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Role of Nutrition in Role of Nutrition in

orthodontics orthodontics
r Venkatesha K r Venkatesha K
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ontents ontents
Introduction Introduction
einitions einitions
assiication o ood assiication o ood
Proteins. arbohydrates. Lipids. Vitamins. Proteins. arbohydrates. Lipids. Vitamins.
Mineras Mineras
Nutrition and dento acia growth Nutrition and dento acia growth
Nutritiona inuence on the periodontium Nutritiona inuence on the periodontium
Guideines or eauation & assessment o nutritiona status Guideines or eauation & assessment o nutritiona status
Baanced diet Baanced diet
oncusion oncusion
Bibiography Bibiography
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Introduction Introduction
Nowadays we ie in a ery diet conscious Nowadays we ie in a ery diet conscious
society where more and more peope are society where more and more peope are
adopting a heathy iestye through a heathy adopting a heathy iestye through a heathy
diet. diet.
Lidence or which can be obtained rom Lidence or which can be obtained rom
knowing the act that books written on nutrition knowing the act that books written on nutrition
and diet are amongst the astest moing books and diet are amongst the astest moing books
o the shees o the shees
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Definition Definition
1be .cievce of fooa, tbe vvtrievt. ava otber 1be .cievce of fooa, tbe vvtrievt. ava otber
.vb.tavce. tbereiv ,tbeir actiov ,ivteractiov ava .vb.tavce. tbereiv ,tbeir actiov ,ivteractiov ava
batavce iv retatiov to beattb ava ai.ea.e. ava tbe batavce iv retatiov to beattb ava ai.ea.e. ava tbe
roce..e. b, rbicb tbe orgavi.v ivge.t, aige.t, ab.orb., roce..e. b, rbicb tbe orgavi.v ivge.t, aige.t, ab.orb.,
trav.ort. ,vtitie. ava ecrete. fooa .vb.tavce. trav.ort. ,vtitie. ava ecrete. fooa .vb.tavce.
-- ounci o ood and nutrition o the ounci o ood and nutrition o the
American Medica Association American Medica Association
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Historical Background Historical Background
Schneider`s Schneider`s --
Naturaistic era Naturaistic era--,400 B. ,400 B.--A. 150, A. 150,
hemica anaytic era,150 hemica anaytic era,150--1900, 1900,
Bioogica era,1900 Bioogica era,1900--present, present,

Historical Background Historical Background

Moecuar Moecuar`` ceuar era ceuar era--,1955 ,1955 --present, present,
Guiord Guiord --184 was among the irst to adocate 184 was among the irst to adocate
that dietary deiciencies coud be an underying that dietary deiciencies coud be an underying
cause o dentoacia irreguarities cause o dentoacia irreguarities
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Definition Definition
Science o nourishing the body propery or Science o nourishing the body propery or
anaysis o the eects o ood on iing anaysis o the eects o ood on iing
organisms. organisms.
#etatiov.bi betreev vav ava bi. fooa ava ivtie. tbe #etatiov.bi betreev vav ava bi. fooa ava ivtie. tbe
.,cbotogicat ava .ociat a. rett a. tbe b,.iotogicat ava .,cbotogicat ava .ociat a. rett a. tbe b,.iotogicat ava
biocbevicat a.ect biocbevicat a.ect
--\udkin \udkin
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Definitions Definitions
Nutrition is a dynamic process in which the Nutrition is a dynamic process in which the
ood that is consumed is utiized or ood that is consumed is utiized or
nourishing the body. nourishing the body.
iet : 1he term diet reers to the tota ora iet : 1he term diet reers to the tota ora
intake o substances that urnish nourishment intake o substances that urnish nourishment
and,or caories to the body. and,or caories to the body.
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BASIC IUNC1ION OI NU1RILN1S BASIC IUNC1ION OI NU1RILN1S
Suppy energy . Suppy energy .
1o promote growth. 1o promote growth.
Repair o the body tissues . Repair o the body tissues .
Reguate body processes. Reguate body processes.
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Classification of nutrients Classification of nutrients
Macronutrients, Macronutrients, these are contribute the these are contribute the
main buk o ood. main buk o ood.
Lg, proteins. ats and carbohydrates. Lg, proteins. ats and carbohydrates.
Micronutrients, Micronutrients, they they are itamins and are itamins and
mineras and required in sma amounts rom mineras and required in sma amounts rom
a raction o a miigram to seera grams. a raction o a miigram to seera grams.
1
Classification of food Classification of food
CLASSIIICA1ION BY ORIGIN CLASSIIICA1ION BY ORIGIN
CLASSIIICA1ION BY CHLMICAL CLASSIIICA1ION BY CHLMICAL
COMPOSI1ION COMPOSI1ION
CLASSIIICA1ION BY PRLDOMINAN1 CLASSIIICA1ION BY PRLDOMINAN1
IUNC1ION IUNC1ION
CLASSIIICA1ION BY NU1RI1IVL VALUL CLASSIIICA1ION BY NU1RI1IVL VALUL
1
Classification of foods Classification of foods
Classification by origin: Classification by origin:
ood o anima origin, ood o anima origin,
ood o egetabe origin, ood o egetabe origin,
Classification Classification by by chemical chemical composition composition
proteins proteins
ats ats
arbohydrates arbohydrates
Vitamins Vitamins
mineras mineras
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Classification by predominant Classification by predominant
function function
Body building food Body building food eg, meat. poutry. ish. eg, meat. poutry. ish.
eggs. puses. groundnuts. etc. eggs. puses. groundnuts. etc.
Lnergy giving food Lnergy giving food eg, cereas. sugurs. eg, cereas. sugurs.
roots. tubers. at and ois. roots. tubers. at and ois.
Protective foods Protective foods eg, egitabes. ruits and eg, egitabes. ruits and
mik. mik.
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Classification by nutritive value Classification by nutritive value
ereas ereas
Puses ,egumes, Puses ,egumes,
Vegetabes Vegetabes
Nuts and oiseeds Nuts and oiseeds
ruits ruits
Anima oods Anima oods
ats and ois ats and ois
Sugars and jaggery Sugars and jaggery
ondiments and spices etc. ondiments and spices etc.
