const pptxgen = require("pptxgenjs");
const fs = require("fs");

// Load images
const images = JSON.parse(fs.readFileSync("images/images_b64.json", "utf8"));
const img = (i) => images[i] && !images[i].error ? images[i].base64 : null;

// img[0] = root fracture types diagram
// img[1] = vertical root fracture
// img[2] = radiograph horizontal root fracture
// img[3] = CBCT scan
// img[4] = splinting
// img[5] = root canal MTA
// img[6] = healing patterns
// img[7] = hemisection

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.author = "Seminar Presentation";
pres.title = "Root Fractures and Their Management";

// ============================================================
// COLOR PALETTE
// ============================================================
const DARK_BG    = "0D1B2A";  // deep navy - title/section slides
const MID_BG     = "1B2B3D";  // mid navy - content slides
const LIGHT_BG   = "EEF3F9";  // pale blue - data/list slides
const ACCENT1    = "2EC4B6";  // teal
const ACCENT2    = "E76F51";  // coral/orange
const ACCENT3    = "F4A261";  // amber
const WHITE      = "FFFFFF";
const LIGHT_GREY = "CBD5E1";
const DARK_TEXT  = "1E293B";
const SUBTITLE_CLR = "94A3B8";

// ============================================================
// HELPER FUNCTIONS
// ============================================================
function addDarkSlide(slide) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: DARK_BG } });
}
function addMidSlide(slide) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: MID_BG } });
}
function addLightSlide(slide) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: LIGHT_BG } });
}

function addSectionHeader(slide, text) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.08, h: 5.625, fill: { color: ACCENT1 } });
  slide.addText(text, { x: 0.3, y: 0.15, w: 9.4, h: 0.45, fontSize: 11, color: ACCENT1, bold: true, charSpacing: 3 });
}

function addSlideNumber(slide, num) {
  slide.addText(`${num} / 25`, { x: 8.8, y: 5.2, w: 1, h: 0.3, fontSize: 9, color: SUBTITLE_CLR, align: "right" });
}

function addBullets(slide, items, x, y, w, h, opts = {}) {
  const textItems = items.map((item, i) => ({
    text: item,
    options: { bullet: { indent: 12 }, breakLine: i < items.length - 1, fontSize: opts.fontSize || 14, color: opts.color || WHITE }
  }));
  slide.addText(textItems, { x, y, w, h, lineSpacingMultiple: 1.3 });
}

// ============================================================
// SLIDE 1 — TITLE
// ============================================================
{
  const s = pres.addSlide();
  addDarkSlide(s);
  // Decorative circle
  s.addShape(pres.ShapeType.ellipse, { x: 6.5, y: -1, w: 5, h: 5, fill: { color: "162843" }, line: { color: ACCENT1, width: 1 } });
  s.addShape(pres.ShapeType.ellipse, { x: 7, y: -0.5, w: 4, h: 4, fill: { color: DARK_BG }, line: { color: "none" } });
  if (img(0)) s.addImage({ data: img(0), x: 5.9, y: 0.3, w: 3.8, h: 2.8 });
  // Accent bar
  s.addShape(pres.ShapeType.rect, { x: 0.6, y: 2.0, w: 3.5, h: 0.05, fill: { color: ACCENT1 } });
  s.addText("ROOT FRACTURES", { x: 0.5, y: 0.7, w: 6, h: 0.8, fontSize: 38, bold: true, color: WHITE, charSpacing: 2 });
  s.addText("AND THEIR MANAGEMENT", { x: 0.5, y: 1.5, w: 6.5, h: 0.6, fontSize: 22, color: ACCENT1, charSpacing: 1 });
  s.addText("A Comprehensive Review for the Seminar", { x: 0.5, y: 2.3, w: 6, h: 0.4, fontSize: 13, color: SUBTITLE_CLR, italic: true });
  s.addText("Drawing from Cohen's Pathways of the Pulp, Ingle's Endodontics\nand Contemporary Peer-Reviewed Literature", {
    x: 0.5, y: 2.85, w: 6.2, h: 0.7, fontSize: 11, color: SUBTITLE_CLR
  });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 5.1, w: 10, h: 0.525, fill: { color: "0A1520" } });
  s.addText("June 2026  |  Endodontics Seminar", { x: 0.5, y: 5.15, w: 9, h: 0.38, fontSize: 10, color: SUBTITLE_CLR });
}

// ============================================================
// SLIDE 2 — TABLE OF CONTENTS
// ============================================================
{
  const s = pres.addSlide();
  addMidSlide(s);
  addSectionHeader(s, "OVERVIEW");
  s.addText("Table of Contents", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 24, bold: true, color: WHITE });
  const cols = [
    ["01  Introduction & History", "02  Definitions & Classification", "03  Epidemiology & Etiology", "04  Anatomy & Pathophysiology", "05  Types of Root Fractures", "06  Healing Responses", "07  Pulpal Response & Sequelae", "08  Clinical Diagnosis", "09  Radiographic Diagnosis", "10  CBCT & Advanced Imaging", "11  Differential Diagnosis", "12  AI in VRF Detection"],
    ["13  Management: Horizontal Fractures", "14  Splinting Protocols", "15  Endodontic Intervention", "16  Management: Vertical Fractures", "17  Crown-Root Fractures", "18  Pediatric & Immature Teeth", "19  Post-Endodontic Restoration", "20  Prognosis", "21  Prevention Strategies", "22  Follow-up & Monitoring", "23  Interdisciplinary Considerations", "24  Medicolegal Aspects", "25  Conclusions & References"]
  ];
  cols.forEach((col, ci) => {
    col.forEach((item, ri) => {
      const num = item.slice(0, 2);
      const txt = item.slice(4);
      s.addShape(pres.ShapeType.rect, { x: 0.4 + ci * 4.8, y: 1.25 + ri * 0.325, w: 0.38, h: 0.28, fill: { color: ACCENT1 }, radius: 2 });
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    });
  });
  addSlideNumber(s, 2);
}

