[User]
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Planning for delayed healing post endodontic therapy. Brief history/status: Calcichew-D3, Duloxetine, Bricanyl, Bufomix Easyhaler, Insulin glargine, Esomeprazole, Duroferon. Desired treatment: Report any signs of peri-implantitis and root resorption in 17-27.

[Assistant] Review of CBCT volume dated 200716. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 28: bone height ~ 14.5 mm; implant space ~ 12.0 mm; nearest critical structure: nasal floor. Region 12: bone height ~ 10.3 mm; implant space ~ 4.4 mm; nearest critical structure: incisive canal. Region 46: bone height ~ 7.8 mm; implant space ~ 0.0 mm; nearest critical structure: anterior loop. Region 43: bone height ~ 10.1 mm; implant space ~ 1.8 mm; nearest critical structure: mental foramen. Region 22: bone height ~ 5.6 mm; implant space ~ 0.7 mm; nearest critical structure: sinus floor. Region 18: bone height ~ 5.5 mm; implant space ~ 0.0 mm; nearest critical structure: sinus floor. Region 21: bone height ~ 8.5 mm; implant space ~ 5.2 mm; nearest critical structure: nasal floor. Region 34: bone height ~ 12.4 mm; implant space ~ 8.5 mm; nearest critical structure: anterior loop. Region 13: bone height ~ 9.7 mm; implant space ~ 8.0 mm; nearest critical structure: nasal floor. Region 14: bone height ~ 16.2 mm; implant space ~ 7.4 mm; nearest critical structure: sinus floor. Impression: Findings consistent with chronic apical periodontitis at 38 and 25.

Question: Planning for delayed healing post endodontic therapy. Brief history/status: Calcichew-D3, Duloxetine, Bricanyl, Bufomix Easyhaler, Insulin glargine, Esomeprazole, Duroferon. Desired treatment: Report any signs of peri-implantitis and root resorption in 17–27.

Answer: Review of CBCT volume dated 200716. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 28: bone height ≈ 14.5 mm; implant space ≈ 12.0 mm; nearest critical structure: nasal floor. Region 12: bone height ≈ 10.3 mm; implant space ≈ 4.4 mm; nearest critical structure: incisive canal. Region 46: bone height ≈ 7.8 mm; implant space ≈ 0.0 mm; nearest critical structure: anterior loop. Region 43: bone height ≈ 10.1 mm; implant space ≈ 1.8 mm; nearest critical structure: mental foramen. Region 22: bone height ≈ 5.6 mm; implant space ≈ 0.7 mm; nearest critical structure: sinus floor. Region 18: bone height ≈ 5.5 mm; implant space ≈ 0.0 mm; nearest critical structure: sinus floor. Region 21: bone height ≈ 8.5 mm; implant space ≈ 5.2 mm; nearest critical structure: nasal floor. Region 34: bone height ≈ 12.4 mm; implant space ≈ 8.5 mm; nearest critical structure: anterior loop. Region 13: bone height ≈ 9.7 mm; implant space ≈ 8.0 mm; nearest critical structure: nasal floor. Region 14: bone height ≈ 16.2 mm; implant space ≈ 7.4 mm; nearest critical structure: sinus floor. Impression: Findings consistent with chronic apical periodontitis at 38 and 25.


[User]
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Planning for pre-surgical bone mapping. Brief history/status: Atorvastatin, Insulin glargine, Duloxetine, Duroferon, Bufomix Easyhaler, Esomeprazole, Bricanyl. Desired treatment: Evaluate periapical status of teeth 37, 13, and 14, and overall sinus condition.

[Assistant] Review of CBCT volume dated 220806. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 41: bone height ~ 6.0 mm; implant space ~ 3.8 mm; nearest critical structure: mandibular canal. Region 21: bone height ~ 13.3 mm; implant space ~ 6.4 mm; nearest critical structure: sinus floor. Region 24: bone height ~ 18.1 mm; implant space ~ 13.5 mm; nearest critical structure: incisive canal. Region 34: bone height ~ 7.1 mm; implant space ~ 3.9 mm; nearest critical structure: mandibular canal. Region 28: bone height ~ 12.6 mm; implant space ~ 10.1 mm; nearest critical structure: sinus floor. Region 47: bone height ~ 17.7 mm; implant space ~ 9.1 mm; nearest critical structure: mental foramen. Region 42: bone height ~ 6.3 mm; implant space ~ 0.0 mm; nearest critical structure: mental foramen. Region 32: bone height ~ 13.4 mm; implant space ~ 5.6 mm; nearest critical structure: mandibular canal. Region 17: bone height ~ 4.0 mm; implant space ~ 2.3 mm; nearest critical structure: sinus floor. Region 12: bone height ~ 5.4 mm; implant space ~ 0.0 mm; nearest critical structure: nasal floor. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Impression: Normal bone density throughout; suitable for implant placement.

Question: Planning for pre-surgical bone mapping. Brief history/status: Atorvastatin, Insulin glargine, Duloxetine, Duroferon, Bufomix Easyhaler, Esomeprazole, Bricanyl. Desired treatment: Evaluate periapical status of teeth 37, 13, and 14, and overall sinus condition.

Answer: Review of CBCT volume dated 220806. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 41: bone height ≈ 6.0 mm; implant space ≈ 3.8 mm; nearest critical structure: mandibular canal. Region 21: bone height ≈ 13.3 mm; implant space ≈ 6.4 mm; nearest critical structure: sinus floor. Region 24: bone height ≈ 18.1 mm; implant space ≈ 13.5 mm; nearest critical structure: incisive canal. Region 34: bone height ≈ 7.1 mm; implant space ≈ 3.9 mm; nearest critical structure: mandibular canal. Region 28: bone height ≈ 12.6 mm; implant space ≈ 10.1 mm; nearest critical structure: sinus floor. Region 47: bone height ≈ 17.7 mm; implant space ≈ 9.1 mm; nearest critical structure: mental foramen. Region 42: bone height ≈ 6.3 mm; implant space ≈ 0.0 mm; nearest critical structure: mental foramen. Region 32: bone height ≈ 13.4 mm; implant space ≈ 5.6 mm; nearest critical structure: mandibular canal. Region 17: bone height ≈ 4.0 mm; implant space ≈ 2.3 mm; nearest critical structure: sinus floor. Region 12: bone height ≈ 5.4 mm; implant space ≈ 0.0 mm; nearest critical structure: nasal floor. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Impression: Normal bone density throughout; suitable for implant placement.


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Planning for pre-orthodontic assessment. Brief history/status: Insulin glargine, Amlodipine, Duloxetine, Betolvex, Atorvastatin, Losartan, Bufomix Easyhaler, Esomeprazole. Desired treatment: Check the bone healing and trabecular fill post extraction sites 15-25.

[Assistant] Review of CBCT volume dated 221110. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 25: bone height ~ 11.0 mm; implant space ~ 8.0 mm; nearest critical structure: nasal floor. Region 46: bone height ~ 7.2 mm; implant space ~ 2.5 mm; nearest critical structure: anterior loop. Region 28: bone height ~ 5.8 mm; implant space ~ 3.7 mm; nearest critical structure: sinus floor. Region 38: bone height ~ 8.8 mm; implant space ~ 0.0 mm; nearest critical structure: mandibular canal. Region 27: bone height ~ 5.6 mm; implant space ~ 0.0 mm; nearest critical structure: sinus floor. Region 23: bone height ~ 10.6 mm; implant space ~ 4.9 mm; nearest critical structure: incisive canal. Region 13: bone height ~ 12.1 mm; implant space ~ 3.9 mm; nearest critical structure: sinus floor. Region 14: bone height ~ 8.3 mm; implant space ~ 6.4 mm; nearest critical structure: incisive canal. Region 37: bone height ~ 16.1 mm; implant space ~ 9.0 mm; nearest critical structure: mental foramen. Region 45: bone height ~ 19.9 mm; implant space ~ 16.1 mm; nearest critical structure: mental foramen. Periapical radiolucency near 45; lamina dura loss noted. Smaller radiolucency at 46. Impression: Mild to moderate mucosal thickening bilaterally in maxillary sinuses.

Question: Planning for pre-orthodontic assessment. Brief history/status: Insulin glargine, Amlodipine, Duloxetine, Betolvex, Atorvastatin, Losartan, Bufomix Easyhaler, Esomeprazole. Desired treatment: Check the bone healing and trabecular fill post extraction sites 15–25.

Answer: Review of CBCT volume dated 221110. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 25: bone height ≈ 11.0 mm; implant space ≈ 8.0 mm; nearest critical structure: nasal floor. Region 46: bone height ≈ 7.2 mm; implant space ≈ 2.5 mm; nearest critical structure: anterior loop. Region 28: bone height ≈ 5.8 mm; implant space ≈ 3.7 mm; nearest critical structure: sinus floor. Region 38: bone height ≈ 8.8 mm; implant space ≈ 0.0 mm; nearest critical structure: mandibular canal. Region 27: bone height ≈ 5.6 mm; implant space ≈ 0.0 mm; nearest critical structure: sinus floor. Region 23: bone height ≈ 10.6 mm; implant space ≈ 4.9 mm; nearest critical structure: incisive canal. Region 13: bone height ≈ 12.1 mm; implant space ≈ 3.9 mm; nearest critical structure: sinus floor. Region 14: bone height ≈ 8.3 mm; implant space ≈ 6.4 mm; nearest critical structure: incisive canal. Region 37: bone height ≈ 16.1 mm; implant space ≈ 9.0 mm; nearest critical structure: mental foramen. Region 45: bone height ≈ 19.9 mm; implant space ≈ 16.1 mm; nearest critical structure: mental foramen. Periapical radiolucency near 45; lamina dura loss noted. Smaller radiolucency at 46. Impression: Mild to moderate mucosal thickening bilaterally in maxillary sinuses.


[User]
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Planning for orthodontic anchorage evaluation. Brief history/status: Levaxin, Calcichew-D3, Insulin glargine, Bricanyl, Duloxetine. Desired treatment: Assess proximity to mandibular canal and sinus floor for 16-26 and 13-23.

[Assistant] Review of CBCT dated 210915. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 35: bone height ~ 10.9 mm; implant space ~ 3.1 mm; nearby nasal floor. Region 24: bone height ~ 11.2 mm; implant space ~ 7.9 mm; nearby mandibular canal. Region 45: bone height ~ 4.9 mm; implant space ~ 0.9 mm; nearby mandibular canal. Region 41: bone height ~ 12.8 mm; implant space ~ 6.0 mm; nearby anterior loop. Region 32: bone height ~ 17.0 mm; implant space ~ 11.8 mm; nearby anterior loop. Region 27: bone height ~ 7.3 mm; implant space ~ 4.7 mm; nearby nasal floor. Region 12: bone height ~ 8.6 mm; implant space ~ 7.4 mm; nearby mandibular canal. Region 18: bone height ~ 16.3 mm; implant space ~ 13.5 mm; nearby sinus floor. Region 22: bone height ~ 7.7 mm; implant space ~ 5.9 mm; nearby mental foramen. Region 46: bone height ~ 6.9 mm; implant space ~ 2.4 mm; nearby incisive canal. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 11; minor sclerosis near 24. Impression: Radiolucent lesion at 48 consistent with radicular cyst; recommend correlation.

Question: Planning for orthodontic anchorage evaluation. Brief history/status: Levaxin, Calcichew-D3, Insulin glargine, Bricanyl, Duloxetine. Desired treatment: Assess proximity to mandibular canal and sinus floor for 16–26 and 13–23.

Answer: Review of CBCT dated 210915. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 35: bone height ≈ 10.9 mm; implant space ≈ 3.1 mm; nearby nasal floor. Region 24: bone height ≈ 11.2 mm; implant space ≈ 7.9 mm; nearby mandibular canal. Region 45: bone height ≈ 4.9 mm; implant space ≈ 0.9 mm; nearby mandibular canal. Region 41: bone height ≈ 12.8 mm; implant space ≈ 6.0 mm; nearby anterior loop. Region 32: bone height ≈ 17.0 mm; implant space ≈ 11.8 mm; nearby anterior loop. Region 27: bone height ≈ 7.3 mm; implant space ≈ 4.7 mm; nearby nasal floor. Region 12: bone height ≈ 8.6 mm; implant space ≈ 7.4 mm; nearby mandibular canal. Region 18: bone height ≈ 16.3 mm; implant space ≈ 13.5 mm; nearby sinus floor. Region 22: bone height ≈ 7.7 mm; implant space ≈ 5.9 mm; nearby mental foramen. Region 46: bone height ≈ 6.9 mm; implant space ≈ 2.4 mm; nearby incisive canal. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 11; minor sclerosis near 24. Impression: Radiolucent lesion at 48 consistent with radicular cyst; recommend correlation.