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Carbohydrates Carbohydrates
Lnergy yieding nutrients, is the argest singe Lnergy yieding nutrients, is the argest singe
component ,aside rom water ,o most diets. component ,aside rom water ,o most diets.
omposed o omposed o --
--carbon carbon
--hydrogen hydrogen
--oxygen oxygen
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Carbohydrates Carbohydrates
Sources Sources--
-- rice rice -- sweet potato sweet potato
--wheat wheat -- honey honey
--bajra bajra -- jaggery jaggery
--puses puses
--egetabes egetabes
Recommended daiy intake Recommended daiy intake--440gms. 440gms.
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Carbohydrates Carbohydrates
assiied as assiied as--
Monosaccharides Monosaccharides -- eg, gucose ,ructose eg, gucose ,ructose
,gaactose. ,gaactose.
isaccharides isaccharides -- eg, sucrose , actose ,matose eg, sucrose , actose ,matose
Poysaccharides Poysaccharides-- eg, starch, gycogen eg, starch, gycogen
,ceuose ,ceuose
Oigosacchrides Oigosacchrides--eg, matotriose eg, matotriose
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Digestion of carbohydrates Digestion of carbohydrates
In mouth by saiary amyase poysaccharides are In mouth by saiary amyase poysaccharides are
conerted into disaccharides, conerted into disaccharides,
In stomach by acid urther degradation o In stomach by acid urther degradation o
moecue takes pace, moecue takes pace,
In sma intestine by pancreatic amyase In sma intestine by pancreatic amyase
competes the breakdown to monosaccharide, competes the breakdown to monosaccharide,
1hese monosaccharide then pass through the 1hese monosaccharide then pass through the
sma intestina ii into boodstream, sma intestina ii into boodstream,
0
Carbohydrates Carbohydrates
SUROSL GLUOSL - RU1OSL SUROSL GLUOSL - RU1OSL
MAL1OSL GLUOSL - GLUOSL MAL1OSL GLUOSL - GLUOSL
LA1OSL GLUOSL - GALA1OSL LA1OSL GLUOSL - GALA1OSL
1
Carbohydrates Carbohydrates
Absorption and storage Absorption and storage --
sma intestines sma intestines
stored as gycogen in ier and musce stored as gycogen in ier and musce
unction unction --
main source o energy. main source o energy.
1 gm 1 gm -- 4 kca o energy 4 kca o energy

Summary Summary
Gycogenesis Gycogenesis-- surpus gucose conerted to surpus gucose conerted to
gycogen and stored in ier. gycogen and stored in ier.
Gycogenoysis Gycogenoysis--breakdown o gycogen in breakdown o gycogen in
ier to gucose. ier to gucose.
. Gycoysis . Gycoysis--in musce berakdown o gycogen in musce berakdown o gycogen
to pyruic acid to pyruic acid
Guconeogenesis or gyconeogenesis Guconeogenesis or gyconeogenesis--gouse gouse
and gycogen can be synthesised by the ier and gycogen can be synthesised by the ier
rom substances which are deried rom non rom substances which are deried rom non
carbhohydrates sources eg,aminoacid,seen carbhohydrates sources eg,aminoacid,seen
during proonged staration. during proonged staration.

Carbohydrates Carbohydrates
Amost nothing is known o the eect o Amost nothing is known o the eect o
carbohydrate deicient diet on the ora caity. carbohydrate deicient diet on the ora caity.
eiciency dosage eiciency dosage -- ess than 440gms per day ess than 440gms per day
eads to underweight,weight eads to underweight,weight
oss,ethargy,anaemia. oss,ethargy,anaemia.
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Carbohydrates Carbohydrates
1here is a group o disease which represents a 1here is a group o disease which represents a
primary geneticay determined disturbance o primary geneticay determined disturbance o
the mucopoysaccharide metaboism the mucopoysaccharide metaboism
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Carbohydrates Carbohydrates
lurer syndrome lurer syndrome--
inica eatures are. inica eatures are.
lead lead --appears arge with prominent appears arge with prominent
orehead orehead
--puy eyeids puy eyeids
--nasa congestion with noisy breathing nasa congestion with noisy breathing
--shortening and broadening o the mandibe shortening and broadening o the mandibe
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Carbohydrates Carbohydrates
-- wide intergonia distance wide intergonia distance
-- increased arch ength rom ramus to ramus increased arch ength rom ramus to ramus
dentition dentition--sma and misshaped teeth. sma and misshaped teeth.
Sot tissue Sot tissue --gingia hyperpasia. gingia hyperpasia.

Lipids Lipids
1hese are the most concentrated energy yieding 1hese are the most concentrated energy yieding
group o nutrients. group o nutrients.
Basic structure Basic structure --moecues o gycero to which moecues o gycero to which
one to three atty acid moecues one to three atty acid moecues
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Lipids Lipids
Sources Sources --
--ruits ruits --egg yok egg yok
--egetabes egetabes --butter butter
-- mik mik -- ghee ghee
--meat meat --cereas cereas
--ish ish
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Lipids Lipids
assiied as assiied as
-- saturated saturated
--unsaturated unsaturated
Physica properties Physica properties --
insoube in water. insoube in water.
ess dense than water. ess dense than water.
not aected by temperature. not aected by temperature.
0
Lipids Lipids
igestion igestion--
stomach stomach-- with the hep o ingua ipase secreted by the with the hep o ingua ipase secreted by the
ora saiary gand and gastric ipase secreted rom the ora saiary gand and gastric ipase secreted rom the
stomach. stomach.
sma intestine sma intestine--emusiied by bie and urther broken emusiied by bie and urther broken
down by pancreatic ipase then absorbed through the down by pancreatic ipase then absorbed through the
sma intestina ii. sma intestina ii.
ong chain atty acids are conerted into a chyomicron ong chain atty acids are conerted into a chyomicron
and dumped into the ymph system,which carries the and dumped into the ymph system,which carries the
chyomicron to the boodstream chyomicron to the boodstream
1
Lipids Lipids
0 0--ree atty acid combine with bie sats ree atty acid combine with bie sats
0 0--resynthesised immediatey to orm resynthesised immediatey to orm
trigycerides trigycerides
Normay the ats stored in adipose tissue. Normay the ats stored in adipose tissue.

Lipids Lipids
unction unction --
Source o energy Source o energy --1gm 1gm--9kca. 9kca.
It insuate the body and protect arious interna It insuate the body and protect arious interna
organs. organs.
arrier o the at soube itamins.A,,L and K arrier o the at soube itamins.A,,L and K
Source o other essentia atty acids. Source o other essentia atty acids.