// ============================================================
// SLIDE 3 — INTRODUCTION & HISTORY
// ============================================================
{
  const s = pres.addSlide();
  addMidSlide(s);
  addSectionHeader(s, "01  INTRODUCTION");
  s.addText("Introduction & Historical Perspective", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: WHITE });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2, w: 5.8, h: 0.02, fill: { color: ACCENT1 } });
  const pts = [
    "Root fractures involve simultaneous disruption of dentine, cementum, pulp, and the periodontal ligament — making them among the most complex dental injuries",
    "Earliest recorded treatment: gold wire & silk ligature splinting (referenced in Ingle's Endodontics)",
    "Grossman (early 20th century): detailed horizontal/diagonal mid-root fractures; considered coronal third fractures to carry an unfavorable prognosis",
    "Ellis (1945): durable classification system — conceptual backbone of the IADT classification used today",
    "Landmark longitudinal studies by Jens O. Andreasen et al. (Denmark): established biological healing paradigms, transforming management from interventionist to biologically informed",
    "Recognition of VRFs as a distinct iatrogenic entity emerged in the latter 20th century (Tamse, Berman)",
    "Today: CBCT, bioceramic materials (MTA), regenerative endodontics, and AI-driven diagnosis are reshaping the field"
  ];
  const textItems = pts.map((p, i) => ({ text: "  " + p, options: { bullet: { indent: 10 }, breakLine: i < pts.length - 1, fontSize: 12.5, color: LIGHT_GREY } }));
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  addSlideNumber(s, 3);
}

// ============================================================
// SLIDE 4 — DEFINITIONS & CLASSIFICATION
// ============================================================
{
  const s = pres.addSlide();
  addLightSlide(s);
  addSectionHeader(s, "02  DEFINITIONS");
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.08, h: 5.625, fill: { color: ACCENT1 } });
  s.addText("Definitions, Terminology & Classification", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: DARK_TEXT });
  // Two columns
  // Left: Root Fracture
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.25, w: 4.4, h: 4.0, fill: { color: MID_BG }, radius: 6 });
  s.addText("INTRA-ALVEOLAR ROOT FRACTURE", { x: 0.45, y: 1.38, w: 4.1, h: 0.38, fontSize: 11, bold: true, color: ACCENT1, charSpacing: 1 });
  const rfDefs = [
    "Fracture perpendicular / oblique to the long axis",
    "Disrupts: dentine, cementum, pulp, PDL",
    "Classified by level: Apical third (best prognosis), Middle third (most common), Cervical third (worst prognosis)",
    "IADT Category 7 in the Bourguignon 2020 classification",
    "Also called: transverse, horizontal, intra-alveolar fracture"
  ];
  const rfItems = rfDefs.map((r, i) => ({ text: r, options: { bullet: { indent: 10 }, breakLine: i < rfDefs.length - 1, fontSize: 12, color: LIGHT_GREY } }));
  s.addText(rfItems, { x: 0.45, y: 1.8, w: 4.05, h: 3.2, lineSpacingMultiple: 1.4 });
  // Right: VRF
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.25, w: 4.6, h: 4.0, fill: { color: MID_BG }, radius: 6 });
  s.addText("VERTICAL ROOT FRACTURE (VRF)", { x: 5.25, y: 1.38, w: 4.3, h: 0.38, fontSize: 11, bold: true, color: ACCENT2, charSpacing: 1 });
  const vrfDefs = [
    "Runs parallel / subparallel to the long axis",
    "Overwhelmingly iatrogenic (endodontic/restorative procedures)",
    "Incomplete VRF: craze lines / partial crack", 
    "Complete VRF: full separation of root",
    "Orientation: Buccolingual (most common) or Mesiodistal",
    "Distinct from traumatic fractures in etiology, diagnosis, and management"
  ];
  const vrfItems = vrfDefs.map((v, i) => ({ text: v, options: { bullet: { indent: 10 }, breakLine: i < vrfDefs.length - 1, fontSize: 12, color: LIGHT_GREY } }));
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  addSlideNumber(s, 4);
}