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Planning for sinus-related complaints. Brief history/status: Amlodipine, Omeprazole, Levaxin, Losartan, Calcichew-D3, Esomeprazole. Desired treatment: Assess presence of periapical lesions and proximity to anatomical structures across 36-46.

[Assistant] Review of CBCT volume dated 230703. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 28: bone height ~ 15.4 mm; implant space ~ 9.7 mm; nearest critical structure: nasal floor. Region 16: bone height ~ 21.7 mm; implant space ~ 17.9 mm; nearest critical structure: incisive canal. Region 42: bone height ~ 10.8 mm; implant space ~ 3.6 mm; nearest critical structure: anterior loop. Region 47: bone height ~ 11.0 mm; implant space ~ 2.9 mm; nearest critical structure: mandibular canal. Region 33: bone height ~ 7.7 mm; implant space ~ 1.2 mm; nearest critical structure: anterior loop. Region 12: bone height ~ 14.4 mm; implant space ~ 12.0 mm; nearest critical structure: sinus floor. Region 26: bone height ~ 12.2 mm; implant space ~ 10.1 mm; nearest critical structure: incisive canal. Region 48: bone height ~ 20.9 mm; implant space ~ 14.7 mm; nearest critical structure: mental foramen. Region 17: bone height ~ 19.4 mm; implant space ~ 16.3 mm; nearest critical structure: sinus floor. Region 35: bone height ~ 4.0 mm; implant space ~ 0.0 mm; nearest critical structure: mandibular canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Metallic restorations cause localized streak artifacts, slightly limiting detail. Impression: Bone quantity borderline in posterior maxilla; sinus augmentation may be indicated.

Question: Planning for sinus-related complaints. Brief history/status: Amlodipine, Omeprazole, Levaxin, Losartan, Calcichew-D3, Esomeprazole. Desired treatment: Assess presence of periapical lesions and proximity to anatomical structures across 36–46.

Answer: Review of CBCT volume dated 230703. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 28: bone height ≈ 15.4 mm; implant space ≈ 9.7 mm; nearest critical structure: nasal floor. Region 16: bone height ≈ 21.7 mm; implant space ≈ 17.9 mm; nearest critical structure: incisive canal. Region 42: bone height ≈ 10.8 mm; implant space ≈ 3.6 mm; nearest critical structure: anterior loop. Region 47: bone height ≈ 11.0 mm; implant space ≈ 2.9 mm; nearest critical structure: mandibular canal. Region 33: bone height ≈ 7.7 mm; implant space ≈ 1.2 mm; nearest critical structure: anterior loop. Region 12: bone height ≈ 14.4 mm; implant space ≈ 12.0 mm; nearest critical structure: sinus floor. Region 26: bone height ≈ 12.2 mm; implant space ≈ 10.1 mm; nearest critical structure: incisive canal. Region 48: bone height ≈ 20.9 mm; implant space ≈ 14.7 mm; nearest critical structure: mental foramen. Region 17: bone height ≈ 19.4 mm; implant space ≈ 16.3 mm; nearest critical structure: sinus floor. Region 35: bone height ≈ 4.0 mm; implant space ≈ 0.0 mm; nearest critical structure: mandibular canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Metallic restorations cause localized streak artifacts, slightly limiting detail. Impression: Bone quantity borderline in posterior maxilla; sinus augmentation may be indicated.


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Planning for sinus-related complaints. Brief history/status: Metoprolol, Trulicity, Insulin glargine, Levaxin, Duloxetine, Losartan, Esomeprazole, Atorvastatin. Desired treatment: Assess presence of periapical lesions and proximity to anatomical structures across 15-25.

[Assistant] Review of CBCT volume dated 220824. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 48: bone height ~ 13.6 mm; implant space ~ 11.2 mm; nearest critical structure: mandibular canal. Region 41: bone height ~ 18.5 mm; implant space ~ 13.2 mm; nearest critical structure: anterior loop. Region 15: bone height ~ 21.2 mm; implant space ~ 17.1 mm; nearest critical structure: incisive canal. Region 12: bone height ~ 22.0 mm; implant space ~ 18.5 mm; nearest critical structure: incisive canal. Region 43: bone height ~ 9.5 mm; implant space ~ 4.9 mm; nearest critical structure: mandibular canal. Region 14: bone height ~ 8.7 mm; implant space ~ 2.1 mm; nearest critical structure: sinus floor. Region 32: bone height ~ 4.2 mm; implant space ~ 1.9 mm; nearest critical structure: anterior loop. Region 17: bone height ~ 12.2 mm; implant space ~ 10.5 mm; nearest critical structure: incisive canal. Region 44: bone height ~ 21.1 mm; implant space ~ 15.8 mm; nearest critical structure: anterior loop. Region 11: bone height ~ 10.0 mm; implant space ~ 5.2 mm; nearest critical structure: nasal floor. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency near 37; lamina dura loss noted. Smaller radiolucency at 38. Impression: Cyst-like well-defined radiolucency near 36, likely radicular cyst.

Question: Planning for sinus-related complaints. Brief history/status: Metoprolol, Trulicity, Insulin glargine, Levaxin, Duloxetine, Losartan, Esomeprazole, Atorvastatin. Desired treatment: Assess presence of periapical lesions and proximity to anatomical structures across 15–25.

Answer: Review of CBCT volume dated 220824. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 48: bone height ≈ 13.6 mm; implant space ≈ 11.2 mm; nearest critical structure: mandibular canal. Region 41: bone height ≈ 18.5 mm; implant space ≈ 13.2 mm; nearest critical structure: anterior loop. Region 15: bone height ≈ 21.2 mm; implant space ≈ 17.1 mm; nearest critical structure: incisive canal. Region 12: bone height ≈ 22.0 mm; implant space ≈ 18.5 mm; nearest critical structure: incisive canal. Region 43: bone height ≈ 9.5 mm; implant space ≈ 4.9 mm; nearest critical structure: mandibular canal. Region 14: bone height ≈ 8.7 mm; implant space ≈ 2.1 mm; nearest critical structure: sinus floor. Region 32: bone height ≈ 4.2 mm; implant space ≈ 1.9 mm; nearest critical structure: anterior loop. Region 17: bone height ≈ 12.2 mm; implant space ≈ 10.5 mm; nearest critical structure: incisive canal. Region 44: bone height ≈ 21.1 mm; implant space ≈ 15.8 mm; nearest critical structure: anterior loop. Region 11: bone height ≈ 10.0 mm; implant space ≈ 5.2 mm; nearest critical structure: nasal floor. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency near 37; lamina dura loss noted. Smaller radiolucency at 38. Impression: Cyst-like well-defined radiolucency near 36, likely radicular cyst.


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Planning for bone grafting assessment. Brief history/status: Trulicity, Atorvastatin, Bricanyl, Metoprolol, Losartan. Desired treatment: Please analyze bone height, width, and proximity to critical anatomy across 14-24 and 14-24.

[Assistant] Review of CBCT scan dated 250615. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 31: bone height ~ 13.6 mm; implant space ~ 8.9 mm; nearby structure: sinus floor. Region 11: bone height ~ 16.1 mm; implant space ~ 9.5 mm; nearby structure: nasal floor. Region 24: bone height ~ 12.8 mm; implant space ~ 6.8 mm; nearby structure: anterior loop. Region 26: bone height ~ 14.9 mm; implant space ~ 7.8 mm; nearby structure: nasal floor. Region 42: bone height ~ 21.8 mm; implant space ~ 20.7 mm; nearby structure: mental foramen. Region 36: bone height ~ 17.8 mm; implant space ~ 16.4 mm; nearby structure: anterior loop. Region 21: bone height ~ 4.5 mm; implant space ~ 0 mm; nearby structure: anterior loop. Region 25: bone height ~ 11.2 mm; implant space ~ 4.3 mm; nearby structure: anterior loop. Region 16: bone height ~ 17.0 mm; implant space ~ 10.8 mm; nearby structure: anterior loop. Region 14: bone height ~ 6.2 mm; implant space ~ 2.1 mm; nearby structure: nasal floor. Maxillary sinus shows mild mucosal thickening bilaterally. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Residual ridge height insufficient in 41; sinus lift recommended.

Question: Planning for bone grafting assessment. Brief history/status: Trulicity, Atorvastatin, Bricanyl, Metoprolol, Losartan. Desired treatment: Please analyze bone height, width, and proximity to critical anatomy across 14–24 and 14–24.

Answer: Review of CBCT scan dated 250615. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 31: bone height ≈ 13.6 mm; implant space ≈ 8.9 mm; nearby structure: sinus floor. Region 11: bone height ≈ 16.1 mm; implant space ≈ 9.5 mm; nearby structure: nasal floor. Region 24: bone height ≈ 12.8 mm; implant space ≈ 6.8 mm; nearby structure: anterior loop. Region 26: bone height ≈ 14.9 mm; implant space ≈ 7.8 mm; nearby structure: nasal floor. Region 42: bone height ≈ 21.8 mm; implant space ≈ 20.7 mm; nearby structure: mental foramen. Region 36: bone height ≈ 17.8 mm; implant space ≈ 16.4 mm; nearby structure: anterior loop. Region 21: bone height ≈ 4.5 mm; implant space ≈ 0 mm; nearby structure: anterior loop. Region 25: bone height ≈ 11.2 mm; implant space ≈ 4.3 mm; nearby structure: anterior loop. Region 16: bone height ≈ 17.0 mm; implant space ≈ 10.8 mm; nearby structure: anterior loop. Region 14: bone height ≈ 6.2 mm; implant space ≈ 2.1 mm; nearby structure: nasal floor. Maxillary sinus shows mild mucosal thickening bilaterally. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Residual ridge height insufficient in 41; sinus lift recommended.


[User]
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Planning for implant planning. Brief history/status: Levaxin, Betolvex, Metoprolol, Amlodipine, Calcichew-D3, Esomeprazole. Desired treatment: Please evaluate bone height, implant space, and anatomical constraints for regions 14-24 and 33-43.

[Assistant] Review of CBCT dated 240115. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 41: bone height ~ 16.8 mm; implant space ~ 12.7 mm; nearby incisive canal. Region 24: bone height ~ 6.4 mm; implant space ~ 0 mm; nearby mandibular canal. Region 13: bone height ~ 21.7 mm; implant space ~ 17.4 mm; nearby incisive canal. Region 15: bone height ~ 13.1 mm; implant space ~ 10.0 mm; nearby mental foramen. Region 42: bone height ~ 12.4 mm; implant space ~ 9.2 mm; nearby nasal floor. Region 46: bone height ~ 4.7 mm; implant space ~ 3.2 mm; nearby nasal floor. Region 22: bone height ~ 18.3 mm; implant space ~ 11.5 mm; nearby anterior loop. Region 47: bone height ~ 17.7 mm; implant space ~ 16.7 mm; nearby mental foramen. Region 12: bone height ~ 13.8 mm; implant space ~ 10.3 mm; nearby nasal floor. Region 18: bone height ~ 21.8 mm; implant space ~ 14.5 mm; nearby anterior loop. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 32; minor sclerosis near 24. Image artifacts due to metallic restorations reduce detail locally. Impression: Peri-implantitis changes evident at 24; marginal bone loss noted.

Question: Planning for implant planning. Brief history/status: Levaxin, Betolvex, Metoprolol, Amlodipine, Calcichew-D3, Esomeprazole. Desired treatment: Please evaluate bone height, implant space, and anatomical constraints for regions 14–24 and 33–43.

Answer: Review of CBCT dated 240115. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 41: bone height ≈ 16.8 mm; implant space ≈ 12.7 mm; nearby incisive canal. Region 24: bone height ≈ 6.4 mm; implant space ≈ 0 mm; nearby mandibular canal. Region 13: bone height ≈ 21.7 mm; implant space ≈ 17.4 mm; nearby incisive canal. Region 15: bone height ≈ 13.1 mm; implant space ≈ 10.0 mm; nearby mental foramen. Region 42: bone height ≈ 12.4 mm; implant space ≈ 9.2 mm; nearby nasal floor. Region 46: bone height ≈ 4.7 mm; implant space ≈ 3.2 mm; nearby nasal floor. Region 22: bone height ≈ 18.3 mm; implant space ≈ 11.5 mm; nearby anterior loop. Region 47: bone height ≈ 17.7 mm; implant space ≈ 16.7 mm; nearby mental foramen. Region 12: bone height ≈ 13.8 mm; implant space ≈ 10.3 mm; nearby nasal floor. Region 18: bone height ≈ 21.8 mm; implant space ≈ 14.5 mm; nearby anterior loop. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 32; minor sclerosis near 24. Image artifacts due to metallic restorations reduce detail locally. Impression: Peri-implantitis changes evident at 24; marginal bone loss noted.


