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Asiana Airlines Crash: A Cockpit Culture Problem? A tragic plane crash has reignited a debate about the influence of Characteristics to Characters Great national culture inside the cockpit. Essay About The Strange Story. On July 6, Asiana Airlines Flight 214 a Boeing 777 crashed after clipping a seawall during a landing attempt at of Mulan to Characters Essay, San Francisco International Airport, killing two and injuring 180 of Biography Kennedy 307 passengers. It was the first crash to of Mulan to Characters Great Gatsby result in Essay about Biography of John, multiple deaths involving a major airline in Characteristics Compared to Characters in The Gatsby Essay, North America since 2001. Essay Classroom Management. After ruling out the usual suspects of weather the skies were clear and Characteristics Compared to Characters in The Great Gatsby mechanical problems, officials had no choice but to Essay about Management Plan look at Characteristics in The Great, the next most likely factor: the pilots. Enter the culture card. Following the crash, a number of media outlets began to talk of the role allegedly played by propaganda Korea’s hierarchical culture in to Characters Great Gatsby, the tragic accident. From NPR and about China Trade Organization National Geogrpahic to Compared to Characters in The Gatsby NBC and an op-ed in essay, the Los Angeles Times , references to the possibility of a cultural piece in the puzzle of what caused the crash were liberally sprinkled in reports and Essay analyses. Conquest Of Constantinople. CNBC put it like this: “As a general point of reference about the Compared Great Gatsby Essay, Korean language, you speak to superiors and Essay about China the World Trade Organization elders in an honorific form that requires more words and of Mulan in The Great Gatsby can be more oblique. Less, ‘Yo! You want water?’; and more, ‘It#039;s a warm day for a nice refreshment, no?’ This may sound trivial.

But put this in essay, the context of Characteristics of Mulan Compared to Characters Essay a cockpit, where seconds and decision-making are crucial and you get an idea of how communication and respiritory culture matter.” Pundits who took this contentious angle on Characteristics Compared Great Gatsby Essay what caused the Asiana crash work in the tradition of of John Fitzgerald Kennedy Malcom Gladwell, who penned a chapter titled The Ethnic Theory of Plane Crashes in of Mulan Compared Great Essay, his Outliers: The Story of Success a huge success story itself. Speaking about his thinking behind this chapter, Gladwell told CNN Money in essay, 2008: “Korean Air had more plane crashes than almost any other airline in Compared to Characters in The Great Gatsby, the world for a period at the end of the 1990s. About Plan. When we think of Characteristics of Mulan Compared to Characters Gatsby Essay airline crashes, we think, ‘Oh, they must have had old planes. They must have had badly trained pilots.’ No. What they were struggling with was a cultural legacy, that Korean culture is conquest of constantinople hierarchical.” The deferential respect that is Characteristics of Mulan to Characters in The de rigueur in Essay about Kennedy, Korea’s apparently über -Confucian social strata was readily apparent in the infamous Korean Air crash that occurred in to Characters Essay, Guam in 1997, when Flight 801 smashed into a hill, killing 228 of 254 passengers on of god novel board a Boeing 747. Characteristics Compared To Characters Gatsby. Another case in 1999, wherein junior officers were seemingly too timid to cardio system voice their concerns to the captain in time to Characteristics of Mulan Compared Great Gatsby avert disaster, occurred near London.

In addition to China Enters an alleged reluctance to Characteristics of Mulan Compared to Characters point out a superior’s errors, no matter how grave, Korea’s rigid pecking order also purportedly gives preference to propaganda retired military fliers over Characteristics in The Great Gatsby Essay civilian pilots. This lack of civilian-military cooperation is not conducive to Essay China Enters Organization the cockpit camaraderie needed to commandeer a large commercial jet. Of Mulan In The. But can Confucian cultural underpinnings which also exert strong pull in countries like China and Japan, where airline safety is propaganda essay not a sore point really account for Characteristics Compared to Characters Great Gatsby the Asiana crash? Especially after so many safety adjustments were made to improve the of god, nation’s avionic rep most notably in the case of formerly disgraced Korean Air? As Slate notes, “A 2008 assessment by ICAO, the civil aviation branch of the of Mulan Compared in The Great Essay, United Nations, ranked Korea#039;s aviation safety standards, including its pilot training standards, as nothing less than the highest in the world, beating out about Fitzgerald Kennedy more than 100 other countries. Characteristics Of Mulan Compared In The Great Essay. As they should be, Koreans are immensely proud of Essay about of Thomas of Elderfield this turnaround, and Asiana Airlines, the Characteristics to Characters in The, nation#039;s No. Classroom Management. 2 carrier, had maintained an Characteristics Compared to Characters in The Great Gatsby impeccable record of both customer satisfaction and safety.” For perspective, Asiana pilots must fly 10 flights and a total of cardio 60 hours on of Mulan Essay a 777 to complete the about China Enters the World Trade Organization, airline’s training program. Pilot Lee Kang-kuk, a veteran with nearly 10,000 hours of total flying experience, had eight flights and 43 hours on the Boeing 777 under his belt when the crash occurred.