// ============================================================
// SLIDE 5 — EPIDEMIOLOGY
// ============================================================
{
  const s = pres.addSlide();
  addMidSlide(s);
  addSectionHeader(s, "03  EPIDEMIOLOGY");
  s.addText("Epidemiology & Etiology", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: WHITE });
  // Stats boxes
  const stats = [
    { val: "0.5–7%", lbl: "of dental trauma cases\ninvolve root fractures" },
    { val: "2nd decade", lbl: "of life most\ncommonly affected" },
    { val: "Maxillary\nCentral Incisor", lbl: "most frequently\nfractured tooth" },
    { val: "2–5%", lbl: "prevalence in\nroot-filled teeth (VRF)" }
  ];
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    s.addShape(pres.ShapeType.rect, { x: 0.3 + i * 2.35, y: 1.2, w: 2.15, h: 0.06, fill: { color: i < 2 ? ACCENT1 : ACCENT2 } });
    s.addText(st.val, { x: 0.3 + i * 2.35, y: 1.35, w: 2.15, h: 0.65, fontSize: 17, bold: true, color: i < 2 ? ACCENT1 : ACCENT2, align: "center" });
    s.addText(st.lbl, { x: 0.3 + i * 2.35, y: 2.0, w: 2.15, h: 0.65, fontSize: 11, color: LIGHT_GREY, align: "center" });
  });
  // Etiology
  s.addText("Key Etiological Factors", { x: 0.3, y: 3.0, w: 9.3, h: 0.38, fontSize: 15, bold: true, color: WHITE });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 3.38, w: 4.5, h: 0.04, fill: { color: ACCENT1 } });
  s.addText("TRAUMATIC (Horizontal RF)\n• Blow to labial surface of anterior teeth\n• Sports injuries, falls, road accidents\n• Males > Females; peak age 11–20 years\n• Immature roots have greater pulpal regenerative capacity", {
    x: 0.3, y: 3.45, w: 4.35, h: 1.85, fontSize: 12.5, color: LIGHT_GREY, lineSpacingMultiple: 1.3
  });
  s.addShape(pres.ShapeType.rect, { x: 5.2, y: 3.38, w: 4.5, h: 0.04, fill: { color: ACCENT2 } });
  s.addText("IATROGENIC (VRF)\n• Over-instrumentation / canal over-preparation\n• Lateral condensation of gutta-percha\n• Intracanal post placement\n• Excessive obturation pressure\n• Parafunctional habits (bruxism)", {
    x: 5.2, y: 3.45, w: 4.5, h: 1.85, fontSize: 12.5, color: LIGHT_GREY, lineSpacingMultiple: 1.3
  });
  addSlideNumber(s, 5);
}

// ============================================================
// SLIDE 6 — ANATOMY & PATHOPHYSIOLOGY
// ============================================================
{
  const s = pres.addSlide();
  addLightSlide(s);
  addSectionHeader(s, "04  ANATOMY");
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.08, h: 5.625, fill: { color: ACCENT1 } });
  s.addText("Anatomy & Pathophysiology", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: DARK_TEXT });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.15, w: 5.9, h: 4.2, fill: { color: MID_BG }, radius: 6 });
  s.addText("Root Structure & Mechanical Properties", { x: 0.5, y: 1.28, w: 5.5, h: 0.4, fontSize: 13, bold: true, color: ACCENT1 });
  const anatPts = [
    "Root composed of dentine — mineralized tissue with dentinal tubules radiating from pulp to periphery",
    "Outer surface covered by cementum: anchors PDL via Sharpey's fibres",
    "Periodontal Ligament (PDL): suspends tooth, transmits occlusal forces, houses pluripotent progenitor cells critical for healing",
    "Dentine is anisotropic: high compressive strength, lower tensile/shear strength",
    "Microcracks initiate at areas of stress concentration: inner canal walls, apico-coronal midpoint, areas of reduced wall thickness",
    "Oval cross-section roots (mandibular incisors, mesiobuccal roots of upper molars) most susceptible to VRF",
    "Endodontic treatment removes vital pulp moisture → increased dentine brittleness"
  ];
  const anatItems = anatPts.map((p, i) => ({ text: p, options: { bullet: { indent: 10 }, breakLine: i < anatPts.length - 1, fontSize: 12.5, color: LIGHT_GREY } }));
  s.addText(anatItems, { x: 0.5, y: 1.75, w: 5.5, h: 3.5, lineSpacingMultiple: 1.35 });
  // Right panel
  s.addShape(pres.ShapeType.rect, { x: 6.5, y: 1.15, w: 3.2, h: 4.2, fill: { color: MID_BG }, radius: 6 });
  s.addText("Critical Wall Thickness", { x: 6.65, y: 1.28, w: 2.9, h: 0.4, fontSize: 12, bold: true, color: ACCENT2 });
  s.addText("< 1 mm", { x: 6.65, y: 1.75, w: 2.9, h: 0.6, fontSize: 32, bold: true, color: ACCENT2, align: "center" });
  s.addText("labial/lingual walls in oval-shaped roots", { x: 6.65, y: 2.35, w: 2.9, h: 0.5, fontSize: 11, color: LIGHT_GREY, align: "center" });
  s.addShape(pres.ShapeType.rect, { x: 6.8, y: 2.9, w: 2.6, h: 0.04, fill: { color: ACCENT1 } });
  s.addText("PDL stem cells are the primary biological mediators of repair and healing following root fracture", { x: 6.65, y: 3.0, w: 2.9, h: 1.0, fontSize: 11.5, color: LIGHT_GREY, align: "center", italic: true });
  addSlideNumber(s, 6);
}