[User]
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Planning for pre-surgical bone mapping. Brief history/status: Duroferon, Duloxetine, Calcichew-D3, Bricanyl, Losartan, Metoprolol, Esomeprazole, Atorvastatin, Levaxin. Desired treatment: Report any signs of peri-implantitis and root resorption in 15-25.

[Assistant] Review of CBCT volume dated 210425. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 37: bone height ~ 15.4 mm; implant space ~ 10.7 mm; nearest critical structure: anterior loop. Region 25: bone height ~ 9.6 mm; implant space ~ 3.5 mm; nearest critical structure: sinus floor. Region 46: bone height ~ 19.8 mm; implant space ~ 11.4 mm; nearest critical structure: mandibular canal. Region 24: bone height ~ 13.1 mm; implant space ~ 6.6 mm; nearest critical structure: sinus floor. Region 36: bone height ~ 13.4 mm; implant space ~ 10.9 mm; nearest critical structure: mental foramen. Region 16: bone height ~ 12.4 mm; implant space ~ 8.2 mm; nearest critical structure: nasal floor. Region 11: bone height ~ 8.6 mm; implant space ~ 4.9 mm; nearest critical structure: nasal floor. Region 18: bone height ~ 9.6 mm; implant space ~ 3.2 mm; nearest critical structure: incisive canal. Region 38: bone height ~ 21.8 mm; implant space ~ 13.0 mm; nearest critical structure: anterior loop. Region 34: bone height ~ 6.9 mm; implant space ~ 0.0 mm; nearest critical structure: mental foramen. Streak artifacts from metallic restorations locally reduce interpretability. Impression: Findings consistent with chronic apical periodontitis at 28 and 43.

Question: Planning for pre-surgical bone mapping. Brief history/status: Duroferon, Duloxetine, Calcichew-D3, Bricanyl, Losartan, Metoprolol, Esomeprazole, Atorvastatin, Levaxin. Desired treatment: Report any signs of peri-implantitis and root resorption in 15–25.

Answer: Review of CBCT volume dated 210425. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 37: bone height ≈ 15.4 mm; implant space ≈ 10.7 mm; nearest critical structure: anterior loop. Region 25: bone height ≈ 9.6 mm; implant space ≈ 3.5 mm; nearest critical structure: sinus floor. Region 46: bone height ≈ 19.8 mm; implant space ≈ 11.4 mm; nearest critical structure: mandibular canal. Region 24: bone height ≈ 13.1 mm; implant space ≈ 6.6 mm; nearest critical structure: sinus floor. Region 36: bone height ≈ 13.4 mm; implant space ≈ 10.9 mm; nearest critical structure: mental foramen. Region 16: bone height ≈ 12.4 mm; implant space ≈ 8.2 mm; nearest critical structure: nasal floor. Region 11: bone height ≈ 8.6 mm; implant space ≈ 4.9 mm; nearest critical structure: nasal floor. Region 18: bone height ≈ 9.6 mm; implant space ≈ 3.2 mm; nearest critical structure: incisive canal. Region 38: bone height ≈ 21.8 mm; implant space ≈ 13.0 mm; nearest critical structure: anterior loop. Region 34: bone height ≈ 6.9 mm; implant space ≈ 0.0 mm; nearest critical structure: mental foramen. Streak artifacts from metallic restorations locally reduce interpretability. Impression: Findings consistent with chronic apical periodontitis at 28 and 43.


[User]
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Planning for full-mouth rehabilitation. Brief history/status: Esomeprazole, Calcichew-D3, Trulicity, Levaxin, Duloxetine, Atorvastatin, Bricanyl, Losartan. Desired treatment: Assess healing of extraction sockets and bone regeneration at 33-43.

[Assistant] Review of CBCT dated 200106. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 37: bone height ~ 20.6 mm; implant space ~ 15.1 mm; nearby mandibular canal. Region 17: bone height ~ 4.8 mm; implant space ~ 0 mm; nearby sinus floor. Region 38: bone height ~ 8.9 mm; implant space ~ 3.0 mm; nearby sinus floor. Region 12: bone height ~ 20.3 mm; implant space ~ 15.8 mm; nearby anterior loop. Region 13: bone height ~ 16.3 mm; implant space ~ 11.2 mm; nearby incisive canal. Region 21: bone height ~ 13.6 mm; implant space ~ 9.4 mm; nearby incisive canal. Region 41: bone height ~ 14.9 mm; implant space ~ 11.6 mm; nearby mandibular canal. Region 36: bone height ~ 17.3 mm; implant space ~ 13.0 mm; nearby anterior loop. Region 18: bone height ~ 18.4 mm; implant space ~ 17.4 mm; nearby mandibular canal. Region 24: bone height ~ 5.8 mm; implant space ~ 3.9 mm; nearby incisive canal. Periapical radiolucency observed near 17; minor sclerosis near 42. Image artifacts due to metallic restorations reduce detail locally. Impression: Vertical root fracture suspected at 43, extending coronally.

Question: Planning for full-mouth rehabilitation. Brief history/status: Esomeprazole, Calcichew-D3, Trulicity, Levaxin, Duloxetine, Atorvastatin, Bricanyl, Losartan. Desired treatment: Assess healing of extraction sockets and bone regeneration at 33–43.

Answer: Review of CBCT dated 200106. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 37: bone height ≈ 20.6 mm; implant space ≈ 15.1 mm; nearby mandibular canal. Region 17: bone height ≈ 4.8 mm; implant space ≈ 0 mm; nearby sinus floor. Region 38: bone height ≈ 8.9 mm; implant space ≈ 3.0 mm; nearby sinus floor. Region 12: bone height ≈ 20.3 mm; implant space ≈ 15.8 mm; nearby anterior loop. Region 13: bone height ≈ 16.3 mm; implant space ≈ 11.2 mm; nearby incisive canal. Region 21: bone height ≈ 13.6 mm; implant space ≈ 9.4 mm; nearby incisive canal. Region 41: bone height ≈ 14.9 mm; implant space ≈ 11.6 mm; nearby mandibular canal. Region 36: bone height ≈ 17.3 mm; implant space ≈ 13.0 mm; nearby anterior loop. Region 18: bone height ≈ 18.4 mm; implant space ≈ 17.4 mm; nearby mandibular canal. Region 24: bone height ≈ 5.8 mm; implant space ≈ 3.9 mm; nearby incisive canal. Periapical radiolucency observed near 17; minor sclerosis near 42. Image artifacts due to metallic restorations reduce detail locally. Impression: Vertical root fracture suspected at 43, extending coronally.


[User]
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Planning for pre-implant radiological mapping. Brief history/status: Calcichew-D3, Levaxin, Bufomix Easyhaler, Metoprolol, Esomeprazole, Duloxetine. Desired treatment: Evaluate cortical thickness and spongy bone quality in 33-43.

[Assistant] Review of CBCT scan dated 250422. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 27: bone height ~ 16.1 mm; implant space ~ 14.0 mm; nearby structure: mandibular canal. Region 15: bone height ~ 7.3 mm; implant space ~ 0 mm; nearby structure: mandibular canal. Region 21: bone height ~ 17.2 mm; implant space ~ 12.4 mm; nearby structure: sinus floor. Region 28: bone height ~ 6.1 mm; implant space ~ 3.0 mm; nearby structure: nasal floor. Region 17: bone height ~ 16.5 mm; implant space ~ 10.7 mm; nearby structure: nasal floor. Region 44: bone height ~ 7.0 mm; implant space ~ 0 mm; nearby structure: mental foramen. Region 43: bone height ~ 9.1 mm; implant space ~ 3.7 mm; nearby structure: anterior loop. Region 37: bone height ~ 9.2 mm; implant space ~ 3.8 mm; nearby structure: nasal floor. Region 22: bone height ~ 15.6 mm; implant space ~ 13.8 mm; nearby structure: mental foramen. Region 32: bone height ~ 12.6 mm; implant space ~ 7.4 mm; nearby structure: mental foramen. Maxillary sinus shows mild mucosal thickening bilaterally. Periapical radiolucency visible at 17, additional smaller lesion near 35. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Residual ridge height insufficient in 15; sinus lift recommended.

Question: Planning for pre-implant radiological mapping. Brief history/status: Calcichew-D3, Levaxin, Bufomix Easyhaler, Metoprolol, Esomeprazole, Duloxetine. Desired treatment: Evaluate cortical thickness and spongy bone quality in 33–43.

Answer: Review of CBCT scan dated 250422. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 27: bone height ≈ 16.1 mm; implant space ≈ 14.0 mm; nearby structure: mandibular canal. Region 15: bone height ≈ 7.3 mm; implant space ≈ 0 mm; nearby structure: mandibular canal. Region 21: bone height ≈ 17.2 mm; implant space ≈ 12.4 mm; nearby structure: sinus floor. Region 28: bone height ≈ 6.1 mm; implant space ≈ 3.0 mm; nearby structure: nasal floor. Region 17: bone height ≈ 16.5 mm; implant space ≈ 10.7 mm; nearby structure: nasal floor. Region 44: bone height ≈ 7.0 mm; implant space ≈ 0 mm; nearby structure: mental foramen. Region 43: bone height ≈ 9.1 mm; implant space ≈ 3.7 mm; nearby structure: anterior loop. Region 37: bone height ≈ 9.2 mm; implant space ≈ 3.8 mm; nearby structure: nasal floor. Region 22: bone height ≈ 15.6 mm; implant space ≈ 13.8 mm; nearby structure: mental foramen. Region 32: bone height ≈ 12.6 mm; implant space ≈ 7.4 mm; nearby structure: mental foramen. Maxillary sinus shows mild mucosal thickening bilaterally. Periapical radiolucency visible at 17, additional smaller lesion near 35. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Residual ridge height insufficient in 15; sinus lift recommended.


[User]
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Planning for pre-surgical bone mapping. Brief history/status: Atorvastatin, Metoprolol, Calcichew-D3, Bufomix Easyhaler, Omeprazole, Amlodipine, Betolvex. Desired treatment: Review the sinus floor elevation and ridge thickness for 37-47.

[Assistant] Review of CBCT volume dated 250112. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 11: bone height ~ 6.8 mm; implant space ~ 0.0 mm; nearest critical structure: sinus floor. Region 45: bone height ~ 16.1 mm; implant space ~ 10.3 mm; nearest critical structure: mandibular canal. Region 31: bone height ~ 14.8 mm; implant space ~ 9.0 mm; nearest critical structure: mandibular canal. Region 13: bone height ~ 21.7 mm; implant space ~ 13.3 mm; nearest critical structure: nasal floor. Region 24: bone height ~ 20.9 mm; implant space ~ 17.4 mm; nearest critical structure: sinus floor. Region 34: bone height ~ 17.2 mm; implant space ~ 15.1 mm; nearest critical structure: mandibular canal. Region 44: bone height ~ 16.0 mm; implant space ~ 13.1 mm; nearest critical structure: mental foramen. Region 27: bone height ~ 20.1 mm; implant space ~ 17.5 mm; nearest critical structure: incisive canal. Region 25: bone height ~ 15.6 mm; implant space ~ 10.1 mm; nearest critical structure: nasal floor. Region 38: bone height ~ 18.2 mm; implant space ~ 13.5 mm; nearest critical structure: mandibular canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Impression: Mild to moderate mucosal thickening bilaterally in maxillary sinuses.

Question: Planning for pre-surgical bone mapping. Brief history/status: Atorvastatin, Metoprolol, Calcichew-D3, Bufomix Easyhaler, Omeprazole, Amlodipine, Betolvex. Desired treatment: Review the sinus floor elevation and ridge thickness for 37–47.

