Special dentistry

@Dr_zainab99990

او تواصلوا وياي

السلام عليكم طلاب

طلاب محتاجتكم بموضوع كلش ضروري


طلاب الي يعرف احد من كربلاء زمرة دمه سالب o ياريت يتبرع تتبرعونه
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Q: What is the primary difference between inherited and acquired bleeding disorders?

A) Inherited bleeding disorders are caused by external factors, while acquired bleeding disorders are genetic.

B) Inherited bleeding disorders are genetically transmitted, while acquired bleeding disorders occur due to diseases, drugs, or treatments like radiation or chemotherapy.

C) Inherited bleeding disorders affect platelets only, while acquired bleeding disorders affect vascular wall integrity.

D) Inherited bleeding disorders occur due to drugs, while acquired bleeding disorders are genetically transmitted

1. Which phase begins immediately after an injury and involves vasoconstriction of arteries and veins?

A) Coagulation phase

B) Inflammatory phase

C) I-Vascular phase

D) Proliferative phase



2. Under normal conditions, endothelial cells synthesize and secrete which of the following as anti-platelet agents?

A) Adenosine triphosphate, epinephrine, and collagen

B) Prostacyclin, nitric oxide, and adenine nucleotides

C) Heparin, serotonin, and fibrinogen

D) Thromboxane, histamine, and serotonin





3. Exposure of vessel wall subendothelial tissues initiates coagulation through which pathway?

A) Intrinsic pathway

B) Extrinsic pathway

C) Common pathway

D) Platelet pathway




4. Which factor is released by injured endothelial cells to promote platelet adhesion?

A) von Willebrand’s factor (vWF)

B) Adenosine diphosphate (ADP)

C) Fibrinogen

D) Thrombin





5. Endothelial cells contribute to normal hemostasis and vascular integrity through the synthesis of which of the following?

A) Type III collagen, fibrin, and vWF

B) Type IV collagen, fibronectin, and vWF

C) Elastin, thromboplastin, and prostacyclin

D) Platelet factor, albumin, and fibrinogen

MCQ
عن ملزمة ال bleeding disorders

ميزان جراحة الفم ..المرحلة الرابعة تقويمي
#ORAL_surgery4

منو عنده بوت ملازم بغداد مرحله رابعه

@Dr_zainab99990

@Dr_zainab99990

صباح الخير

طلاب اريد سمنار

Pulp therapy in primary teeth

عيب إذا انت. طبيب أسنان ومتعرف أنواع الغسولات مال الفم

https://www.instagram.com/reel/DByL-gaN_UD/?igsh=Zm1jejJ0ZDZpMjRv

شوفوا هذا الريلز

مساء الخير عليكم طلابنا


طلاب راح تنزل اسئلة MCQ عن مادة البريو هنا بالقناة لأول أربع محاضرات


الي عنده مد خلي يستغل هالفرصه ويتابعنا

والي عنده تراكمات هم خلي يستغل الفرصه


والي قاري هم خلي يستغل الفرصه ويراجع


انتضرونا 🩵 باجر لو عكبة ينزلن


شاركوا المنشور بكروباتكم

Special dentistry pinned «هلو 🙃 حبدي انشر ملخصات حضرو نفسكم واي ملخص تردو اكتبو اسم الماده بالعربي ورقم المحاضرة بالبحث وتطلعلكم»

Physiologic dentin:
Odontoblasts synthesize and secrete extracellular organic matrix, which, following mineralization, forms the primary and secondary dentin

تكمله

ملخص اوبرتف محاضرة 2
Dentin :🥸
Dentin is a mineralized connective tissue that
covered by enamel in the crown and cementum in the root, as well as enclosing the innermost pulp.

الخلايا المكونه للعاج اسمها odontoblasts

Odontoblasts are considered
part of pulp and dentin tissues because their cell bodies are in the pulp cavity, but their long, slender cytoplasmic cell processes (Tome's fibers) extend well into the tubules in the mineralized dentin.

_Because of these odontoblastic cell
processes dentin is considered a
living tissue

_These processes
extend beyond the DEJ into the
enamel forming enamel spindles,

which are responsible for sensitivity
sensation during cavity preparation
in enamel.
الدينتين يتكون قبل المينا

The most
recently formed layer of dentin is always on the pulpal surface.


_Odontoblasts generate an extracellular collagen matrix as they begin to move away
from adjacent ameloblasts

_from adjacent ameloblasts.
• Mineralization of the collagen matrix, facilitated by non-collagenous proteins

_unmineralized zone of dentin is immediately next to the cell bodies of odontoblasts
and is called predentin.

_Dentin formation begins at areas subjacent to the cusp tip or incisal ridge spreads at
the rate of ~4 μm/day, to the apex of the root

_dentin formation
continues after tooth eruption and throughout the life of the pulp.

_The dentin forming the initial shape of the tooth is called primary dentin and is usually completed 3 years after tooth eruption

Dentinal Tubules 🥸
small canal that remain from the process of dentinogenesis extend from the pulp to the DEJ

_The tubules comprise about 10% of dentin volume

_Each tubule contains the cytoplasmic cell process (Tome's fiber)،and lined with a layer of peritubular dentin which is more mineralized than intertubular dentin .