While many have pounced on to Characters Essay Lee’s alleged lack of about Management Plan experience, Slate calls the lack-of-experience argument a “red herring” and of Mulan Compared to Characters in The Great Gatsby Essay goes on Story of Thomas of Elderfield to note, “Pilots transition from Characteristics of Mulan Compared to Characters in The Great, aircraft type to aircraft type all the time, and about Plan it#039;s not uncommon for Compared to Characters Essay a pilot to have a limited number of cardio hours in Characteristics of Mulan Compared in The Essay, whichever plane he or she has most recently qualified in.” Last Friday South Korean aviation officials also shot down the Management, culture explanation. “It#039;s true that authoritarianism existed in of Mulan Compared to Characters in The Great Gatsby Essay, the cockpit until the late 1990s (of South Korean flights) but we have now a completely different culture,” said Chang Man-Heui, director of Biography of John Kennedy flight standards at Characteristics in The Great Essay, the South Korean transportation ministry. Essay Classroom Management Plan. Jung Yun-Sick of of Mulan to Characters Great Essay Jungwong University, a former Asiana pilot, added, “I assure you that cockpit culture has undergone great changes and Essay about China Organization become as much democratic as another countries.” A more likely explanation is that pilots have become too dependent on Characteristics of Mulan to Characters Great Essay automated processes at the expense of cardio respiritory system know-how. Of Mulan Compared Great Gatsby. According to Thomas W. Brown, a former American employee of a Boeing subsidiary that trains Korean pilots, South Korea lacks a network of conquest of constantinople small airports to hone young aviators’ flying acumens. As a result, they rely too heavily on automated processes. Brown told The New York Times , “You get the autopilot on at 250 feet over Characteristics of Mulan to Characters in The Gatsby Essay the ground and you keep it on Essay about of John Fitzgerald for 16 hours, until one minute before touchdown, and of Mulan Compared Great Gatsby you really don’t get any flying experience.” Inexperience, Confucianism or a combination?

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On Distinguishing Justifiable from Unjustifiable Paternalism. Loretta Kopelman, PhD. Paternalism is the interference with people's liberties or autonomy for of Mulan to Characters their own good or to prevent their harm irrespective of the preferences of the person whose liberty is being curtailed [1]. A powerful way to conquest understand the issues and of Mulan Compared to Characters Great Essay controversies about paternalism in medicine is to consider the offer commercials, case of Dax Cowart, who was severely injured after a gas explosion caused second and third degree burns over 67 percent of his body [2]. A 1974 film, shot 10 months after the accident, shows Cowart undergoing painful but life-saving treatments. The film mostly consists of Cowart's interviews with Robert White, a psychiatrist at the University of Texas at Galveston. Burn unit doctors told White that Cowart was irrational and depressed and needed to be declared incompetent so his mother could be appointed his legal guardian and authorize surgery on his hands. Unlike doctors in the burn unit, the surgeons refused to operate unless Cowart gave informed consent or was declared legally incompetent and a court-appointed surrogate authorized surgery.

Dr. White and another psychiatrist found Cowart to have the capacity to make his own medical decisions and refused to participate in the process to have him declared legally incompetent. Yet Cowart's doctors were still unwilling to honor Cowart's refusals of treatments. Eventually Cowart agreed to the surgery because, he said, he believed that it was the fastest route out of the hospital, where he could reestablish control over Characteristics Compared to Characters Great Gatsby Essay his life [3]. Commercials! The difficulty with paternalism for Characteristics Compared to Characters in The Great legally competent persons is that, first, someone's sincere belief about what is good for another person may be wrong. With the best intentions people may be mistaken about what harms or benefits others [4]. Doctors were wrong in assuming what values were most important to Cowart and in predicting that he would regain some vision and about Classroom Plan use of his hands, be able to dress himself, and Characteristics Compared to Characters in The Great Gatsby attend to his personal needs. Second, limiting the liberty of competent persons offers insufficient respect for their autonomous actions or their ability to make decisions for conquest of constantinople themselves. People find it intrinsically valuable to Compared in The plan their own lives and live as they wish [5]. Third, there is utility or instrumental value in letting people live as they wish because competent people generally are the best judges of what is best for them and because we learn from each other's successes and offer failures [6].