Answer: Review of CBCT volume dated 250112. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 11: bone height ≈ 6.8 mm; implant space ≈ 0.0 mm; nearest critical structure: sinus floor. Region 45: bone height ≈ 16.1 mm; implant space ≈ 10.3 mm; nearest critical structure: mandibular canal. Region 31: bone height ≈ 14.8 mm; implant space ≈ 9.0 mm; nearest critical structure: mandibular canal. Region 13: bone height ≈ 21.7 mm; implant space ≈ 13.3 mm; nearest critical structure: nasal floor. Region 24: bone height ≈ 20.9 mm; implant space ≈ 17.4 mm; nearest critical structure: sinus floor. Region 34: bone height ≈ 17.2 mm; implant space ≈ 15.1 mm; nearest critical structure: mandibular canal. Region 44: bone height ≈ 16.0 mm; implant space ≈ 13.1 mm; nearest critical structure: mental foramen. Region 27: bone height ≈ 20.1 mm; implant space ≈ 17.5 mm; nearest critical structure: incisive canal. Region 25: bone height ≈ 15.6 mm; implant space ≈ 10.1 mm; nearest critical structure: nasal floor. Region 38: bone height ≈ 18.2 mm; implant space ≈ 13.5 mm; nearest critical structure: mandibular canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Impression: Mild to moderate mucosal thickening bilaterally in maxillary sinuses.


[User]
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Planning for implant site evaluation. Brief history/status: Metoprolol, Bufomix Easyhaler, Bricanyl, Betolvex, Duroferon, Duloxetine, Amlodipine, Trulicity, Insulin glargine. Desired treatment: Please report bone height and available implant space for regions 15-25 and 35-45.

[Assistant] Review of CBCT volume dated 251114. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 24: bone height ~ 10.6 mm; implant space ~ 3.6 mm; nearest critical structure: incisive canal. Region 18: bone height ~ 10.8 mm; implant space ~ 4.5 mm; nearest critical structure: incisive canal. Region 33: bone height ~ 4.5 mm; implant space ~ 2.1 mm; nearest critical structure: anterior loop. Region 48: bone height ~ 13.6 mm; implant space ~ 7.9 mm; nearest critical structure: anterior loop. Region 11: bone height ~ 21.2 mm; implant space ~ 15.4 mm; nearest critical structure: nasal floor. Region 41: bone height ~ 8.3 mm; implant space ~ 5.9 mm; nearest critical structure: mandibular canal. Region 26: bone height ~ 6.2 mm; implant space ~ 1.8 mm; nearest critical structure: nasal floor. Region 23: bone height ~ 21.2 mm; implant space ~ 13.7 mm; nearest critical structure: sinus floor. Region 16: bone height ~ 5.2 mm; implant space ~ 1.0 mm; nearest critical structure: nasal floor. Region 35: bone height ~ 21.1 mm; implant space ~ 12.2 mm; nearest critical structure: mandibular canal. Impression: Impaction of third molar in quadrant 1 with mesioangular inclination.

Question: Planning for implant site evaluation. Brief history/status: Metoprolol, Bufomix Easyhaler, Bricanyl, Betolvex, Duroferon, Duloxetine, Amlodipine, Trulicity, Insulin glargine. Desired treatment: Please report bone height and available implant space for regions 15–25 and 35–45.

Answer: Review of CBCT volume dated 251114. Bone quality ranges from ordinary to reduced in posterior segments. Implant space is referenced from a 5 mm minimal bone width threshold. Region 24: bone height ≈ 10.6 mm; implant space ≈ 3.6 mm; nearest critical structure: incisive canal. Region 18: bone height ≈ 10.8 mm; implant space ≈ 4.5 mm; nearest critical structure: incisive canal. Region 33: bone height ≈ 4.5 mm; implant space ≈ 2.1 mm; nearest critical structure: anterior loop. Region 48: bone height ≈ 13.6 mm; implant space ≈ 7.9 mm; nearest critical structure: anterior loop. Region 11: bone height ≈ 21.2 mm; implant space ≈ 15.4 mm; nearest critical structure: nasal floor. Region 41: bone height ≈ 8.3 mm; implant space ≈ 5.9 mm; nearest critical structure: mandibular canal. Region 26: bone height ≈ 6.2 mm; implant space ≈ 1.8 mm; nearest critical structure: nasal floor. Region 23: bone height ≈ 21.2 mm; implant space ≈ 13.7 mm; nearest critical structure: sinus floor. Region 16: bone height ≈ 5.2 mm; implant space ≈ 1.0 mm; nearest critical structure: nasal floor. Region 35: bone height ≈ 21.1 mm; implant space ≈ 12.2 mm; nearest critical structure: mandibular canal. Impression: Impaction of third molar in quadrant 1 with mesioangular inclination.


[User]
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Planning for pre-implant radiological mapping. Brief history/status: Duroferon, Levaxin, Bricanyl, Betolvex, Losartan, Omeprazole. Desired treatment: Please analyze bone height, width, and proximity to critical anatomy across 36-46 and 13-23.

[Assistant] Review of CBCT scan dated 230921. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 25: bone height ~ 5.6 mm; implant space ~ 0 mm; nearby structure: anterior loop. Region 48: bone height ~ 15.4 mm; implant space ~ 10.0 mm; nearby structure: anterior loop. Region 47: bone height ~ 20.9 mm; implant space ~ 16.6 mm; nearby structure: nasal floor. Region 28: bone height ~ 17.2 mm; implant space ~ 10.0 mm; nearby structure: nasal floor. Region 14: bone height ~ 11.4 mm; implant space ~ 9.4 mm; nearby structure: mental foramen. Region 33: bone height ~ 7.7 mm; implant space ~ 1.2 mm; nearby structure: sinus floor. Region 12: bone height ~ 16.0 mm; implant space ~ 13.5 mm; nearby structure: sinus floor. Region 43: bone height ~ 12.7 mm; implant space ~ 8.2 mm; nearby structure: mental foramen. Region 16: bone height ~ 11.3 mm; implant space ~ 7.0 mm; nearby structure: nasal floor. Region 13: bone height ~ 14.7 mm; implant space ~ 7.8 mm; nearby structure: mental foramen. Maxillary sinus shows mild mucosal thickening bilaterally. Impression: Normal trabecular pattern observed; cortical plates intact.

Question: Planning for pre-implant radiological mapping. Brief history/status: Duroferon, Levaxin, Bricanyl, Betolvex, Losartan, Omeprazole. Desired treatment: Please analyze bone height, width, and proximity to critical anatomy across 36–46 and 13–23.

Answer: Review of CBCT scan dated 230921. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 25: bone height ≈ 5.6 mm; implant space ≈ 0 mm; nearby structure: anterior loop. Region 48: bone height ≈ 15.4 mm; implant space ≈ 10.0 mm; nearby structure: anterior loop. Region 47: bone height ≈ 20.9 mm; implant space ≈ 16.6 mm; nearby structure: nasal floor. Region 28: bone height ≈ 17.2 mm; implant space ≈ 10.0 mm; nearby structure: nasal floor. Region 14: bone height ≈ 11.4 mm; implant space ≈ 9.4 mm; nearby structure: mental foramen. Region 33: bone height ≈ 7.7 mm; implant space ≈ 1.2 mm; nearby structure: sinus floor. Region 12: bone height ≈ 16.0 mm; implant space ≈ 13.5 mm; nearby structure: sinus floor. Region 43: bone height ≈ 12.7 mm; implant space ≈ 8.2 mm; nearby structure: mental foramen. Region 16: bone height ≈ 11.3 mm; implant space ≈ 7.0 mm; nearby structure: nasal floor. Region 13: bone height ≈ 14.7 mm; implant space ≈ 7.8 mm; nearby structure: mental foramen. Maxillary sinus shows mild mucosal thickening bilaterally. Impression: Normal trabecular pattern observed; cortical plates intact.


[User]
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Planning for assessment of residual ridge. Brief history/status: Bricanyl, Duloxetine, Calcichew-D3, Bufomix Easyhaler, Insulin glargine. Desired treatment: Measure available vertical height and ridge width in 33-43 and 14-24.

[Assistant] Review of CBCT scan dated 250810. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 47: bone height ~ 10.0 mm; implant space ~ 3.5 mm; nearby structure: nasal floor. Region 35: bone height ~ 13.4 mm; implant space ~ 6.1 mm; nearby structure: nasal floor. Region 21: bone height ~ 8.8 mm; implant space ~ 3.6 mm; nearby structure: anterior loop. Region 46: bone height ~ 20.1 mm; implant space ~ 12.3 mm; nearby structure: nasal floor. Region 27: bone height ~ 10.8 mm; implant space ~ 7.2 mm; nearby structure: mandibular canal. Region 33: bone height ~ 10.3 mm; implant space ~ 5.3 mm; nearby structure: anterior loop. Region 34: bone height ~ 4.0 mm; implant space ~ 1.0 mm; nearby structure: sinus floor. Region 18: bone height ~ 10.1 mm; implant space ~ 2.7 mm; nearby structure: nasal floor. Region 15: bone height ~ 19.6 mm; implant space ~ 17.7 mm; nearby structure: mandibular canal. Region 25: bone height ~ 6.2 mm; implant space ~ 1.6 mm; nearby structure: mandibular canal. Maxillary sinus shows mild mucosal thickening bilaterally. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Diffuse radiolucency with irregular margin near 16; correlate clinically.

Question: Planning for assessment of residual ridge. Brief history/status: Bricanyl, Duloxetine, Calcichew-D3, Bufomix Easyhaler, Insulin glargine. Desired treatment: Measure available vertical height and ridge width in 33–43 and 14–24.

Answer: Review of CBCT scan dated 250810. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 47: bone height ≈ 10.0 mm; implant space ≈ 3.5 mm; nearby structure: nasal floor. Region 35: bone height ≈ 13.4 mm; implant space ≈ 6.1 mm; nearby structure: nasal floor. Region 21: bone height ≈ 8.8 mm; implant space ≈ 3.6 mm; nearby structure: anterior loop. Region 46: bone height ≈ 20.1 mm; implant space ≈ 12.3 mm; nearby structure: nasal floor. Region 27: bone height ≈ 10.8 mm; implant space ≈ 7.2 mm; nearby structure: mandibular canal. Region 33: bone height ≈ 10.3 mm; implant space ≈ 5.3 mm; nearby structure: anterior loop. Region 34: bone height ≈ 4.0 mm; implant space ≈ 1.0 mm; nearby structure: sinus floor. Region 18: bone height ≈ 10.1 mm; implant space ≈ 2.7 mm; nearby structure: nasal floor. Region 15: bone height ≈ 19.6 mm; implant space ≈ 17.7 mm; nearby structure: mandibular canal. Region 25: bone height ≈ 6.2 mm; implant space ≈ 1.6 mm; nearby structure: mandibular canal. Maxillary sinus shows mild mucosal thickening bilaterally. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Diffuse radiolucency with irregular margin near 16; correlate clinically.


[User]
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Planning for assessment for guided surgery. Brief history/status: Levaxin, Omeprazole, Amlodipine, Calcichew-D3, Duroferon, Losartan. Desired treatment: Report any signs of peri-implantitis and root resorption in 35-45.

[Assistant] Review of CBCT volume dated 230415. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 33: bone height ~ 4.6 mm; implant space ~ 0.0 mm; nearest critical structure: mental foramen. Region 43: bone height ~ 19.6 mm; implant space ~ 11.8 mm; nearest critical structure: anterior loop. Region 47: bone height ~ 12.3 mm; implant space ~ 6.5 mm; nearest critical structure: mental foramen. Region 14: bone height ~ 20.8 mm; implant space ~ 13.3 mm; nearest critical structure: incisive canal. Region 24: bone height ~ 18.6 mm; implant space ~ 13.8 mm; nearest critical structure: incisive canal. Region 36: bone height ~ 17.7 mm; implant space ~ 10.7 mm; nearest critical structure: mandibular canal. Region 34: bone height ~ 12.5 mm; implant space ~ 9.6 mm; nearest critical structure: mental foramen. Region 44: bone height ~ 11.0 mm; implant space ~ 3.8 mm; nearest critical structure: mental foramen. Region 35: bone height ~ 17.4 mm; implant space ~ 10.2 mm; nearest critical structure: mandibular canal. Region 16: bone height ~ 20.4 mm; implant space ~ 16.1 mm; nearest critical structure: nasal floor. Impression: Bone quantity borderline in posterior maxilla; sinus augmentation may be indicated.

Question: Planning for assessment for guided surgery. Brief history/status: Levaxin, Omeprazole, Amlodipine, Calcichew-D3, Duroferon, Losartan. Desired treatment: Report any signs of peri-implantitis and root resorption in 35–45.