_In mature dentin, the odontoblastic process extends within the dentinal tubule to about one-third the dentinal thickness.

The number of tubules increases from 15,000 _20,000/mm2 at the DEJ to

45,000 _65,000/mm2 at the pulp.

_The lumen of the tubules in DEJ is 0.5 to 0.9 μm, but this increases to 2 to 3 μm near the pulp.

_Tubules are oriented perpendicular to the
DEJ

_ هاي التيوبات بيها أنابيب فرعية اسمها
called canaliculi or lateral canals

_The lateral canals are formed as a result of the presence of secondary branches of adjacent odontoblastic processes during dentinogenesis

DEG : 🥸
transition between the highlymineralized enamel and the collagencontaining dentin.

_DEJ must resist fracture and separation

_DEJ width falls within a range of 2 to 15 μm.

Dentin Composition🥸

_Mature dentin is a crystalline material that is less hard than enamel but slightly harder than bone.

_The odontoblast secretes the organic dentin matrix and regulates mineralization.

_Mature dentin is 45% - 50% inorganic or
mineralized material, 30% organic material, and 25% water. The organic material is approximately 90% type I collagen and 10% non-collagenous proteins

_The crystalline formation of mature dentin
consists of calcium hydroxyapatite with the Ca10(PO4 )6 (OH)2

_calcium hydroxyapatite
نسبته أعلى بالانمل من الدينتين
وبنسبة اقل بالسمنت والعظم

_ بالإضافة البلورات الموجوده بالدينتين أصغر 30% من الي موجوده بالاانمل

_The thickness of the apatite crystals 3.5
nm near the DEJ about 2 nm close to the pulp.

_The mineral content of dentin increases with age.

Structurally there are two main types🥸

1.Intertubular dentin:
المكون الرئيسي الها هو
hydroxyapatite- embedded
collagen matrix between tubules

_it is the hypermineralized
dentin limited to the walls of dentinal tubules

_peritubular dentin in
the primary dentin thicken ، with age. The dentin therefore becomes harder, denser, and, because tubular fluid low becomes more restricted as the lumen spaces become smaller, less sensitive

_dentin sclerosis.: increased amount of mineral in the primary dentin

physiologic dentin sclerosis: Dentin sclerosis resulting from aging

Tensor veli palatini:
- This slender muscle when taut, can influence the denture contour in the hamular notch area.


▪ Levator veli palatini

- It elevates the soft tissues during swallowing
- helps in determining position of the vibrating line

Palatoglossus:
- When the two palatoglossi contract, they draw the tongue and soft palate toward each other

Why study these soft palate muscles?🥸

Because of the need to determine the vibrating line which is located on soft palate not over the palatine bone

شلون نحدد vibrating line

نخلي المريض يسد خشمه و يكول AH الهوا الي يطلع
من الفتحات الي موجوده بالحنك هي الي يحددلي التقاطع بين الحنك الرخو والصلب

Soft palate can be classified into:


Class I: horizontal with little muscular movement. In this case more tissue coverage is possible for posterior palatal seal

Class II: soft palate makes 45 degree angle to the hard palate , Tissue coverage for posterior palatal seal is less

Class III: soft palate makes 70 degree angle to the hard palate. Tissue coverage for posterior palatal seal is minimum.


The Tongue🥸

The tongue is a muscular structure composed of intrinsic and extrinsic muscles fibers.

_The intrinsic muscles: originate and insert within the tongue ,responsible for change in shape


_The extrinsic muscles: originate in structure outside the tongue
and can move the tongue as well as alter its shape.


▪ The denture flange must be contoured to allow the tongue to
have its normal wide range of functional movement


During muscle trimming procedure during lower impression,
Patient is asked to :
▪ Move his tongue to the left and right
▪ Protruding it anteriorly in Moisture their lips.

Muscle physiology🥸

The oral cavity has many sensory nerve fiber receptors; many of these are associated with periodontium, when teeth are lost these receptors are lost too.


Muscle contraction is of two types : 🥸

1. Isometric contraction : occur when the muscle does not shorten during contraction


2. Isotonic contraction occur when the muscle shortens, but the tension remains the same.


In the mandible both occurs
Isotonic → to move the mandible
Isometric → to brace the mandible when teeth contact.


_When load applied on muscle it elongates with limit, the greater the
load the greater the stretch, this is of importance during recording of
jaw relation.

Oral Mucosal🥸

Significance: helps support a complete denture directly

Masticatory Mucosa:
طبقه كيراتينية تغطي ريسيجول رج والهارد باليت

Lining Mucosa: مو كيراتينية

Specialized Mucosa : تغطي ضهر اللسان

Salivary gland and saliva 🥸

عدنا 3 عدد لعابية رئيسية

1. Parotid gland (serous secretions)
2. Submandibular glands (mixed, mostly serous)
3. Sublingual glands (mixed,)

+ Minor salivary glands (smaller glands in lips, cheek, and palate


سماكة اللعاب مهمه : اللعاب السميك يسويلي مشاكل مثل

1_ يطلعلي الدنجر من مكانه

2_Complicates impression making? by forming voids in the impression surface

3_Causing the patients to gag
أثناء ما اسوي طبعه وكذالك من يلبس الدنجر الجديد


The Factors affecting on retention :🥸

Atmospheric Pressure:
Depend on peripheral seal
تاكد انو الدنجر بوردر واصله لحدوده الصحيحه

Adhesion: attraction of saliva to denture

Cohesion:
It is the attraction of molecules of saliva to each other.

