Laboratory Communication. If the clinician is to transfer these important parameters of the maxillary dental midline, the lack of midline cant, and the incisal horizontal plane to the dental technician, which should all be referenced to the facial midline and interpupillary line, how is this reliably accomplished?

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• Simplifying Posterior Dental Anatomy
• Anterior Anatomy And The Science Of A Natural Smile Pdf Software Download
• Anterior Anatomy And The Science Of A Natural Smile Pdf Software 2017

• Cerec SW 4.2 and PRSD are CAD/CAM software that can be used for designing anterior restorations and may require frontal photographs and intra-oral digital impressions to design ceramic restorations. VisagiSMile and DSD App share the use of the concept of visagism which suggests that temperament can be used as a factor in smile design.
• Professionals in the field, on the art and science of cosmetic dentistry. 108 Individualizing a Smile Makeover (CE article) ❖. Revitalizing Discolored Anterior Restorations ❖. After the primary and secondary anatomy had been. Preserving natural tooth structure with composite resin.

The sclera of the eye is the white portion at the side of the iris. It continues as the cornea which is the clear central region of the eye through which the iris (eye colour) and pupil (black centre) may be seen. At the medial corner of the eye is the lacrimal lake in which the tears collect. Tears originate in the lacrimal gland on the upper outer aspect of the orbit and flow downwards and inwards across the eye to hydrate the cornea.

Once collected in the lacrimal lake, the tears drain into the nasal cavity. The eye and lacrimal apparatus is shown in Fig. Functional muscle testing of the extraocular muscles. From Drake et al. (2010).The following signs and symptoms are indications for immediate ophthalmology referral ( Brukner and Khan, 2007): ▪severe eye pain ▪persistent blurred vision or photophobia (light sensitivity) ▪diplopia (double vision) ▪markedly impaired vision ▪loss of part of the visual field ▪embedded foreign body ▪hyphemia (blood within the anterior chamber of the eye)Eye injuries may arise from collisions in which a finger or elbow goes into the eye. Small balls (squash balls, shuttlecock) may cause ocular damage, while larger balls (cricket or hockey) are more likely to cause orbital fractures. Mud, grit or stone chips can enter the eye and cause both irritation and damage.

It is interesting to note the speed at which a ball may move. In squash, the ball can travel at 140 m.p.h., in cricket at 110 m.p.h. And in football 35–75 m.p.h. ( Reid, 1992). A small object travelling at these speeds obviously creates considerable force and potential for damage.

This is borne out by the sad fact that over 10% of eye injuries in sport result in blindness in that eye ( Pashby, 1986). KeypointAn eyewash bottle (sterile water) is an essential item for first aid in sport. With the athlete sitting, pour water into the inner corner of the eye while they look up, right, left, and then down.In some instances, particularly if the foreign body is an eyelash, the eyelid may be rolled back on itself. This procedure is carried out by first asking the athlete to look down.

The practitioner then grasps the lashes of the upper lid, pulling them gently down and out, away from the eye. A cotton swab is placed on the outside of the lid level with the lid crease. The lashes are then folded upwards over the swab to reveal the inside of the eyelid, and the foreign body is washed away. The eyelid goes back to its normal position when the athlete looks up and blinks.A foreign body is one of the most common eye problems on the sports field.

The reaction is usually pain and tear production. If the object is not removed, blinking may cause corneal abrasion and extreme pain for about 48 hours. It is important not to allow the athlete to touch the foreign body as this will simply increase the area of abrasion. If the object cannot be washed out easily, cover the eye with a sterile dressing and take the athlete to hospital. Encourage the athlete to keep the eyes still as movement of the uninjured eye will also move the injured one increasing tissue damage. KeypointContact lenses should not be re-inserted until the eye has healed and been completely symptom free for 24 hours following injury.When contact lenses become dislodged, the wearer, with the aid of a mirror, is often the person most capable of removing them.

Hard lenses may be removed with a small suction cup available from an optician, and persistent soft lenses may be dislodged by water from a squeeze bottle, or by gently wiping with a cotton swab.Following injury, basic vision assessment should be carried out and if any abnormalities are detected the athlete should be referred to an ophthalmologist. A distance chart (placed 6 m from the subject) and a near vision chart (35 cm from the eyes) should be used. Failure to read the 20/40 line on either chart is a reason for referral ( Ellis, 1987). Visual fields are tested in all four quadrants.

