concepts_of_occlusion_mostafa fathy.pptx

CHANGES IN THE RELATIONSHIP OF THE
DENTAL ARCHES
•
The clinician must realize that there are differences between the
preeruptive and posteruptive shapes and relationships of the upper
and lower dental arches

Ideal Occlusion
•
The ideal relationship of the teeth can be defined in terms of static (or
morphological) and functional occlusion

key to normal occlusion
•
e anteroposterior position of the first permanent molars
•
define the dental arch relationship
•
good cuspal interdigitation to provide mutual support for the teeth in
function

e key to normal occlusion
•
Key 1Molar relationship
•
•
Key 2Crown angulation (mesiodistal tip)
•
•
Key 3Crown inclination (torque)
•
•
Key 4No rotations
•
•
Key 5No spacing
•
•
Key 6Flat occlusal plane

traditionally based their treatment upon
these static goals
•
Progress to consider : the dynamics of occlusion or the
temporomandibular joints and associated musculature that form the
masticatory system
•
aspects of the occlusion in function
•
an ideal functional occlusion and why it is important

the anterior teeth protect the posterior
•
An immediate and permanent posterior disocclusion in lateral and
protrusive contact with no associated non-working side interferences
•
by the presence of canine guidance or group function in lateral
excursion
•
by the presence of canine guidance or group function in lateral
excursion

,
the posterior teeth protect the anterior
teeth
•
Multiple, simultaneous and bilateral contacts of the posterior teeth in
the InterCuspal Position (ICP or Centric Occlusion, CO) with the incisor
teeth slightly out of contact

ICP coincident with the Retruded Contact
Position (RCP or Centric Relation, CR)
•
some limited freedom for the mandible to move slightly forwards in
the sagittal and horizontal planes from ICP. Only around 10% of the
population actually have an RCP that is coincident with ICP, so a 0–2-
mm discrepancy is considered normal

Classification of Malocclusion
•
Malocclusion can be defined
•
deviation from the ideal that may be considered aesthetically or
functionally unsatisfactory
•
Unlike a disease process, when the presence of specific features
classifies the disease
•
wide range of occlusal traits can constitute a malocclusion
•
allows communication and a basis for diagnosis

Occlusal Definitions
•
•
Retruded Contact Position (RCP) or Centric Relation (CR) is a
gnathological term that describes the position of the mandible in
relation to the maxilla, with the condyles in the most stable and
reproducible position. Where this is thought to be has changed from a
retruded, posterior and superior condyle position to an anterior–
superior condylar position
.

•
•
InterCuspal Position (ICP) or Centric Occlusion (CO) is the occlusion
that occurs with the teeth in a position of maximum intercuspation
•
Canine guidance is present when contact is maintained on the
working side canine teeth during lateral excursion of the mandible
.
•
.
•
Non-working side interferences are occlusal contacts present on the
nonworking side during lateral excursion of the mandi

•
Canine guidance is present when contact is maintained on the
working side canine teeth during lateral excursion of the mandible
•
Non-working side interferences are occlusal contacts present on the
nonworking side during lateral excursion of the mandi

classification of occlusion on relative
mesiodistal position
.
•
When defining an ideal occlusion, Angle found that the mesiobuccal
cusp of the upper first permanent molar should occlude with the
groove between the mesial and distal buccal cusps of the lower first
permanent molar (buccal groove)

Class I
–
•
•
the position of the dental arches is normal, with first permanent
molars in normal occlusion

Class II
–
•
the relations of the dental arches are abnormal, with all the
mandibular teeth occluding distal to normal. Angle recognised two
subdivisions under class II

•
Class II division 1
•
upper incisors are protruding
;

•
Class II division 2
•
upper incisors are palatally inclined

Class III
–
•
the relations of the dental arches are also abnormal, with all
mandibular teeth occluding mesial to normal
.