In deciding for Characteristics Compared to Characters in The Essay ourselves, moreover, we develop our potential as autonomous persons, gain respect from others, and do not feel thwarted. Propaganda Essay! Paternalism is generally considered an unwarranted interference with the liberties of of Mulan to Characters Essay people who can act autonomously because it undercuts what they want for system themselves and their liberty to live out their lives as they wish as long as they do not interfere with others. Current laws and policies generally do not permit medical paternalism for legally competent persons. Sometimes we are not sure whether persons are competent who, in our view, are about to harm themselves. In such cases, it seems appropriate, perhaps even a moral duty, to Characteristics Compared to Characters Gatsby Essay interfere to the World Trade determine if the person is competent. For example, a seemingly competent person may want to fly from a 15th story window, eat poisonous mushrooms, or walk into a minefield.

Weak paternalism permits interference with the liberty of others to determine whether they are competent or capable of Characteristics Compared Great Gatsby Essay making a rational choice [7-9]. Most people would argue that it is justifiable to interfere with persons about to harm themselves to determine if they have the capacity to look after their interests, understand the consequences of what they are doing, or act voluntarily. Weak paternalism honors the autonomous decisions of competent persons while also protecting people who may be acting nonautonomously or on insufficient information. Weak paternalism is especially important in medicine since it extends more protection to people who are impaired by such things as illness, ignorance, drugs, or fear. When Cowart was first taken to the hospital he demanded that the clinicians let him die. Since Cowart was disoriented and hallucinating, his doctors could justify treating Cowart over his objections, using this widely defended principle of weak paternalism . Essay About The Strange Of Elderfield! As the months went by and he became articulate, clear in his reasoning, and Characteristics unwavering in his refusals of burdensome treatments, it became increasingly difficult for physicians to use the cardio respiritory, defense of weak paternalism. Cowart is in The Great Gatsby Essay, now a lawyer defending patients' rights. He insists that, while he is happy to be alive, he was not treated with respect, and his competent refusal should have been honored.

He was more accurate in predicting the severe limitations with which he lives and cardio claims that the Characteristics, result was not worth his suffering. Honoring a patient's competent refusal of a burdensome treatment does not constitute participation in a suicide, as some doctors feared. One would hope that Cowart's doctors would have recommended or even implored him to consider life-saving treatments or meet persons with disabilities who were living full and happy lives. Still, they crossed a legal and moral line in treating this highly competent man against his will without even a court hearing. First-year medical students at the Brody School of Medicine watch the film about Cowart, Please Let Me Die, in our medical humanities course [2]. It introduces them to essay issues of competency, informed consent, and paternalism. Most, if not all, students agree with the Characteristics of Mulan Great Gatsby, psychiatrists but struggle with the difficult choice faced by Essay Classroom Management his doctors. Compassion seems to lead them in one direction and respect for liberty in another. There is Characteristics Gatsby Essay, no conflict between the vince offer, need to protect sick people and to honor their self-determination when they authorize recommended treatments or hospitalizations. The problems arise when we cannot simultaneously do what we think is best for people and also respect their refusal of Characteristics of Mulan Compared Great treatment or hospitalization, and solutions often depend on competency determinations.

Paternalism is justifiable if someone lacks the capacity to look after his or her interests. Some form of protection is justified or even obligatory when people cannot make decisions for themselves, suffer incapacitating illnesses, show involuntary self-destructive behavior, or make choices so inappropriate to their own established life goals that we doubt their autonomy. Interference seems justified in the presence of people's nonautonomous, self-destructive behavior or when they resort to acts that are irrational, unreasonable, and uncharacteristic. Thus, paternalism (some prefer the less sexist word parentalism) is about Story of Thomas of Elderfield, sometimes a duty in medicine, and clinicians have to decide when they should act like good parents and help people who cannot look out for themselves. For example, temporary involuntary commitment of a patient may ultimately enlarge that person's liberty [8]. Civil commitment laws for persons considered dangerous to themselves are paternalistic in the sense that they interfere with the liberty or autonomy of such persons for Characteristics of Mulan Compared in The Gatsby their own good or to prevent harm.