Lipids Lipids
isturbances in the ipid metaboism are isturbances in the ipid metaboism are
not ery common but they do occur not ery common but they do occur
--Gauchers disease Gauchers disease
--Neimann Pick disease Neimann Pick disease
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Gauchers disease Gauchers disease
Gauchers disease is an autosoma recessie deect Gauchers disease is an autosoma recessie deect
o ipid metaboism. o ipid metaboism.
Clinical feature Clinical feature
-- lepatospenomegay lepatospenomegay
-- Osteoytic disease ensues aong with pumonary Osteoytic disease ensues aong with pumonary
disuction disuction
-- Bone marrow shows diuse changes numerous Bone marrow shows diuse changes numerous
arge,omey,sighty granuar ces with sma,round arge,omey,sighty granuar ces with sma,round
pyknotic nucei pyknotic nucei
1reatment and prognosis 1reatment and prognosis,the disease resuting in ,the disease resuting in
death usuay with in irst year. death usuay with in irst year.
5
Niemann Niemann- -Pick Disease Pick Disease
AU1OSOMAL RLLSSIVL 1RAI1 AU1OSOMAL RLLSSIVL 1RAI1: characterized by : characterized by
abnorma storage o phosphoipids. resuting abnorma storage o phosphoipids. resuting
rom inherited deiciency o sphingomyeinase. rom inherited deiciency o sphingomyeinase.
1reatment and prognosis 1reatment and prognosis: symptomatic and : symptomatic and
consists mainy o antibiotic or pumonary consists mainy o antibiotic or pumonary
inection. Len organ transpantation aso inection. Len organ transpantation aso
recommended. recommended.
6
Proteins Proteins
1he term proteins mean 1he term proteins mean --`to take irst pace` `to take irst pace`--
Muder Muder --198 198
la the dry weight and 0 o the tota weight la the dry weight and 0 o the tota weight
o an adut is protein. o an adut is protein.

Proteins Proteins
Basic structure Basic structure --
compex substances made up o many amino compex substances made up o many amino
acids. acids.
there are 0 dierent naturay occurring amino there are 0 dierent naturay occurring amino
acid that hae been identiied as the buiding acid that hae been identiied as the buiding
bocks or body protein. bocks or body protein.
8
Proteins Proteins
Sources Sources--
--wheat wheat -- peanut butter peanut butter
--mik mik -- peas peas
--egg white egg white --cottage cheese cottage cheese
--egume egume --rice rice
--boied ham boied ham --oatmea oatmea
9
Proteins Proteins
assiied according to unctiona point o assiied according to unctiona point o
iew iew
--amino acids amino acids --essentia amino acids essentia amino acids
--non essentia amino acid non essentia amino acid
assiied according to quaity o protein assiied according to quaity o protein
-- compete compete
-- incompete incompete
--compementary compementary
--suppementary suppementary
40
Proteins Proteins
igestion and absorption igestion and absorption
--attached to another substance or surrounded by attached to another substance or surrounded by
at or carbohydrate at or carbohydrate
Stomach Stomach -- gastric proteases ,pepsin, gastric proteases ,pepsin,
Sma Intestine Sma Intestine -- pancreatic enzymes pancreatic enzymes
41
Proteins Proteins
0 0 --absorbed directy absorbed directy
0 0-- chain o two or three AA chain o two or three AA
dipeptidases amino acids dipeptidases amino acids
Amino acids Amino acids -- enters bood stream enters bood stream
4
Proteins Proteins
unctions unctions --
Lssentia or growth Lssentia or growth--hair,skin,nai hair,skin,nai
ormation o essentia body compounds ormation o essentia body compounds
Reguation o the water baance Reguation o the water baance
Act as buers Act as buers
Protectie roe Protectie roe
1ransport o nutrients. 1ransport o nutrients.
4
Proteins Proteins
1he inadequate consumption o protein and 1he inadequate consumption o protein and
energy as a resut o primary dietary deiciency energy as a resut o primary dietary deiciency
conditioned deiciency may cause oss o body conditioned deiciency may cause oss o body
mass and adipose tissue ,resuting in protein mass and adipose tissue ,resuting in protein
energy manutrition energy manutrition--
Kwashiorkor Kwashiorkor
Marasmus Marasmus
44
Proteins Proteins
Kwashiorkor Kwashiorkor --
einition einition-- protein deiciency with suicient caorie protein deiciency with suicient caorie
intake. intake.
Age Age--6 months and yrs 6 months and yrs --
inica eatures inica eatures --growth aiure growth aiure
wasting o musces wasting o musces
-- edema edema
--enarged atty ier enarged atty ier
--serum protein ow serum protein ow
-- ag sign ag sign
45
Proteins Proteins
Marasmus Marasmus
einition einition --staration in inants with a oera ack staration in inants with a oera ack
o caorie. o caorie.
Age Age--inants under 1 yr o age inants under 1 yr o age
eature eature--wasting o a tissues wasting o a tissues
--no edema no edema
--no hepatic enargement no hepatic enargement
--monkey ike ace monkey ike ace
46
Vitamins Vitamins
eined as organic substances not made by the eined as organic substances not made by the
body ,which is soube in either at or water and body ,which is soube in either at or water and
ordinariy is needed in ony minute quantities to ordinariy is needed in ony minute quantities to
act in a ariety o metaboic reactions. act in a ariety o metaboic reactions.
4
vlTAHltS
FAT SOLUBLE
WATER SOLUBLE
48
Vitamins Vitamins
at soube at soube \ater soube \ater soube
Intake is in excess Minima storage o Intake is in excess Minima storage o
o daiy body needs dietary excess o daiy body needs dietary excess
Not excreted Lxcreted in urine Not excreted Lxcreted in urine
eiciency symptoms eeop rapidy eiciency symptoms eeop rapidy
sow to deeop sow to deeop
Not absoutey necessary Must be suppied in diet Not absoutey necessary Must be suppied in diet
49
Vitamins Vitamins
Metaboism o itamins Metaboism o itamins
1hey are reeased rom ood during the digestie 1hey are reeased rom ood during the digestie
process but are not digested, process but are not digested,
\ater soube itamins are absorbed through the \ater soube itamins are absorbed through the
sma intestine, excess is excreated by the kidney sma intestine, excess is excreated by the kidney
in the urine, in the urine,
at soube itamins are absorbed through the at soube itamins are absorbed through the
sma intestine they are sent to the ier and at sma intestine they are sent to the ier and at
depots and circuate through the bood. depots and circuate through the bood.