How Important Is an Ideal Functional
Occlusion
?
•
an ideal functional occlusion claim it is necessary to avoid
temporomandibular joint dysfunction, periodontal breakdown and
long-term occlusal instability
•
indicated in all young adults in whom the occlusion is not functionally
optimal
.

meant by contacts and interferences
•
type of non-working side contacts typically found in post-orthodontic patients
•
deviation of the mandible from its normal pattern of movement
•
type of non-working side contacts typically found in post-orthodontic patients
•
Canine guidance has been reported to reduce ElectroMyoGraphic (EMG)
activity of the muscles of mastication

the upper anterior apical alveolar area
•
the upper anterior apical alveolar area is typically more posterior than
the lower anterior apical area
•
The upper incisors are usually more labially inclined than the lower
incisors

shape of the mandibular posterior area
•
shape of the mandibular posterior area is wider than the upper
posterior area
•
the apices of the teeth are more lateral in the lower posterior
segment than in the upper posterior segment
•
the buccolingual inclination of the lower posterior teeth is usually
more pronounced

Maxillary Anterior Region
•
primary incisor mesiodistal crown dimensions are, on the average,
75% the size of their permanent successors
•
permanent incisor tooth width is 8 mm larger than the primary teeth
•
The lateral incisor is lingual to the central incisor and canine
•
The incisors erupt in a more labial position than the primary incisors
•
Eruption of the permanent canines causes mesial movement of the
lateral incisors and closure of midline diastemas

Maxillary Posterior Region
•
The primary canines are 85% of the size of the permanent canines
•
The primary first molars may equal the size of the first premolars
•
primary second molars are larger than the second premolars
•
Correlation coefficient (r) between the mesiodistal width of individual
primary teeth to their permanent successors ranges between 0.2 and
0.5 mm
•
first premolars are typically more occlusal (second premolars and
canines are relatively more apical )
•
second premolars and canines are relatively more apical

Mandibular Anterior Region
•
t lower incisor mesiodistal crown widths are 6 mm more than the
total primary incisor widths
.
•
The central incisor crypts overlap the lateral incisor crypts
•
central incisors and lateral incisors erupt lingual to their predecessors
and then move labially
•
emerge rotated and then realign if sufficient space is available

Mandibular Posterior Segment
•
primary first molars are 115% of the size of the first premolars
•
primary second molars are 138% of the size of the second premolar
•
s the correlation coefficient of the sum of the mesiodistal widths of C-
D-E to that of 3-4-5 is 0.5
•
average leeway space is 1.7 range from +3.8 mm to -5.6 mm

Normal is average rather than ideal
•
decisions to intercede are often made in response to pressure exerted
by the parents ‘to do something
’
•
Calcification and eruption times for determining whether a
developing tooth not present on radiographic examination can be
considered absent , localized hypocalcification or hypoplasia

The transition from primary to mixed
dentition
•
Eruption of the primary dentition ) is usually completed around 3
years of age
•
The deciduous incisors erupt upright and spaced
•
lack of spacing strongly suggests that the permanent successors will
be crowded
•
.
Overbite reduces throughout the primary dentition until the incisors
are edge to edge
•
marked attrition

Average calcification and eruption times
•
Calcification commences (weeks in utero) Eruption (months) Primary
dentition Central incisors 12–16 6–7
•
Lateral incisors 13–16 7–8
•
Canines 15–18 18–20
•
First molars 14–17 12–15
•
Second molars 16–23 24–36
•
Root development complete 1–1½ years after eruption

The mixed dentition phase
•
eruption of either the first permanent molars or the lower central incisors
•
lower labial segment teeth erupt before their counterparts lingual to their
predecessors
•
crowding of the permanent lower incisors as they emerge into the mouth,
which reduces with intercanine growth
•
lower incisors often erupt slightly lingually placed and/or rotated
•
align spontaneously if space becomes available
•
If the arch is inherently crowded, this space shortage will not resolve with
intercanine growth

The transition from primary to mixed
dentition upper teeth
•
The upper permanent incisors also develop lingual to their predecesor
•
Additional space is gained to accommodate their greater width
because they erupt onto a wider arc and are more proclined
•
If the arch is intrinsically crowded, the lateral incisors will not be able
to move labially
•
developing lateral incisor often gives rise to spacing between the
central incisors which resolves as the laterals erupt

Lateral icisor and ugly duckling’ stage
•
If the arch is intrinsically crowded, the lateral incisors will not be able to
move labially
•
therefore may erupt palatal to the arch
•
tilted distally by the canines lying on the distal aspect of their root
.
•
As the canines erupt, the lateral incisors usually upright themselves and the
spaces close
.
•
upper canines develop palatally
•
migrate labially to come to lie slightly labial and distal to the root apex of the
lateral incisors
.
•
can be palpated buccally from as young as 8 years of age
.

leeway space
•
The combined width of the deciduous canine, first molar, and second molar is
greater than that of their permanent successors
,
•
in general is of the order of 1–1.5 mm in the maxilla and 2–2.5 mm in the
mandible
•
teeth that retained until their normal exfoliation time then,will accomodate
sufficient space for the permanent canine and premolars
.
•
deciduous second molars usually erupt with their distal surfaces flush
anteroposteriorly
•
The transition to the stepped Class I molar relationship occurs during the
mixed dentition as a result of differential mandibular growth and/or the
leeway space
.