One eye is covered, and the athlete should look into the examiner's eyes. The examiner moves a finger to the edge of the visual field in both horizontal and vertical directions until the athlete loses sight of it. Decreased visual acuity or loss of the visual field in one area warrants referral ( Ellis, 1987). KeypointMost sports injuries to the eye could be prevented if athletes wore eye protection.Individual athletes should also protect themselves. The eye protectors worn must be capable of dissipating force, but should not restrict the field of vision or the player's comfort. In addition, if they are to be acceptable to a player they must be cosmetically attractive and inexpensive.Each sport will have its own specific requirements. Where the blow is of great intensity, the eye protector must be incorporated into a helmet, and if there is a danger of irritation (chlorine in a swimming pool) the material used must be chemically resistant.

Goggles for skiing must filter out ultraviolet light, while those for shooting may have to be suitable for low light conditions or capable of screening out glare.For general protection in racquet sports, polycarbonate lenses mounted in plastic rather than wire frames are the choice. The nasal bridge and sides of such a protector should be broad and strong to deflect or absorb force. Facial nerve distribution ( Fig.

16-4): All facial muscles are innervated from the underside. 1.The temporal branch innervates the frontalis, corrugator, procerus, and orbicularis oculi (upper lid). A.The nerve is most superficial as it crosses the zygomatic arch, where it lies beneath the SMAS/TP fascia. B.Injury to this nerve results in paralysis of the forehead and brow. 2.The zygomatic branch innervates the orbicularis oculi (lower lid), buccinator, and upper lip muscles (orbicularis oris, levator labii muscles, zygomaticus muscles) and the ala muscles. A.Injury to this nerve results in paralysis of the upper lip and cheek.

3.The buccal branch innervates the buccinator and the upper and lower lip muscles (orbicularis oris, risorius, depressor anguli oris). A.Injury to this nerve results in paralysis of the upper lip and cheek. 4.The marginal mandibular branch innervates the lower lip muscles. A.Injury results in paralysis to lower lip. Ted Wojno, in, 2012 The Lower Eyelid and Surrounding TissueThe surface anatomy of the lower eyelid has several important cosmetic elements (see Fig. The lid-cheek junction delineates the inferior orbital rim and is accentuated by the orbital septum, arcus marginalis, and orbitomalar ligament. A prominent nasojugal groove, known as a tear trough deformity, can be of cosmetic importance and is often the target for periocular injectable fillers or fat repositioning.

Younger patients may also have lower eyelid folds. Nasally, an epicanthal fold may extend from the lower lid toward the upper lid.There are three anterior orbital fat pockets in the lower lid. The medial and central fat pockets are separated by the inferior oblique muscle, which is frequently encountered during lower blepharoplasty and should be left untouched. The arcuate expansion of the inferior oblique separates the central and lateral pockets and can be violated without consequence. The lacrimal sac is deep and medial to the nasal fat pocket and is easily avoided.

The medial palpebral artery is often encountered in the medial fat pocket and frequently requires attention (see Fig. William Townley, in, 2017 Superficial LandmarksThe surface anatomy of the facial nerve is critical to both facial reconstructive and esthetic surgeons. In the infant and young child, landmarks are not as reliable because of differences in the rate of anatomic development of the parotid gland and mastoid.The main trunk is commonly identified in relation to the tragal pointer (1 cm deep and 1 cm inferomedial) and the medial attachment of the posterior belly of digastric (1 cm deep).

The anatomical landmarks of the terminal branches have been extensively studied. The trajectory of the frontal branch is classically defined by Pitanguy's line—a line drawn from a point 0.5 cm inferior to the tragus to a point 1.5 cm superior and lateral to the eyebrow, although this has been widely criticized as reliant on soft landmarks and therefore inconsistent. 1,2The zygomatic branch is rarely injured during approaches to the mid-face, although a transient paresis has been observed in up to 5% of zygomatic fractures accessed through a coronal approach. 3 In one cadaveric study, the zygomatic branch was identified at a mean of 30.71 mm anterior to the tragus at the anterior border of the parotid and 19.29 mm inferior from the midway point of the tragus and lateral palpebral commissure. 4A common area for injury of the buccal branch is at its exit point from the parotid within the loose areolar sub–superficial muscular aponeurotic system (SMAS) tissue anterior to the gland. The buccal branch is most frequently located inferior to the parotid duct. The facial nerve branch that innervates the zygomaticus muscles is of great interest in facial reanimation surgery because it is responsible for the smile action.