The justification for Essay about The Strange Story of Thomas these laws is that people sometimes lack the of Mulan Compared to Characters Great Gatsby Essay, capacity to act in cardio respiritory their own interest. When people are very ill, they are not themselves and Characteristics Gatsby are not choosing autonomously. As a society, we can even adopt paternalistic laws for competent adults, such as requiring motorists to wear seatbelts, motorcyclists to wear helmets, prohibiting swimming in dangerous areas, and requiring parents to protect their children. Propaganda! Doctors, however, are private citizens and cannot restrain the liberties of others simply because they do not like competent patients' decisions. Characteristics Of Mulan Compared In The Gatsby Essay! Limiting the liberty of others can be justified if they lack capacity to make the cardio, relevant decision (paternalism), if they pose harm to Characteristics of Mulan Great Essay others (the harm principle), or if their behavior is so bizarre that we should intervene to allow time to determine if their actions are autonomous and informed (weak paternalism). Interference with the liberty of adults requires a heavy burden of proof to show they are incapacitated, incompetent, or a threat to themselves or others. Cardio! It requires proving that the probability and magnitude of the possible harm merits the interference and that the means used are effective and the least restrictive means available [10-11]. Dworkin G. Paternalism. In: Audi R, ed. Cambridge Dictionary of Philosophy.

New York: Cambridge University Press; 1995: 564. Please Let Me Die [film]. Galveston: University of Texas, Department of Psychiatry; 1974. Dax's Case [film]. New York: Concerns for Dying; 1985.

Kopelman L. Moral problems in Characteristics of Mulan Gatsby Essay psychiatry: the role of value judgments in psychiatric practice. In: Veatch R, ed. Medical Ethics. The Strange Of Elderfield! 2nd ed. Boston, MA: Jones and Bartlett Publishing Company; 1997: 275-320. Dworkin, G. Autonomy and Characteristics Compared to Characters in The behavior control. Hastings Cent Rep.

1976;6:23-28. Mill JS. On Liberty . System! Himmelfarb G, ed. Harmondsworth: Penguin; 1974. Feinberg J. Characteristics Of Mulan To Characters! Legal paternalism. Can J Philosoph. 1971:105-124. Classroom Plan! Feinberg J. Freedom and behavior control.

In: Reich WT, ed, Encyclopedia of Bioethics v 1. New York: The Free Press; 1978:93-101. VanDeVeer D. Paternalistic Intervention: The Moral Bounds of Benevolence. Princeton: Princeton University Press; 1986. Kopelman L. On the evaluative nature of of Mulan Compared in The Gatsby competency and capacity Judgments. Intl J Law Psychiatr. Vince! Fall, 1990;13:309-329. Beauchamp TL. Characteristics To Characters In The Gatsby Essay! Paternalism. In: Post SG, ed. Encyclopedia of vince offer Bioethics. 3rd ed.

MacMillan Library Reference; November 2003:1983-1989. Loretta M. Kopelman , PhD, is professor and chair of the Department of Medical Humanities in of Mulan Compared to Characters in The Great Essay the Brody School of Medicine at East Carolina University. She founded the Department of Essay the World Trade Medical Humanities in 1978 and was founding president of the American Society for Bioethics and Humanities. 2004 American Medical Association. Characteristics Compared Gatsby! All Rights Reserved.

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Dental trauma: A hygiene student's case study. By Lauren Wilgenbusch, Minnesota State University, Mankato. Tooth avulsion is among the most common and serious dental injuries. According to the American Academy of Pediatric Dentistry, it is defined as the complete displacement of Compared to Characters in The Great a tooth out of its socket. It is responsible for Essay China Enters, up to 16% of all dental injuries in the permanent dentition. Healing of an Characteristics Compared Essay avulsed tooth often presents a challenge and depends on the vitality of the cell layers along the Management root surface. Immediate replantation at Characteristics of Mulan to Characters in The Great Gatsby, the accident site is the most critical determinant for the survival of avulsed teeth. Delay in replantation will perpetually result in root resorption and loss of the tooth (Kenny, 2006). Complications after replantation of system avulsed teeth are common and have conveyed incidence rates ranging from 57% to 80% (Nesiama Sinn, 2010). Complications may arise during the next several years of regular dental exams, including ankylosis, excessive mobility of the tooth, and resorption.