Development of the dental arches
•
Intercanine width is measured across the cusps of the
deciduous/permanent canines
•
during the primary dentition an increase of around 1–2 mm is seen
•
In the mixed dentition increase of about 3 mm occurs
•
completed around a developmental stage of 9
•
minimal increase up to age 13 years
•
After this time, a gradual decrease is the norm
.

Development of the dental arches
•
Arch width is measured across the arch between the lingual cusps of
the second deciduous molars or second premolars
•
Between the ages of 3 and 18 years, an increase of 2–3 mm occurs
•
for clinical purposes arch width is largely established in the mixed
dentition

•
Arch circumference is determined by measuring around the buccal
cusps and incisal edges of the teeth to the distal aspect of the second
deciduous molars or second premolars
.
•
On average, there is little change with age in the maxilla
•
In mandible arch circumference decreases by about 4 mm because of
the leeway space
•
with crowded mouths a greater reduction may be seen
.

In summary
•
little change in the size of the arch anteriorly after the establishment
of the primary dentition
•
increase in intercanine width which results in a modification of arch
shape
.
•
Growth posteriorly provides space for the permanent molars
•
considerable appositional vertical growth occurs to maintain the
relationship of the arches during vertical facial growth

Abnormalities of eruption and exfoliation
•
Screening : careful observation of the developing dentition for
evidence of any problems
•
If an abnormality is suspected, then further investigation including
radiographs is indicated
.
•
Around 9–10 years of age it is important to palpate the buccal sulcus
around maxillary canines in order to detect any abnormalities in the
eruption path of this tooth

Natal teeth
•
A tooth, which is present at birth, or erupts soon after, is described as a natal
tooth
•
Neonatal teeth are teeth that erupt within the first few weeks after birth
•
most commonly arise anteriorly in the mandible and are typically a lower
primary incisor
•
root formation is not complete at this stage, natal teeth can be quite mobile, but
they usually become firmer relatively quickly
•
If the tooth (or teeth) interferes with breastfeeding or is so mobile that there is a
danger of inhalation, removal is indicated
•
accomplished with topical anaesthesia. If the tooth is symptomless, it can be left
in situ

Eruption cyst
•
An eruption cyst is caused by an accumulation of fluid or blood in the
follicular space overlying the crown of an erupting tooth
•
They usually rupture spontaneously, but very occasionally
marsupialization may be necessary
.

Failure of/delayed eruption
•
There is a wide individual variation in eruption times
•
period of observation is indicated
.
•
An asymmetry in eruption pattern between contralateral teeth. If a
tooth on one side of the arch has erupted and 6 months later there is
still no sign of its equivalent on the other side, radiographic
examination is indicated
•
Localized failure of eruption is usually due to mechanical obstruction
— this is advantageous as if the obstruction is removed then the
affected tooth/teeth has/have the potential to erupt

Causes of delayed eruption
•
Generalized causes
•
Hereditary gingival fibromatosis
•
Down syndrome
•
Cleidocranial dysostosis
•
Cleft lip and palate
•
Rickets
.

Causes of delayed eruption
•
Localized causes
•
Congenital absence
•
Crowding
•
Delayed exfoliation of primary predecessor
•
Supernumerary tooth
•
Dilaceration
•
Abnormal position of crypt
•
Primary failure of eruption

arrest of eruption (the tooth erupts, but then
fails to keep up with eruption
•
usually affects molar teeth
•
all teeth distal to the affected tooth in that quadrant may also be
involved
.
•
all teeth distal to the affected tooth in that quadrant may also be
involved
.

