serve as an important reference for researchers of dental sciences, anatomy, evolutionary biology, paleoanthropology, paleontology, archaeology, prehistoric anthropology, comparative anatomy, genetics, embryology, and forensic medicine.
Permar's Oral Embryology and Microscopic Anatomy
Permar's Oral Embryology and Microscopic Anatomy continues to provide comprehensive, yet concise coverage of embryology and histology for dental hygiene and dental assisting professions. It can also be used as an introductory text for dental students. This text begins with the basics of general histology, progresses through the development of the human embryo and fetus, and concludes with a focus on the development of the face and oral cavity. New to this edition are over 40 additional illustrations, including four-color micrographs. High-quality images of microscopic embryonic development and oral anatomy help students identify histologic structures. A new chapter regarding salivary glands includes information about remineralization, demineralization, fluoride, bacterial diseases, and HIV. Clinical aspects of oral tissue are covered to help readers expand their knowledge from basic to clinical sciences and apply fundamental principles. Suggested readings help readers find additional resources.
A biometric approach to predictable treatment of clinical crown discrepancies
Dental professionals have long been guided by mathematical principles when interpreting aesthetic andtooth proportions for their patients. While many acknowledge that such principles are merely launch points for a smile design or reconstructive procedure, their very existence appears to indicate practitioners’ desire for some predictable, objective, and reproducible means of achieving success in aesthetic dentistry.
The clinical reality, however, is that intra-arch tooth relationships used as guidelines for smile designs (eg, the Golden Proportion) are applicable to a confined segment of the patient population.1 In addition, dentists have been found to be less pleased with aesthetic outcomes with smiles designed using the Golden Proportion,2 and patients have been found to dislike such a proportion relationship. 3 Therefore the only tangible parameter in aesthetic dentistry is individual tooth size and proportion.4,5 Individual tooth size can be thought of as the building blocks of a smile design. Once the tooth size and proportion of the maxillary anterior teeth are corrected, they can then be arranged within the dental arch. Intra-arch tooth relationship proportions such as the recurring aesthetic dental proportion,6 which has been found to be amenable to patients and clinicians, can be used to arrange the teeth
The clinical reality, however, is that intra-arch tooth relationships used as guidelines for smile designs (eg, the Golden Proportion) are applicable to a confined segment of the patient population.1 In addition, dentists have been found to be less pleased with aesthetic outcomes with smiles designed using the Golden Proportion,2 and patients have been found to dislike such a proportion relationship. 3 Therefore the only tangible parameter in aesthetic dentistry is individual tooth size and proportion.4,5 Individual tooth size can be thought of as the building blocks of a smile design. Once the tooth size and proportion of the maxillary anterior teeth are corrected, they can then be arranged within the dental arch. Intra-arch tooth relationship proportions such as the recurring aesthetic dental proportion,6 which has been found to be amenable to patients and clinicians, can be used to arrange the teeth
Figure 1. Prototype proportion gauge; a Siamese twin instrument tip
with preset markings notched into the surface with measurements
indicating a predetermined 78% width to length proportion.
with preset markings notched into the surface with measurements
indicating a predetermined 78% width to length proportion.