50
Vitamins Vitamins
Vitamin A Vitamin A
Acidic ,acohoic, adehyde orm. Acidic ,acohoic, adehyde orm.
Sources Sources --spinach spinach
-- carrot, broccoi carrot, broccoi
--peas ,cabbage peas ,cabbage
-- mik ,cheese mik ,cheese
--butter, meat ,ish butter, meat ,ish
--egg, bee egg, bee
51
Vitamins Vitamins
unctions unctions--
--Vision Vision --roe in dark adaptation and roe in dark adaptation and
ision in dim ight ision in dim ight
--leps in bone remodeing. leps in bone remodeing.
RI RI--approximatey 800 mcg,day. approximatey 800 mcg,day.
5
Vitamins Vitamins
eiciency eiciency--night bindness night bindness
--keratinzation o cornea keratinzation o cornea
--bitots spots bitots spots
-- xerosis conjunctia xerosis conjunctia
-- xeropthamia xeropthamia
-- compete bindness compete bindness
--oss o sense o taste oss o sense o taste
5
DEFICIENCY DEFICIENCY
Blindness from xerophthalmia
54
ERODERMA
FOLLCULAR KERATOSS
55
#NIFESTTINS #NIFESTTINS
56
Vitamins Vitamins
Lxcess Vit A eads to Lxcess Vit A eads to ,,
leadache leadache
Vomiting Vomiting
oube ision oube ision
lair oss lair oss
Bone abnormaities Bone abnormaities
Lier damage Lier damage
5
Vitamins Vitamins
entition entition--disturbances in dierentiation and disturbances in dierentiation and
growth o deeoping teeth growth o deeoping teeth
--caciication o teeth caciication o teeth
--retardation o eruption retardation o eruption
-- disturbances in periodonta tissues. disturbances in periodonta tissues.
--aiure to orm tooth ename. aiure to orm tooth ename.
--xerostomia. xerostomia.
58
Vitamins Vitamins
Vitamin Vitamin
Group o compounds caed as choicaceero. Group o compounds caed as choicaceero.
-- Source Source - -
-- Lndogenous synthesis Lndogenous synthesis--sunight sunight
-- Lxogenous synthesis Lxogenous synthesis--deep sea ish ,ish oi, deep sea ish ,ish oi,
butter, mik. butter, mik.
59
Vitamins Vitamins
unction unction--
Maintain norma pasma ee o cacium and Maintain norma pasma ee o cacium and
phosphorus. phosphorus.
It is necessary or a animas with a bony It is necessary or a animas with a bony
skeeton ,since it aciitates absorption and skeeton ,since it aciitates absorption and
utiization cacium and phosphorus or bone utiization cacium and phosphorus or bone
ormation ormation
60
Vitamins Vitamins
LIILN\ O VI1 LIILN\ O VI1
1.Rickets in growing chid 1.Rickets in growing chid
inica eatures are, inica eatures are,
--harrisons sucus harrisons sucus
--Rickets rosary Rickets rosary
--pigeon chest pigeon chest
--Bow egs Bow egs
--Knock knees Knock knees
61
eiciency o Vitamin . eiciency o Vitamin .
Reduction in bood cacium and phosphorus, deayed cosure o Reduction in bood cacium and phosphorus, deayed cosure o
ontanes. ontanes.
isproportionate growth occurs between ace and sku. It may isproportionate growth occurs between ace and sku. It may
cause intererence with bone growth. cause intererence with bone growth.
It causes retarded eruption o teeth eary oss o decidious teeth It causes retarded eruption o teeth eary oss o decidious teeth
due to caries. due to caries.
Jaw bones become thick. Jaw bones become thick.
1eeth are ir 1eeth are ir--reguary arranged reguary arranged
6
Maxia become narrow and paate becomes high. Maxia become narrow and paate becomes high.
Mandibe becomes short. Mandibe becomes short.
Inants with ow itamin intakes showed deayed Inants with ow itamin intakes showed deayed
eruption o teeth. eruption o teeth.
Increased susceptibiity o osseous tissue to muscuar Increased susceptibiity o osseous tissue to muscuar
traction as undesirabe ora habits. traction as undesirabe ora habits.
Open bite, transerse hypodimensions and misshapen Open bite, transerse hypodimensions and misshapen
paate are requenty obsered in itamin deiciency. paate are requenty obsered in itamin deiciency.
6
Vitamins Vitamins
. .Osteomaacia Osteomaacia --in aduts in aduts
--osteoid matrix which is aid down ais to osteoid matrix which is aid down ais to
mineraize mineraize
inica uture , inica uture ,
--ague bony pain ague bony pain
--muscuar weakness muscuar weakness
--requent ractures requent ractures
64
Vitamins Vitamins
ce.. ce.. of 1it D teaa. to of 1it D teaa. to ,,
Nausea,omiting,and headache. Nausea,omiting,and headache.
Irreersibe damage to kidney and cardioascuar Irreersibe damage to kidney and cardioascuar
tissue. tissue.
DRI DRI-- -- approximatey 5 to10 mcg,day. approximatey 5 to10 mcg,day.
65
Vitamins Vitamins
Vitamin L Vitamin L--
Acts as an antioxidant and protects red bood Acts as an antioxidant and protects red bood
ce. ce.
Sources Sources --egetabe ois, yeow egetabe ois, yeow
cornmea, wheat cornmea, wheat
bread, egg ,butter . bread, egg ,butter .
Roe in human nutrition is poory Roe in human nutrition is poory
understood. understood.
66
Vitamins Vitamins
Deficievc, of rit teaa. to Deficievc, of rit teaa. to ;;
leamoytic anemia leamoytic anemia
ce.. ivta/e of rit teaa. to ce.. ivta/e of rit teaa. to ,,
Nausea Nausea
iarrhea iarrhea
ramps and beeding ramps and beeding
Interereance with anticoaguant drug Interereance with anticoaguant drug
RI RI--15 mg,day 15 mg,day..
6
Vitamins Vitamins
Vitamin K Vitamin K
Basic structures consist o a group caed as Basic structures consist o a group caed as
quinones quinones
Sources Sources--green egetabes green egetabes
--ruits ruits
unction unction--it is necessary or the synthesis o it is necessary or the synthesis o
prothrombin. prothrombin.