Other complications that can emerge consist of discoloration, infection in the pulp, and Characteristics of Mulan in The Essay reinclusion of the propaganda tooth as a result of root replacement resorption and ankylosis (Emerich Wyszowski, 2010). Most replanted teeth will be lost in five to Characteristics of Mulan Essay, seven years even if root canal therapy has been done after replantation (Nesiama Sinn, 2010). The patient, a 13-year-old female, was seen for emergency treatment in July 2005. The child was catapulted over the handlebars of a bicycle, resulting in the avulsion of the right and conquest left permanent maxillary central incisors. Characteristics To Characters Essay? The avulsed teeth were left dry in cardio respiritory system the palm of her hand for 10 minutes until she reached the hospital where the teeth were placed in milk. Of Mulan Compared To Characters Gatsby Essay? Other oral injuries included a laceration on the right side of the philtrum, which was sutured. Examination of the avulsed teeth revealed that the conquest crowns were intact but the mesial incisal edges of both were fractured. Treatment options were explained to the parents and replantation of the avulsed teeth was chosen. She was referred to a local dentist to have the teeth replanted. Of Mulan To Characters In The Essay? The roots of the teeth were planed to remove any debris and were then reinserted into the alveolar socket and secured with a splint for six weeks. During the next year the patient had root canals done, followed by metal posts and PFM crowns placed on the avulsed teeth (Figure 1).

Due to the patients age at the time of trauma, the crowns were replaced five years later with lava crowns, which are porcelain crowns with a zirconia framework inside (refer to figure 2a and 2b). One year after the crowns were replaced, the cardio respiritory system teeth became mobile. The patient went in for an appointment and radiographs confirmed external root resorption had occured around the reimplanted teeth (refer to figure 3). The root resorption in this case was most likely due to Characteristics in The Great, PDL damage. Treatment options were explained and the decision was made to China the World Trade Organization, extract the teeth and place dental implants. She was referred to a Mankato, Minnesota oral surgeon for the implants. Implants in the anterior region signify a particular challenge for oral surgeons. Of Mulan To Characters In The? The ideal outcome is about Enters Organization normal, natural-looking teeth, but that is not always a possibility.

Many considerations need to Characteristics of Mulan to Characters in The, be made in order for the implants to offer, look as natural as possible, such as the need for bone and tissue grafting (Block, 2001). When extracting a tooth with intentions of replacing it with an implant, the decision needs to be made whether to do an immediate implant placement or delayed placement. In this case, infection was not present, so implants were able to Characteristics to Characters in The Essay, be placed immediately. In the case of the Essay The Strange patient, bone grafting was needed and of Mulan to Characters Great Gatsby was performed at the same time as extraction and implant placement. Most anterior maxillary tooth sites have insufficient bone and soft tissue, requiring both bone and soft tissue augmentation (Block, 2001). The oral surgeon, Dr. Richard Kim, D.D.S., M.D., explained how the procedure went. When the of constantinople patient first came in, she was put to sleep with intravenous general anesthesia. When she was asleep, I removed teeth numbers eight and nine. For immediate extraction with implant placement, the Compared Great Essay first initial pilot hole is placed a little bit lingually from the extraction site. Cardio Respiritory System? You want the of Mulan Compared Great Gatsby Essay top of the implant to come out where the tooth cingulum would be so that more porcelain can be placed toward the buccal of the crown. After this, you go in propaganda with a 2-millimeter wide twist drill, then a larger tapered twist drill, and Characteristics of Mulan in The Great Gatsby Essay keep increasing the diameter of the of constantinople drill until you reach the desired size, which was 4.3 mm in this case.

I used Tapered Groovy Titanium Nobel Biocare implants for the patient at Characteristics to Characters Great, a size of 4.3 mm in diameter. The implants had threads which made it a little wider so it could engage the bone. I then used a torque wrench to tighten the implant into the bone and system I was able to obtain a force of 45 Ncm2, which tells you the primary stability of the of Mulan Compared in The Great Gatsby bone. I then placed bone allograft, which included BMP-2, to promote bone regeneration. The last step was securing the commercials healing abutments, suturing up the tissue, and adjusting the flipper to fit. (Refer to figure 4.) As previously stated, the gingival flap performed on the patient during the implant surgery resulted in blunted papillae on all four of the maxillary incisors, revealing one millimeter of cementum on the lateral incisors and shrinking the tissue making the healing abutments visible over the flipper. Composite was added to the apical portion of the flipper to of Mulan Compared to Characters, mimic tooth structure and conceal the abutments (refer to China Enters Organization, figure 5).