Figure 2. Surgical crown lengthening was provided additional
clinical crown exposure; the proportion gauge was used to
position the FGM of the soft tissue flap apicocoronally
clinical crown exposure; the proportion gauge was used to
position the FGM of the soft tissue flap apicocoronally
Figure 3. Preoperative smile of patient requiring aesthetic
crown lengthening to restore proper individual tooth
dimensions/proportion and decrease gingival display
crown lengthening to restore proper individual tooth
dimensions/proportion and decrease gingival display
for a pleasing smile.6 This task is simplified in removable prosthodontics, in which selection of the proper tooth size and form is the primary step before their arrangement within
the dental arch or tooth setup. With the natural dentition, this task is infinitely more difficult, since the dilemma is such that existing teeth may exhibit altered width and/or length discrepancies due to developmental anomalies, changes resulting from the aging process, or prior restorative
procedures. Therefore, correction may require combination therapies such as orthodontics and/or periodontics prior to aesthetic restorative dentistry
the dental arch or tooth setup. With the natural dentition, this task is infinitely more difficult, since the dilemma is such that existing teeth may exhibit altered width and/or length discrepancies due to developmental anomalies, changes resulting from the aging process, or prior restorative
procedures. Therefore, correction may require combination therapies such as orthodontics and/or periodontics prior to aesthetic restorative dentistry
In daily practice, the clinician’s use of “nonstandard” proportions to treat teeth with abnormal size relative to accepted width and height values can yield narrow or square teeth that are unnatural in size and shape and fail to achieve the aesthetic expectations of either the patient or clinician. This can be particularly challenging when performed with visual assessment only (ie, absent of clinical tools). Standardized individual tooth size and proportions fall within a given range around mean values, however, and gender differences exist between anterior tooth groups.7 Therefore, these parameters can be used to predictably diagnosis and correct discrepancies in tooth size
and individual tooth proportio
and individual tooth proportio
Figure 4. View of the smile after crown lengthening using
the prototype gauge to predict the proper clinical crown
length exposure
the prototype gauge to predict the proper clinical crown
length exposure
Figure 5. Diagram of T-Bar proportion gauge tip designed
for simultaneous width and length measurements of maxillary
anterior teeth within a range of small to extra large
tooth dimensions
for simultaneous width and length measurements of maxillary
anterior teeth within a range of small to extra large
tooth dimensions
Historical Background
Traditionally, dental instruments (eg, explorers, probes) have been used as reference standards to detect diseases such as caries and periodontitis. Periodontitis is detected, evaluated, and assessed using numerical values indicative of health or stage of disease.8-11 Instrumentation does not exist, however, to address aesthetic deformities from diagnosis to correction
Traditionally, dental instruments (eg, explorers, probes) have been used as reference standards to detect diseases such as caries and periodontitis. Periodontitis is detected, evaluated, and assessed using numerical values indicative of health or stage of disease.8-11 Instrumentation does not exist, however, to address aesthetic deformities from diagnosis to correction
Aesthetic tooth dimensions can be evaluated and treated by similar numerical analysis. To test the application of these concepts, the author created prototype instruments. Metal wire (ie, 0.036 gauge) was soldered to form a Siamese twin instrument tip with preset markings notched into the surface with measurements indicating a 78% width (W) to length (L), proportion
(Figure 1). Once the incisal edge position was established, the width of a tooth could be measured with the prototype instrument, and the notch on the short arm noted; then the corresponding notch on the long arm could be marked as the reference point for the new clinical crown length at a preset W/L ratio (Figures 2 through 4
(Figure 1). Once the incisal edge position was established, the width of a tooth could be measured with the prototype instrument, and the notch on the short arm noted; then the corresponding notch on the long arm could be marked as the reference point for the new clinical crown length at a preset W/L ratio (Figures 2 through 4
Revolutionary Instrumentation
Aesthetic measurement gauges (ie, Chu’s Aesthetic Gauges, Hu-Friedy Inc, Chicago, IL), designed for diagnosis and correction of tooth size discrepancies and deformities, have been developed to eliminate the subjectivity associated with restorative care