Lack of saliva (xerostomia) cause some problems:🥸

1_Reduced retention of denture

2_Formation of sore spot under the denture
3_Sticking of cheeks and lips to the denture base


factors affect salivation : 🥸
_Agreeable taste stimuli result in profuse salivation
_A smooth surface inserted into the mouth
_As one ages, the saliva becomes? more ropy in consistency

Function of saliva :
1_ هضم لان تحتوي على ببتيد انزيم
2_ وقايه
4_تزيد الرتينشن لدنجر
3_▪ Lubricant for the mucosa and surface of the denture.

5_▪ Mechanical cleansing

Thank you 😊🙏

ملخص بروس ملزمة 2

Facial Expression Muscles in Lower Half of Face🥸

1. Zygomaticus major الكبيره

2. Zygomaticus minor الصغيره
3. Levator labii superioris
(elevates) (lip)
4. Depressor labii inferioris
(depresses) (lip)
5. Levator anguli oris
(elevates) (angle) (of mouth)
6. Depresser anguli oris
(depresses) (angle) (of mouth)
7. Incisivus superioris
8. Incisivus inferioris
9. Risorious = (Laughing)
10. Platysma = (Plate)
11. Mentalis = (Mental)
12. Buccinator = (Buccal)
13. Orbicularis oris
(circle) (mouth)
14. levator labii superioris alaeque nasi
(Elevates) (lip) (superiorly) (alae) (of nose)

Functions of muscles of facial expression🥸
1. Laughing
2. Smiling
3. Frowning

Why study the perioral muscles of facial expression? 🥸

Perioral Muscles Of Facial Expression🥸

Modiolus: عقدة تلتقي بيها العضلات
concentration of many
fibers for the perioral muscles,

موقعها: laterally and slightly above the
corner of the mouth

Denture Modifications For The Modiolus🥸

1. The labial flange of the maxillary denture should be reduced in thickness → as not to effect the stability of the upper denture.

2_lowe 4 should be arranged on the crest of residual ridge → to avoid any interference with this modiolus.

Mentalis muscle
Functions related to prosthodontic : 🥸

1. Contraction of this muscle is capable of dislodging mandibular denture

2_dictate the level of extension of the labial flange of lower denture

3_ تخلي
lower vestibule shallower when it contract.
4. Surgical repositioning of the mentalis muscle is sometimes advisable

The incisivus labii superioris and inferioris muscles 🥸

Act on vestibular fornix similar to mentalis muscles

ذني عضلات صغار نادرا ميسون ازاحة للدنجر صح شغلهن مشابه للمنتالس مسل بس لان صار مالهن ذاك التاثير

هاي العضلة موجوده اسفل mucous membrane
هذا الموقع ممكن يسببلي مشاكل متعلقة
with flange extension
and denture retention.

Buccinators muscle🥸
Dislodge denture Not directly ?

It contracts in a line parallel to the plane of occlusion.
بحيث تكون عامودين على masseter

Prosthodontics significance:
من تتنشط عضلة الماسيتر حتدفع البوكسنيتر ميزيلي على
medially against denture border in the area of the retromolar pad

Management:
Denture should be contoured to accommodate interaction between these two muscles. This contour is known as masseter groove.

▪ Orbicularis oris muscle🥸

Function
Sphincter muscle of the mouth

➢ Muscle support
The upper lip is supported by the six anterior teeth and not the denture border.

_In normal occlusion the superior border of lower lip is supported by incisal third of the maxillary anterior teeth,

_When the muscles of the lips are relaxed, the lips become flaccid

Suprahyoid Muscles🥸
Digastric - Stylohyoid - Geniohyoid - Mylohyoid

وضيفتهن :
Elevation of the hyoid bone and larynx
▪ Depression of the mandible.

_Geniohyoid and Mylohyoid
ممكن ياثرن على حدود الدنجر

Mylohyoid muscles: 🥸

_muscular floor of the mouth
_Elevates hyoid bone, tongue and membranous floor of the mouth during swallowing
_Depresses the mandible

_If the denture extend below and under the mylohyoid line
حياثر على شغل هاي العضلة

Infrahyoid muscles🥸
No particular significance in complete denture

_Significance
Their
action is to fix the hyoid bone so that the suprahyoid muscles can act
on the mandible.

Muscles of Mastication🥸

_Temporalis
_Masseter
_Lateral Pterygoid
_Medial Pterygoid

Functions of these muscles:
1. Masticatory and non-masticatory movement of the mandible


2_ In complete denture, the non-masticatory movement
اهم من الماستكتوري موفمنت

3., centric relation occlusion is obtained with aid of posterior fibers of temporalis muscles.