Premature loss of deciduous teeth
•
major effect of early loss of a primary tooth : localization of preexisting
crowding
•
In an uncrowded mouth this will not occur
.
•
.
However, where some crowding exists and a primary tooth is extracted, the
adjacent teeth will drift or tilt depends upon the degree of crowding,
patient’s age, and the site
•
,
as the degree of crowding increases so does the pressure for the remaining
teeth to move into the extraction space. The younger the child is when the
primary tooth is extracted, the greater is the potential for drifting to ensue
.
•
increased potential for mesial drift in the maxilla

Deciduous incisor
•
premature loss of a deciduous incisor has little impact, mainly
because they are shed relatively early in the mixed dentition
.

Deciduous canine
•
unilateral loss of a primary canine in a crowded mouth will lead to a
centreline shift (Fig. 3.10). To avoid this when unilateral premature
loss of a deciduous canine is necessary, consideration should be given
to balancing with the extraction of the contralateral tooth

Deciduous first molar
•
unilateral loss of this tooth may result in a centreline shift, particularly
in cases of crowding. In most cases, an automatic balancing extraction
is not necessary, but the centreline should be kept under observation
and, if indicated, a tooth on the opposite side of the arch removed
.

Deciduous second molar
:
•
:
if a second primary molar is extracted, the first permanent molar will drift
forwards
•
if loss occurs before the eruption of the permanent tooth and for this reason
it is better, if at all possible, to try to preserve the second deciduous molar at
least until the first permanent molar has appeared
.
•
In most cases, balancing or compensating extractions of other sound second
primary molars is not necessary unless they are also of poor long-term
prognosis
•
at all times a degree of common sense and forward planning should be
applied
•
in essence a risk–benefit analysis needs to be worked

Balancing and compensating extractions
•
Balancing extraction is the removal of the contralateral tooth—
rationale is to avoid centreline shift problems
.
•
Compensating extraction is the removal of the equivalent opposing
tooth—rationale is to maintain occlusal relationships between the
arches

example
•
if extraction of a carious first primary molar is required and the
contralateral tooth is also doubtful
•
preferable in the long term to extract both
•
children with an absent permanent tooth (or teeth
•
early extraction of the primary buccal segment teeth may be
advantageous to encourage forward movement of the first permanent
molars if space closure (rather than space opening) is planned
.
•
The effect of early extraction of a primary tooth on the eruption of its
successor is variable and will not necessarily result in a hastening of
eruption

Space maintenance
•
best space maintenance is a tooth— particularly as this will preserve
alveolar bone
•
most orthodontists avoid this approach in the mixed dentition
because of the implications for dental health and to minimize
straining patient cooperation needed for definitive orthodontic
treatment later
)
•
The exception to this is where preservation of space for a permanent
successor will avoid subsequent appliance treatment

Retained deciduous teeth
•
A difference of more than 6 months between the shedding of
contralateral teeth should be regarded with suspicion. Provided that
the permanent successor is present, retained primary teeth should be
extracted, particularly if they are causing deflection of the permanent
tooth

Infra-occluded (submerged) primary molars
•
Infra-occlusion is now the preferred term for describing the process
where a tooth fails to achieve or maintain its occlusal relationship
with adjacent or opposing teeth
•
Most infra-occluded deciduous teeth erupt into occlusion but
subsequently become ‘submerged’ because bony growth and
development of the adjacent teeth continues
•
Most infra-occluded deciduous teeth erupt into occlusion but
subsequently become ‘submerged’ because bony growth and
development of the adjacent teeth continues

Resorption of deciduous teeth
•
resorption is interchanged with periods of repair
•
If a temporary predominance of repair occurs, this can result in
ankylosis and infra-occlusion
•
genetic tendency
•
including ectopic eruption of first permanent molars
•
palatal displacement of maxillary canines
•
congenital absence of premolar teeth

provided the permanent successor is present
and in a good position
•
provided the permanent successor is present and in a good position
•
There is a danger of the tooth disappearing below gingival level
•
Root formation of the permanent tooth is nearing completion (as
eruptive force reduces markedly after this event)
.

permanent successor is missing
•
permanent successor is missing
•
ervation of the primary molar will preserve bone, therefore
consideration should be given to building up the occlusal surface to
maintain occlusal relationships
•
.
If this is not practicable then extraction may be indicated

Impacted first permanent molars
•
Impaction of a first permanent molar tooth against the second deciduous
molar occurs in approximately 2–6% of children and is indicative of crowding
•
most commonly occurs in the upper arch
•
Spontaneous disimpaction may occur
•
rare after 8 years of age
•
Mild cases can sometimes be managed by tightening a brass separating wire
around the contact point between the two teeth over a period of about 2
months
•
pushing the permanent molar distally
•
letting it jump free
.