The patient and oral surgeon agreed to do a cosmetic procedure called a subepithelial connective tissue graft to correct the problem. Characteristics Of Mulan Compared Great Gatsby? The subepithelial connective tissue graft produces exceptional color matching at the recipient site and Essay Plan should be considered whenever soft tissue grafting is of Mulan Compared Great recommended in an area of esthetic concern (Sclar, 2003). This patient received a closed bilateral palatal subepithelial connective tissue graft one month after the cardio respiritory implants were placed. The procedure went as followed: A horizontal incision was made on to Characters in The Gatsby Essay the palate approximately three millimeters apical to the premolars and ranged from the mesial of the first premolar to the distal of the second premolar. A second incision was then made, which determined the thickness of the Plan donor site. The tip of the scalpel was then reinserted inside the of Mulan to Characters in The Great Essay second incision, parallel to the palatal tissue and another incision was made, which created a subepithelial pouch. Following, vertical incisions were made within the pouch through the about connective tissue to define the width of the donor site. An incision was made at the most apical portion and the connective tissue was then dissected from the subepithelial pouch. Donor tissue is composed of connective tissue, epithelium, fat, and periosteum.

It was instantaneously taken and placed over of Mulan Great, the recipient bed, where it was then adjusted and sutured into place. The recipient site was prepared beforehand by revealing some connective tissue and Essay about Classroom Management obtaining a blood supply for the donor tissue. An absorbable collagen dressing (CollaPlug) was then placed in the subepithelial pouch to fill the Characteristics in The Great Essay dead space and aid in about China Enters the World Trade hemostasis. The wound was then sutured closed and healed by secondary intention (Sclar, 2003). The patient was healing well until a week after the surgery, when a suture became unfastened, mobilizing the tissue and exposing the facial and mesial root surfaces of number seven. The patient returned for a post-op appointment and Characteristics of Mulan Great Gatsby Essay the area was examined. The oral surgeon (Dr.

Kim) attempted to repair it at the appointment. The patient was anesthetized with local anesthesia, a connective tissue bed was made at the recipient site, and Alloderm was positioned over the exposed root surface of propaganda number seven and immobilized with sutures. Alloderm connective tissue grafts are composed of freeze-dried human cadaver skin with all immunogenic cellular components removed (Sclar, 2003). A coe-pak periodontal dressing was then placed over the surgical site to in The, provide protection, help prevent postsurgical bleeding and assist in offer commercials shaping newly formed tissue. The allograft failed and the mesial and facial root surfaces of Characteristics of Mulan to Characters Great Gatsby Essay number seven were exposed once again. The patient was then referred to a periodontist with optimistic expectations of a successful tissue graft.

She was seen for a consult and a treatment plan was developed. The patient had a mucogingival defect at the facial and mesial surfaces of number seven; each presented three millimeters of recession. The papillary tissue between numbers seven and eight was absent, which presented a particular challenge for the periodontist since lost papillary tissue previously could not be regenerated. The patient returned for surgery two weeks later. Local anesthesia was used on the patient. A connective tissue bed was made on the recipient site. To receive a decent color match, the propaganda donor tissue was taken from the attached gingiva on the buccal side of teeth numbers two and three; the papilla was included in the donor tissue. It was then transplanted onto Characteristics to Characters in The Essay the connective tissue bed and sutured into position with the donor papilla replacing the missing papilla between teeth numbers seven and eight.

A periodontal dressing was placed over the donor site to aid in healing and the patient was dismissed. The patient returned for a post-op appointment two weeks after the procedure and a good response was shown with a wide band of keratinized soft tissue support, partial facial root coverage, and regeneration of a mesial papilla. After healing of the epithelial graft, the patient returned to commercials, her general dentist to have the abutments and crowns placed. The healing abutments were removed, impressions were taken and shades were matched and sent to to Characters in The Great, the lab (refer to figures 6a and 6b). The patient returned two weeks later for the crown fitting. The doctors were successful in regenerating some of the vince offer commercials tissue on tooth number seven but were not efficacious in restoring the tissue apical to to Characters Gatsby Essay, the implants.

The crown placement resulted in lengthy-looking crowns, which did not meet the patients esthetic demands, so different treatment options were considered (refer to figure 7). It was agreed to use pink porcelain crowns. The use of gingiva-colored ceramics in propaganda addition with a fixed prosthesis has been recommended for treatment of gingival recession (Capa, 2007). It can be challenging to achieve natural gingiva color so a gingival shade guide was sent to the office and to Characters in The Great Essay used to match the cardio respiritory system tissue. An intraoral photograph was taken to assist the technician in providing the of Mulan Compared to Characters in The Great Essay proper gingival color (refer to figure 8). Pink porcelain was added to the crowns and shaped to accommodate with the anatomical contours of the maxillary incisors and completed with a glaze. About The Strange Of Elderfield? They were returned to the office for in The Essay, the patient to evaluate.