68
Vitamins Vitamins
Deficievc, of rit K re.vtt. Deficievc, of rit K re.vtt. ,,
Proonged beeding Proonged beeding
Increased cotting time Increased cotting time
Ora maniestations are, Ora maniestations are,
Increased gingia beeding, Increased gingia beeding,
Prothrombin ee 5 Prothrombin ee 5-- --beeding ater tooth brushing, beeding ater tooth brushing,
Prothrombin ee 0 Prothrombin ee 0-- --spontaneous gingia hemorrhage, spontaneous gingia hemorrhage,
e.. ivta/e of rit K e.. ivta/e of rit K ;;
Interere with anticoaguants, which coud resuts in Interere with anticoaguants, which coud resuts in
hemorrhaging hemorrhaging
RI RI--approximatey 100 mcg,day approximatey 100 mcg,day
69
Vitamins Vitamins
Vitamin C (Ascorbic Acid) Vitamin C (Ascorbic Acid)
Sources Sources--citrus ruits citrus ruits --orange ,emon ,grape ,certain orange ,emon ,grape ,certain
egetabes. egetabes.
Vit is Lssentia or, Vit is Lssentia or,
--ormation o intraceuar substance . ormation o intraceuar substance .
--ormation o ibrus tissue matrices o bone. ormation o ibrus tissue matrices o bone.
--ormation o tendon and cartiage. ormation o tendon and cartiage.
--utiization o iron and cacium . utiization o iron and cacium .
RI RI--approximatey 60 mg,day. approximatey 60 mg,day.
0
vlTAHlt C vlTAHlt C
1
Vitamin deiciency eads to, Vitamin deiciency eads to,
In seere deiciency, the gums may become In seere deiciency, the gums may become
retracted ormation o periodonta pockets. retracted ormation o periodonta pockets.
Loosening o teeth and oss o teeth. Loosening o teeth and oss o teeth.
Vitamin deiciency produces sub Vitamin deiciency produces sub--cinica cinica
scury which is reated with damage in scury which is reated with damage in
deeopment and eruption o the teeth and deeopment and eruption o the teeth and
ormation o hypodimensiona osseous bases. ormation o hypodimensiona osseous bases.
Lxess eads to, Gi upset,diarrhea,and iron Lxess eads to, Gi upset,diarrhea,and iron
toxicity. toxicity.

Vitamins Vitamins

Vitamins Vitamins
4
Vitamins Vitamins
B compex B compex--these consist o a group o essentia these consist o a group o essentia
compounds which are biochemicay unreated compounds which are biochemicay unreated
but occur together in some oods but occur together in some oods
Sources Sources--green eay egetabes, cereas ,yeast green eay egetabes, cereas ,yeast
,ier, and mik. ,ier, and mik.
5
Vitamin B complex Vitamin B complex
1haimine(BJ) 1haimine(BJ)
Source, best source is pork, meat, poutry and egg. Source, best source is pork, meat, poutry and egg.
unction unction--carbohydrate metaboism. carbohydrate metaboism.
eiciency eiciency-- BLRI BLRI BLRI BLRI
ry beri beri ry beri beri--neuromuscuar symptoms weakness, neuromuscuar symptoms weakness,
paresthesia, sensory oss, poyneuritis. paresthesia, sensory oss, poyneuritis.
\et beri beri \et beri beri--V inoement V inoement
RI RI--approximatey 1.1mg. approximatey 1.1mg.
6
Vitamin B complex Vitamin B complex
Riboflavin(B2) Riboflavin(B2)
unction unction--ceuar respiration ceuar respiration
RI RI--depends on tota caorie intake,energy needs,body depends on tota caorie intake,energy needs,body
size and growth rate. Around 1.1mg. size and growth rate. Around 1.1mg.

Vitamin B complex Vitamin B complex

Vitamin B deiciency produces retardation Vitamin B deiciency produces retardation
o growth o dentoacia structures. o growth o dentoacia structures.
A prenata matarna riboain ,B, A prenata matarna riboain ,B,
deiciency produces anomaies o jaw and teeth, deiciency produces anomaies o jaw and teeth,
which shows shortness o mandibe, and maxia, which shows shortness o mandibe, and maxia,
cet paate, seere anomaies o incisor teeth, cet paate, seere anomaies o incisor teeth,
dentoacia maormations resembed anger`s c dentoacia maormations resembed anger`s c
II maoccusion II maoccusion
--ocuar esions ocuar esions
--cheiosis ,anguar stomatitis cheiosis ,anguar stomatitis
--gossitis. gossitis.
--dermatitis. dermatitis.
8
Vitamins Vitamins
Niacin:B Niacin:B--
unction unction--metaboism o at metaboism o at
eiciency eiciency--peagra peagra--dermatitis. dermatitis.
--diarrhoea. diarrhoea.
--dementia. dementia.
Lxess Lxess-- acia ushing. acia ushing.
Lier damage. Lier damage.
RI RI-- approxmatey 14mg. approxmatey 14mg.
9
Vitamins Vitamins
Pyridoxine,B6, Pyridoxine,B6,
unction unction--exact unction not known exact unction not known
--at and protein metaboism at and protein metaboism
--transmission o neura impuse transmission o neura impuse
Source Source--any thing o anima origin any thing o anima origin
eiciency eiciency--dermatitis dermatitis
--gossitis gossitis
--anguar stomatitis anguar stomatitis
80
Vitamin Vitamin
Lxcess intake o it B6 Lxcess intake o it B6 --permanent permanent
neuroogic damage. neuroogic damage.
1hat incudes numbness in extremities and 1hat incudes numbness in extremities and
uncoordinated musce moement. uncoordinated musce moement.
RI RI--around 1.4mg,day. around 1.4mg,day.
81
Vitamins Vitamins
Vit B Vit B--9 ,oic acid, 9 ,oic acid,
unction unction--heps in amino acid synthesis. heps in amino acid synthesis.
Source Source--dark green eay egetabes dark green eay egetabes
eiciency eiciency--causes eta neura tube deect and causes eta neura tube deect and
macrocytic anemia macrocytic anemia
RI RI--approximatey 400mcg,day approximatey 400mcg,day
8
Vitamin Vitamin
Vit B Vit B--1 ,cobaamine, 1 ,cobaamine,
unction unction-- -- conerts oate into the orm in conerts oate into the orm in
which it can be used to produce red bood ce which it can be used to produce red bood ce
and nuceic acids or NA synthesis. and nuceic acids or NA synthesis.
eiciency eiciency- -may cause pernicious anemia. may cause pernicious anemia.