The actual branch is a middle facial nerve branch that is often attributed as a buccal branch, although it may have a zygomatic component. In an elegant anatomic dissection study, it was shown to be reliably found at Zuker's point, the midway point on a line drawn from the root of the helix and the lateral commissure of the mouth. 5The marginal mandibular branch of the facial nerve is frequently encountered during various surgical approaches. Marginal mandibular branch injury has been reported following parotidectomy, neck dissection, rhytidectomy, reduction of mandibular angle fractures, and other forms of surgery in the submandibular region. 1 Its anatomy is variable but is often described in relation to the inferior border of the mandible, being up to 2 cm below it. 6,7The cervical branch of the facial nerve supplies platysma.

Cervical branch injuries have little functional consequence, although the anatomy is of interest due to the application of cervical motor branches in brachial plexus reconstruction. The cervical branch of the facial nerve has been shown to be reliably located within 1 cm below a perpendicular line from the angle of the mandible to a line drawn from the mentum to the mastoid process (see Figure 50-1).

Stephen Caldwell, in, 2018 Incorrect Size and Shape of Block Graft Etiology.The recipient surface anatomy of a bony defect is typically irregular in its size and shape, which presents the clinician with a challenge as it pertains to grafting. In areas where block grafts are necessary to build appropriate bone volume, the clinician must make a choice whether to modify the shape of the block or the recipient site to ensure a proper integration and resolution of the defect. An ideal graft/recipient position eliminates as much space between the two surfaces as possible. Complication.Failure to properly adapt a cortical graft to closely approximate the recipient bed will often lead to a gap that could inhibit early angiogenesis and eventually osteogenesis. A block that is “inlayed” into the recipient site limits this gap and allows proper integration of the newly forming bone into the recipient bed. Rocking of a cortical graft will invariably lead to a failed union of the cortical graft with the recipient bed.

Micromovement of any graft leads to poor results, if not outright failure. Prevention.A thorough examination of the anatomy of the bony defect is required to determine the dimensional volume of bone needed for proper support of the implant in the required restorative position.

This dimensional volume must then be realistically assessed to make sure that the donor site will provide a graft with adequate bone thickness for the size and shape of the defect. When a recipient site requires more than 4 mm of bone, grafting from the ramus area is not indicated. Anatomic limitations of the ramus in this region limit the thickness of the graft to 3 to 4 mm. Larger grafts in the ramus can impinge on the safety zone around the surrounding vital structures.All fibrous tissue must be removed from the surface of the recipient site using a course, round acrylic bur (e.g., 10-12 round bur).

The bed of the graft site is then aggressively shaped to provide a flat-surfaced base for the graft. If possible, the block should be recessed into the ridge for support and for improved integration into the native bony ridge. The reshaping of the recipient bed stimulates a regional acceleratory phenomenon (RAP), improving the chances of a strong bond between the block and the recipient bed. Block preparation. First, the surface anatomy of the femoral artery and the SIEA is marked on the skin after Doppler ultrasound identification. 35,105,106,126 Then the planed flap design is transduced to the lower abdominal wall, keeping the SIEA in the center of the flap.

The SIEA emerges from the femoral artery between 2 and 4 cm below the inguinal ligament. Here the Y-shaped skin incision is performed to start off the dissection from caudal to cranial direction. The SIEV and the SCIV, the SIEA and the SCIA, or their common trunks are identified. Following these vessels cranially, the flap is raised superficial to the aponeurosis of the external oblique abdominal muscle and flap harvesting is completed ( Figures 42-46 to 42-48).

In, 2014Chapter 1 discusses surface anatomy. It contains information useful not only to the student who has yet to palpate his or her first patient, but also to the clinician who examines patients on a daily basis.

Chapters 2 and 3 Chapter 2 Chapter 3 relate the general characteristics of the spine and spinal cord, using a basic approach. These chapters are directed primarily to the novice student. A quick review of these chapters, with attention focused on the sections highlighted by red brackets, should also be of benefit to the more advanced student. Chapter 2 includes a section on advanced diagnostic imaging. This section is provided for the individual who does not routinely view advanced imaging.

