TOC¶
using dot cross or matrix to solve a patient signs into disease and treatments. so,there will be no decision errors(the main problem and scam in medicine)
Actually,these calculations made by doctor cognitive skills from his knowledge as we do multiplication in mind from known multiples.so to get solution and to prove, we use paper as like my theory method is used on paper to solve patient and The calculator is my software
(0D)Scalars: have only magnitude or categorical values (e.g., mass ,tooth number, pain score).
(1D)Vectors : While they don't represent "physical" magnitude(scalar) and direction, For example, [pain intensity, swelling level, redness level] forms a vector, where each value corresponds to a specific attribute's magnitude. The "direction" in this context is relationship between them i.e the direction they connected each other
The sum of those vectors i.e both magnitude(scalar) and relation(direction) leads to diagnosis .so likewise using dot cross or matrix to solve a patient signs into disease and treatments. so,there will be no decision errors(the main problem and scam in medicine)
(nD)Tensors: These are next to vectors that can represent relationships across multiple axes (e.g.,severity over time). If there is n different relations(directions) in a magnitude then n tensor .actually in context of programming ,tensors are used for to build ai example tensorflow framework.in context of mathematics tensors used to solve calculus .in context of physics tensors are used for calculating mechanics then why won't we use in medicine
As these Scalars,Vectors,Tensors are fundamental concepts in mathematics,physics,computer science, medicine or any science where to deal with relations and data.
Feature vector Vector representation is +1,-1
Here ,+ is direction 1 is magnitude i.e scalar Also True or false
Use these as classification is called binary classification Multiclass classification
. For example, deciding on whether an image is showing a banana, an orange, or an apple is a multiclass classification problem, with three possible classes (banana, orange, apple), while deciding on whether an image contains an apple or not is a binary classification.
The existing multi-class classification techniques can be categorised into
transformation to binary extension from binary hierarchical classification
Binary classification is the task of classifying the elements of a set into one of two groups (each called class
Class or set Contingency table or matrix or feature construction
Confusion Matrix and Classifiers
Predictive value
classification are:
Decision trees Random forests Bayesian networks Support vector machines Neural networks Logistic regression Probit model Genetic Programming Multi expression programming Linear genetic programming
Presence of cancer is t or f or + or -
Often, the individual observations are analyzed into a set of quantifiable properties, known variously as explanatory variables or features. These properties may variously be categorical (e.g. "A", "B", "AB" or "O", for blood type), ordinal (e.g. "large", "medium" or "small"), integer-valued (e.g. the number of occurrences of a particular word in an email) or real-valued (e.g. a measurement of blood pressure). Other classifiers work by comparing observations to previous observations by means of a similarity or distance function.
An algorithm that implements classification, especially in a concrete implementation, is known as a classifier. The term "classifier" sometimes also refers to the mathematical function, implemented by a classification algorithm, that maps input data to a category.
Terminology across fields is quite varied. In statistics, where classification is often done with logistic regression or a similar procedure, the properties of observations are termed explanatory variables (or independent variables, regressors, etc.), and the categories to be predicted are known as outcomes, which are considered to be possible values of the dependent variable. In machine learning, the observations are often known as instances, the explanatory variables are termed features (grouped into a feature vector), and the possible categories to be predicted are classes. Other fields may use different terminology: e.g. in community ecology, the term "classification" normally refers to cluster analysis.
algorithm (/ˈælɡərɪðəm/ ⓘ) is a finite sequence of mathematically rigorous instructions, typically used to solve a class of specific problems or to perform a computation.[1] Algorithms are used as specifications for performing calculations and data processing
More advanced algorithms can use conditionals to divert the code execution through various routes (referred to as automated decision-making) and deduce valid inferences (referred to as automated reasoning)
As an effective method, an algorithm can be expressed within a finite amount of space and time[3] and in a well-defined formal language
Algorithms can be expressed in many kinds of notation, including natural languages, pseudocode, flowcharts, drakon-charts, programming languages or control tables (processed by interpreters).