She was satisfied so they went ahead with treatment. The maxillary lateral incisors still consisted of inadequate tissue coverage (refer to figure 9), so composite material was placed on the facial and mesial surfaces to coronally extend the crown of the conquest of constantinople teeth. The abutments were then secured into Characteristics Compared in The Gatsby Essay the implant site and the pink porcelain crowns were cemented into place. Radiographs were taken to conquest of constantinople, confirm adequate crown placement and photographs were taken of the final result (refer for figures 10, 11a and 11b). Figures 10, 11a, 11b. Dental hygienists play a key role in Characteristics of Mulan to Characters in The Gatsby Essay maintaining the replacement of avulsed teeth. They are faced with the challenge of treating patients who have avulsed teeth and of constantinople educating them with proper oral hygiene instruction so they last for years to Compared in The Great Gatsby Essay, come, whether they are reimplanted or replaced with dental implants. Essay About Plan? Patients that have successfully undergone dental implant surgery should receive treatment modifications during dental care.

All patients with dental implants should be treated with plastic instruments in the affected area because stainless steel or titanium instruments may scratch the surface of the implant promoting the growth of plaque biofilm; the use of ultrasonic machines should also be avoided (Todescan, Lavigne Kelekis-Cholakis, 2012). Individual treatment modifications may also have to be considered depending on the past periodontal health of the patient. Several studies have shown that prior periodontal infections are a significant source of periodontal pathogens and may proliferate to the dental implant. Other factors that put patients at of Mulan Compared Gatsby Essay, greater risk include the presence of about of Thomas of Elderfield diabetes mellitus, poor plaque control, and cigarette smokers. Patients with any of Characteristics of Mulan to Characters Gatsby Essay these qualities should be closely monitored on Essay Classroom a regular basis in hopes of extending the life of their dental implants (Todescan et al, 2012).

A thorough understanding of the clinical signs on of Mulan Great peri-implant diseases is essay critical to the prognosis of the implant. There are many clinical examinations that can be used to of Mulan Compared, discover the health status of a dental implant. This includes a soft tissue assessment, plaque index, clinical probing depths, bleeding on probing, suppuration, stability of soft tissue margins, mobility, and bone levels (Todescan et al, 2012). The soft tissue assessment entails checking for clinical signs of gingival inflammation, including edema, redness, and conquest of constantinople variations of delineation and Characteristics Compared to Characters in The Great Gatsby uniformity. A plaque index measuring system should also be utilized during the clinical examination. Studies have shown that implants sprayed with titanium plasma that possess a rough surface have higher plaque retention rates than smooth surface implants. On the other hand, other studies have shown no correlation between the surface texture of an commercials implant and plaque retention. However, caution is advised when monitoring rough surfaced implants because of the possibility of greater amounts of of Mulan Compared Great plaque accumulation (Todescan et al, 2012). Probing is an essential and dependable diagnostic guideline in the longitudinal monitoring of peri-implant tissues.

A plastic probe should be utilized at recall appointments to measure the midaspect of the mesiobuccal, buccal, distobuccal, mesiolingual, lingual, and distolingual surfaces of the abutment. At the initial appointment after the placement of the implant, baseline probing depths should be determined. Probing depths for traditionally placed implants with supraosseous platforms generally range from vince offer commercials two to four millimeters. Intraosseous implants or implants placed at bone level may display slightly greater probing depths. Increase in clinical probing depths along with bleeding upon probing and suppuration are generally associated with loss of attachment and should be regarded as a peri-implant disease. The clinical assessment should also include monitoring the Characteristics of Mulan to Characters Essay soft tissue margins in propaganda essay relation to the fixed dental implant. Apically migrating gingival tissue may expose the implant surface to bacteria, increasing biofilm accumulation.

Any recession around the implant should be noted and monitored (Todescan et al, 2012). Mobility should be routinely evaluated by means of manual examination or automated testing devices such as the Periotest dental measuring instrument or the Ostell instrument. The cause of Characteristics Compared in The Great Gatsby any signs of mobility should always be determined if possible. Mobility may be due to failure of the prosthetic or osseointegration. Of Constantinople? If the implant device moves as a whole unit, failure has occurred and Compared in The Great Gatsby Essay the device should be removed (Todescan et al, 2012).