Aesthetic measurement gauges (ie, Chu’s Aesthetic Gauges, Hu-Friedy Inc, Chicago, IL), designed for diagnosis and correction of tooth size discrepancies and deformities, have been developed to eliminate the subjectivity associated with restorative care
Figure 6. Representation of In-Line proportion gauge tip; it is used to
measure widths and lengths of lateral incisors, canines, and central
incisors independently when crowding is present
measure widths and lengths of lateral incisors, canines, and central
incisors independently when crowding is present
Figure 7. T-Bar tip utility; numbers and color bars on the horizontal
axis correspond to those on the vertical axis, providing the clinician
with a visual representation of optimal ITP
axis correspond to those on the vertical axis, providing the clinician
with a visual representation of optimal ITP
These measurement tips include the Proportion Gauge (PG), which represents an objective mathematical appraisal of tooth size ranges. Through the use of such instrumentation, the clinician has a clearly visible means of applying aesthetic values to a patient chairside, directly or indirectly in the laboratory during projected treatment planning, and to objectively determine the intended treatment outcome
The PG is designed as a double-ended instrument (ie, gauge) with a T-Bar and In-Line tip screwed into the handle at opposing ends. The T-Bar tip features an incisal edge position (ie, incisal stop); when a tooth is oriented with the tip accordingly, the practitioner can accurately evaluate its length (ie, vertical arm) and width (ie, horizontal arm) dimensions simultaneously. The width is indicated in equidistant 0.5-mm increments bilaterally, each with a vertical mark in a corresponding color (Figure 5).Thus, a central incisor with a “red” width of 8.5 mm will be in proper proportion if its height is also the “red” height (ie, 11 mm
The In-Line tip is analogous to the metal prototype used in the aforementioned case study; the most significant difference being that the latter is a color-coded,
plastic, disposable unit. The utility of the In-line gauge is identical to the T-Bar tip, except for the fact that the horizontal arm of the T-Bar is now the short arm of the In-Line tip; the vertical arm and long arm of the tips are also the same. The short arm, at 1-mm increments, measures
the tooth width, and the long arm measures the corresponding length at alternating 1.5-mm/1-mm increments, since the gauge is mathematically set at 78% W/L proportion. The black line at the base of the tip denotes the incisal guide, which is the starting point of measurement (Figure 6
plastic, disposable unit. The utility of the In-line gauge is identical to the T-Bar tip, except for the fact that the horizontal arm of the T-Bar is now the short arm of the In-Line tip; the vertical arm and long arm of the tips are also the same. The short arm, at 1-mm increments, measures
the tooth width, and the long arm measures the corresponding length at alternating 1.5-mm/1-mm increments, since the gauge is mathematically set at 78% W/L proportion. The black line at the base of the tip denotes the incisal guide, which is the starting point of measurement (Figure 6
Figure 8. In-Line tip width utility; the short arm is aligned with the
tip perpendicular to the long axis of the tooth to measure the width
tip perpendicular to the long axis of the tooth to measure the width
Figure 9. In-Line tip length utility; the corresponding red band on the
long arm measures the clinical crown length. The outer blue bands
and the intermediate yellow bands measure the lateral incisors and
canines, respectively
long arm measures the clinical crown length. The outer blue bands
and the intermediate yellow bands measure the lateral incisors and
canines, respectively
Design forms of all cases of RPD using attachments or implants
Case Design #1
Bilateral Free-End Distal ExtensionBilateral free-end distal extension partial dentures are most
commonly restored with resilient function attachments when
opposing natural teeth or fixed bridgework. Solid function
attachments are indicated when opposing a removable partial
or full denture. Milled lingual arms arm recommended with
solid function attachments. Double abutting is always recommended
when possible, especially when using solid function
attachments. Leave rugae open for comfort when possible.
commonly restored with resilient function attachments when
opposing natural teeth or fixed bridgework. Solid function
attachments are indicated when opposing a removable partial
or full denture. Milled lingual arms arm recommended with
solid function attachments. Double abutting is always recommended
when possible, especially when using solid function
attachments. Leave rugae open for comfort when possible.
Option #1 Extracoronal Resilient
or SolidIndirect retention should be added for attachments such as
the ORS-DE or SA Anchor/Ceka, etc. Attachments such as
the Dalbo and ASC 52 have built-in indirect retention. Milled
linguals are recommended for solid/rigid attachments such as
the D 2.7, Strategy, Vario, etc.