Pterygomandibular raphae:🥸

location: between the pterygoid hamulus
superiorly retromolar pad inferiorly

أهميتها : هي نقطة ارتباط
buccinators muscles laterally superior pharyngeal muscles medially

Muscles of the soft palate 🥸

1. Palatoglossus
2. Muscular uvulae
3. Tensor veli palatini
4. Levator veli palatini

ملخص جراحة المحاضرة 3+ 4


Cardiac Arrhythmias🥸

disturbance of heartbeat
15-17% of the
population may have arrhythmias
وتزداد مع العمر

حالات عدم انتضام دقات القلب القاتله سببها اما سترسس أو دواء أو dental treatment

They are classified according to:🥸

Rate into: tachycardia and bradycardia.
Mechanism into: automaticity, re-entry and fibrillation.
Site of origin into: supraventricular and ventricular arrhythmias.

Signs include🥸

اما بطئ اقل من 60 نبضه بدقيقه أو تسارع ، أكثر من 60\ min

The primary tool for diagnosis of arrhythmia is electrocardiogram (ECG). مهم 🥸🥸🥸 🥸


Medical Management 🥸

1_ الضغط على الرقبة يحفز البارا سمباثاتك على القلب وبتالي
inhibiting electrical conduction through the AV nodes.

2_Antiarrhythmic Drugs:

class I are sodium channel blockers,
class II beta blockers
,class III drugs act on potassium channels and prolong the duration of action potential
class IV drugs are calcium channel blockers.

3_Pacemakers: منضم دقات القلب
هو عباره عن جهاز يزرعو
left infraclavicular area
حته يخلق نبضه عصبيه هاي النبضه تنتقل عن طريق سلك داخل للقلب عن طريق subclavian vein ورايح لقطب متصل ب عظلة القلب

4_Implanted Cardioverter-Defibrillator (ICD) :
يشابه البيسميكر من ناحية انو ثنينهن يشتغلن بالمجال المغناطيسي

ICDs are capable not only
of delivering a shock but also of providing antitachycardia pacing (ATP) and ventricular bradycardia pacing


5_Radiofrequency Catheter Ablation:
يتم إدخال قسطرة من خلال الوريد إلى المكان البي مشكله
radiofrequency energy is
then delivered that cause irreversible tissue destruction.

6_Surgery:
7_Anticoagulants :
8_Defibrillation or Cardioversion

Patients with cardiac arrhythmias may be identified by the following:🥸

1_ Medical history
2_b) Risk for arrhythmia is increased in the presence of other cardiovascular or pulmonary disease.
3_Vital signs

يفضل بالحالات الخطرة علاج الأسنان اما نتجنبه أو يكون بالمستشفى مع مراعات مايلي :
b) Provide limited care only for pain control,
treatment of acute infection, or control of
bleeding.

d) Sedation
e) (ECG) monitoring
f) Pulse oximeter
g) Blood pressure monitoring
h) Avoid or limit adrenalin.

Stress and anxiety reduction🥸

1_Schedule short, morning appointments.

2_Provide preoperative sedation (short-acting benzodiazepine
قبل ليلة أو قبل ساعه
3_Administer intraoperative sedation (nitrous oxide/oxygen)
4_Provide adequate postoperative analgesia

The use vasoconstrictors🥸

تجنب استخدام مضيقات الأوعية الدموية
because of the
possibility
of cardiac tachycardia or another arrhythmia

خاصة البيشنت الي ياخذون
digoxin
potential for inducing arrhythmias.

اذا جان اخذ vasoconstrictors ضروري للمرضى
low- to intermediate-risk
الي ياخذون nonselective betablockers

ف امان ننطيهم بس بجرعة
0.036mg of epinephrine

intravascular injections should be avoided.

_Avoid the use of adrenalin in retraction cord.

Patients who are taking Warfarin 🥸

Should have international normalized ratio (INR)
خلال 24 ساعه من البروسيجر

اذا كان INR 2_3.5 ف اكدر اسوي دنتل تريتمنت وحته اورل سيرجري بسيط

c) Local measures include gelatin sponge or oxidized cellulose in sockets, suturing, gauze pressure packs, preoperative stents, and tranexamic acid or aminocaproic acid mouth rinse and/or to soak gauze

Patients with pacemakers 🥸
انتي بايوتك قبل الجراحه مننصح بي
is not recommended.

_Avoid the use of electrosurgery and ultrasonic scalers.

Patients taking Digoxin🥸
a) Watch for signs or symptoms of toxicity (e.g., hypersalivation).
b) Avoid adrenalin or levonordefrine.

Thank you 😊🙏

أول 6 اشهر بعد العملية تعتبر Prophylaxis is
reasonable because endothelialization of prosthetic material occurs within 6 months after the procedure.

6_Repaired CHD with residual defects which inhibits endothelialization

7_Cardiac transplantation


كل الي ذكرناهم فوك لازم ننطيهم انتي بايوتك قبل الدنتل بروسيجر حته نحمي من IE


هناك اجرائات لا تحتاج إلى وقاية مثل : 🥸
1_anesthetic injections through noninfected tissue
2_dental radiographs
3_suture removal, fluoride treatment
4_bleeding from trauma to the lips or oral mucosa.
5_ تقويم الأسنان و تعويضات البروس

Antibiotic prophylaxis regimens🥸

Cephalosporins should not be used in an individual
with a history of anaphylaxis, angioedema, or urticaria
with penicillins or ampicillin.

بدال هل شي ننطيهم كاجراء وقائي
0.2% Chlohexidine mouth washes

_• In patients who are already taking penicillin or amoxicillin
حتكون عدهم
streptococcus viridans that are relatively resistant to penicillin or amoxicillin.