Impacted first permanent molars simple and
severe
•
In more severe cases of impaction an appliance can be used to
distalize the permanent molar and disimpact it
•
Alternatively, it can be kept under observation
•
extraction of the deciduous tooth may be indicated if it becomes
abscessed or the permanent tooth becomes carious and restoration is
precluded by poor access
.
•
The resultant space loss can be dealt with in the permanent dentition
.

Dilaceration
•
Dilaceration is a distortion or bend in the root of a tooth. It usually
affects the upper central and/or lateral incisor

Aetiology of dilaceration
•
Developmental
•
usually affects an isolated central incisor and occurs more often in females than
males. The crown of the affected tooth is turned upward and labially and no
disturbance of enamel and dentine is seen
•
Trauma
:
•
intrusion of a deciduous incisor : displacement of the underlying developing
permanent tooth germ
•
causes the developing permanent tooth crown to be deflected palatally
,
•
enamel and dentine forming at the time of the injury are disturbed
,
•
Hypoplasia
•
more than one tooth may be involved depending upon the extent of the trauma

Management
•
Dilaceration usually results in failure of eruption
•
severe, there is often no alternative but to remove the affected tooth
.
•
milder cases, it may be possible to expose the crown surgically and
apply traction to align the tooth
,
•
root apex will be sited within cancellous bone at the completion of
crown alignment

Supernumerary teeth
•
supernumerary tooth is one that is additional to the normal series
•
2%
of the population and in the primary dentition in less than 1%
,
•
in the deciduous dentition is often followed by a supernumerary in
the permanent dentition
•
genetic component
•
more commonly in males
•
commonly found in the region of the cleft in individuals with a cleft of
the alveolus

Supernumerary teeth can be described according
to their morphology or position in the arch
.
•
Morphology
•
Supplemental: this type resembles a tooth and occurs at the end of a
tooth series, for example, an additional lateral incisor, second
premolar, or fourth molar
•
Conical: the conical or peg-shaped supernumerary most often occurs
between the upper central incisors (Fig. 3.18). It is said to be more
commonly associated with displacement of the adjacent teeth, but
can also cause failure of eruption or not affect the other teeth
.

Tuberculate
•
this type is described as being barrel shaped, but usually any
supernumerary which does not fall into the conical or supplemental
categories is included. Classically, this type is associated with failure of
eruption

Odontome
:
•
this variant is rare. Both compound (a conglomeration of small tooth-
like structures) and complex (an amorphous mass of enamel and
dentine) forms have been described
.

Position
•
Supernumerary teeth can occur within the arch, but when they
develop between the central incisors they are often described as a
mesiodens
•
A supernumerary tooth distal to the arch is called a distomolar, and
one adjacent to the molars is known as a paramolar
•
Eighty per cent of supernumeraries occur in the anterior maxilla

Effects of supernumerary teeth and their
management
•
Failure of eruption
:
•
The presence of a supernumerary tooth is the most common reason for
the non-appearance of a maxillary central incisor. However, failure of
eruption of any tooth in either arch can be caused by a supernumerary
•
Management of this problem involves removing the impediment to
eruption
•
erupt spontaneously within 1 year
,
•
Or operation to expose it and apply orthodontic traction may be required

Displacement
•
The presence of a supernumerary tooth can be associated with
displacement or rotation of an erupted permanent tooth
•
Management involves firstly removal of the supernumerary
•
followed by fixed appliances to align the affected tooth or teeth
•
this type of displacement has a high tendency to relapse
•
usually in the form of a rotation or an apical displacement which, in
themselves, are particularly liable to relapse
.