Resilient Attachments: Dalbo or Swiss Mini, ASC 52, Swiss
Anchor, ORS-DE, Zaag RPD.
Solid Attachments: D 2.7, Strategy, Vario SG, Swiss-EX,
or SolidIndirect retention should be added for attachments such as
the ORS-DE or SA Anchor/Ceka, etc. Attachments such as
the Dalbo and ASC 52 have built-in indirect retention. Milled
linguals are recommended for solid/rigid attachments such as
the D 2.7, Strategy, Vario, etc.
Resilient Attachments: Dalbo or Swiss Mini, ASC 52, Swiss
Anchor, ORS-DE, Zaag RPD.
Solid Attachments: D 2.7, Strategy, Vario SG, Swiss-EX,
Option #2 Intracoronal SolidRemovable Partial Denture with double abutted crowns on
#6-7 and 10-11. Milled lingual arms are recommended for stability,
retention and support. A cylinder type attachment such
as the Omega-M maybe placed interproximal between 6-7
and 10-11. The male of the Omega-M attachment becomes
part of the removable milled lingual arm.
Attachments Indicated: Score PD, PT Snap, Biloc,
McCollum
#6-7 and 10-11. Milled lingual arms are recommended for stability,
retention and support. A cylinder type attachment such
as the Omega-M maybe placed interproximal between 6-7
and 10-11. The male of the Omega-M attachment becomes
part of the removable milled lingual arm.
Attachments Indicated: Score PD, PT Snap, Biloc,
McCollum
Option #3 Implant BridgesBridges may be cemented over titanium post abutments or
retained with set screws. Angled Titanium Abutments may be
needed for divergent implants. Bridges may also be screw
retained using direct UCLA abutments. Hexed UCLA
Abutments may be used to make custom angled abutments.
The Score-UP placed intracoronally into #6 & #11 with or without
the U-Pin.
Implant Components: Titanium Abutment Posts Straight or
angled, UCLA Abutments, non-hexed for bridges and hexed
for custom angled abutments.
Attachments: Set Screws, Score-UP
retained with set screws. Angled Titanium Abutments may be
needed for divergent implants. Bridges may also be screw
retained using direct UCLA abutments. Hexed UCLA
Abutments may be used to make custom angled abutments.
The Score-UP placed intracoronally into #6 & #11 with or without
the U-Pin.
Implant Components: Titanium Abutment Posts Straight or
angled, UCLA Abutments, non-hexed for bridges and hexed
for custom angled abutments.
Attachments: Set Screws, Score-UP
Case Design #2
Unilateral EdentulousThe unilaterally edentulous arch is a common situation with
special concerns. Cross stabilization with clasps or attachments
is required when restoring more than a three-tooth
span. For unilateral removable partials without cross arch stabilization
see Case #110. Two abutments should be splinted
when possible. Milled lingual arms are recommended when
using intracoronal attachments or solid function extracoronal
attachments.
special concerns. Cross stabilization with clasps or attachments
is required when restoring more than a three-tooth
span. For unilateral removable partials without cross arch stabilization
see Case #110. Two abutments should be splinted
when possible. Milled lingual arms are recommended when
using intracoronal attachments or solid function extracoronal
attachments.
Option #1 Extracoronal ResilientRemovable Unilateral Partial Denture with double abutted
crowns on #10 & 11 and cross arch stabilized between #3 &
#4 with a Cross Arch Roach attachment. A resilient attachment
such as the ASC 52 or Mini Dalbo is placed on the distal
of #27. Milled lingual arms are contraindicated for resilient
designs. For comfort we recommend an open rugae on maxillary
restorations when possible.