Answer: Review of CBCT volume dated 230415. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 33: bone height ≈ 4.6 mm; implant space ≈ 0.0 mm; nearest critical structure: mental foramen. Region 43: bone height ≈ 19.6 mm; implant space ≈ 11.8 mm; nearest critical structure: anterior loop. Region 47: bone height ≈ 12.3 mm; implant space ≈ 6.5 mm; nearest critical structure: mental foramen. Region 14: bone height ≈ 20.8 mm; implant space ≈ 13.3 mm; nearest critical structure: incisive canal. Region 24: bone height ≈ 18.6 mm; implant space ≈ 13.8 mm; nearest critical structure: incisive canal. Region 36: bone height ≈ 17.7 mm; implant space ≈ 10.7 mm; nearest critical structure: mandibular canal. Region 34: bone height ≈ 12.5 mm; implant space ≈ 9.6 mm; nearest critical structure: mental foramen. Region 44: bone height ≈ 11.0 mm; implant space ≈ 3.8 mm; nearest critical structure: mental foramen. Region 35: bone height ≈ 17.4 mm; implant space ≈ 10.2 mm; nearest critical structure: mandibular canal. Region 16: bone height ≈ 20.4 mm; implant space ≈ 16.1 mm; nearest critical structure: nasal floor. Impression: Bone quantity borderline in posterior maxilla; sinus augmentation may be indicated.


[User]
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Planning for implant site evaluation. Brief history/status: Omeprazole, Levaxin, Bricanyl, Betolvex, Trulicity, Insulin glargine, Duloxetine. Desired treatment: Evaluate periapical status of teeth 18, 16, and 17, and overall sinus condition.

[Assistant] Review of CBCT volume dated 220804. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 12: bone height ~ 4.8 mm; implant space ~ 0.0 mm; nearest critical structure: nasal floor. Region 32: bone height ~ 15.1 mm; implant space ~ 6.2 mm; nearest critical structure: mandibular canal. Region 48: bone height ~ 16.3 mm; implant space ~ 14.0 mm; nearest critical structure: mental foramen. Region 14: bone height ~ 5.5 mm; implant space ~ 1.0 mm; nearest critical structure: incisive canal. Region 45: bone height ~ 4.9 mm; implant space ~ 1.8 mm; nearest critical structure: mandibular canal. Region 28: bone height ~ 14.2 mm; implant space ~ 6.8 mm; nearest critical structure: nasal floor. Region 37: bone height ~ 21.8 mm; implant space ~ 15.1 mm; nearest critical structure: mental foramen. Region 31: bone height ~ 19.0 mm; implant space ~ 13.1 mm; nearest critical structure: mental foramen. Region 41: bone height ~ 21.4 mm; implant space ~ 15.9 mm; nearest critical structure: mental foramen. Region 16: bone height ~ 8.9 mm; implant space ~ 6.6 mm; nearest critical structure: incisive canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency near 28; lamina dura loss noted. Smaller radiolucency at 33. Impression: Findings consistent with chronic apical periodontitis at 47 and 28.

Question: Planning for implant site evaluation. Brief history/status: Omeprazole, Levaxin, Bricanyl, Betolvex, Trulicity, Insulin glargine, Duloxetine. Desired treatment: Evaluate periapical status of teeth 18, 16, and 17, and overall sinus condition.

Answer: Review of CBCT volume dated 220804. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 12: bone height ≈ 4.8 mm; implant space ≈ 0.0 mm; nearest critical structure: nasal floor. Region 32: bone height ≈ 15.1 mm; implant space ≈ 6.2 mm; nearest critical structure: mandibular canal. Region 48: bone height ≈ 16.3 mm; implant space ≈ 14.0 mm; nearest critical structure: mental foramen. Region 14: bone height ≈ 5.5 mm; implant space ≈ 1.0 mm; nearest critical structure: incisive canal. Region 45: bone height ≈ 4.9 mm; implant space ≈ 1.8 mm; nearest critical structure: mandibular canal. Region 28: bone height ≈ 14.2 mm; implant space ≈ 6.8 mm; nearest critical structure: nasal floor. Region 37: bone height ≈ 21.8 mm; implant space ≈ 15.1 mm; nearest critical structure: mental foramen. Region 31: bone height ≈ 19.0 mm; implant space ≈ 13.1 mm; nearest critical structure: mental foramen. Region 41: bone height ≈ 21.4 mm; implant space ≈ 15.9 mm; nearest critical structure: mental foramen. Region 16: bone height ≈ 8.9 mm; implant space ≈ 6.6 mm; nearest critical structure: incisive canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency near 28; lamina dura loss noted. Smaller radiolucency at 33. Impression: Findings consistent with chronic apical periodontitis at 47 and 28.


[User]
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Planning for pre-surgical bone mapping. Brief history/status: Omeprazole, Metoprolol, Levaxin, Esomeprazole, Losartan, Betolvex, Duroferon. Desired treatment: Evaluate periapical status of teeth 15, 38, and 35, and overall sinus condition.

[Assistant] Review of CBCT volume dated 230307. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 46: bone height ~ 10.9 mm; implant space ~ 5.8 mm; nearest critical structure: anterior loop. Region 22: bone height ~ 12.2 mm; implant space ~ 5.4 mm; nearest critical structure: incisive canal. Region 16: bone height ~ 4.4 mm; implant space ~ 1.7 mm; nearest critical structure: incisive canal. Region 15: bone height ~ 15.9 mm; implant space ~ 7.6 mm; nearest critical structure: sinus floor. Region 27: bone height ~ 21.3 mm; implant space ~ 13.8 mm; nearest critical structure: incisive canal. Region 24: bone height ~ 11.9 mm; implant space ~ 8.0 mm; nearest critical structure: sinus floor. Region 17: bone height ~ 9.4 mm; implant space ~ 4.1 mm; nearest critical structure: sinus floor. Region 12: bone height ~ 9.8 mm; implant space ~ 3.3 mm; nearest critical structure: sinus floor. Region 35: bone height ~ 7.9 mm; implant space ~ 3.9 mm; nearest critical structure: mental foramen. Region 26: bone height ~ 7.7 mm; implant space ~ 1.8 mm; nearest critical structure: incisive canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Metallic restorations cause localized streak artifacts, slightly limiting detail. Impression: Cyst-like well-defined radiolucency near 43, likely radicular cyst.

Question: Planning for pre-surgical bone mapping. Brief history/status: Omeprazole, Metoprolol, Levaxin, Esomeprazole, Losartan, Betolvex, Duroferon. Desired treatment: Evaluate periapical status of teeth 15, 38, and 35, and overall sinus condition.

Answer: Review of CBCT volume dated 230307. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 46: bone height ≈ 10.9 mm; implant space ≈ 5.8 mm; nearest critical structure: anterior loop. Region 22: bone height ≈ 12.2 mm; implant space ≈ 5.4 mm; nearest critical structure: incisive canal. Region 16: bone height ≈ 4.4 mm; implant space ≈ 1.7 mm; nearest critical structure: incisive canal. Region 15: bone height ≈ 15.9 mm; implant space ≈ 7.6 mm; nearest critical structure: sinus floor. Region 27: bone height ≈ 21.3 mm; implant space ≈ 13.8 mm; nearest critical structure: incisive canal. Region 24: bone height ≈ 11.9 mm; implant space ≈ 8.0 mm; nearest critical structure: sinus floor. Region 17: bone height ≈ 9.4 mm; implant space ≈ 4.1 mm; nearest critical structure: sinus floor. Region 12: bone height ≈ 9.8 mm; implant space ≈ 3.3 mm; nearest critical structure: sinus floor. Region 35: bone height ≈ 7.9 mm; implant space ≈ 3.9 mm; nearest critical structure: mental foramen. Region 26: bone height ≈ 7.7 mm; implant space ≈ 1.8 mm; nearest critical structure: incisive canal. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Metallic restorations cause localized streak artifacts, slightly limiting detail. Impression: Cyst-like well-defined radiolucency near 43, likely radicular cyst.


[User]
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Planning for full-mouth rehabilitation. Brief history/status: Omeprazole, Duroferon, Insulin glargine, Calcichew-D3, Betolvex, Metoprolol, Losartan, Levaxin. Desired treatment: Measure crest-to-canal and crest-to-foramen distances across 33-43.

[Assistant] Review of CBCT dated 231012. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 46: bone height ~ 14.4 mm; implant space ~ 7.6 mm; nearby mandibular canal. Region 27: bone height ~ 6.3 mm; implant space ~ 0 mm; nearby mandibular canal. Region 36: bone height ~ 8.2 mm; implant space ~ 6.6 mm; nearby nasal floor. Region 16: bone height ~ 12.6 mm; implant space ~ 6.2 mm; nearby sinus floor. Region 41: bone height ~ 11.5 mm; implant space ~ 7.0 mm; nearby incisive canal. Region 42: bone height ~ 10.8 mm; implant space ~ 4.0 mm; nearby mental foramen. Region 45: bone height ~ 12.1 mm; implant space ~ 10.4 mm; nearby anterior loop. Region 11: bone height ~ 5.1 mm; implant space ~ 0 mm; nearby anterior loop. Region 17: bone height ~ 10.8 mm; implant space ~ 3.3 mm; nearby incisive canal. Region 35: bone height ~ 18.6 mm; implant space ~ 11.5 mm; nearby anterior loop. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 26; minor sclerosis near 38. Image artifacts due to metallic restorations reduce detail locally. Impression: Peri-implantitis changes evident at 17; marginal bone loss noted.

Question: Planning for full-mouth rehabilitation. Brief history/status: Omeprazole, Duroferon, Insulin glargine, Calcichew-D3, Betolvex, Metoprolol, Losartan, Levaxin. Desired treatment: Measure crest-to-canal and crest-to-foramen distances across 33–43.

Answer: Review of CBCT dated 231012. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 46: bone height ≈ 14.4 mm; implant space ≈ 7.6 mm; nearby mandibular canal. Region 27: bone height ≈ 6.3 mm; implant space ≈ 0 mm; nearby mandibular canal. Region 36: bone height ≈ 8.2 mm; implant space ≈ 6.6 mm; nearby nasal floor. Region 16: bone height ≈ 12.6 mm; implant space ≈ 6.2 mm; nearby sinus floor. Region 41: bone height ≈ 11.5 mm; implant space ≈ 7.0 mm; nearby incisive canal. Region 42: bone height ≈ 10.8 mm; implant space ≈ 4.0 mm; nearby mental foramen. Region 45: bone height ≈ 12.1 mm; implant space ≈ 10.4 mm; nearby anterior loop. Region 11: bone height ≈ 5.1 mm; implant space ≈ 0 mm; nearby anterior loop. Region 17: bone height ≈ 10.8 mm; implant space ≈ 3.3 mm; nearby incisive canal. Region 35: bone height ≈ 18.6 mm; implant space ≈ 11.5 mm; nearby anterior loop. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 26; minor sclerosis near 38. Image artifacts due to metallic restorations reduce detail locally. Impression: Peri-implantitis changes evident at 17; marginal bone loss noted.


[User]
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Planning for pre-implant radiological mapping. Brief history/status: Duloxetine, Levaxin, Calcichew-D3, Metoprolol, Duroferon, Bufomix Easyhaler. Desired treatment: Measure vertical height from alveolar crest to anatomical constraints for 34-44.

[Assistant] Review of CBCT scan dated 240309. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 31: bone height ~ 5.6 mm; implant space ~ 3.4 mm; nearby structure: nasal floor. Region 15: bone height ~ 7.3 mm; implant space ~ 0 mm; nearby structure: nasal floor. Region 42: bone height ~ 14.2 mm; implant space ~ 7.6 mm; nearby structure: nasal floor. Region 36: bone height ~ 17.3 mm; implant space ~ 12.4 mm; nearby structure: mandibular canal. Region 41: bone height ~ 11.6 mm; implant space ~ 9.0 mm; nearby structure: nasal floor. Region 43: bone height ~ 10.2 mm; implant space ~ 8.0 mm; nearby structure: anterior loop. Region 22: bone height ~ 14.7 mm; implant space ~ 9.8 mm; nearby structure: anterior loop. Region 24: bone height ~ 21.9 mm; implant space ~ 15.9 mm; nearby structure: nasal floor. Region 28: bone height ~ 12.9 mm; implant space ~ 11.1 mm; nearby structure: nasal floor. Region 18: bone height ~ 21.8 mm; implant space ~ 16.4 mm; nearby structure: nasal floor. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Residual ridge height insufficient in 28; sinus lift recommended.

Question: Planning for pre-implant radiological mapping. Brief history/status: Duloxetine, Levaxin, Calcichew-D3, Metoprolol, Duroferon, Bufomix Easyhaler. Desired treatment: Measure vertical height from alveolar crest to anatomical constraints for 34–44.