RI RI--approximatey .4mcg,day. approximatey .4mcg,day.
8
Summary of deficiency states of vitamins Summary of deficiency states of vitamins
VI1AMINS VI1AMINS LIILN\ LIILN\
A A XLROP1lALMIA, R\ L\L. XLROP1lALMIA, R\ L\L.
BB--11 BLRIBLRI BLRIBLRI
BB-- ARIBOLAVINOSIS ARIBOLAVINOSIS
BB-- PLLLAGRA PLLLAGRA
BB--66 MIRO\1I ANLMIA MIRO\1I ANLMIA
BB--99 NLURAL 1UBL LL1 O L1US. NLURAL 1UBL LL1 O L1US.
BB--1 1 PLRNIIOUS AN MLGALOBLAS1I PLRNIIOUS AN MLGALOBLAS1I
ANLMIA. ANLMIA.
SURV\ . SURV\ .
RIKL1S AN OS1LOMALAIA RIKL1S AN OS1LOMALAIA
L L lLAMOL\1I ANLMIA lLAMOL\1I ANLMIA
KK lLAMORRAGL lLAMORRAGL --AILURL 1O BLOO LO1. AILURL 1O BLOO LO1.
84
Oral deficency symptoms Oral deficency symptoms
Vit A Vit A-- -- xerostomia xerostomia
ora eukopakia ora eukopakia
hyperkerotosis hyperkerotosis
soteing o sku bone due to a deposition soteing o sku bone due to a deposition
Vit B Vit B-- -- red swoen ips red swoen ips
burning,smooth,red tongue burning,smooth,red tongue
ucerated burning gingia ucerated burning gingia
Vit Vit -- -- beeding,swoen gums.oose teeth beeding,swoen gums.oose teeth
sow heaing. sow heaing.
85
Oral deficiency symptoms Oral deficiency symptoms
Vit Vit --aiure o bone wounds to hea aiure o bone wounds to hea
ename hypocaciication ename hypocaciication
oss o aeoar bone oss o aeoar bone
thinning o trabecuation thinning o trabecuation
Vit L Vit L--no known deiciency symptoms no known deiciency symptoms
Vit K Vit K--aiure o wounds to stop beeding aiure o wounds to stop beeding
86
Minerals Minerals
Macro mineras which are present in reatiey high Macro mineras which are present in reatiey high
amount in body amount in body --cacium cacium
--phosphorus phosphorus
--potassium potassium
--sodium sodium
Micro mineras those which are 0.005 o the body Micro mineras those which are 0.005 o the body
weight weight --iron iron
--copper copper
--manganese manganese
8
Minerals Minerals
acium acium
Inert inorganic eement which is associated with Inert inorganic eement which is associated with
bone and tooth ormation. bone and tooth ormation.
RI RI--60mg or inants and 800mg chidren and 60mg or inants and 800mg chidren and
aduts aduts
1ota cacium in the body is 100 1ota cacium in the body is 100--10g 10g
99 o which ound in hard tissue. 99 o which ound in hard tissue.
1he ee o the bood cacium controed by 1he ee o the bood cacium controed by
parathyroid gand parathyroid gand
Sources Sources--mik and mik products mik and mik products
green eay egetabes green eay egetabes
egumes egumes
citrus ruits citrus ruits
88
Minerals Minerals
unction unction --
1. 1. Bone ormation. Bone ormation.
. . 1ooth ormation. 1ooth ormation.
. . Lssentia or growth Lssentia or growth
4. 4. Necessary or bood coaguation Necessary or bood coaguation
5. 5. Actiation o seera enzymes and reease o certain Actiation o seera enzymes and reease o certain
hormones hormones
6. 6. Roe in the process o impuse transmission at Roe in the process o impuse transmission at
neuromuscuar junction. neuromuscuar junction.
89
Iactors which influence plasma Iactors which influence plasma
Calcium level Calcium level
Parathyroid hormone Parathyroid hormone: Increase pasma a- ees and : Increase pasma a- ees and
at the same time the pasma phosphate ee, at the same time the pasma phosphate ee,
high ee o bone matrix stimuates the actiity o high ee o bone matrix stimuates the actiity o
osteocasts this causes demineraization o the matrix. osteocasts this causes demineraization o the matrix.
a- and phosphate are remoed a- and phosphate are remoed
Regulation of P1H secretion Regulation of P1H secretion :decrease in a- ee :decrease in a- ee
in pasma stimuates P1l secretion and increase in in pasma stimuates P1l secretion and increase in
ionic a- ee in pasma inhibits P1l secretion ionic a- ee in pasma inhibits P1l secretion
90
Iactors which influence plasma Iactors which influence plasma
Calcium level Calcium level
Calcitonin Calcitonin :hormone secreted by paraoicuar :hormone secreted by paraoicuar
ces o thyroid gand, incerase in a- ee ces o thyroid gand, incerase in a- ee
stimuate reease o cacitonin which in turn stimuate reease o cacitonin which in turn
decreases the a- in pasma. decreases the a- in pasma.
Plasma protein Plasma protein: decrease in these protein wi : decrease in these protein wi
be accompanied by decrease in tota a- ee. be accompanied by decrease in tota a- ee.
Phosphate Phosphate: a- and PO4- ions in pasma hae : a- and PO4- ions in pasma hae
reciproca reationship, increase in serum PO4- reciproca reationship, increase in serum PO4-
causes a a in a- ions. causes a a in a- ions.
91
Minerals Minerals
Abnormaities o a Metaboism Abnormaities o a Metaboism --
Osteoporosis Osteoporosis--midde aged women midde aged women
decreased density o bone decreased density o bone
shortening stature shortening stature
bone ractures bone ractures
Osteomaacia Osteomaacia --decrease in the minera decrease in the minera
content content
ack o Vit . ack o Vit .
9
Minerals Minerals
9
Minerals Minerals
Phosphorus Phosphorus
1 o the tota body weight. 1 o the tota body weight.
Major constituents o bone and teeth Major constituents o bone and teeth
Reguates the reease o energy in the orm Reguates the reease o energy in the orm
o A1P. o A1P.