// ============================================================
// SLIDE 7 — TYPES OF ROOT FRACTURES (with main image)
// ============================================================
{
  const s = pres.addSlide();
  addDarkSlide(s);
  addSectionHeader(s, "05  TYPES OF ROOT FRACTURES");
  s.addText("Types of Root Fractures", { x: 0.3, y: 0.55, w: 6, h: 0.55, fontSize: 22, bold: true, color: WHITE });
  if (img(0)) s.addImage({ data: img(0), x: 5.6, y: 0.6, w: 4.1, h: 3.2 });
  const types = [
    { color: ACCENT1, name: "Horizontal / Transverse RF", desc: "Perpendicular to long axis; traumatic; classified by third" },
    { color: ACCENT2, name: "Vertical Root Fracture (VRF)", desc: "Parallel to long axis; usually iatrogenic; often missed" },
    { color: ACCENT3, name: "Crown-Root Fracture", desc: "Involves both crown and root; may expose pulp" },
    { color: "7DD3FC", name: "Oblique Root Fracture", desc: "Diagonal orientation; intermediate features" },
  ];
  types.forEach((t, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.3 + i * 0.9, w: 5.0, h: 0.75, fill: { color: "162843" }, radius: 5 });
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.3 + i * 0.9, w: 0.06, h: 0.75, fill: { color: t.color } });
    s.addText(t.name, { x: 0.5, y: 1.34 + i * 0.9, w: 4.6, h: 0.3, fontSize: 13, bold: true, color: t.color });
    s.addText(t.desc, { x: 0.5, y: 1.65 + i * 0.9, w: 4.6, h: 0.28, fontSize: 11, color: LIGHT_GREY });
  });
  // Fracture level box
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 4.95, w: 5.1, h: 0.48, fill: { color: "162843" }, radius: 4 });
  s.addText("Fracture Level → Prognosis:  Apical (best)  |  Middle  |  Cervical (worst)", { x: 0.4, y: 4.97, w: 4.9, h: 0.42, fontSize: 11.5, color: ACCENT1 });
  addSlideNumber(s, 7);
}

// ============================================================
// SLIDE 8 — HEALING RESPONSES (with image)
// ============================================================
{
  const s = pres.addSlide();
  addMidSlide(s);
  addSectionHeader(s, "06  BIOLOGICAL HEALING");
  s.addText("Biological Healing Responses", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: WHITE });
  if (img(6)) s.addImage({ data: img(6), x: 5.5, y: 1.1, w: 4.2, h: 4.2 });
  const healingTypes = [
    { type: "Type 1: Hard Tissue Callus", desc: "Calcified bridge forms between fragments — most favorable outcome. Seen in apical and mid-root fractures.", color: ACCENT1 },
    { type: "Type 2: Connective Tissue Healing", desc: "PDL fibres bridge fragments without calcification; fragments remain separated but functional.", color: ACCENT3 },
    { type: "Type 3: Bone & CT Interposition", desc: "Alveolar bone grows into the fracture site, separating fragments permanently.", color: "7DD3FC" },
    { type: "Type 4: Granulation Tissue", desc: "Inflammatory/granulation tissue fills the fracture; indicates pulp necrosis, requires RCT or extraction.", color: ACCENT2 }
  ];
  healingTypes.forEach((h, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2 + i * 1.05, w: 5.0, h: 0.9, fill: { color: "162843" }, radius: 5 });
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2 + i * 1.05, w: 0.06, h: 0.9, fill: { color: h.color } });
    s.addText(h.type, { x: 0.5, y: 1.24 + i * 1.05, w: 4.6, h: 0.3, fontSize: 12.5, bold: true, color: h.color });
    s.addText(h.desc, { x: 0.5, y: 1.55 + i * 1.05, w: 4.6, h: 0.45, fontSize: 11, color: LIGHT_GREY });
  });
  addSlideNumber(s, 8);
}

// ============================================================
// SLIDE 9 — PULPAL RESPONSE
// ============================================================
{
  const s = pres.addSlide();
  addLightSlide(s);
  addSectionHeader(s, "07  PULPAL RESPONSE");
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.08, h: 5.625, fill: { color: ACCENT1 } });
  s.addText("Pulpal Response & Sequelae", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: DARK_TEXT });
  const pulpData = [
    { pct: "~80%", desc: "Pulp remains vital after horizontal RF", color: ACCENT1 },
    { pct: "~20%", desc: "Develop pulp necrosis (mostly in coronal fragment)", color: ACCENT2 },
    { pct: "< 1%", desc: "Apical fragment becomes necrotic independently", color: ACCENT3 }
  ];
  pulpData.forEach((p, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3 + i * 3.2, y: 1.2, w: 2.9, h: 1.5, fill: { color: MID_BG }, radius: 6 });
    s.addText(p.pct, { x: 0.3 + i * 3.2, y: 1.3, w: 2.9, h: 0.75, fontSize: 30, bold: true, color: p.color, align: "center" });
    s.addText(p.desc, { x: 0.3 + i * 3.2, y: 2.05, w: 2.9, h: 0.5, fontSize: 11.5, color: LIGHT_GREY, align: "center" });
  });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 2.95, w: 9.3, h: 0.04, fill: { color: ACCENT1 } });
  s.addText("Pulpal Sequelae and Histological Changes", { x: 0.3, y: 3.1, w: 9.3, h: 0.4, fontSize: 14, bold: true, color: DARK_TEXT });
  const pulpPts = [
    "Initial response: transient pulp injury with hyperemia, haemorrhage between fragments, and disruption of the neurovascular supply",
    "Revascularization can occur in open-apex teeth — the immature apex allows re-entry of new vessels and nerve fibres",
    "In mature teeth, revascularization is rare; survival depends on intact apical blood supply",
    "Coronal fragment more susceptible to necrosis because it is separated from the main blood supply",
    "Pulp canal obliteration (PCO) — increased secondary dentine deposition — is a common benign finding after trauma; does not require treatment",
    "Active inflammatory root resorption signals pulp necrosis and mandates endodontic intervention"
  ];
  const pulpItems = pulpPts.map((p, i) => ({ text: p, options: { bullet: { indent: 10 }, breakLine: i < pulpPts.length - 1, fontSize: 12, color: DARK_TEXT } }));
  s.addText(pulpItems, { x: 0.3, y: 3.55, w: 9.3, h: 1.85, lineSpacingMultiple: 1.3 });
  addSlideNumber(s, 9);
}