Crowding
•
This is caused by the supplemental type and is treated by removing
the most poorly formed or more displaced tooth

No effect
•
supernumerary tooth (usually of the conical type)
•
extra tooth will not interfere with any planned movement of the
upper incisors
•
can be left in situ under radiographic observation
•
In practice, these teeth usually remain symptomless
•
Some conical supernumeraries erupt palatally to the upper incisors, in
which case their removal is straightforward

Habits
•
The effect of a habit will depend upon the frequency and intensity of
indulgence

First permanent molars of poor long-term
prognosis
•
The integrity of the first permanent molars is often compromised due
to caries and/or hypoplasia secondary to a childhood illness
•
several competing factors have to be considered
•
rarely the first tooth of choice for extraction as their position within
the arch means that little space is provided anteriorly for relief of
crowding or correction of the incisor relationship unless appliances
are used

Removal of maxillary first molars often
compromises anchorage in the upper arch
•
good spontaneous result in the lower arch following extraction of the
first molars is rare
•
patients for whom enforced extraction of the first molars is required
are often the least able to support complicated treatment
•
the prognosis for that tooth and the remaining first molars should be
considered

Factors to consider when assessing first
permanent molars of poor long-term prognosis
•
It is impossible to produce hard and fast rules regarding the extraction
of first permanent molars
•
Check for the presence of all permanent teeth. If any are absent,
extraction of the first permanent molar in that quadrant should be
avoided
.
•
If the dentition is uncrowded extraction of first permanent molars
should be avoided as space closure will be difficult
.
•
in the maxilla there is a greater tendency for mesial drift and so the
timing of the extraction of upper first permanent molars is less critical
if aiming for space closure
.

in the lower arch, a good spontaneous result
is more likely if
:
•
the lower second permanent molar has developed as far as its
bifurcation
•
the angle between the long axis of the crypt of the lower second
permanent molar and the first permanent molar is between 15° and
30°
•
the crypt of the second molar overlaps the root of the first molar (a
space between the two reduces the likelihood of good space closure)

•
Extraction of the first molars alone will relieve buccal segment
crowding, but will have little effect on a crowded labial segment
•
If space is needed anteriorly for the relief of labial segment crowding
delay extraction of the first molar, if possible, until the second
permanent molar has erupted in that arch
.
•
The space can then be utilized, in conjunction with appliance therapy,
for correction of the labial segment
.

Serious consideration
•
extracting the opposing upper first permanent molar, should
extraction of a lower molar be necessary
?
•
If the upper molar is not extracted, it will over-erupt and prevent
forward drift of the lower second molar

compensating extraction
•
in the lower arch (when extraction of an upper first permanent molar
is necessary)
•
If there will be no good chance of spontaneous result Avoid extraction

•
Impaction of the third permanent molars is less likely, but not impos
sible, following extraction of the first molar
.

Median diastema
•
Prevalence
•
Median diastema occurs in around 98% of 6-year-olds, 49% of 11-
yearolds, and 7% of 12–18-year-o

Aetiology
•
Aetiology Factors which have been considered to lead to a median
diastema include the following
•
Physiological (normal dental development)
•
Familial or racial trait
•
•
Small teeth in large jaws (a spaced dentition)
•
•
Missing teeth
•
•
Midline supernumerary tooth/teeth
•
•
Proclination of the upper labial segment
•
•
Prominent fraenum

•
A median diastema is normally present between the maxillary per
manent central incisors when they first erupt
•
normal feature of the developing dentition
•
if it persists after eruption of the canines, it is unlikely that it will close
spontaneously

Diastima in In the deciduous dentition
•
the upper midline fraenum runs between the central incisors

the upper midline fraenum can contribute to
the persistence of a diastema
•
When the fraenum is placed under tension there is blanching of the
incisive papilla
•
Radiographically, a notch can be seen at the crest of the interdental
bone between the upper central incisors
•
The anterior teeth may be crowded

referral
•
Deciduous dentition • Cleft lip and/or palate (if patient not under the
care of a cleft team). • Other craniofacial anomalies (if patient not
under the care of a mul

Referal in Mixed dentition
•
Severe Class III skeletal problems which would benefit from orthopaedic
treatment
.
•
•
Delayed eruption of the permanent incisors
.
•
•
Presence of a supplemental incisor and the decision as to which to
extract is not clear-cut
•
Severe Class III skeletal problems which would benefit from orthopaedic
treatment
.
•
•
Delayed eruption of the permanent incisors
.
•
•
Presence of a supplemental incisor and the decision as to which to
extract is not clear-cut

Growth modification
•
Growth modification

concepts_of_occlusion_mostafa fathy.pptx

More Related Content

Similar to concepts_of_occlusion_mostafa fathy.pptx

More from AhmedNabil54550

Recently uploaded

concepts_of_occlusion_mostafa fathy.pptx