So to represent I use Natural language for to read Pseudocode or programming language for software Control tables or matrices for solving with paper Graphs or charts for visuals
algorithm not represent in single formula but in mathematical models and computational methods Formula is
By implementation - Recursion - Serial, parallel or distributed - Deterministic or non-deterministic - Exact or approximate - Quantum algorithm By design [[paradigm]] - Brute-force or exhaustive search - Divide and conquer - Search and enumeration - Randomized algorithm - Reduction of complexity - Back tracking
Optimization problems - Linear programming - Dynamic programming - The greedy method - The heuristic method
Example
One of the simplest algorithms finds the largest number in a list of numbers of random order. Finding the solution requires looking at every number in the list. From this follows a simple algorithm, which can be described in plain English as:
High-level description:
If a set of numbers is empty, then there is no highest number. Assume the first number in the set is the largest. For each remaining number in the set: if this number is greater than the current largest, it becomes the new largest. When there are no unchecked numbers left in the set, consider the current largest number to be the largest in the set. (Quasi-)formal description: Written in prose but much closer to the high-level language of a computer program, the following is the more formal coding of the algorithm in pseudocode or pidgin code:
Algorithm LargestNumber
Input: A list of numbers L. Output: The largest number in the list L.
if L.size = 0 return null largest ← L[0] for each item in L, do if item > largest, then largest ← item return largest
So dentamap algorithm
Input = signs Output = disease and treatment
So list of inputs i.e signs
-¶
Etiology=> signs => diagnosis => treatment
Direct acyclic graph
Etiology=> treatment Treatment => etiology
Etiology inputs are Frequency of water intake Smoking habit
Disease predication and chances. If prediction more then sign exists
Signs algorithm
Divide this big algorithm into parts We classify signs,diseases into anatomical region so parts of algorithm are
Hard tissue (Tooth)
-
Enamel
-
sharp
-
decay
- fracture
- attrition
- Pulp
- Pulpitis
-
supporting structures(Peridontium) - pdl - apical periodontitis - apical peridontal Abscess - Alveolar bone loss - mobility - pocket - recession
By anatomy Pdl and gums => alveolar bone Soft tissues Gums - gingivitis - periodontitis
Systemic
- ulcers
- neoplasm
Flow
Hard tissue -> supporting structures -> soft tissues Soft tissues -> supporting structures -> hard tissue
So, Hard tissue -> soft tissues
At any stage like enamel,pulp, supporting structure
-
record case history
-
spread of infection
- excessive pressure on pdl through tooth
- periodontitis and gingivitis plaque in space
- systemic condition
- hormonal
In sign algorithm
Total 3 main sets I.e hard tissue, peridontium, soft tissues
Hard tissue -> Periodontium -> Soft tissue Soft tissues -> peridontium -> hard tissue
typical Soft tissues -> hard tissue hard tissue-> Soft tissues
![[Hasse_diagram_of_powerset_of_3.png]]
Get in any way => Hard tissue => Periodontium => Soft tissue
And the connection between them
=>Hard tissue -> Periodontium -> Soft tissue =>Hard tissue -> Periodontium =>Periodontium-> Soft tissue*
=>Soft tissues -> periodontium -> hard tissue =>Soft tissues -> periodontium' =>Periodontium → Hard Tissue
=> Hard tissue -> Soft tissue -> Periodontium => Hard tissue -> soft tissue => Soft tissue -> Periodontium'
=>periodontium -> Soft tissue -> hard tissue =>periodontium -> Soft tissue * =>Soft tissue -> hard tissue
- hard tissue algorithm
- peridontium algorithm
- soft tissue algorithm
- thier connection algorithm (as before soft tissue=> peridontium=> hard tissue)
Again Hard tissue algorithm (!missing then enamel algorithm then pulp algorithm) - enamel algorithm - pulp algorithm
So,parts of algorithm are
The reachability relation of a DAG can be formalized as a partial order ≤ on the vertices of the DAG. In this partial order, two vertices u and v are ordered as u ≤ v exactly when there exists a directed path from u to v in the DAG; that is, when u can reach v (or v is reachable from u).[5] However, different DAGs may give rise to the same reachability relation and the same partial order.[6] For example, a DAG with two edges u → v and v → w has the same reachability relation as the DAG with three edges u → v, v → w, and u → w. Both of these DAGs produce the same partial order, in which the vertices are ordered as u ≤ v ≤ w.