Answer: Review of CBCT scan dated 240309. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 31: bone height ≈ 5.6 mm; implant space ≈ 3.4 mm; nearby structure: nasal floor. Region 15: bone height ≈ 7.3 mm; implant space ≈ 0 mm; nearby structure: nasal floor. Region 42: bone height ≈ 14.2 mm; implant space ≈ 7.6 mm; nearby structure: nasal floor. Region 36: bone height ≈ 17.3 mm; implant space ≈ 12.4 mm; nearby structure: mandibular canal. Region 41: bone height ≈ 11.6 mm; implant space ≈ 9.0 mm; nearby structure: nasal floor. Region 43: bone height ≈ 10.2 mm; implant space ≈ 8.0 mm; nearby structure: anterior loop. Region 22: bone height ≈ 14.7 mm; implant space ≈ 9.8 mm; nearby structure: anterior loop. Region 24: bone height ≈ 21.9 mm; implant space ≈ 15.9 mm; nearby structure: nasal floor. Region 28: bone height ≈ 12.9 mm; implant space ≈ 11.1 mm; nearby structure: nasal floor. Region 18: bone height ≈ 21.8 mm; implant space ≈ 16.4 mm; nearby structure: nasal floor. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Residual ridge height insufficient in 28; sinus lift recommended.


[User]
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Planning for pathology review. Brief history/status: Betolvex, Omeprazole, Levaxin, Losartan, Duloxetine, Metoprolol, Duroferon, Calcichew-D3. Desired treatment: Review periapical status and note any signs of infection in regions 41, 28, 24.

[Assistant] Review of CBCT dated 220612. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 38: bone height ~ 8.8 mm; implant space ~ 2.8 mm; nearby incisive canal. Region 18: bone height ~ 11.0 mm; implant space ~ 5.2 mm; nearby mandibular canal. Region 42: bone height ~ 7.6 mm; implant space ~ 0.8 mm; nearby incisive canal. Region 32: bone height ~ 14.6 mm; implant space ~ 7.7 mm; nearby mandibular canal. Region 36: bone height ~ 6.4 mm; implant space ~ 3.1 mm; nearby sinus floor. Region 26: bone height ~ 10.3 mm; implant space ~ 9.2 mm; nearby incisive canal. Region 46: bone height ~ 5.3 mm; implant space ~ 3.5 mm; nearby mental foramen. Region 15: bone height ~ 20.9 mm; implant space ~ 14.5 mm; nearby mandibular canal. Region 44: bone height ~ 6.6 mm; implant space ~ 0 mm; nearby mandibular canal. Region 33: bone height ~ 5.6 mm; implant space ~ 2.5 mm; nearby mandibular canal. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 48; minor sclerosis near 11. Image artifacts due to metallic restorations reduce detail locally. Impression: Peri-implantitis changes evident at 44; marginal bone loss noted.

Question: Planning for pathology review. Brief history/status: Betolvex, Omeprazole, Levaxin, Losartan, Duloxetine, Metoprolol, Duroferon, Calcichew-D3. Desired treatment: Review periapical status and note any signs of infection in regions 41, 28, 24.

Answer: Review of CBCT dated 220612. Overall bone density within expected limits except in posterior maxilla. Implant feasibility evaluated with 5 mm minimal bone width threshold. Region 38: bone height ≈ 8.8 mm; implant space ≈ 2.8 mm; nearby incisive canal. Region 18: bone height ≈ 11.0 mm; implant space ≈ 5.2 mm; nearby mandibular canal. Region 42: bone height ≈ 7.6 mm; implant space ≈ 0.8 mm; nearby incisive canal. Region 32: bone height ≈ 14.6 mm; implant space ≈ 7.7 mm; nearby mandibular canal. Region 36: bone height ≈ 6.4 mm; implant space ≈ 3.1 mm; nearby sinus floor. Region 26: bone height ≈ 10.3 mm; implant space ≈ 9.2 mm; nearby incisive canal. Region 46: bone height ≈ 5.3 mm; implant space ≈ 3.5 mm; nearby mental foramen. Region 15: bone height ≈ 20.9 mm; implant space ≈ 14.5 mm; nearby mandibular canal. Region 44: bone height ≈ 6.6 mm; implant space ≈ 0 mm; nearby mandibular canal. Region 33: bone height ≈ 5.6 mm; implant space ≈ 2.5 mm; nearby mandibular canal. Maxillary sinus: mucosal thickening mild on both sides. Periapical radiolucency observed near 48; minor sclerosis near 11. Image artifacts due to metallic restorations reduce detail locally. Impression: Peri-implantitis changes evident at 44; marginal bone loss noted.


[User]
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Planning for follow-up after implant restoration. Brief history/status: Bufomix Easyhaler, Levaxin, Omeprazole, Atorvastatin, Bricanyl, Insulin glargine, Calcichew-D3. Desired treatment: Review the relationship between alveolar crest and mandibular canal in 16-26.

[Assistant] Review of CBCT scan dated 240405. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 42: bone height ~ 11.3 mm; implant space ~ 4.6 mm; nearby structure: sinus floor. Region 34: bone height ~ 19.7 mm; implant space ~ 15.7 mm; nearby structure: nasal floor. Region 26: bone height ~ 12.4 mm; implant space ~ 6.8 mm; nearby structure: nasal floor. Region 38: bone height ~ 15.4 mm; implant space ~ 8.4 mm; nearby structure: mental foramen. Region 11: bone height ~ 18.1 mm; implant space ~ 14.3 mm; nearby structure: anterior loop. Region 27: bone height ~ 15.9 mm; implant space ~ 14.9 mm; nearby structure: sinus floor. Region 43: bone height ~ 17.8 mm; implant space ~ 12.4 mm; nearby structure: mandibular canal. Region 24: bone height ~ 19.4 mm; implant space ~ 17.0 mm; nearby structure: anterior loop. Region 46: bone height ~ 15.8 mm; implant space ~ 10.6 mm; nearby structure: nasal floor. Region 12: bone height ~ 14.6 mm; implant space ~ 7.7 mm; nearby structure: anterior loop. Maxillary sinus shows mild mucosal thickening bilaterally. Periapical radiolucency visible at 27, additional smaller lesion near 35. Impression: No radiographic evidence of acute infection or pathology detected.

Question: Planning for follow-up after implant restoration. Brief history/status: Bufomix Easyhaler, Levaxin, Omeprazole, Atorvastatin, Bricanyl, Insulin glargine, Calcichew-D3. Desired treatment: Review the relationship between alveolar crest and mandibular canal in 16–26.

Answer: Review of CBCT scan dated 240405. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 42: bone height ≈ 11.3 mm; implant space ≈ 4.6 mm; nearby structure: sinus floor. Region 34: bone height ≈ 19.7 mm; implant space ≈ 15.7 mm; nearby structure: nasal floor. Region 26: bone height ≈ 12.4 mm; implant space ≈ 6.8 mm; nearby structure: nasal floor. Region 38: bone height ≈ 15.4 mm; implant space ≈ 8.4 mm; nearby structure: mental foramen. Region 11: bone height ≈ 18.1 mm; implant space ≈ 14.3 mm; nearby structure: anterior loop. Region 27: bone height ≈ 15.9 mm; implant space ≈ 14.9 mm; nearby structure: sinus floor. Region 43: bone height ≈ 17.8 mm; implant space ≈ 12.4 mm; nearby structure: mandibular canal. Region 24: bone height ≈ 19.4 mm; implant space ≈ 17.0 mm; nearby structure: anterior loop. Region 46: bone height ≈ 15.8 mm; implant space ≈ 10.6 mm; nearby structure: nasal floor. Region 12: bone height ≈ 14.6 mm; implant space ≈ 7.7 mm; nearby structure: anterior loop. Maxillary sinus shows mild mucosal thickening bilaterally. Periapical radiolucency visible at 27, additional smaller lesion near 35. Impression: No radiographic evidence of acute infection or pathology detected.


[User]
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Planning for implant planning evaluation. Brief history/status: Bufomix Easyhaler, Bricanyl, Insulin glargine, Esomeprazole, Duroferon, Levaxin, Calcichew-D3. Desired treatment: Quantify vertical bone loss around implants in 17-27 and assess anterior maxillary density.

[Assistant] Review of CBCT volume dated 230914. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 18: bone height ~ 21.3 mm; implant space ~ 13.1 mm; nearest critical structure: sinus floor. Region 44: bone height ~ 11.7 mm; implant space ~ 4.5 mm; nearest critical structure: anterior loop. Region 38: bone height ~ 6.3 mm; implant space ~ 0.0 mm; nearest critical structure: mandibular canal. Region 15: bone height ~ 15.2 mm; implant space ~ 6.7 mm; nearest critical structure: incisive canal. Region 26: bone height ~ 21.4 mm; implant space ~ 14.4 mm; nearest critical structure: nasal floor. Region 43: bone height ~ 7.9 mm; implant space ~ 4.9 mm; nearest critical structure: mandibular canal. Region 41: bone height ~ 10.9 mm; implant space ~ 4.7 mm; nearest critical structure: mental foramen. Region 34: bone height ~ 21.3 mm; implant space ~ 19.6 mm; nearest critical structure: mental foramen. Region 17: bone height ~ 13.8 mm; implant space ~ 7.8 mm; nearest critical structure: sinus floor. Region 37: bone height ~ 20.5 mm; implant space ~ 16.9 mm; nearest critical structure: mandibular canal. Impression: Impaction of third molar in quadrant 4 with mesioangular inclination.

Question: Planning for implant planning evaluation. Brief history/status: Bufomix Easyhaler, Bricanyl, Insulin glargine, Esomeprazole, Duroferon, Levaxin, Calcichew-D3. Desired treatment: Quantify vertical bone loss around implants in 17–27 and assess anterior maxillary density.

Answer: Review of CBCT volume dated 230914. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 18: bone height ≈ 21.3 mm; implant space ≈ 13.1 mm; nearest critical structure: sinus floor. Region 44: bone height ≈ 11.7 mm; implant space ≈ 4.5 mm; nearest critical structure: anterior loop. Region 38: bone height ≈ 6.3 mm; implant space ≈ 0.0 mm; nearest critical structure: mandibular canal. Region 15: bone height ≈ 15.2 mm; implant space ≈ 6.7 mm; nearest critical structure: incisive canal. Region 26: bone height ≈ 21.4 mm; implant space ≈ 14.4 mm; nearest critical structure: nasal floor. Region 43: bone height ≈ 7.9 mm; implant space ≈ 4.9 mm; nearest critical structure: mandibular canal. Region 41: bone height ≈ 10.9 mm; implant space ≈ 4.7 mm; nearest critical structure: mental foramen. Region 34: bone height ≈ 21.3 mm; implant space ≈ 19.6 mm; nearest critical structure: mental foramen. Region 17: bone height ≈ 13.8 mm; implant space ≈ 7.8 mm; nearest critical structure: sinus floor. Region 37: bone height ≈ 20.5 mm; implant space ≈ 16.9 mm; nearest critical structure: mandibular canal. Impression: Impaction of third molar in quadrant 4 with mesioangular inclination.


[User]
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Planning for delayed healing post endodontic therapy. Brief history/status: Bricanyl, Bufomix Easyhaler, Trulicity, Atorvastatin, Amlodipine, Levaxin, Duroferon, Omeprazole. Desired treatment: Quantify vertical bone loss around implants in 37-47 and assess anterior maxillary density.

[Assistant] Review of CBCT volume dated 210110. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 17: bone height ~ 13.7 mm; implant space ~ 8.9 mm; nearest critical structure: sinus floor. Region 44: bone height ~ 10.0 mm; implant space ~ 4.8 mm; nearest critical structure: mandibular canal. Region 35: bone height ~ 16.5 mm; implant space ~ 8.5 mm; nearest critical structure: mental foramen. Region 12: bone height ~ 7.6 mm; implant space ~ 5.1 mm; nearest critical structure: sinus floor. Region 42: bone height ~ 15.4 mm; implant space ~ 10.9 mm; nearest critical structure: anterior loop. Region 31: bone height ~ 10.2 mm; implant space ~ 8.3 mm; nearest critical structure: anterior loop. Region 45: bone height ~ 13.2 mm; implant space ~ 8.4 mm; nearest critical structure: mandibular canal. Region 26: bone height ~ 12.7 mm; implant space ~ 9.1 mm; nearest critical structure: incisive canal. Region 43: bone height ~ 10.2 mm; implant space ~ 3.3 mm; nearest critical structure: mental foramen. Region 46: bone height ~ 12.9 mm; implant space ~ 6.9 mm; nearest critical structure: anterior loop. Impression: Vertical root fracture suspected at 47; recommend clinical correlation.