Attachments Indicated: ASC 52, Mini Dalbo, SA Anchor, etc
on distal. Cross Arch Roach interproximal of #3 & #4.
crowns on #10 & 11 and cross arch stabilized between #3 &
#4 with a Cross Arch Roach attachment. A resilient attachment
such as the ASC 52 or Mini Dalbo is placed on the distal
of #27. Milled lingual arms are contraindicated for resilient
designs. For comfort we recommend an open rugae on maxillary
restorations when possible.
Attachments Indicated: ASC 52, Mini Dalbo, SA Anchor, etc
on distal. Cross Arch Roach interproximal of #3 & #4.
Option #2 Intracoronal SolidRemovable Unilateral Partial Denture with double abutted
crowns on # 10 & #11 and cross arch stabilized with an
attachment such as the Biloc or Omega-M between #3 & #4.
Milled linguals are recommended on the abutments. For comfort
we recommend an open rugae on maxillary restorations.
Attachments Indicated: Score-PD, Biloc, PT-Snap,
McCollum, etc. For additional stability the Omega-M may be
placed interproximal. For cross arch stabilization you may
select the Biloc, Pt-Snap, McCollum etc.
crowns on # 10 & #11 and cross arch stabilized with an
attachment such as the Biloc or Omega-M between #3 & #4.
Milled linguals are recommended on the abutments. For comfort
we recommend an open rugae on maxillary restorations.
Attachments Indicated: Score-PD, Biloc, PT-Snap,
McCollum, etc. For additional stability the Omega-M may be
placed interproximal. For cross arch stabilization you may
select the Biloc, Pt-Snap, McCollum etc.
Option #3 Implant BridgesBridges may be cemented over titanium post abutments or
retained with set screws. Angled Titanium Abutments may be
needed for divergent implants. Bridges may also be screw
retained using direct UCLA abutments. Hexed UCLA
Abutments may be used to make custom angled abutments.
The Score-UP placed intracoronally into #6 & #11 with or without
the U-Pin.
Implant Components: Titanium Abutment Posts Straight or
angled, UCLA Abutments, non-hexed for bridges and hexed
for custom angled abutments.
Attachments: Set Screws, Score U-P
retained with set screws. Angled Titanium Abutments may be
needed for divergent implants. Bridges may also be screw
retained using direct UCLA abutments. Hexed UCLA
Abutments may be used to make custom angled abutments.
The Score-UP placed intracoronally into #6 & #11 with or without
the U-Pin.
Implant Components: Titanium Abutment Posts Straight or
angled, UCLA Abutments, non-hexed for bridges and hexed
for custom angled abutments.
Attachments: Set Screws, Score U-P
Case Design #3
Posterior Unilateral ToothborneRestorative options for this partially edentulous situation
include a one-piece bridge, segmented bridge, implant bridge,
implant single units or a removable partial denture. If abutments
are not parallel or if the posterior abutment is questionable
a segmented bridge with an intracoronal attachment
is indicated. In cases with severe tissue defect a removable
partial denture may be indicated.
include a one-piece bridge, segmented bridge, implant bridge,
implant single units or a removable partial denture. If abutments
are not parallel or if the posterior abutment is questionable
a segmented bridge with an intracoronal attachment
is indicated. In cases with severe tissue defect a removable
partial denture may be indicated.
Option #1 IntracoronalFixed bridge with divergent preparations. Intracoronal attachment
placed on distal of #6 with the possibility to convert easily
to a partial denture if the molars fail. An attachment such
as the Score BR or Score U-P is easily converted for this
purpose.
Attachments Indicated: Score-BR, Score U-P, PDC,
Beyeler, Biloc, Strauss Micro, McCollum, etc.
placed on distal of #6 with the possibility to convert easily
to a partial denture if the molars fail. An attachment such
as the Score BR or Score U-P is easily converted for this
purpose.
Attachments Indicated: Score-BR, Score U-P, PDC,
Beyeler, Biloc, Strauss Micro, McCollum, etc.