// ============================================================
// SLIDE 10 — CLINICAL DIAGNOSIS
// ============================================================
{
  const s = pres.addSlide();
  addMidSlide(s);
  addSectionHeader(s, "08  CLINICAL DIAGNOSIS");
  s.addText("Clinical Diagnosis", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: WHITE });
  const diagSections = [
    {
      title: "History & Chief Complaint",
      items: ["Nature, mechanism, and time of injury", "Prior trauma or dental treatment to the tooth", "Symptoms: pain, mobility, sensitivity to bite", "Medical history; tetanus status in trauma"]
    },
    {
      title: "Clinical Examination",
      items: ["Mobility testing: coronal fragment mobility without apical mobility is pathognomonic", "Discoloration of crown (grey/pink tint)", "Palpation of alveolus for tenderness/swelling", "Soft tissue lacerations or ecchymosis"]
    },
    {
      title: "Vitality Testing",
      items: ["Electric pulp test (EPT): may give false negative acutely", "Cold/thermal testing (preferred): more reliable", "Laser Doppler flowmetry: gold standard (rarely available)", "Repeat testing at 4, 8, 12 weeks after trauma"]
    },
    {
      title: "Periodontal Assessment",
      items: ["Deep narrow probing defect = VRF (sinus tract to fracture)", "Furcation involvement in multirooted teeth", "Alveolar bone levels on radiograph", "Mobility grading (Miller classification)"]
    }
  ];
  diagSections.forEach((sec, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    s.addShape(pres.ShapeType.rect, { x: 0.3 + col * 4.9, y: 1.2 + row * 2.15, w: 4.5, h: 2.0, fill: { color: "162843" }, radius: 6 });
    s.addShape(pres.ShapeType.rect, { x: 0.3 + col * 4.9, y: 1.2 + row * 2.15, w: 4.5, h: 0.06, fill: { color: ACCENT1 } });
    s.addText(sec.title, { x: 0.45 + col * 4.9, y: 1.32 + row * 2.15, w: 4.2, h: 0.38, fontSize: 12.5, bold: true, color: ACCENT1 });
    const items = sec.items.map((it, j) => ({ text: it, options: { bullet: { indent: 8 }, breakLine: j < sec.items.length - 1, fontSize: 11.5, color: LIGHT_GREY } }));
    s.addText(items, { x: 0.45 + col * 4.9, y: 1.72 + row * 2.15, w: 4.2, h: 1.35, lineSpacingMultiple: 1.25 });
  });
  addSlideNumber(s, 10);
}

// ============================================================
// SLIDE 11 — RADIOGRAPHIC DIAGNOSIS (with image)
// ============================================================
{
  const s = pres.addSlide();
  addDarkSlide(s);
  addSectionHeader(s, "09  RADIOGRAPHIC DIAGNOSIS");
  s.addText("Radiographic Diagnosis", { x: 0.3, y: 0.55, w: 6, h: 0.55, fontSize: 22, bold: true, color: WHITE });
  if (img(2)) s.addImage({ data: img(2), x: 5.5, y: 1.1, w: 4.2, h: 3.5 });
  const radPts = [
    { head: "Periapical Radiography", body: "First-line investigation; paralleling technique preferred for accurate fracture level assessment. Fracture line appears as radiolucent line perpendicular to long axis." },
    { head: "Multiple Angulations", body: "A single view may miss a fracture. IADT recommends 3 views: standard periapical + 2 additional angulations (mesial/distal offset). Fracture visible in one plane only." },
    { head: "Bisecting Angle Technique", body: "Can mask fractures by foreshortening or elongating. Paralleling technique is more reliable for fracture detection." },
    { head: "Limitations", body: "Horizontal RF can be missed if fracture line is not perpendicular to X-ray beam. VRF is frequently undetectable on conventional radiographs." }
  ];
  radPts.forEach((r, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2 + i * 1.05, w: 4.9, h: 0.9, fill: { color: "162843" }, radius: 5 });
    s.addText(r.head, { x: 0.45, y: 1.24 + i * 1.05, w: 4.5, h: 0.32, fontSize: 12.5, bold: true, color: ACCENT1 });
    s.addText(r.body, { x: 0.45, y: 1.58 + i * 1.05, w: 4.5, h: 0.44, fontSize: 11, color: LIGHT_GREY });
  });
  addSlideNumber(s, 11);
}