بدل هل شي ننطيهم
• Clindamycin, azithromycin, or clarithromycin

_Cephalosporins should be avoided because of cross resistance.

الافضل انو تنتضر 10 أيام بعد منكمل العلاج بالمضادات الحيوية قبل لا انطي prophylactic antibiotics

اذا جانت الدنتل بروسيجر حطول أكثر من 6 ساعات ف يفضل ننطي additional
prophylactic dose

Thank you 😊🙏

ملخص جراحة محاضرة 4

Infective endocarditis 🥸
defined as a microbial
infection of the endothelial surface of the heart or heart valves
يكون اما وراثي أو مكتسب

intracardiac effects include :
valvular insufficiency ، myocardial abscesses,

البكتيريا هي المسبب الرئيسي لكن الفطريات والكائنات الحيه هم ممكن تسبب انفكشن لذالك استخدمنا مصطلح
infective endocarditis (IE)
حته يشمل كل الكائنات
Classification🥸

1_causative microorganism

2_The type of valve that is infected (e.g., native valve ,prosthetic valve)

3_ The source of infection; من المستشفى ، من المجتمع ، من دوا ، من حقن بالوريد

Etiology🥸

1_Streptococci are the most common cause of IE 30%-65%,
2_oral flora and gastrointestinal tract, remain the most common cause of community acquired NVE.

coagulase-positive Staphylococcus aureus🥸 which is the most common pathogen in IE associated with IV drug
abuse and nonvalvular cardiovascular device infections.

حاليا تعد
, S. aureus has emerged as the
most common cause of IE

بينما
streptococci have decreased.

اخر شي مجموعه الكائنات الأقل اقل شيوعا هو كروب e HACEK group
كل كائن يبدي بأول حرف من هاي الكلمة

Predisposing conditions attributed to IE include: 🥸

- Mitral valve prolapse 25%-30%.
- Aortic valve disease 12%-30%.
- Congenital heart disease 10%-20%.
- Prosthetic valve 10%-30%.
- Intravenous drug abuse 5%-20%.
- No identifiable condition 25%-47%.

Pathophysiology🥸

المرض عباره عن سلسلة من الاحداث تشمل :
1_damage to an endothelial surface,
غالبا يكون cardiac valve leaflet

2_ Fibrin and platelets
حيلتسقن endothelial surface a ويسوون mass اسمها nonbacterial thrombotic endocarditis

هاي الماسيز مابيها مايكرو اورگانزم
3_ من يصير عندي bacteremia حتلتسق المايكروبات بهاي الماسيز

4. Additional platelets and fibrin are then deposited onto the surface of the mass
يعني حيصيرن مثل غلاف وقائي للبكتيريا
5. The clinical outcome results from:

1_destructive intracardiac (valvular)
2_Embolization resulting in infarction
3_Hematogenous seeding

Signs and symptoms🥸
الفترة بين تسمم الدم البدائي وضهور اعراض IE تكون

less than 2 weeks in more than 80% of patients.

_Fever
_Heart murmur.
_Petechiae
_Osler's nodes (small, tender, subcutaneous nodules that develop in the pulp of the digits)
They are caused by immune-complex
deposition.

_Janeway lesions (small, erythematous or hemorrhagic, macular nontender lesions on the palms and soles)

_Splinter hemorrhages in the nail beds

_Roth spots (oval retinal hemorrhages with pale centers). Caused by immune complex mediated vasculitis

_Splenomegaly
_Clubbing of the digits.
_Positive blood cultures in most cases.

Although up to
30% of cases of IE are initially found to be “culture negative
خاصة الي اخذو انتي بايوتك قبل التشخيص

Diagnosis🥸

Major criteria:
1. Positive blood cultures.
2. Evidence of endocardial involvement (e.g., positive echocardiography, presence of new valvular regurgitation.

Minor criteria:
1. Predisposing heart condition or IV drug use.
2. Fever.
3. Vascular phenomena
4. Immunologic phenomena.
5. Microbiologic evidence other than positive blood culture.

التشخيص النهائي اما عندي 2 معايير رئيسية ، أو واحد رئيسي و 3 ثانويات ٫ أو 5 ثانويات
Complications🥸

• Heart failure as a result of severe valvular dysfunction.

_Embolization of vegetation fragments leads to stroke, MI, pulmonary embolism
وهاي الخثره ممكن تشمل اجهزه أخرى وتسويلي تلف بيهن
_Renal dysfunction is also common and may be due to immune complex glomerulonephritis or infarction.

Dental management 🥸

IE is most often due to a
bacteremia that results from an invasive dental procedure,

ويمكن الوقاية من IE عن طريق اعطاء المضادات الحيويه قبل البروسيجر

تجرثم الدم ممكن سببه العادات اليومية مثل التفريش ، استخدام الخيط ، المسواك وغيرهن.

حالات القلب الي تكون Highest Risk لل IE ولازم نحذر منها هي

1. Prosthetic cardiac valve
2. Previous infective endocarditis
3. Congenital heart disease
4_• Unrepaired cyanotic CHD
5_Completely repaired CHD ٫ with prosthetic material or device by surgery

ملخص بريو المحاضرة 3

Cementum🥸
It is a thin specialized calcified tissue covering of the root surface. Which develop from
undifferentiated mesenchymal
cells in the connective tissue of the dental follicle.