The graph enumeration problem of counting directed acyclic graphs was studied by Robinson (1973).[11] The number of DAGs on n labeled vertices, for n = 0, 1, 2, 3, … (without restrictions on the order in which these numbers appear in a topological ordering of the DAG) is be computed by the recurrence relation
Eric W. Weisstein conjectured,[12] and McKay et al. (2004) proved, that the same numbers count the (0,1) matrices for which all eigenvalues are positive real numbers. The proof is bijective: a matrix A is an adjacency matrix of a DAG if and only if A + I is a (0,1) matrix with all eigenvalues positive, where I denotes the identity matrix. Because a DAG cannot have self-loops, its adjacency matrix must have a zero diagonal, so adding I preserves the property that all matrix coefficients are 0 or 1.[13]
Total orders Different total orders may lead to the same acyclic orientation, so an n-vertex graph can have fewer than n! acyclic orientations. The number of acyclic orientations is equal to |χ(−1)|, where χ is the chromatic polynomial of the given graph.[19]
headh¶
heaf¶
hig
Linear extension Topical orientation and ordering DAG Algorithm is if then ,path, unique
Logic Pseudo code If then !
True or false = -1 or +1 = matrix with Direction sum = diagnosis (final relation) = value
feature vector is an n-dimensional vector of numerical features that represent some object. Many algorithms in machine learning require a numerical representation of objects, since such representations facilitate processing and statistical analysis. When representing images, the feature values might correspond to the pixels of an image, while when representing texts the features might be the frequencies of occurrence of textual terms. Feature vectors are equivalent to the vectors of explanatory variables used in statistical procedures such as linear regression. Feature vectors are often combined with weights using a dot product in order to construct a linear predictor function that is used to determine a score for making a prediction.
The vector space associated with these vectors is often called the feature space. In order to reduce the dimensionality of the feature space, a number of dimensionality reduction techniques can be employed.
Higher-level features can be obtained from already available features and added to the feature vector; for example, for the study of diseases the feature 'Age' is useful and is defined as Age = 'Year of death' minus 'Year of birth' . This process is referred to as feature construction.[2][3] Feature construction is the application of a set of constructive operators to a set of existing features resulting in construction of new features. Examples of such constructive operators include checking for the equality conditions {=, ≠}, the arithmetic operators {+,−,×, /}, the array operators {max(S), min(S), average(S)} as well as other more sophisticated operators, for example count(S,C)[4] that counts the number of features in the feature vector S satisfying some condition C or, for example, distances to other recognition classes generalized by some accepting device. Feature construction has long been considered a powerful tool for increasing both accuracy and understanding of structure, particularly in high-dimensional problems.[5] Applications include studies of disease and emotion recognition from speech.[6]
(https://en.m.wikipedia.org/wiki/Linear_predictor_function). Variables and functions
Binary classification
Cons,endo,pros(hard tissue examination) Surgery(jaw) Periodontic([[gingival examination]]) Orthodontic (Functional examination) Oral medicine (systemic examination) Pedo(mixed and primary teeth examination)
- pit and fissure caries
- Proximal caries of posterior
- Mesio-occlusal-distal
- mesio-occlusal
- disto-occlusal
- Distal
-
Mesial
-
Proximal caries of anterior
- Mesial
- Distal
- Facial
-
Lingual
-
Disto-incisial
-
Mesio-incisial
-
Root caries
- Class 6 = cusp tips = attrition
-
Class 5 = root = abrasion
-
discrete mathematics
- logic=>statements,rules,frames
- graph theory=>counting, relationships,direction,matrix Discrete mathematics provides the theoretical framework, and programming applies those concepts practically.