// ============================================================
// SLIDE 12 — CBCT & ADVANCED IMAGING (with CBCT image)
// ============================================================
{
  const s = pres.addSlide();
  addMidSlide(s);
  addSectionHeader(s, "10  CBCT & ADVANCED IMAGING");
  s.addText("CBCT & Advanced Diagnostic Methods", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: WHITE });
  if (img(3)) s.addImage({ data: img(3), x: 5.7, y: 1.05, w: 4.0, h: 3.2 });
  const cbctPts = [
    { title: "CBCT — Gold Standard", body: "3D volumetric imaging; detects fractures invisible on 2D. Essential for VRF diagnosis and pre-surgical planning.", color: ACCENT1 },
    { title: "Technical Parameters", body: "Small FOV (<5 cm); high resolution (0.076–0.125 mm voxel); ALARA principle limits radiation exposure.", color: ACCENT3 },
    { title: "Accuracy", body: "Systematic reviews: CBCT sensitivity 80–90%, specificity >90% for VRF. Superior to periapical radiographs.", color: "7DD3FC" },
    { title: "AI in VRF Detection", body: "Convolutional neural networks applied to CBCT/periapical images; early studies show accuracy comparable to specialists.", color: ACCENT2 }
  ];
  cbctPts.forEach((c, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2 + i * 1.05, w: 5.1, h: 0.9, fill: { color: "162843" }, radius: 5 });
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2 + i * 1.05, w: 0.06, h: 0.9, fill: { color: c.color } });
    s.addText(c.title, { x: 0.5, y: 1.24 + i * 1.05, w: 4.7, h: 0.3, fontSize: 12.5, bold: true, color: c.color });
    s.addText(c.body, { x: 0.5, y: 1.56 + i * 1.05, w: 4.7, h: 0.44, fontSize: 11, color: LIGHT_GREY });
  });
  // Bottom note
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 4.55, w: 9.3, h: 0.78, fill: { color: "162843" }, radius: 5 });
  s.addText("Additional Methods:  Transillumination & Staining (direct vision, especially VRF on extracted teeth)  •  Optical Coherence Tomography (emerging, high resolution)  •  Periodontal probing pattern (\"halo\" defect pathognomonic for VRF)", {
    x: 0.5, y: 4.6, w: 9.0, h: 0.65, fontSize: 11, color: LIGHT_GREY
  });
  addSlideNumber(s, 12);
}

// ============================================================
// SLIDE 13 — DIFFERENTIAL DIAGNOSIS
// ============================================================
{
  const s = pres.addSlide();
  addLightSlide(s);
  addSectionHeader(s, "11  DIFFERENTIAL DIAGNOSIS");
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.08, h: 5.625, fill: { color: ACCENT1 } });
  s.addText("Differential Diagnosis", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: DARK_TEXT });
  const ddxRows = [
    ["Condition", "Key Differentiating Features", "Clinching Test"],
    ["Vertical Root Fracture", "Deep narrow sinus tract; 'halo' bone loss; pain on biting specific cusp", "CBCT; transillumination on extracted root"],
    ["Periodontal Disease", "Generalized bone loss; plaque/calculus; multiple teeth", "Full periodontal chart; OPG"],
    ["External Root Resorption", "Radiolucency outside root contour; vital pulp early on", "Periapical radiograph; CBCT"],
    ["Internal Root Resorption", "Central radiolucency within canal; often asymptomatic", "Periapical radiograph; non-vital"],
    ["Cracked Tooth Syndrome", "Pain on biting/release; incomplete crack above CEJ; EPT positive", "Transillumination; bite stick test"],
    ["Endodontic-Perio Lesion", "Combined perio + endo origin; complex probing pattern", "Sequential treatment response"],
    ["Dens Invaginatus", "Anomalous anatomy; seen radiographically from eruption", "Periapical radiograph"]
  ];
  ddxRows.forEach((row, ri) => {
    const isHeader = ri === 0;
    const bg = isHeader ? DARK_BG : (ri % 2 === 0 ? "EEF3F9" : "E2EAF4");
    const fg = isHeader ? ACCENT1 : DARK_TEXT;
    const fw = isHeader;
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.18 + ri * 0.55, w: 9.3, h: 0.5, fill: { color: bg } });
    [row[0], row[1], row[2]].forEach((cell, ci) => {
      const wx = [2.5, 3.8, 2.6];
      const xx = [0.35, 2.9, 6.75];
      s.addText(cell, { x: xx[ci], y: 1.2 + ri * 0.55, w: wx[ci], h: 0.45, fontSize: isHeader ? 11 : 10.5, bold: fw, color: fg, valign: "middle" });
    });
  });
  addSlideNumber(s, 13);
}

// ============================================================
// SLIDE 14 — MANAGEMENT: HORIZONTAL RF (with splint image)
// ============================================================
{
  const s = pres.addSlide();
  addDarkSlide(s);
  addSectionHeader(s, "12  MANAGEMENT: HORIZONTAL ROOT FRACTURES");
  s.addText("Management of Horizontal Root Fractures", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 20, bold: true, color: WHITE });
  if (img(4)) s.addImage({ data: img(4), x: 5.4, y: 0.95, w: 4.3, h: 3.3 });
  const mgmtSteps = [
    { step: "1", title: "Emergency Management", body: "Reposition displaced coronal fragment gently (within hours). Stabilize. Irrigate, suture lacerations. Pain management." },
    { step: "2", title: "Repositioning & Splinting", body: "Rigid splint for cervical third; semi-rigid (flexible) for mid and apical third. Duration: 4 weeks (mid/apical) to 4 months (cervical)." },
    { step: "3", title: "Splint Types", body: "Preferred: TTS (titanium trauma splint) + composite resin. Wire-composite splint acceptable. Avoid rigid arch bars for >4 weeks." },
    { step: "4", title: "Follow-up & Pulp Monitoring", body: "Clinical + radiographic review: 4 wks, 3 months, 6 months, 1 year, then annually for 5 years (IADT 2020 guidelines)." }
  ];
  mgmtSteps.forEach((m, i) => {
    s.addShape(pres.ShapeType.ellipse, { x: 0.3, y: 1.22 + i * 1.0, w: 0.42, h: 0.42, fill: { color: ACCENT1 } });
    s.addText(m.step, { x: 0.3, y: 1.22 + i * 1.0, w: 0.42, h: 0.42, fontSize: 13, bold: true, color: DARK_BG, align: "center", valign: "middle" });
    s.addShape(pres.ShapeType.rect, { x: 0.85, y: 1.22 + i * 1.0, w: 4.3, h: 0.85, fill: { color: "162843" }, radius: 5 });
    s.addText(m.title, { x: 1.0, y: 1.25 + i * 1.0, w: 4.0, h: 0.3, fontSize: 12.5, bold: true, color: ACCENT1 });
    s.addText(m.body, { x: 1.0, y: 1.55 + i * 1.0, w: 4.0, h: 0.44, fontSize: 11, color: LIGHT_GREY });
  });
  addSlideNumber(s, 14);
}