عنده خصائص تشبه العظم بس يختلف بما يلي:
It’s microscopic organization.
 Has no innervation
 Does not undergo physiological remodeling
بس يصير بي deposition throughout life

Functions of cementum 🥸

1_attach of the tooth in the alveolus
2_To attach the PDL fibers to the teeth
3_To contribute to the process of repair
after damage to the root surface

Cemento- enamel junction (C.E.J) 🥸
Three types of relationships

_Cementum overlaps the enamel (60%-65%)
_Edge-to edge (30%)
_Cementum & enamel fail to meet (5%-10%)

بالحالة الأخيرة ممكن يصير عدنا
gingival recession which may result in
sensitivity because the dentin is exposed.

ممكن هاي العلاقات الثلاثه نلكاهن بنفس السن

There are two types of cementum🥸

1.Primary (acellular cementum):-
 Is the first to be formed in
conjunction with root formation &
tooth eruption.
 It does not contain cells
 Sharpey's fibers make up most of its
structure .
 Generally it covers the cervical third
of the root


2.Secondary (cellular cementum):
formed after tooth eruption & in
response to functional demands

_grows faster & over a thin
layer of acellular cementum at the apical
third of the root & furcations of
multirooted teeth .

_This type of cementum contains cells
(cementocytes)and sharpey's
fibers occupy a smaller portion

_Cellular cementum is less calcified than
the acellular type.

Microscopic feature of cementum🥸
Both acellular cementum & cellular cementum are arranged in lamellae separated by incremental lines parallel to the long axis
of the root .

هاي الخطوط تمثل
rest periods”
in cementum formation & they are more mineralized than the adjacent cementum.

Reversal line:-
The newly formed cementum is demarcated
from the root by a deeply staining irregular
line

Structure Of Cementum:🥸

1_Fibrous elements (collagen fibers) which is composed of type I (90%)
and type III (about 5%) collagens.

2_Cellular elements.
3_ Calcified interfibrillar matrix

1.Fibrous elements🥸

1_Extrinsic fibers (sharpey's fibers): which are the embedded
portion of the principal fibers of the PDL & are formed by the fibroblast cells .
هاي الاياف تشكل اغلب بنية acellular cementum

تشكل زاوية قائمة وي سطح الروت

b. Intrinsic fibers: produced by cementoblast cells ، parallel to the long axis of the root

2.Cellular elements: 🥸

تتكون ب pdl
A. Cementoblast cells: responsible for the formation cellular & acellular cementum.

B. Cementocyte cells: are found only in
cellular cementum
هاي الخلايا تتواصل مع بعضها بواسطة canaliculi
هاي القنوات ينقل بيها nutrients
to the maintenance of the vitality of this tissue.

3_ Fibroblast cells: these cells belong to the PDL responsible for synthesis of principal fibers
هاي الخلايا تشارك بطريقة غير مباشرة بتخليق السمنت

4_ Cementoclast cell: responsible for root
resorption
Permanent teeth do not undergo resorption but localized cemental resorption may occur which appears as concavities in the root surface

اما بسبب
Local conditions i.e. trauma from occlusion, orthodontic movement, cyst & occur on mesial surfaces in association with mesial drift.
أو
Systemic conditions ie. calcium deficiency and hypothyroidism.

Trauma from occlusion Forces that exceed the adaptive capacity of the periodontium & produce injury.

Interfibrillar matrix🥸

These are composed of proteoglycans , glycoproteins and phosphoproteins formed by cementoblast cells

Proteoglycans are most likely play a role in regulating cell-cell & cell-matrix interactions
during the regeneration of cementum

Mineralization of cementum:🥸
Occur by deposition of the hydroxyapatite crystals,
first within the collagen fibers,
later upon the fiber surface & finally in the
interfibrillar matrix

Cementum mineralization is less than that of the bone, enamel and dentin.

ملخص اوبرتف محاضرة 3

Patient Assessment, Diagnosis and Treatment Planning🥸

Before the examination and diagnosis, attention is given to infection control. Before, during and after any patient visit

Patient Assessment🥸

1. Medical History
medical history that helps to identify conditions that could alter, complicate or contraindicate dental procedures.

Ex:

A _Contagious diseases: that require special precautions, procedures, or referral.
B _ Allergies or medications : that may contraindicate the use of some drugs.
C_Systemic diseases and cardiac abnormalities: that demand prophylactic antibiotic
D_Physiologic changes associated with aging may alter the clinical presentation


2. Chief Complaint 🥸
▪ the first information obtained
Chief complaints are symptoms or problems
expressed by the patient in his own words

By this discussion, the dentist accomplishes many important goals:🥸

1_ مشاعر المريض بحيث تتقوى العلاقة بين دكتور والمريض
2_determine the cause and treatment of the complaint

3. Dental History🥸

تاريخ العلاجي السابق ينطيني تصور حول
patient's tolerance for dental treatment

Patients may not volunteer this information;
مثل
thermal sensitivity, discomfort during chewing, gingival bleeding, and pain

4. Clinical Examination 🥸

observing both normal and abnormal conditions.