Option #2 Extracoronal Screw
RetainedTelescopic operator removable bridge with a cemented crown
on #6 with an extracoronal screw type attachment such as the
ScrewBloc or SwissBloc. A telescopic coping on #3 may also
be made incorporating a tube from the Tube & Screw
Attachment. The pontics would be attached to the telescopic
crown on #3.
Attachments Indicated: ScrewBloc, SwissBloc, Fletcher
Bloc, T-Bloc, etc. Tube & Screw Attachment.
RetainedTelescopic operator removable bridge with a cemented crown
on #6 with an extracoronal screw type attachment such as the
ScrewBloc or SwissBloc. A telescopic coping on #3 may also
be made incorporating a tube from the Tube & Screw
Attachment. The pontics would be attached to the telescopic
crown on #3.
Attachments Indicated: ScrewBloc, SwissBloc, Fletcher
Bloc, T-Bloc, etc. Tube & Screw Attachment.
Option #3 Implant BridgesSingle or splinted implant crowns over Titanium Abutment
Posts may be cemented or retained with Set Screws. Angled
Titanium abutments may be necessary for divergent implants.
Screw retained single units or custom angled abutments may
be made with the hexed UCLA cylinders. Non-hexed UCLA
cylinders are used for bridges.
Implant Components: Titanium straight or angled abutment
posts, UCLA hex type abutments for single units or custom
angled abutments. Non-hexed UCLA Abutments for splinted
crowns.
Attachments Indicated: Set Screws.
Posts may be cemented or retained with Set Screws. Angled
Titanium abutments may be necessary for divergent implants.
Screw retained single units or custom angled abutments may
be made with the hexed UCLA cylinders. Non-hexed UCLA
cylinders are used for bridges.
Implant Components: Titanium straight or angled abutment
posts, UCLA hex type abutments for single units or custom
angled abutments. Non-hexed UCLA Abutments for splinted
crowns.
Attachments Indicated: Set Screws.
Case Design #4
Bilateral ToothborneRestorative options for this partially edentulous situation
include one-piece bridges, segmented bridges, implant
bridges, implant single units or a removable partial denture. If
abutments are not parallel or if the posterior abutments are
questionable, segmented bridges with intracoronal attachments
are indicated.
include one-piece bridges, segmented bridges, implant
bridges, implant single units or a removable partial denture. If
abutments are not parallel or if the posterior abutments are
questionable, segmented bridges with intracoronal attachments
are indicated.
Option #1 Intracoronal SolidFixed segmented bridges with Score-UP attachments in #22
& #27. If the posterior abutments are lost in the future, a
removable partial denture may be constructed. If #31 is questionable,
a Cross Arch Roach may be placed into #20 for
future resilient partial denture or a Biloc may be placed into
#20 for future solid function partial denture.
Attachments Indicated: Score-UP on #22 & #27. A Cross
Arch Roach or Biloc into #20 pontic.
& #27. If the posterior abutments are lost in the future, a
removable partial denture may be constructed. If #31 is questionable,
a Cross Arch Roach may be placed into #20 for
future resilient partial denture or a Biloc may be placed into
#20 for future solid function partial denture.
Attachments Indicated: Score-UP on #22 & #27. A Cross
Arch Roach or Biloc into #20 pontic.
Option #2 ExtracoronalRemovable partial denture with solid or resilient attachments.
While solid function attachments are most commonly used in
this situation, resilient attachments may be selected if posterior
abutments are questionable. This would allow for conversion
to resilient function. The lingual arms on the partial denture
would have to be removed to allow resilient function.
Attachments Solid: D 2.7, Swiss-EX, Bredent, Strategy
Attachments Resilient: Dalbo or Swiss Mini, ASC 52,ORS -
DE
While solid function attachments are most commonly used in
this situation, resilient attachments may be selected if posterior
abutments are questionable. This would allow for conversion
to resilient function. The lingual arms on the partial denture
would have to be removed to allow resilient function.