// ============================================================
// SLIDE 15 — ENDODONTIC INTERVENTION (with MTA image)
// ============================================================
{
  const s = pres.addSlide();
  addMidSlide(s);
  addSectionHeader(s, "13  ENDODONTIC INTERVENTION");
  s.addText("Endodontic Intervention After Root Fracture", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 20, bold: true, color: WHITE });
  if (img(5)) s.addImage({ data: img(5), x: 5.6, y: 1.0, w: 4.1, h: 3.8 });
  const endoPts = [
    { color: ACCENT2, title: "Indications for RCT", body: "Pulp necrosis (non-vital EPT, persistent symptoms, pathological root resorption, periapical pathology). RCT of the CORONAL fragment only; apical fragment rarely requires treatment." },
    { color: ACCENT1, title: "Canal Preparation", body: "Conservative preparation maintaining canal taper. Avoid excessive enlargement of the apical third. Irrigate with NaOCl + EDTA. Calcium hydroxide dressing for 1–3 months first." },
    { color: ACCENT3, title: "MTA Apical Plug", body: "Mineral Trioxide Aggregate: gold standard for apical barrier in open-apex / immature teeth. Biocompatible, sealing, and bacteriostatic. 4–5 mm plug recommended." },
    { color: "7DD3FC", title: "Apical Fragment", body: "Usually vital and asymptomatic — retain and monitor. Extraction only if apical fragment also becomes necrotic (rare). Surgical removal if obstructing treatment." }
  ];
  endoPts.forEach((e, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2 + i * 1.05, w: 5.0, h: 0.9, fill: { color: "162843" }, radius: 5 });
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2 + i * 1.05, w: 0.07, h: 0.9, fill: { color: e.color } });
    s.addText(e.title, { x: 0.5, y: 1.23 + i * 1.05, w: 4.6, h: 0.3, fontSize: 12.5, bold: true, color: e.color });
    s.addText(e.body, { x: 0.5, y: 1.55 + i * 1.05, w: 4.6, h: 0.5, fontSize: 11, color: LIGHT_GREY });
  });
  addSlideNumber(s, 15);
}

// ============================================================
// SLIDE 16 — MANAGEMENT: VERTICAL ROOT FRACTURES (with image)
// ============================================================
{
  const s = pres.addSlide();
  addDarkSlide(s);
  addSectionHeader(s, "14  MANAGEMENT: VERTICAL ROOT FRACTURES");
  s.addText("Management of Vertical Root Fractures", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 20, bold: true, color: WHITE });
  if (img(7)) s.addImage({ data: img(7), x: 5.5, y: 1.0, w: 4.2, h: 3.2 });
  const vrfMgmt = [
    { title: "Single-Rooted Teeth", body: "Extraction is the standard of care. Poor prognosis with any conservative attempt due to progressive periodontal destruction along the fracture.", color: ACCENT2 },
    { title: "Multi-Rooted Teeth: Root Resection", body: "Hemisection or root resection: removal of fractured root while retaining the remainder of the tooth. Requires sound periodontal support on remaining roots.", color: ACCENT1 },
    { title: "Intentional Replantation", body: "Tooth extracted, VRF bonded with MTA/bioceramic resin under magnification, replanted and splinted. Success rates variable; limited long-term data.", color: ACCENT3 },
    { title: "Bioceramic Repair (MTA / BioAggregate)", body: "Emerging technique: non-surgical internal sealing of VRF with bioceramic material via orthograde approach. Very limited evidence; not yet standard of care.", color: "7DD3FC" }
  ];
  vrfMgmt.forEach((v, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2 + i * 1.05, w: 5.0, h: 0.9, fill: { color: "162843" }, radius: 5 });
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2 + i * 1.05, w: 0.06, h: 0.9, fill: { color: v.color } });
    s.addText(v.title, { x: 0.5, y: 1.23 + i * 1.05, w: 4.6, h: 0.3, fontSize: 12.5, bold: true, color: v.color });
    s.addText(v.body, { x: 0.5, y: 1.55 + i * 1.05, w: 4.6, h: 0.5, fontSize: 11, color: LIGHT_GREY });
  });
  addSlideNumber(s, 16);
}