Question: Planning for delayed healing post endodontic therapy. Brief history/status: Bricanyl, Bufomix Easyhaler, Trulicity, Atorvastatin, Amlodipine, Levaxin, Duroferon, Omeprazole. Desired treatment: Quantify vertical bone loss around implants in 37–47 and assess anterior maxillary density.

Answer: Review of CBCT volume dated 210110. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 17: bone height ≈ 13.7 mm; implant space ≈ 8.9 mm; nearest critical structure: sinus floor. Region 44: bone height ≈ 10.0 mm; implant space ≈ 4.8 mm; nearest critical structure: mandibular canal. Region 35: bone height ≈ 16.5 mm; implant space ≈ 8.5 mm; nearest critical structure: mental foramen. Region 12: bone height ≈ 7.6 mm; implant space ≈ 5.1 mm; nearest critical structure: sinus floor. Region 42: bone height ≈ 15.4 mm; implant space ≈ 10.9 mm; nearest critical structure: anterior loop. Region 31: bone height ≈ 10.2 mm; implant space ≈ 8.3 mm; nearest critical structure: anterior loop. Region 45: bone height ≈ 13.2 mm; implant space ≈ 8.4 mm; nearest critical structure: mandibular canal. Region 26: bone height ≈ 12.7 mm; implant space ≈ 9.1 mm; nearest critical structure: incisive canal. Region 43: bone height ≈ 10.2 mm; implant space ≈ 3.3 mm; nearest critical structure: mental foramen. Region 46: bone height ≈ 12.9 mm; implant space ≈ 6.9 mm; nearest critical structure: anterior loop. Impression: Vertical root fracture suspected at 47; recommend clinical correlation.


[User]
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Planning for implant planning evaluation. Brief history/status: Atorvastatin, Bricanyl, Duroferon, Trulicity, Insulin glargine. Desired treatment: Please report bone height and available implant space for regions 17-27 and 37-47.

[Assistant] Review of CBCT volume dated 210428. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 36: bone height ~ 21.7 mm; implant space ~ 19.8 mm; nearest critical structure: mandibular canal. Region 38: bone height ~ 9.6 mm; implant space ~ 1.7 mm; nearest critical structure: anterior loop. Region 22: bone height ~ 4.8 mm; implant space ~ 0.0 mm; nearest critical structure: incisive canal. Region 21: bone height ~ 7.2 mm; implant space ~ 0.9 mm; nearest critical structure: incisive canal. Region 17: bone height ~ 14.5 mm; implant space ~ 7.7 mm; nearest critical structure: nasal floor. Region 45: bone height ~ 21.1 mm; implant space ~ 17.5 mm; nearest critical structure: mental foramen. Region 47: bone height ~ 5.1 mm; implant space ~ 0.0 mm; nearest critical structure: mandibular canal. Region 16: bone height ~ 10.5 mm; implant space ~ 6.8 mm; nearest critical structure: incisive canal. Region 33: bone height ~ 9.6 mm; implant space ~ 4.1 mm; nearest critical structure: mental foramen. Region 41: bone height ~ 12.0 mm; implant space ~ 5.0 mm; nearest critical structure: anterior loop. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency near 16; lamina dura loss noted. Smaller radiolucency at 32. Metallic restorations cause localized streak artifacts, slightly limiting detail. Impression: Bone quantity borderline in posterior maxilla; sinus augmentation may be indicated.

Question: Planning for implant planning evaluation. Brief history/status: Atorvastatin, Bricanyl, Duroferon, Trulicity, Insulin glargine. Desired treatment: Please report bone height and available implant space for regions 17–27 and 37–47.

Answer: Review of CBCT volume dated 210428. Bone quality ranges from ordinary to reduced in posterior segments. Implant space referenced from 5 mm minimal bone width threshold. Region 36: bone height ≈ 21.7 mm; implant space ≈ 19.8 mm; nearest critical structure: mandibular canal. Region 38: bone height ≈ 9.6 mm; implant space ≈ 1.7 mm; nearest critical structure: anterior loop. Region 22: bone height ≈ 4.8 mm; implant space ≈ 0.0 mm; nearest critical structure: incisive canal. Region 21: bone height ≈ 7.2 mm; implant space ≈ 0.9 mm; nearest critical structure: incisive canal. Region 17: bone height ≈ 14.5 mm; implant space ≈ 7.7 mm; nearest critical structure: nasal floor. Region 45: bone height ≈ 21.1 mm; implant space ≈ 17.5 mm; nearest critical structure: mental foramen. Region 47: bone height ≈ 5.1 mm; implant space ≈ 0.0 mm; nearest critical structure: mandibular canal. Region 16: bone height ≈ 10.5 mm; implant space ≈ 6.8 mm; nearest critical structure: incisive canal. Region 33: bone height ≈ 9.6 mm; implant space ≈ 4.1 mm; nearest critical structure: mental foramen. Region 41: bone height ≈ 12.0 mm; implant space ≈ 5.0 mm; nearest critical structure: anterior loop. Maxillary sinuses: mucosal thickening mild to moderate bilaterally. Periapical radiolucency near 16; lamina dura loss noted. Smaller radiolucency at 32. Metallic restorations cause localized streak artifacts, slightly limiting detail. Impression: Bone quantity borderline in posterior maxilla; sinus augmentation may be indicated.


[User]
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Planning for assessment of residual ridge. Brief history/status: Esomeprazole, Levaxin, Calcichew-D3, Trulicity, Losartan, Atorvastatin, Metoprolol. Desired treatment: Check for apical radiolucency or infection in regions 37, 14, and 38.

[Assistant] Review of CBCT scan dated 230413. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 25: bone height ~ 14.2 mm; implant space ~ 9.4 mm; nearby structure: mental foramen. Region 14: bone height ~ 5.2 mm; implant space ~ 0 mm; nearby structure: mental foramen. Region 21: bone height ~ 11.3 mm; implant space ~ 8.8 mm; nearby structure: mental foramen. Region 22: bone height ~ 8.3 mm; implant space ~ 5.9 mm; nearby structure: anterior loop. Region 34: bone height ~ 18.3 mm; implant space ~ 12.6 mm; nearby structure: nasal floor. Region 35: bone height ~ 11.6 mm; implant space ~ 5.5 mm; nearby structure: mandibular canal. Region 36: bone height ~ 19.3 mm; implant space ~ 13.3 mm; nearby structure: nasal floor. Region 15: bone height ~ 18.1 mm; implant space ~ 11.6 mm; nearby structure: mental foramen. Region 47: bone height ~ 5.0 mm; implant space ~ 0 mm; nearby structure: mandibular canal. Region 42: bone height ~ 17.3 mm; implant space ~ 14.9 mm; nearby structure: sinus floor. Periapical radiolucency visible at 37, additional smaller lesion near 15. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: No radiographic evidence of acute infection or pathology detected.

Question: Planning for assessment of residual ridge. Brief history/status: Esomeprazole, Levaxin, Calcichew-D3, Trulicity, Losartan, Atorvastatin, Metoprolol. Desired treatment: Check for apical radiolucency or infection in regions 37, 14, and 38.

Answer: Review of CBCT scan dated 230413. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 25: bone height ≈ 14.2 mm; implant space ≈ 9.4 mm; nearby structure: mental foramen. Region 14: bone height ≈ 5.2 mm; implant space ≈ 0 mm; nearby structure: mental foramen. Region 21: bone height ≈ 11.3 mm; implant space ≈ 8.8 mm; nearby structure: mental foramen. Region 22: bone height ≈ 8.3 mm; implant space ≈ 5.9 mm; nearby structure: anterior loop. Region 34: bone height ≈ 18.3 mm; implant space ≈ 12.6 mm; nearby structure: nasal floor. Region 35: bone height ≈ 11.6 mm; implant space ≈ 5.5 mm; nearby structure: mandibular canal. Region 36: bone height ≈ 19.3 mm; implant space ≈ 13.3 mm; nearby structure: nasal floor. Region 15: bone height ≈ 18.1 mm; implant space ≈ 11.6 mm; nearby structure: mental foramen. Region 47: bone height ≈ 5.0 mm; implant space ≈ 0 mm; nearby structure: mandibular canal. Region 42: bone height ≈ 17.3 mm; implant space ≈ 14.9 mm; nearby structure: sinus floor. Periapical radiolucency visible at 37, additional smaller lesion near 15. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: No radiographic evidence of acute infection or pathology detected.


[User]
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Planning for pre-implant radiological mapping. Brief history/status: Levaxin, Duroferon, Atorvastatin, Losartan, Betolvex. Desired treatment: Assess implant site quality and need for sinus lift or graft in 33-43.

[Assistant] Review of CBCT scan dated 220528. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 48: bone height ~ 7.8 mm; implant space ~ 3.7 mm; nearby structure: sinus floor. Region 47: bone height ~ 6.1 mm; implant space ~ 4.3 mm; nearby structure: mandibular canal. Region 14: bone height ~ 13.1 mm; implant space ~ 8.4 mm; nearby structure: mandibular canal. Region 11: bone height ~ 6.4 mm; implant space ~ 0 mm; nearby structure: nasal floor. Region 34: bone height ~ 13.1 mm; implant space ~ 5.7 mm; nearby structure: mental foramen. Region 36: bone height ~ 18.2 mm; implant space ~ 13.8 mm; nearby structure: mandibular canal. Region 28: bone height ~ 18.4 mm; implant space ~ 17.3 mm; nearby structure: anterior loop. Region 31: bone height ~ 19.3 mm; implant space ~ 12.4 mm; nearby structure: mental foramen. Region 44: bone height ~ 12.6 mm; implant space ~ 6.4 mm; nearby structure: nasal floor. Region 32: bone height ~ 4.4 mm; implant space ~ 0 mm; nearby structure: mental foramen. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Chronic apical periodontitis noted at 12 and 24; recommend endodontic consultation.

Question: Planning for pre-implant radiological mapping. Brief history/status: Levaxin, Duroferon, Atorvastatin, Losartan, Betolvex. Desired treatment: Assess implant site quality and need for sinus lift or graft in 33–43.

Answer: Review of CBCT scan dated 220528. Bone density within expected physiological range. Implant feasibility evaluated assuming 5 mm minimum bone width threshold. Region 48: bone height ≈ 7.8 mm; implant space ≈ 3.7 mm; nearby structure: sinus floor. Region 47: bone height ≈ 6.1 mm; implant space ≈ 4.3 mm; nearby structure: mandibular canal. Region 14: bone height ≈ 13.1 mm; implant space ≈ 8.4 mm; nearby structure: mandibular canal. Region 11: bone height ≈ 6.4 mm; implant space ≈ 0 mm; nearby structure: nasal floor. Region 34: bone height ≈ 13.1 mm; implant space ≈ 5.7 mm; nearby structure: mental foramen. Region 36: bone height ≈ 18.2 mm; implant space ≈ 13.8 mm; nearby structure: mandibular canal. Region 28: bone height ≈ 18.4 mm; implant space ≈ 17.3 mm; nearby structure: anterior loop. Region 31: bone height ≈ 19.3 mm; implant space ≈ 12.4 mm; nearby structure: mental foramen. Region 44: bone height ≈ 12.6 mm; implant space ≈ 6.4 mm; nearby structure: nasal floor. Region 32: bone height ≈ 4.4 mm; implant space ≈ 0 mm; nearby structure: mental foramen. Metallic restorations cause mild streak artifacts affecting local clarity. Impression: Chronic apical periodontitis noted at 12 and 24; recommend endodontic consultation.


[User]
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What does this chart represent in the context of protein sequence analysis?

[Assistant] This chart represents a scoring system for amino acid alignments, likely illustrating how different amino acid substitutions or pairings are weighted based on a specific scoring matrix. Such plots are used in bioinformatics to evaluate the similarity between protein sequences, where higher scores typically indicate more favorable or conserved substitutions.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_0349.png

C:\Users\HARI\Desktop\DocSmile\rl\__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed.md

Construction of an evolutionary tree based on sequence comparisons revealed approximate times for the gene duplication events separating myoglobin and hemoglobin as well as the α and β subunits of hemoglobin. Evolutionary trees based on sequences can be compared to those based on fossil records.

## Modern Techniques Make the Experimental Exploration of Evolution Possible

The exploration of evolution can also be a laboratory science. In favorable cases, PCR amplification of well-preserved samples allows the determination of the nucleotide sequences from extinct organisms. Sequences so determined can help authenticate aspects of an evolutionary tree constructed by other means. Molecular evolutionary experiments performed in the test tube can examine how molecules such as ligand-binding RNA molecules might have been generated.