A brief description of the strengths and weaknesses of computed tomography and magnetic resonance imaging and a concise overview of other less frequently used advanced imaging procedures are included. Chapters 3 and 4 Chapter 3 Chapter 4 relate soft tissues to the “bones” by describing the spinal cord and its meningeal coverings, and the muscles that surround and influence the spine. This material is followed by a detailed study of the regional anatomy of the spine in Chapters 5 through 8 Chapter 5 Chapter 6 Chapter 7 Chapter 8. These chapters also include information concerning the ligamentous tissues of the spine. A more thorough presentation of the anatomy of the spinal cord and autonomic nervous system is found in Chapters 9 and 10 Chapter 9 Chapter 10, and the development (from inception to adulthood) and histologic composition of the spine and spinal cord are found in Chapters 12 through 14 Chapter 12 Chapter 13 Chapter 14. Knowledge of the surface anatomy of the chest can be extremely valuable clinically:.The angle of Louis, which is the ridge produced by the manubriosternal joint, lies at the level of thoracic vertebra T4, but more useful is the site of the second costochondral junction marking the second rib from which subsequent intercostal spaces can be defined. These features also mark the upper limit of the surface markings of the heart.The 4th intercostal space marks the dome of the diaphragm and the uppermost edge of the liver.

RibsRibs generate a negative pressure for respiration (−5 to −15 mmHg).When aspirating or inserting a chest drain, the position of the neurovascular bundle should be remembered and access should be achieved by running the needle or drain over the rib rather than under it. The fifth intercostal space in the mid-axillary line is usually used, but in pregnancy it is best to go up one space to allow for the raised diaphragm.The higher level of the diaphragm in pregnancy is also relevant in situations of trauma to the chest which is more likely to involve intra-abdominal organs.The parietal pleura is innervated segmentally from the intercostal nerves and therefore when inflamed produces pain which is referred to the cutaneous distribution of that nerve. Thus anterior abdominal wall pain can arise from pleural irritation mimicking an abdominal event. The diaphragm.

Simplifying Posterior Dental Anatomy

This is a musculotendinous structure which separates the thorax from the abdomen. It arises from:.The xiphisternum.The lower six ribs and their costal cartilages.The medial and lateral arcuate ligaments.The first three lumbar vertebrae on the right/first two on the left (right and left crus) and fuses into a trifoliate central tendon below the pericardium.The motor nerve supply is from the phrenic nerve (C3 45), and sensory supply is from the lower six intercostal nerves. The blood supply comes from the lower intercostal arteries superiorly, and the phrenic arteries (branches of aorta) inferiorly.

The three main openings in the diaphragm and their vertebral levels are as follows: 1.The aortic opening at the level of T12 transmits the aorta with the thoracic duct and the azygous vein (from left to right). 2.The oesophageal opening which passes through the right crus of the diaphragm at the level of T10, and also transmits the left gastric artery and both vagi. 3.The inferior vena cava runs through the central tendon at the level of T8 together with the right phrenic nerve.Other structures which penetrate the diaphragm include the greater and lesser splanchnic nerves and the sympathetic chain. Figure 2.9 illustrates the surface anatomy of the back. Surface features of the trapezius and the latissimus dorsi can be examined at the back.

The superolateral border of the trapezius is seen and felt in the lower part of the neck. This can be made more prominent by raising the point of the shoulder against resistance. The spinous processes of the vertebrae are palpable in the midline.

They can be made more prominent by bending the trunk forward. The lateral border of the latissimus dorsi is visible as the posterior axillary fold. The muscle can be palpated here by adducting the abducted arm against resistance. The medial border, the inferior angle and the spine of the scapula and the acromion are also seen. As the scapula contributes to the movement of the shoulder, the mobility of the shoulder joint (glenohumeral joint) is assessed by immobilising the scapula by holding on to it at the back.

Anterior Anatomy And The Science Of A Natural Smile Pdf Software Download

The anatomy of the smile is an integral part of dentistry. Its understanding involves close scrutiny of all elements of the oral region. It is not enough to establish the size of teeth based on the high and low lip lines, size of the mouth, and a shade to blend with the age and complexion. To create a harmonious smile the dentist must maintain or create the normal curvature of the lips, proper exposure of the red zone of the lips, an undistorted philtrum, and undisturbed nasolabial grooves. These entities, maintained in harmony with the exposed teeth, constitute the anatomy of a smile.In order that patients may be served properly, the smile must be understood, recorded, and analyzed so that desirable aspects may be preserved and graceless components returned to attractiveness.

Anterior Anatomy And The Science Of A Natural Smile Pdf Software 2017

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