Attachments Solid: D 2.7, Swiss-EX, Bredent, Strategy
Attachments Resilient: Dalbo or Swiss Mini, ASC 52,ORS -
DE
Option #3 Implant BridgesA Titanium Abutment Post may be placed onto #20 implant
and splinted to #22 via a Score-BR or Score-UP. The implant
crown may be cemented or retained with a lingual Set Screw.
The #20 implant bridge may also be restored with a nonhexed
UCLA Abutment and Screw. Implants #27-#30 may be
restored with Titanium Posts or UCLA abutments. Angled
abutments may be necessary for divergent implants.
Implant Components: Titanium Abutment Posts, UCLA
Abutments
Attachments: Score UP or Score BR, Swiss Set Screw
and splinted to #22 via a Score-BR or Score-UP. The implant
crown may be cemented or retained with a lingual Set Screw.
The #20 implant bridge may also be restored with a nonhexed
UCLA Abutment and Screw. Implants #27-#30 may be
restored with Titanium Posts or UCLA abutments. Angled
abutments may be necessary for divergent implants.
Implant Components: Titanium Abutment Posts, UCLA
Abutments
Attachments: Score UP or Score BR, Swiss Set Screw
Case Design #5
Anterior ToothborneSince 5 teeth are missing in this example, a patient removable
restoration is recommended. If restored with implants, a
cemented or screw retained bridge may be fabricated, except
in cases with severe bone loss where a removable implant
restoration would be indicated. Palatal coverage for a removable
partial denture may be avoided with attachments placed
mesially inconjuction with milled lingual arms for stability.
restoration is recommended. If restored with implants, a
cemented or screw retained bridge may be fabricated, except
in cases with severe bone loss where a removable implant
restoration would be indicated. Palatal coverage for a removable
partial denture may be avoided with attachments placed
mesially inconjuction with milled lingual arms for stability.
Option #1 IntracoronalRemovable Partial Denture with double abutted crowns on
#5-6 and #12-13. Intracoronal attachments are placed mesially
with milled linguals. A cylinder type attachment such as the
Omega-M may be placed interproximal between #5-6 and
#12-13. If possible, do not cover the rugae area unless there
is a palatal defect. This design maximizes patient comfort.
Attachments: Score-PD, Biloc, PT-Snap, McCollum, etc.
Omega-M interproximal.
#5-6 and #12-13. Intracoronal attachments are placed mesially
with milled linguals. A cylinder type attachment such as the
Omega-M may be placed interproximal between #5-6 and
#12-13. If possible, do not cover the rugae area unless there
is a palatal defect. This design maximizes patient comfort.
Attachments: Score-PD, Biloc, PT-Snap, McCollum, etc.
Omega-M interproximal.
Simple Method for Aligning Retroclined or Ectopic Teeth
be both difficult and problematic.1 First, the forces used to create space in the arch can oppose those needed to align the teeth. This can cause binding and notching of the wire at the locations of the most misaligned teeth, resulting in increased friction and thus negating the archwire’s superelastic
properties.2,3 Potentially harmful forces are also placed on the anchorage unit when aligning ectopic teeth.4 Furthermore, bonding brackets to the buccal
properties.2,3 Potentially harmful forces are also placed on the anchorage unit when aligning ectopic teeth.4 Furthermore, bonding brackets to the buccal
Diagnosis and Treatment PlanA 10-year-old girl presented with the chief complaint of unesthetic dental appearance
ectopically erupting maxillary right canine,
and retroclined maxillary right lateral incisor in crossbite before treatment.
and retroclined maxillary right lateral incisor in crossbite before treatment.