94
Clinical Implications Clinical Implications
95
Nutrition deficiencies Nutrition deficiencies and and
dentofacial growth dentofacial growth
Nutrition and Skeeta Maturation Nutrition and Skeeta Maturation
Studies hae shown Studies hae shown
proonged nutritie aiure in growing chid proonged nutritie aiure in growing chid
resut in retardation o bone growth centers in resut in retardation o bone growth centers in
the hand and wrist radiographs`. the hand and wrist radiographs`.
acium, Vit and phosphorus are essentia or acium, Vit and phosphorus are essentia or
the ormation o bone and teeth. the ormation o bone and teeth.
96
Nutrition deficiencies Nutrition deficiencies and and
dentofacial growth dentofacial growth
Maormations and prenata deiciencies Maormations and prenata deiciencies--
ietary intake o the expectant mother is directy ietary intake o the expectant mother is directy
reated to the condition o the inant at birth. reated to the condition o the inant at birth.
\arkany \arkany --showed riboain showed riboain--cet paate, cet paate,
shortening o mandibe shortening o mandibe
9
Nutrition deficiencies Nutrition deficiencies and and
dentofacial growth dentofacial growth
Lans ,neson Lans ,neson--showed acute oic acid deiciency showed acute oic acid deiciency--cet paate. cet paate.
uring hyperpastic phase Nutritiona deiciencies eads uring hyperpastic phase Nutritiona deiciencies eads
permanent damage to the tissue permanent damage to the tissue
uring hypertrophyic phase bcz o Nutritiona deiciencies uring hypertrophyic phase bcz o Nutritiona deiciencies
growth may stop temporariy growth may stop temporariy
Lect o Nutrition on teeth Lect o Nutrition on teeth--
Local effect Local effect : chemica or physica action on the externa surace : chemica or physica action on the externa surace
o the tooth o the tooth
Systemic effect Systemic effect :important during the tooth deeopment. :important during the tooth deeopment.
Important during matrix ormation and caciication Important during matrix ormation and caciication
Inuenced by materna, inant and chidhood diet. Inuenced by materna, inant and chidhood diet.
98
Nutrition deficiencies Nutrition deficiencies and and
dentofacial growth dentofacial growth
Roe o uorides Roe o uorides--
Anticariogenic actor. Anticariogenic actor.
Long continued exposure to excessie amounts Long continued exposure to excessie amounts
may resut may resut --denta uorosis denta uorosis
--skeeta uorosis skeeta uorosis
99
Nutrition deficiencies Nutrition deficiencies and and
dentofacial growth dentofacial growth
Increased density o arious bones . Increased density o arious bones .
Increased caciication o igaments, tendons and Increased caciication o igaments, tendons and
ague pain in sma joints o the hands and eet ague pain in sma joints o the hands and eet
In the most seerest orm In the most seerest orm --stiening o the stiening o the
spine irtuay making the patient immobie. spine irtuay making the patient immobie.
100
Nutrition deficiencies Nutrition deficiencies and and
dentofacial growth dentofacial growth
Nutrition and maoccusion Nutrition and maoccusion--
resuts rom arious nutrient deiciencies resuts rom arious nutrient deiciencies--
abnorma bone growth abnorma bone growth
--oss o teeth. oss o teeth.
--seere caries. seere caries.
--periodonta breakdown. periodonta breakdown.
101
Nutrition deficiencies Nutrition deficiencies and and
dentofacial growth dentofacial growth
Vitamins in reation to growth and dentition Vitamins in reation to growth and dentition--
VitA VitA--disturbances in dierentiation and disturbances in dierentiation and
positiona growth o the deeoping teeth. positiona growth o the deeoping teeth.
deectie caciication. deectie caciication.
Retardation o eruption. Retardation o eruption.
disturbances o periodonta tissues. disturbances o periodonta tissues.
10
Nutrition deficiencies Nutrition deficiencies and and
dentofacial growth dentofacial growth
Vit B Vit B--
--oss o apatite oss o apatite
--disturbed digestion. disturbed digestion.
--Retardation o growth Retardation o growth
Vit Vit
--disturbed caciication o teeth. disturbed caciication o teeth.
--retarded eruption. retarded eruption.
--thickened jawbones. thickened jawbones.
--narrow maxia. narrow maxia.
--short mandibe. short mandibe.
--ligh aut paate. ligh aut paate.
10
Role of nutrition on the Role of nutrition on the
periodontium periodontium
Physica nature o the ood Physica nature o the ood--
--sot ood s. ibrous ood. sot ood s. ibrous ood.
Vitamin deiciency Vitamin deiciency
Vit A eads to keratinizing metapasia o the epitheium, Vit A eads to keratinizing metapasia o the epitheium,
susceptabiity to inection and disturbances in bone growth. susceptabiity to inection and disturbances in bone growth.
Vit B deiciency eads to gingiitis, gossitis and gossodynia, Vit B deiciency eads to gingiitis, gossitis and gossodynia,
anguar cheitis and inamation o ora mucosa anguar cheitis and inamation o ora mucosa
Vit eads to scury Vit eads to scury
-- intereres with bone ormation and remodeing o the intereres with bone ormation and remodeing o the
periodonta bone periodonta bone
Vit eads to osteoporosis o aeoar bone and cementa Vit eads to osteoporosis o aeoar bone and cementa
resorption. resorption.
104
Role of Nutrition in Root Resorption Role of Nutrition in Root Resorption
ommon iatrogenic probem associated with ommon iatrogenic probem associated with
orthodontic treatment orthodontic treatment
Marsha et.a Marsha et.a--greater degree o greater degree o
resorption in deicient diets. resorption in deicient diets.
Beck Beck --cacium deiciency were more susceptibe. cacium deiciency were more susceptibe.
105
Lffects of consistency of food Lffects of consistency of food
1hroughout its arious stages o growth mouth is 1hroughout its arious stages o growth mouth is
aected by compex system o orces generated by aected by compex system o orces generated by
masticatory and respiratory actiities. masticatory and respiratory actiities.
iet that does not suppy ood o a suicient hard iet that does not suppy ood o a suicient hard
consistency does not suppy adequate stimuus or consistency does not suppy adequate stimuus or
proper mastication resuting in a narrow maxiary arch . proper mastication resuting in a narrow maxiary arch .
Simiar obserations hae been made in humans Simiar obserations hae been made in humans --arch arch
coapse syndrome. coapse syndrome.