## Key Terms

homolog paralog

ortholog sequence alignment

conservative substitution substitution matrix

sequence template self-diagonal plot

divergent evolut


[User]
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Explain the process shown in the diagram for selecting RNA molecules.

[Assistant] The diagram illustrates an affinity chromatography process used to isolate specific RNA molecules from a randomized pool based on their ability to bind to a target molecule, in this case, ATP. First, a diverse pool of RNA molecules is passed through a column containing immobilized ATP. RNA molecules that do not bind to ATP flow through the column and are discarded. The RNA molecules that successfully bind to the ATP are retained within the column. Finally, these bound RNA molecules are eluted (released) from the column by adding free ATP, which competes for the binding sites, resulting in a purified population of ATP-binding RNA molecules.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_0364.png


[User]
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Explain the GTPase cycle shown in the diagram.

[Assistant] The diagram illustrates the GTPase cycle, a molecular switch mechanism used by many proteins to regulate cellular processes. In the 'OFF' position, the protein is bound to GDP. The cycle proceeds to the 'ON' position when GDP is exchanged for GTP. The protein remains in the active 'ON' state while bound to GTP. Eventually, the protein hydrolyzes the bound GTP into GDP and inorganic phosphate (Pi), releasing the phosphate and returning the protein to its inactive 'OFF' state, completing the cycle.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_0817.png


[User]
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Describe the structural changes occurring in the protein shown in the image during the transition from the GDP-bound state to the GTP-bound state.

[Assistant] The image illustrates the conformational change of a G-protein upon nucleotide exchange. In the GDP-bound state (left), the protein adopts a specific conformation. Upon the exchange of GDP for GTP (right), the addition of the gamma phosphate group induces significant structural shifts, particularly in the regions labeled Switch I, Switch II, and Switch III. These 'switch' regions are critical for the protein's ability to interact with downstream effectors, effectively acting as a molecular switch that turns the signaling pathway on or off.

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[User]
<image>
Explain the mechanism shown in the diagram regarding ATP synthesis.

[Assistant] The diagram illustrates the mechanism of ATP synthase, a molecular motor embedded in the mitochondrial membrane. It shows how the electrochemical gradient of protons (H+) across the membrane drives the rotation of the enzyme. Protons from the intermembrane space bind to the enzyme, causing it to rotate clockwise, which facilitates the release of protons into the matrix. This rotational energy is what the enzyme uses to catalyze the synthesis of ATP from ADP and inorganic phosphate.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1060.png

## Photosynthetic yield-

"If a year's yield of photosynthesis were amassed in the form of sugar cane, it would form a heap over two miles high and with a base 43 square miles."

-G. E. Fogge

If all of this sugar cane were converted into sugar cubes (0.5 inch on a side) and stacked end to end, the sugar cubes would extend 1.6 × 10 10 miles, or to the planet Pluto.

I . Transduci

g

Storing E

e

y

19. The Lig t R

ac ons

f Ph to yn

esi

Figure 19.1. Electron Micrograph of a Chloroplast from a Spinach Leaf. The thylakoid membranes pack together to form grana. [Courtesy of Dr. Kenneth Miller.]

<!--image-->

I . Transduci

g

Storing E

e

y

19. The Lig t R

ac ons

f Ph to yn

esi

Figure 19.2. The Light Reactions of Photosynthesis. Light is absorbed and the energy is used to drive electrons from water to generate NADPH and to drive protons across a membrane. These protons return through ATP synthase to make ATP.

<!--image-->

ADP

ATP

Light

NADP+

NADPH

H

H,o

0,

I . Transd


[User]
<image>
Describe the chemical reaction shown in the image involving ribulose 1,5-bisphosphate.

[Assistant] The image illustrates the initial step of the Calvin cycle, where the enzyme Rubisco catalyzes the carboxylation of ribulose 1,5-bisphosphate. The process begins with the formation of an enediolate intermediate, stabilized by a magnesium ion (Mg2+) coordinated with amino acid residues (Asp, Glu, Lys). This intermediate then reacts with CO2 to eventually produce two molecules of 3-phosphoglycerate.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1138.png

The incidence of the most common form of glucose 6-phosphate dehydrogenase deficiency, characterized by a tenfold reduction in enzymatic activity in red blood cells, is 11% among Americans of African heritage. This high frequency suggests that the deficiency may be advantageous under certain environmental conditions. Indeed, glucose 6phosphate dehydrogenase deficiency protects against falciparum malaria . The parasites causing this disease require reduced glutathione and the products of the pentose phosphate pathway for optimal growth. Thus, glucose 6-phosphate dehydrogenase deficiency is a mechanism of protection against malaria, which accounts for its high frequency in malariainfested regions of the world. We see here once again the interplay of heredity and environment in the production of disease.

I . Transduci

g

Storing E

e

y

20. The Calvin yc e a

d th

P

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p

at

P

hw y

20.5 Glucose 6-Ph

p

ate D

hydrogenas Pl y

Ke Rol in Pr

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o

Against Re

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v Oxygen S


[User]
<image>
Describe the molecular components shown in this diagram of RNA synthesis.

[Assistant] This diagram illustrates the catalytic mechanism of RNA synthesis. It shows a growing RNA chain and a ribonucleoside triphosphate substrate. The reaction is facilitated by two metal ions (M2+), which are coordinated by aspartate (Asp) residues. These metal ions help position the 3'-OH group of the growing RNA chain for a nucleophilic attack on the alpha-phosphate of the incoming ribonucleoside triphosphate, leading to the formation of a phosphodiester bond.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1615.png


[User]
<image>
What biological process is depicted in this molecular model, and what is the significance of the tunnel shown?

[Assistant] This image depicts the process of protein synthesis (translation) occurring on a ribosome. The tunnel shown, which passes through the 50S subunit, serves as the escape path for the growing polypeptide chain as it is synthesized at the site of peptide-bond formation.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1668.png

<!--image-->

Methionine

Synthetase

HzN

CH}

0

tRNA

tetrahydrcialate

Translormylase

Tetrahydroldlate

NH

tRNA

Forniylmethionyl-tRMA

(fMet-tRNA)

I

. Synthesiz

g

Molecu

s

f Li e

29. Protein Sy h s

29.3 A Ribos me I

a Ribonucle pr

t

in Pa cle (70S) Made of

Smal (30

)

nd a L

rge (50S)

ub nit

Figure 29.22. Transfer RNA-Binding Sites. (A) Three tRNA-binding sites are present on the 70S ribosome. They are called the A (for aminoacyl), P (for peptidyl), and E (for exit) sites. Each tRNA molecule contacts both the 30S and the 50S subunit. (B) The tRNA molecules in sites A and P are base paired with mRNA.

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(A)

(B)

mRNA

Esice

P site

A site

Esite

Psite

Asite

I

. Synthesiz

g

Molecu

s

f Li e

29. Protein Sy h s

29.3 A Ribos me I

a Ribonucle pr

t

in Pa cle (70S) Made of

Smal (30

)

nd a L

rge (50S)

ub nit

Figure 29.23. Polypeptide Escape Path. A tunnel passes through the 50S subunit beginning at the site of peptide-bond formation (shown


[User]
<image>
What does this chart represent in the context of protein analysis?

[Assistant] This chart is a variability plot, often used in bioinformatics to identify hypervariable regions within a protein sequence. The x-axis represents the residue position, and the y-axis indicates the degree of variability at each position. The regions highlighted in magenta represent areas of high sequence diversity, which are often critical for protein function, such as antigen-binding sites in antibodies or other interaction interfaces.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1909.png


[User]
<image>
Describe the biological process shown in this diagram.

[Assistant] This diagram illustrates the initial steps of T-cell activation. An antigen-presenting cell (APC) displays a peptide on a Class II MHC molecule, which is recognized by the T-cell receptor (TCR) complex on a T-cell. The CD4 co-receptor stabilizes this interaction. The binding triggers the phosphorylation of ITAM motifs on the TCR complex, which then recruits the ZAP-70 kinase. Once activated, ZAP-70 initiates a signaling cascade that leads to the secretion of cytokines, which can then bind to cytokine receptors to propagate the immune response.

__lib_book_Biochemistry_ Biochemistry by Berg_ J M 5th Ed/img_1954.png


[User]
<image>
Describe the structural components of the DNA molecule shown in the diagram.

[Assistant] The DNA molecule is a double-stranded polymer of deoxyribonucleotides. Its structure consists of: 1) A sugar-phosphate backbone, where deoxyribose sugars (S) and phosphate groups (P) are linked by phosphodiester bonds. 2) Nitrogenous base pairs located in the center, held together by hydrogen bonds. Adenine (A) pairs with Thymine (T) via two hydrogen bonds, and Guanine (G) pairs with Cytosine (C) via three hydrogen bonds. The nitrogenous bases are attached to the sugar backbone via glycosidic bonds.

__lib_book_Biochemistry_ Comprehensive Biochemistry For Dentistry by Gupta_ Anil/img_0094.png

C:\Users\HARI\Desktop\DocSmile\rl\__lib_book_Biochemistry_ Comprehensive Biochemistry For Dentistry by Gupta_ Anil.md

## 8.4 Types of Deoxyribonucleotides in DNA

DNA contains four types of deoxyribonucleotides depending on the nature of nitrogenous base.

- 1.
- Deoxyadenosine Monophosphate (dAMP) It is also called as 5 ′

-deoxyadenylic acid or deoxyadenylate as in Fig. 8.6.

2. Deoxyguanosine Monophosphate (dGMP)

It is also called as 5 ′ -deoxyguanylic acid or deoxyguanylate as in Fig. 8.7.

- 3.
- 4.

It is also called as 5 -deoxycytidylic acid or deoxycytidylate as in Fig. 8.9.

- Deoxythymidine Monophosphate (dTMP) It is also called as 5

′ -deoxythymidylic acid or deoxythymidylate as in Fig. 8.8.

- Deoxycytidine Monophosphate (dCMP) ′

## 8.5 Structure of DNA Strand

- It is polymer of deoxyribonucleotides. Adjacent nucleotides are linked together by phosphodiester bond.
- Each DNA strand has polarity.
- -3 ′ End (3 prime)

It is the end of DNA strand where C3 of deoxyribose sugar is not linked and is free.

- -5 ′ End (5 prime)

It is the end of DNA strand where C5 of deoxyribose sugar is no


[User]
<image>
Describe the structural organization of a nuclear receptor as shown in the diagram.

[Assistant] A nuclear receptor is a transcription factor organized into five distinct domains: the N-terminal domain, the DNA-binding domain (DBD), the hinge region, the ligand-binding domain (LBD), and the C-terminal domain.

__lib_book_Biochemistry_ Comprehensive Biochemistry For Dentistry by Gupta_ Anil/img_0138.png

## 10.4.1 Intracellular Receptor-Based Mechanism of Hormonal Action

## Definition

## A receptor which is situated inside the cell is called as intracellular receptor.

Nuclear receptor is a type of intracellular receptor. It can bind with DNA and control gene expression. Therefore, nuclear receptors belong to the family of transcription factors. In human genome, 48 genes for nuclear receptors have been identified.

## Structure of Nuclear Receptor

Nuclear receptor is a transcription factor, and it has a molecular weight of nearly 70,000 daltons. It has the following domains discussed below.

## N-terminal Domain

- This domain exhibits extreme variability in size and sequence of amino acid residues among different receptors. It modulates the process of gene transcription.

## DNA-Binding Domain

- DNA-binding domain has strictly conserved sequence. It contains two zinc fingers (small supersecondary protein structures having coordination with zinc ion). Zinc finger helps in binding w


[User]
<image>
Describe the metabolic pathway and physiological roles of Vitamin A as shown in the diagram.

[Assistant] The diagram illustrates the pathway of Vitamin A metabolism: 1) Dietary beta-carotene and retinyl esters are absorbed by enterocytes and converted to retinol, which is then packaged into chylomicrons. 2) Retinol is transported to the liver, where it is stored as retinyl palmitate. 3) From the liver, retinol is released into the blood bound to Retinol Binding Protein (RBP). 4) In the eye, retinol is converted to 11-cis-retinal, which is essential for the function of rod cells. 5) In other target cells, retinol is converted to retinoic acid, which enters the nucleus to regulate gene transcription and cell function.

__lib_book_Biochemistry_ Comprehensive Biochemistry For Dentistry by Gupta_ Anil/img_0160.png