- elements are units
- sets are groups
- relations are sets to sets
- functions are pathology syndrome formulae from normal to atieolgy to diagnosis to treatment. Each variable in function formal is element
-
logic is each variable value and formula inference
-
abnormal
- normal
- missing
- treated
Abnormal tooth¶
- colour
- shape
- size
- Enamel loss
- attrition
- decayed
- eruption
- impacted
- gums
- recession
- Calculus
- mobility
- interdental papillae -itis
Attrition - segment 4 (lower canine to canine)
Calculus - Three sides of tooth - lingual lower anterior seg4 lingual
Medicine - For pathophysiology diseases classification is systemic - For clinical - parts so, pathophysiology - clinical signs - physical - pyschology - philosophy
Timeline - language of health replica(case history) - knowledge base for language logic(textbook-obisidian-doc)
- propositional logic
- sets,relations,function
- computer objects,elements,frames
-
prolog
-
live suggestions to complete sensory input
- rule based for output and input too
-
input(sensory information) and output(calculated by information )
- kenedy,dmft,vitis,
- diagnosis, treatment plan
- perio
- decay -> endo,cons
- surgery
- ortho lines
- normal,missing prostho
Rules¶
parameters¶
0 = absent 1 = present (symptomatic) 2 = severe (unsymtopic) 3 = very severe(signs)
Only Pain,TOP,VT are parameters for pulp and Periapical diseases
Pain 0 = absent 1 = present 2 = absent but present as in history
TOP 0 = absent 1 = present 2 = absent but present as feel different
VT 0 = absent 1 = present 2 = sinus opening
Any tooth with decay we check these. But decay
TYPE Subopacity Cavitation Grossly decayed Root stemps
If subopacity and cavitation are Pain,TOP,VT = 0 then caries = restoration
If subopacity and cavitation are pain,TOP,VT >0 = root canal
Grossly decayed and rootstemps= extraction
Then why you need to diagnose grossly decayed and rootstemps? Pain,TOP,VT =0 = treatment no need Pain,TOP,VT >0 = treatment needed
Pain,TOP,VT = 0 is Pain+TOP+VT= 0 Correct version
If Caries irt then LOCATION
POSTERIOR LOCATION
1 surface - buccal pit and fissure - lingual pit and fissure - Occlusal pit and fissure 2 surfaces - buccal-occlusal pit and fissure - lingual-occlusal pit and fissure
Proximal caries 1 surface - mesial proximal caries - distal proximal caries 2 surfaces - mesio-occlusal proximal caries - disto-occlusal proximal caries - mesio-distal proximal caries
3 surfaces mesio-occlusal-distal
4 surface - mesio-occlusal-distal-buccal proximal caries - mesio-occlusal-distal-lingual caries
-
cervical caries
-
cuspal tip
ANTERIOR LOCATION - lingual pit and fissure
- mesial-lingual
- distal-lingual
- mesial-buccal
-
distal-buccal
-
mesial-incisal
-
Disto-incisial
-
cervical caries
-
incisal
Posterior - pit and fissure => class 1 - proximal => class 2
Anterior - pit and fissure=> class 1 - non-incisal => class 3 - incisal => class 4
Both - cervical caries => class 5 - attrition tips => class 6 - root caries?