106
Lffects of consistency of food Lffects of consistency of food
1. 1. Low ee o eruption Low ee o eruption --posteriors posteriors
. . Maxiary arch are narrower. Maxiary arch are narrower.
. . Mandibe are shorter and condyes are thinner. Mandibe are shorter and condyes are thinner.
4. 4. Less tonicity o temporais and masseter. Less tonicity o temporais and masseter.
5. 5. Reduced inear dimension o sku. Reduced inear dimension o sku.
10
Lffects of consistency of food Lffects of consistency of food
In humans In humans--
Some authors hae proposed Some authors hae proposed--weakening weakening
o the temporomandibuar articuation o the temporomandibuar articuation
Resuting in maoccusion. Resuting in maoccusion.
108
Nutritional consideration in Nutritional consideration in
orthodontic tooth movement orthodontic tooth movement
1ooth moement inoes bioogic responses to 1ooth moement inoes bioogic responses to
orthodontic orces, orthodontic orces,
\hich may inuenced by ascorbic acid. \hich may inuenced by ascorbic acid.
Lack o Vit intereres with coagen synthesis Lack o Vit intereres with coagen synthesis
thus aecting both periodonta igament and the thus aecting both periodonta igament and the
ormation o osteoid. ormation o osteoid.
Aso aects the stabiity o orthodontic Aso aects the stabiity o orthodontic
correction ,ie,it aects retention. correction ,ie,it aects retention.
109
Nutritional considerations in surgical Nutritional considerations in surgical
patient patient
1he mouth is the porta or entry o ood into 1he mouth is the porta or entry o ood into
the body thus maxioacia surgery o these the body thus maxioacia surgery o these
structures may resut in impaired ood intake structures may resut in impaired ood intake
both prior to and ater surgery. both prior to and ater surgery.
\e must ensure adequate nutritiona support in \e must ensure adequate nutritiona support in
such patient. such patient.
Patient require both an energy source and a Patient require both an energy source and a
protein source. protein source.
110
Nutritional considerations in surgical Nutritional considerations in surgical
patient patient
Nutritiona considerations in surgica patient Nutritiona considerations in surgica patient
arbohydrates energy source or ita organs ike arbohydrates energy source or ita organs ike
brain. brain.
Protein is aso important or imparting strength Protein is aso important or imparting strength
to the racture repair. to the racture repair.
I it is absent then the wound heaing is deayed. I it is absent then the wound heaing is deayed.
Vitamin A heps in epitheiaization,coagen Vitamin A heps in epitheiaization,coagen
synthesis and cross inking & ibrobast synthesis and cross inking & ibrobast
dierentiation, dierentiation,
111
Nutritional considerations in surgical Nutritional considerations in surgical
patient patient
Vit and cacium heps in heaing o hard Vit and cacium heps in heaing o hard
tissues. tissues.
Vit L acts as an antioxidant and thus reduces the Vit L acts as an antioxidant and thus reduces the
damage rom the ree oxygen radica. damage rom the ree oxygen radica.
Vit K heps in actiation o arious cotting Vit K heps in actiation o arious cotting
actors and thus essentia or bood cot actors and thus essentia or bood cot
ormation during heaing. ormation during heaing.
11
hat is balanced diet??
hat does it contain
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11
balanced diet refers to intake of
appropriate types and adequate
amounts of foods and drinks to supply
nutrition and energy for the
maintainence of
bodycells,tissues,organs and to
support normal growth and function".
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114
Conclusion Conclusion
1he proper nutritiona status o the patient is o utmost 1he proper nutritiona status o the patient is o utmost
importance in orthodontic treatment, since success importance in orthodontic treatment, since success
depends on the response o bone to stimuation or the depends on the response o bone to stimuation or the
accompishment o desired resut. accompishment o desired resut.
Ony when we begin to understand these ita nutrients Ony when we begin to understand these ita nutrients
and the roe payed by each one in the norma and the roe payed by each one in the norma
deeopment o oroacia region and the body as a deeopment o oroacia region and the body as a
whoe can we reaize its reeance in cinica appication. whoe can we reaize its reeance in cinica appication.
1his wi aciitate a comprehensie approach to 1his wi aciitate a comprehensie approach to
orthodontic treatment as a whoe. orthodontic treatment as a whoe.
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115
ibtiograb, ibtiograb,
ontemporary orthodontics ontemporary orthodontics--Proffit Proffit
urrent Principes and 1echniques urrent Principes and 1echniques --Craber 1avar.aatt Craber 1avar.aatt
Nutrition and ora heath Nutrition and ora heath--Pottac/ Pottac/
Introductory nutrition Introductory nutrition--etev .varer. etev .varer.
Principes Principes o nutrition o nutrition--!it.ov,i.ber !it.ov,i.ber
inica dietetics and nutrition inica dietetics and nutrition--.P..vtia .P..vtia
Basic pathoogy Basic pathoogy--#obbiv. #obbiv.
Pathoogy or denta students Pathoogy or denta students--ar.b Mobav ar.b Mobav
NA :5 ,1, 1981 NA :5 ,1, 1981
heraskin,L., and Riungsdor, \.M,: Bioogy o the orthodontic heraskin,L., and Riungsdor, \.M,: Bioogy o the orthodontic
patient . 1, pasma ascorbic acid ees. Ange Orthod., 9:5,1969. patient . 1, pasma ascorbic acid ees. Ange Orthod., 9:5,1969.
Litton, S.., Orthodontic tooth moement during an ascorbic acid Litton, S.., Orthodontic tooth moement during an ascorbic acid
deiciency. Am. J. orthod., 65:90,194 deiciency. Am. J. orthod., 65:90,194
Jones, N B.: dietary needs o the ora surgery patient with comparision Jones, N B.: dietary needs o the ora surgery patient with comparision
o dietary suppements. J Ora Surg., 8:89, 190 o dietary suppements. J Ora Surg., 8:89, 190
Mcanies, J M., Aexander. .M., robdent., J. l., et a.: eect o Mcanies, J M., Aexander. .M., robdent., J. l., et a.: eect o
itamin on the mobiity and stabiity o guinea pig incisors under the itamin on the mobiity and stabiity o guinea pig incisors under the
inuence o orthodontic orce. Ange Orthod., 1:5:1961 inuence o orthodontic orce. Ange Orthod., 1:5:1961
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