Although she had experienced a trauma to the maxillary left central incisor, there was no contraindication to orthodontic therapy. Intraoral examination revealed mild maxillary skeletal constriction,
crowding in the maxillary arch, and partial closure of the maxillary left lateral incisor eruption space due to the migration of adjacent teeth. A Class I molar relationship was present (Table 1),
crowding in the maxillary arch, and partial closure of the maxillary left lateral incisor eruption space due to the migration of adjacent teeth. A Class I molar relationship was present (Table 1),
but the mandibular dental midline was deviated to the left. The maxillary right canine was erupting ectopically, and the right lateral incisor was in crossbite and severely retroclined relative to the other upper incisors.
Two treatment options were considered. The first involved extraction of the maxillary premolars to resolve the crowding and allow the canines to erupt without flaring of the incisors.
The second option was to expand both arches by means of fixed appliances, with no extractions.
Two treatment options were considered. The first involved extraction of the maxillary premolars to resolve the crowding and allow the canines to erupt without flaring of the incisors.
The second option was to expand both arches by means of fixed appliances, with no extractions.
To maintain the patient’s profile, and because the maxillary expansion was expected to produce sufficient space for alignment, the second option was chosen.
Treatment Progress
Leveling and alignment were begun in the mandibular arch with full fixed appliances (Fig. 2).
Fig. 2 Self-ligating brackets bonded in lower arch for initial leveling and alignment.
Eight weeks later, the upper right canine had erupted enough to bond the maxillary teeth. We used self-ligating Bidimensional brackets6 (Time 2*) except on the retroclined lateral
incisor, where we bonded a stainless steel cleat to the lingual surface (Fig. 3).
incisor, where we bonded a stainless steel cleat to the lingual surface (Fig. 3).
Fig. 3 After eight weeks of treatment, self-ligating brackets bonded in upper arch, with stainless steel cleat
bonded to lingual surface of right lateral incisor.
bonded to lingual surface of right lateral incisor.
An extremely thin, flexible archwire (.012" nickel titanium) was inserted through the bracket slots and bent around the cleat to progressively align the teeth.
This method has several advantages. The forces used are extremely light, but effective because friction is controlled. Binding is prevented by limiting the wire to one-point contacts with the brackets and by increasin
This method has several advantages. The forces used are extremely light, but effective because friction is controlled. Binding is prevented by limiting the wire to one-point contacts with the brackets and by increasin
A BIOMETRIC APPROACH TO AESTHETIC CROWN LENGTHENING
There exists a synergy between periodontics and restorative dentistry, where the disciplines are interdependent. In aesthetic dentistry where development of the proper tooth size, form, and color of restorations are critical to clinical success, often the periodontal component is considerable and must be addressed for a predictable aesthetic outcome. The need to establish the correct tooth size and thus individual tooth proportion drives the periodontal component of aesthetic restorative dentistry. One specific area of concern is excessively short teeth,2 where the lack of tooth display and excessive gingival display require clinical crown lengthening that can present a clinical dilemma for the aesthetic-oriented periodontist.
There are a myriad of techniques that have evolved over several decades to treat this situation. Techniques that simplify as well as enhance the quality of treatment can provide substantial benefit to both patients and treating practitioners alike. This article describes an innovative approach to periodontal aesthetic crown lengthening utilizing measurement gauges specifically designed for a predictable surgical outcome, thus setting a new standard of diagnosis and treatment within the aesthetic zone. Midfacial surgical crown lengthening has traditionally been performed to establish a healthy biologic dimension of the dentogingival complex (DGC) as an adjunct to aesthetic restorative procedures. While considerable variation in the magnitude or length of this complex has been reported, the mean sulcus depth was 0.69 mm, epithelial attachment was 0.97 mm, and the connective tissue was 1.07 mm.3 Therefore, the total length of the DGC was 2.73 mm. Based on these dimensions, several authors have suggested that 3 mm of supracrestal tooth structure be obtained during surgical crown lengthening.4,5 Other authors have suggested that supracrestal tooth structure ranges from 3.5 mm to 5.25 mm, depending on the placement of the restorative mar in.6,7 It is important, therefore, to establish a consistent measurement
Subscribe to:
Posts (Atom)