[0 0 0] | 0 | normal [0 0 1] | 1 | Not possible [0 0 2] | 2 | Not possible [0 0 3] | 3 | Not possible [0 1 0] | 1 | Not possible [0 1 1] | 2 | Not possible [0 1 2] | 3 | Not possible [0 1 3] | 4 | Not possible [0 2 0] | 2 | Not possible [0 2 1] | 3 | Not possible [0 2 2] | 4 | Not possible [0 2 3] | 5 | Not possible [1 0 0] | 1 | acute pulpitis [1 0 1] | 2 | Not possible [1 0 2] | 3 | Not possible [1 0 3] | 4 | Not possible [1 1 0] | 2 | acute peridontitis [1 1 1] | 3 | acute Abscess [1 1 2] | 4 | chronic abscess [1 1 3] | 5 | abcess [1 2 0] | 3 | chronic periodontitis [1 2 1] | 4 | acute abscess [1 2 2] | 5 | chronic abscess [1 2 3] | 6 | Abscess [2 0 0] | 2 | chronic pulpitis [2 0 1] | 3 | Not possible [2 0 2] | 4 | Not possible [2 0 3] | 5 | Not possible [2 1 0] | 3 | acute peridontitis [2 1 1] | 4 | acute abscess [2 1 2] | 5 | chronic abcess [2 1 3] | 6 | Abscess [2 2 0] | 4 | chronic periodontitis [2 2 1] | 5 | acute abscess [2 2 2] | 6 | chronic Abscess [2 2 3] | 7 | abcess
Signs and chief complaint - bleeding on probe => bleeding gums - pain on probing - pocket - recession - Mobility - calculus - stains
Common Chief complaints - bleeding from gums - bad breath - mobile tooth - increases spacing - food gets stuck - yellow deposits and debris - discoloration - pain on gums - gummy smile - inability open mouth - sensitivity - dark gums
Not necessary all conditions but Any one condition of present leads to diagnosis
Bleeding = acute Not bleeding = chronic
Tooth Attachment-Based diagnosis - Chronic Gingivitis - Chronic Periodontitis - Aggressive Periodontitis - Gingival and Periodontal Abscesses - Pericoronitis/Pericoronal Abscess - Chronic Periodontitis - Aggressive Periodontitis - mild peridontitis - moderate peridontitis - severe peridontitis - advanced peridontitis
Treatment - plaque => scaling - root planing
Why treatment plan
Phase-I - scaling and root planning - plaque control - antibiotic therapy (peridontitis) - local - systemic - periodontal splints (Mobility)
Phase-II - curettage - gingivectomy - gingivoplasty - falp surgery(deep pockets) - resective osseous surgery
0 = absent 1 = present (mild) 2 = (moderate) 3 = severe
Bleeding on probe(sulcus index ,loe and silness) 0 = no bleeding 1 = visible spots , slight colour and edema 2 = blood forms red line , bleeding on probe 3 = heavy bleeding , spontaneous bleeding 4 = necrotized or fibrotic
Recession (Miller ) 0 = < mucogingival junction,complete root coverage 1 = > mucogingival junction,complete root coverage 2 = > mucogingival junction and upto CEJ,partial root coverage 3 = > mucogingival junction,loss of interdental papillae,no root coverage
0 = < mgj 1 = mgi-cej 2 = > cej 3 = complete loss
Pocket= recession= relationship is suprabony and Infrabony Pockets and furcation (periodontal pocket index) 0 = gingival pocket 1 = 2-4 mm 2 = 5-7mm 3 = >8 mm
Mobility (grace and smales index) 0 = no mobility 1 = <1 mm buccal-lingual 2 = 1-2 mm more buccal-lin but not vertical 3 = > 2mm vertical also
Calculus (periodontal disease index) 0 = absent 1 = dental plaque 2 = tartar 3= Calculus interproximal 4 = calculus interproximal and subgingival 5 = calculus interproximal and subgingival and supragingival
Stains
Etiology - dental plaque => brushing - calculus => scaling - host response - smoking - systemic diseases
Gingivitis=>peridontitis=>bone loss=>tooth loss
Pathology - gingivitis - chronic gingivitis - Necrotising ulcerative gingivitis - Desquamative gingivitis (infections) - periodontitis - aggressive peridontitis - gingival enlargement - pericoronitis - periodontal Abscess
Inflammation=
Gingivitis - stage 0 - stage 1 - stage 2 - stage 3 - stage 4
Gingival enlargement - localized - generalized - marginal - papillary - diffuse - disceret
- Grade 0 = no signs of enlargement
- 1 = enlargement of interdental papillae
- 2 = both interdental papillae and marginal papillae
-
3 = covering >3 sides.