_The intraoral assessments involve an examination of the
periodontium, dentition, and occlusion

_The clinical examination systematically in a clean, dry, well- illuminated mouth.

ادوات الفحص :
mirror, explorer, and periodontal probe

_An accurate examination can occur only when the teeth are clean and dry مهم

لازم نسوي
initial scaling, flossing, and a toothbrushing
قبل الفحص

Elements of the clinical examination include:🥸

1. Evaluation of the Dentition:

A. Assessment of caries risk and plaque:

B. Detection of caries lesions:
1. Pit and fissure caries lesions:
It may begin in small enamel defects that lie near DEJ
هاي التسوسات متبين بالاشعه بالبداية لازم تكون أكثر امتدادا حته تبين

examination with sharp explorer into fissure
And sticky sensation felt on the removal of the explorer has been sign of pit and fissure caries.

اثبتت الدراسات إن هاي الطريقة unreliable
لان تنطيني نتائج
false-positive and false-negative diagnosis

بالإضافة انو
explorer can cause cavitation in a demineralized pit

مما يؤدي إلى
preventing the possibility of remineralization.

_Visual observation with magnification of a clean dry tooth has been found to be reliable non destructive method.

_Pit and fissure lesions appear as a gray or gray-yellow opaque area

_Fiberoptic transillumination
هاي الاضاءة هم تكشفلي عن التسوس

2. Smooth-surface caries lesions🥸

Proximal caries are the most difficult to detect clinically، usually detected by radiograph in posterior teeth

_while in anterior teeth may be diagnosed radiographically or with visual examination; using transillumination.

_Smooth caries on the buccal and lingual surfaces detected by visual and tactile examination.

C. Assessment of the pulp🥸
1_The application of cold and hot ( vitality testing.)

اما نخلي قطنة مشبعه tetrafluoroethane تتخلى على السن حته نشوف حيويته
or a pencil of ice made by
freezing water inside a sterilized anaesthetic
cartridge.

_Hot application by applying a heated
piece of gutta-percha on the tooth surface

2_Electric pulp tester
طريقة ثانية لاختبار الحيوية بس بيها شروط
it cannot be used in a wet field or on teeth
with metallic restorations
اذا ماخذنا تدابير عزل الأسنان المجاوره

_Also the method does not reflect
the health of the pulp

3_A test cavity :
Used when thermal and electric pulp tester failed

So the preparation initiated without using
anesthetic. If pain or sensitivity is elicited when dentin is cut with a bur, pulpal vitality is confirmed.

Other tests that should be conducted during examination are: 🥸

Percussion test : tapping the occlusal or incisal surfaces with the
end of the handle of a mouth mirror to determine the presence of tenderness

ملخص اورثو عملي محاضرة 2

Z-Spring🥸

It is used to push one anterior
tooth from the lingual (palatal) side in a labial direction (linguo- labially or palatolabially).

Components🥸

1. Three equal arms: the first of them (active arm) has a non-traumatic end directed away from the gingiva ، This arm is directed to the mesial side unless the tooth is rotated so it is directed to the site of rotation.

2. Two coils 2-3 mm : in internal diameter to increase the flexibility of the wire and
decrease its force. The direction of the first coil is upwards while the second coil is
downwards to keep the spring in one plane

3. Retentive arm (tag): is embedded in the acrylic base plate for retention of the spring into the acrylic. It is zigzag in shape and parallel to the palate midline.

Properties🥸
1. Constructed from 0.5 mm hard stainless steel wire for incisors and 0.6 mm for
canines.
2. Its width is equal to the mesio-distal width of the tooth

3. The active arm sits on the cingulum and the coils perpendicular with the arms to prevent slippage of the wire.

4. The spring is covered by a thin layer of acrylic from the acrylic base-plate to prevent
food accumulation in the area , trauma to the wires, and slippage of the spring
in an incisal direction.

Uses 🥸
1. The main use is the correction of an anterior crossbite of one tooth

2_ Correction of rotation of one incisor less than 90°


....
Alternatives: 🥸
1. T-springs when space is very limited as in the premolars.
2. Screw.


Modification 🥸
The modified Z-spring has a non-traumatic end, extending on the labial surface of the
incisor or canine to give a slight mesiodistal movement in addition to the palato-labial
movement

For activation, we must open the first coil initially to move the tooth distally
and in subsequent visits we open both coils during activation

Thank you 😊👍

#ortho

اورثو عملي 2

ملخص مدسن محاضرة الاولى

The Pancreas🥸
organ of the digestive system and endocrine system located in the abdomen behind the stomach and functions as a gland.

_99% of the pancreas is exocrine and 1% is
endocrine

_it functions mostly to regulate blood
sugar levels, secreting insulin, glucagon,
somatostatin, and pancreatic polypeptide

islets of Langerhans:عبارة عن خلايا موزعه في البنكرياس

contain 1 alpha cells, 2 beta cells, and 3 delta cells, alpha cells (secreting glucagon) and beta cells secreting insulin

_When blood glucose levels are low, alpha cells secrete glucagon, which increases blood glucose levels 😊

_When blood glucose levels are high beta
cells secrete insulin to decrease glucose in blood.😒

_Delta cells secrete somatostatin which😃 decreases the release of insulin and glucagon

Blood Glucose Regulation🥸

Glucose is a simple sugar ( monosaccharide)
it is stored in tissue as glycogen

الجسم يحصل على الكلوكوز من 3 مصادر

1_absorption of food from the breakdown of glycogen

2-the storage glucose found in the liver and muscles

3- gluconeogenesis, i.e. the generation of glucose from non-carbohydrate
substrates in the body like amino acids or fatty acid.