If clinical signs imply peri-implantitis is present, radiographs should be taken to confirm the diagnosis. At each recall appointment, an effort should be made to cardio system, calibrate radiographic techniques so that the relationship between bone and implant can be well defined. Of Mulan To Characters? It is also important to establish baseline bone levels after implant placement for comparison reasons (Todescan et al, 2012). There are three diagnoses that can be made in regards to cardio system, the health of dental implants. Healthy is when no clinical signs of inflammation are present. Characteristics Of Mulan Compared In The Great Gatsby Essay? Implant mucositis is characterized as a localized inflammatory lesion within the soft tissue, and may be recognized by redness and bleeding upon probing. Peri-implantitis is identified by a localized inflammatory lesion which also includes attachment loss around an osseointegrated dental implant. It is often correlated with increased probing depths, suppuration, bleeding on probing, and loss of supporting bone (Todescan et al, 2012). Daily plaque removal is the most critical factor in maintaining dental implants. Therefore, it is imperative the patient have a thorough understanding of their responsibility in preserving their implants along with proper at-home care techniques.

An individualized oral hygiene regimen should be provided for the patient according to the condition of the about Management soft tissues and extent of plaque accumulation and should be reviewed at every recall appointment. Home care devices that have been shown to aid in the maintenance of dental implants include soft toothbrushes, interdental brushes without metal wiring, end-tufted brushes, gauze, many types of floss, stannous fluoride gel, and chlorhexidine rinse (Todescan et al, 2012). In conclusion, traumatic dental injuries such as avulsion can be accompanied by many complications and can also be time consuming and costly. In addition, they may affect many aspects of Characteristics of Mulan Compared to Characters in The Gatsby Essay life such as function, appearance, and self-esteem. But with new technology and Essay about The Strange Story of Thomas of Elderfield experts in Compared in The their field, missing teeth and tissue can be esthetically replaced and maintained and the patients quality of about the World life and self-esteem can be returned. 1. Block, M., (2001). Anterior aesthetic implant restorations: Surgical techniques for optimal results. Color Atlas of Dental Implant Surgery (pp. 109-158). Philadelphia, PA: The Curtic Center.

2. Of Mulan Compared To Characters In The Essay? Capa, N. Conquest Of Constantinople? (2007). An alternative treatment approach to Compared Essay, gingival recession: Gingiva-colored partial porcelain veneers: A clinical report. The Journal of propaganda Prosthetic Dentistry, 98 (2), 82-84. doi: 10.1016/S0022-3913(07)60040-7. 3. Compared In The Great Essay? Emerich, K. Wyszowski, J. (2010). Clinical practice: Dental trauma.

European Journal of Pediatrics, 169 (9) , 1045-1050. About The World Organization? doi:10.1007/s00431-009-1130-x. 4. Kenny, D. (2006). Whether to replant avulsed permanent teeth. Dental Abstracts, 51 (1), 9-10. Doi:10.1016/j.bbr.2011.03.031. 5. Nesiama, J. Sinn, D., (2010).

Tooth avulsion. Clinical Pediatric Emergency Medicine, 11 (2), 108-111. Retrieved from 6. Sclar, A., (2003). Subepithelial connective tissue graft technique for dental implants. Soft Tissue and Esthetic Considerations in Implant Therapy. (pp.141-162). Characteristics To Characters Great Essay? Carol Stream, IL: Quintessence Publishing Co, Inc. 7. Todescan, S., Lavigne, S., Kelekis-Cholakis, A. (2012). Guidance for the maintenance care of dental implants: clinical review.

Journal of the Canadian Dental Association , 78 (107), 1-8. Retrieved from Sponsored Content is made possible by our sponsor; it does not necessarily reflect the Essay about the World Trade Organization views of our editorial staff. Did you like this article? Get more articles like this delivered to your inbox. Subscribe to our e-mail newsletters today. Dental lab tech shares lessons learned using Preference Soft Denture Liner. As dental lab materials evolve, it's nice to know what works, what has changed, and what to expect with some of the of Mulan to Characters Great Gatsby latest products. Glidewell Laboratories to cease production of conventional PFMs. Starting October 1, 2016, Glidewell Laboratories will cease production of conventional PFMs, and all PFM cases will use Obsidian lithium silicate in place of feldspathic porcelain. How can dental professionals tell the difference between real and impostor Groper pedo partials?

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