-
inflammatory
- fibrotic
Necrotising ulcerative gingivitis - stage 1-7
Localised or generalised based on tooth Chronic mild peridontitis = <2 attachment loss Chronic moderate peridontitis = 3-4 attachment loss Chronic severe peridontitis= > 5 mm attachment loss
Aggressive peridontitis Periodontal Abscess
Rules same as Bleeding= gingivitis or inflammation Recession = peridontitis Mobility= bone loss
We use recession instead of pocket because pocket is not visual and not correct findings
Treatment¶
Plaque control Scaling Root planning Chemotherapeutic agents Modulation Periodontal splints Gingival surger Flap surgery Resective osseous surgery Regenerative osseous surgery Furcation management Periodontal lesions Plastic surgery
Indications Caluclus 1,2,3,4 = scaling
Mobility 2,3 = periodontal splints
- Gingival recession -miller classification
- Bleeding probing - gingival inflammation -acute- percentage of sites
-
purulent exudate or suppuration = chronic periodontitis = infected = digital pressure
-
no loss of attachment (gingival recession ) or no periodontal pocket is diagnosed as gingivitis
But definetly present is obligatory
Pocket is sign of change in peridontium - depth - furcation= Infrabony and suprabony - type
- pocket with bluish red
- bluish red vertical zone extending from marginal gingival to mucogingival
- seperated buccal and lingual interdental marginal gingiva
- enlarged edematous
-
rolled-out
-
Clinical attachment loss = distance from marginal gingiva to base of pocket - distance from gingival margin to CEJ
-
true pocket = peridontitis= Glickman horizontal involvement
- Tarnow and Fletcher vertical involvement
-
5 mm => furcation involvement and bone loss
-
true pocket => peridontitis
- <2 mm= mild
- 2-5mm = moderate
-
5 mm= severe
- 30% = 10 tooths => localized or generalized
- if less plaque,young,faster progression =>aggressive peridontitis
- first molars and incisors=> localized aggressive peridontitis
Furcation - moderate bone loss => probe can be easily but not passed out - severe bone loss => probe can be easily but passed out
Mobility => alveolar bone loss or advanced periodontitis
Mobility etiology is peridontitis,trauma,occlusal, endodontic
- bleeding,edema
- all are Reversible Plaque Gingivitis Periodontitis Bone loss
Gingiva colour¶
Normal - coral or salmon pink
Acute gingivitis - red(because of vascularity and decrease in keritinization) - pink(high fibrosis) - full gray(necrosis)
Chronic - bluish hue(venous statics)
Endogenous pigmentation - hemochromatosis = blue gray - melanin = black - jaundice= yellow
Exogenous pigmentation - foods - tobacco - amalgam tattoo
Gingival Contour¶
Normal - scalloped and knife- edged Gingivitis - round,rolled,blunt ANUG - loss of interdental papillae Stillman cleft - triangural shaped gingival recession McCall festoons - rolled,thicked seen commonly in canine with recession
Consistency => applying pressure
Gingival recession¶
- recession is apical shift in position of Gingiva exposing root
-
Gingival recession can also due to brushing
-
leads to dentinal hypersensitivity, root caries,abrasion or recession
Gingival exudate(GCF)¶
Periodontal abscess¶
Periodontitis => abscess - swelling of Gingiva - pain - tooth mobility - tooth elevation - suppuration - digital pressure - pockets
- chronic
- acute
Gingivial abscess¶
- marginal Gingiva
Periapical abscess¶
Plaque =>Bleeding on probe =>True pocket =>Recession =>Mobility
If mobility present there will be history of recession,bleeding,plaque
If mobility present without history then it is trauma
But based on previous treatment. Calculus= 0
And we do treatment for each sign
Key -> Understand mechanism
Chief complaint¶
Diagnosis (oral pathology)¶
Tooth(odontogram)¶
- caries
- pulpitis
- missing
- Treated
oral cavity (anatomical terms)¶
Tongue¶
- cyst
gums(Sexant)¶
- stains
- calculus
- recession
Orthodontics (functional )¶
Type - caries -> restoration -> Black class - pulpitis -> root canal -> - treated -> restoration,root canal, implant - missing -> prosthesis ->. -> extracted
Treatment plan
1.scaling Chief complaint 2.extraction
Appointment Emergency Restorative
Now 3 days
Tooth => enamel => pulp
.Dentition= .tooth code = FDI =
Examination chart
Caries examination IDCAS =
0 :: no caries
Input =>output =>input FDI=>1 => caries => region, =>pain =>pulpitis
FDI_Visual ICDAS
Sexant_Visual
To do¶
All visual
Examination is input of a word For every examination there will be an output Each examination depends on one another.
let's follow the logic.
Tooth present Tooth FDI Tooth region Tooth
How to : Take a condition and solve it like above.