3- gluconeogenesis, i.e. the generation of glucose from amino acids or fatty acid.

Glucagon🥸
main catabolic hormone in the body
It acts to increase glucose levels by glycogen to glucose in the liver It also decreases the
uptake of glucose in fat and muscle

يتحفز من يقل سكر الدم أو أثناء الرياضة

Insulin🥸

considered to be the main anabolic hormone of the body
acts to decrease blood glucose levels by facilitating uptake by cells
خاصة العضلات الهيكليه
and promoting its use in the creation of proteins, fats and carbohydrates.

ينظم عملية التمثيل الغذائي للكربوهيدرات والدهون والبروتين عن طريق تعزيز امتصاص الجلوكوز من الدم إلى خلايا الكبد والدهون والعضلات

بهاي الخلايا الكلوكوز يخزن على شكل جلايكوجين
بعملية glycogenesis أو يخزن على شكل دهون ثلاثية
بعملية lipogenesis

وبالكبد يخزن كدهون و ك جلاجوجين

The Connecting Peptide🥸
C-peptide connects insulin'

diabetes or hypoglycemia, a measurement of C-peptide blood serum levels
can be used to distinguish between different conditions with similar clinical features

Diabetes Mellitus 🥸
It is syndrome characterized with deficiency of insulin or insensitivity of its receptors in the cells or both

symptoms, like thirst, increase urine
amount , weight loss.

If the amount of insulin is insufficient, or if cells respond poorly to insulin (insulin resistance), then glucose is not absorbed by the body cells and not stored in liver and muscles

اذا بقى سكر الدم عالي كل الوقت
kidneys reach a threshold of reabsorption
وحيطرح الجسم السكر مع اليورن
هل شي حيزيد الضغط الاوزموزي لليورن وبتالي حيمنع إعادة امتصاص الماء وبتالي حيصير عدنا polyuria
and increased fluid loss

نتيجة فقدان السوائل حيقل حجم الدم وبتالي حنعوض هذا النقص من سوائل الجسم ف حيصير عدنا جفاف و عطش

كذالك نقص الكلوكوز بالخلايا حيفتح الشهيه

polyphagia : excessive food intake

Type 1 diabetes 🥸
loss of the insulin-producing beta cells
leading to complete insulin deficiency.

This type classified as immune-mediated (type 1a) or idiopathic (type 1b)

autoimmune attack leads to the loss of beta cells and insulin It causes approximately 5-10% case

T1D in adults is lower than in children

Type 2 diabetes🥸
is insulin resistance, which may be combined with reduced insulin secretion. The defective responsiveness of body tissues

_Type 2 diabetes is the most common type of diabetes mellitus.

المرضى بالنوع الثاني سبق وعدهم تاريخ ب prediabetes

diabetes can be slowed or reversed by lifestyle changes or medications that improve insulin sensitivity or reduce the liver's glucose production.

Type 2 diabetes is primarily due to lifestyle factors and genetics

Gestational diabetes 🥸
سكر الحمل يشبه سكر النوع الثاني
It occurs in about 2–10% of all pregnancies and may improve or disappear after delivery.

get tested starting
around 24–28 weeks gestation

https://www.instagram.com/reel/DBgUCKmtZmb/?igsh=azJiYmpyNXM4d2l3

https://www.instagram.com/dr_zainab_u2020?igsh=MW1rcDNzbWxwdHB0Nw%3D%3D&utm_source=qr

الحساب عباره عن معلومات وهلمعلومات صح سهلات بس الكل ينساها 🌚 ادخل للحساب سوي فولوا متخسر شي 🌚🫠👇🏻🫶🏻

https://www.instagram.com/reel/DBVacq2N7MG/?igsh=ZXZybGZzbWl5azhs

تريد تعرف شنو هو الabscess بطب الاسنان ؟!

شوف هذا الريلز 👇🏻

🖇️ Periodontics MCQ Fourth Stage .

⚜️مَصدر 𝐌𝐂𝐐 لإمراض اللثة - المرحلة الرابعة .

#perio_fourth

معلومات خفيفه جدا ومفيده ايضاً 🌚🫶🏻

https://www.instagram.com/reel/DBRdcpctquT/?igsh=aGVzc3hjY3VjaHky

مجموعة من اسئلة للمواد التقويميه
شاركوهم 👆🏻

Special dentistry pinned «Lec1/ صناعة 👆🏻»

Lec1/ صناعة 👆🏻

🖇️ تحديد المُهم لـ المُحاضرة الأولى .

- اللي يكونن مُهمات دائماً يجي منهم حتى بالوزاري العام السابق كذلك اللي كاتبتهم كأرقام هذولي مُهمات .
- الهياكل أهم شيء اللي مَحددته وكذلك تعرفون هي سبورت او ريليڤ

#pros_fourth