Inputs¶
IDCAS Region
Methods BPM
Outputs¶
Caries type Black's classification Diseases or conditions Treatment plan
Anatomy => examination=>diagnosis=>treatment
Here’s a more detailed and comprehensive breakdown of possible links between tooth, periodontal, and soft tissue areas, with clinically significant examples:
- Tooth ↔ Periodontal Links
These links arise because the health of teeth and their supporting structures are interdependent.
Examples:
- Caries leading to periodontal issues:
Deep dental caries extending to the root apex may result in periapical periodontitis or abscess formation, affecting surrounding bone and periodontal structures.
- Periodontal disease causing tooth damage:
Severe periodontitis leads to alveolar bone loss, resulting in tooth mobility, migration, or loss.
- Tooth extraction affecting periodontal health:
Tooth removal can lead to ridge resorption and adjacent teeth drifting, impacting periodontal stability.
- Trauma to teeth causing periodontal involvement:
Dental trauma (e.g., luxation) can lead to periodontal ligament tears, root resorption, or pocket formation.
- Tooth ↔ Soft Tissue Links
The teeth directly or indirectly affect soft tissue through mechanical, chemical, or microbial factors.
Examples:
- Tooth conditions causing soft tissue injury:
Sharp edges of broken teeth or faulty restorations cause ulcers on the tongue, cheek, or lips.
Over-retained deciduous teeth can cause localized soft tissue swelling or irritation.
- Infections spreading from tooth to soft tissue:
Periapical abscess may cause sinus tract formation in the mucosa or facial swelling.
Odontogenic infections (e.g., cellulitis or Ludwig’s angina) can result from untreated tooth infections.
- Soft tissue responses to tooth restorations:
Poorly designed restorations (overhanging margins or crowns) can irritate gingival or oral mucosa, causing hyperplasia or inflammation.
- Impacted teeth affecting soft tissues:
Partially erupted molars (e.g., third molars) often lead to pericoronitis, causing swelling and ulceration in surrounding soft tissues.
- Periodontal ↔ Soft Tissue Links
Periodontal health depends on the condition of soft tissues, especially the gingiva, and systemic or local soft tissue issues may exacerbate periodontal conditions.
Examples:
- Periodontal infections affecting soft tissue:
Gingival abscesses can extend into the oral mucosa, causing swelling, pain, or ulceration.
Chronic periodontitis may lead to soft tissue recession, exposing the roots.
- Soft tissue overgrowths affecting periodontium:
Fibrous hyperplasia (due to chronic irritation or habits) can trap plaque, exacerbating periodontitis.
- Systemic diseases affecting both soft tissue and periodontium:
Autoimmune diseases like lichen planus or pemphigus may cause oral ulcerations and complicate periodontal health.
- Surgical or traumatic injury:
Gingival graft surgery for periodontal repair can result in soft tissue scarring or changes in contour.
- Tooth ↔ Periodontal ↔ Soft Tissue Links (Complex Interactions)
These are cases where all three areas are interrelated, requiring integrated diagnosis and treatment.
Examples:
- Advanced caries:
Deep decay infects the pulp (tooth) → Leads to periapical abscess (periodontal) → Causes mucosal sinus tract (soft tissue).
- Impacted third molar with pericoronitis:
The impacted tooth causes pressure or irritation (tooth) → Leads to gingival inflammation (periodontal) → Soft tissue swelling and infection (soft tissue).
- Chronic bruxism:
Bruxism causes tooth wear and fracture (tooth) → Leads to gingival recession and pocket formation (periodontal) → Soft tissue trauma (cheeks or tongue biting).
- Oral cancer and poor hygiene:
Cancerous lesions in soft tissue (e.g., tongue or cheek) → Result in compromised periodontal support due to inflammation → Teeth in the affected region loosen due to bone loss.
Key Scenarios to Consider
Sinus Involvement:
An infected upper molar (tooth) → Sinusitis (soft tissue and bone).
Systemic Links:
Diabetes may cause periodontal breakdown and poor healing of oral soft tissues.
Prosthetic Issues:
Poorly fitting dentures (soft tissue trauma) → Accelerate ridge resorption and affect adjacent teeth.
Summary Table for Easy Reference
Would you like help in integrating these links into a charting system, visual diagram, or diagnostic workflow?
Based on anatomy because relation occurs
Intraoral anatomy pic
Typical