// ============================================================
// SLIDE 17 — CROWN-ROOT FRACTURES
// ============================================================
{
  const s = pres.addSlide();
  addLightSlide(s);
  addSectionHeader(s, "15  CROWN-ROOT FRACTURES");
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.08, h: 5.625, fill: { color: ACCENT1 } });
  s.addText("Management of Crown-Root Fractures", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: DARK_TEXT });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.15, w: 9.3, h: 0.7, fill: { color: MID_BG }, radius: 5 });
  s.addText("Crown-root fractures involve both the enamel/dentine of the crown AND the root below the CEJ. They frequently extend subgingivally, making management complex. The pulp may or may not be exposed. Management goal: re-establish a biologically sound crown-root ratio and restorable margin.", {
    x: 0.5, y: 1.22, w: 9.0, h: 0.55, fontSize: 12, color: LIGHT_GREY
  });
  const crfOptions = [
    { title: "Orthodontic Extrusion", body: "Slow extrusion of the root over 4–8 weeks brings the fracture margin supragingival. Gold standard for single subgingival fractures. Preserves bone and aesthetics. Requires post-treatment retention.", color: ACCENT1 },
    { title: "Surgical Crown Lengthening", body: "Osseous and soft tissue surgery to expose the fracture margin. Faster than ortho extrusion but may compromise aesthetics and periodontium in the anterior region. Best for posterior teeth.", color: ACCENT2 },
    { title: "Decoronation", body: "Removal of crown; intentional submergence of root for alveolar bone preservation in growing patients. Followed by implant placement when growth complete.", color: ACCENT3 },
    { title: "Extraction + Implant", body: "When fracture extends too apically for any conservative option. Immediate implant placement (if socket bone is adequate) is the definitive solution.", color: "7DD3FC" }
  ];
  crfOptions.forEach((c, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    s.addShape(pres.ShapeType.rect, { x: 0.3 + col * 4.85, y: 2.05 + row * 1.7, w: 4.5, h: 1.55, fill: { color: MID_BG }, radius: 6 });
    s.addShape(pres.ShapeType.rect, { x: 0.3 + col * 4.85, y: 2.05 + row * 1.7, w: 4.5, h: 0.06, fill: { color: c.color } });
    s.addText(c.title, { x: 0.45 + col * 4.85, y: 2.17 + row * 1.7, w: 4.2, h: 0.35, fontSize: 13, bold: true, color: c.color });
    s.addText(c.body, { x: 0.45 + col * 4.85, y: 2.54 + row * 1.7, w: 4.2, h: 0.9, fontSize: 11.5, color: LIGHT_GREY });
  });
  addSlideNumber(s, 17);
}

// ============================================================
// SLIDE 18 — PEDIATRIC & IMMATURE TEETH
// ============================================================
{
  const s = pres.addSlide();
  addMidSlide(s);
  addSectionHeader(s, "16  PEDIATRIC & IMMATURE TEETH");
  s.addText("Root Fractures in Pediatric & Immature Teeth", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 20, bold: true, color: WHITE });
  const pedPts = [
    {
      title: "Primary Dentition",
      items: ["Root fractures in primary teeth are rare; open apex and smaller roots make them more resilient", "If coronal fragment mobile and causing harm, remove it; apical fragment resorbs naturally", "Monitor successor permanent tooth for developmental disturbance", "Ectopic eruption of permanent tooth: earliest sign of damage to tooth germ"]
    },
    {
      title: "Immature Permanent Teeth",
      items: ["Open apex allows revascularization — pulp prognosis significantly better than mature teeth", "Apexogenesis (vital pulp therapy): preferred if pulp vital — allows root development to continue", "Apexification with Ca(OH)₂: monthly dressing changes until calcific barrier forms; time-consuming (9–18 months)", "MTA Apical Plug: faster than Ca(OH)₂; 4–5 mm plug placed in single visit; allows immediate obturation", "Regenerative Endodontic Procedures (REPs): bleeding clot scaffold, MTA barrier, allow biological root maturation — most biologically desirable approach"]
    }
  ];
  pedPts.forEach((p, ci) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3 + ci * 4.85, y: 1.2, w: 4.5, h: 4.15, fill: { color: "162843" }, radius: 6 });
    s.addShape(pres.ShapeType.rect, { x: 0.3 + ci * 4.85, y: 1.2, w: 4.5, h: 0.06, fill: { color: ci === 0 ? ACCENT1 : ACCENT2 } });
    s.addText(p.title, { x: 0.45 + ci * 4.85, y: 1.32, w: 4.2, h: 0.42, fontSize: 14, bold: true, color: ci === 0 ? ACCENT1 : ACCENT2 });
    const items = p.items.map((it, j) => ({ text: it, options: { bullet: { indent: 8 }, breakLine: j < p.items.length - 1, fontSize: 12, color: LIGHT_GREY } }));
    s.addText(items, { x: 0.45 + ci * 4.85, y: 1.8, w: 4.2, h: 3.4, lineSpacingMultiple: 1.35 });
  });
  addSlideNumber(s, 18);
}

// ============================================================
// SLIDE 19 — POST-ENDODONTIC RESTORATION
// ============================================================
{
  const s = pres.addSlide();
  addLightSlide(s);
  addSectionHeader(s, "17  POST-ENDODONTIC RESTORATION");
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.08, h: 5.625, fill: { color: ACCENT1 } });
  s.addText("Post-Endodontic Restoration After Root Fracture", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 20, bold: true, color: DARK_TEXT });
  const restPts = [
    { icon: "⚠", title: "Intracanal Posts — Risks & Rationale", body: "Posts do not strengthen roots — they can weaken them. Post drilling is a major risk factor for VRF. Use only when there is insufficient coronal tooth structure to retain the core. Minimum remaining root length: 2× clinical crown height. Minimum apical seal: 5 mm of gutta-percha.", color: ACCENT2 },
    { icon: "✓", title: "Passive Post Placement", body: "Parallel-sided, passive, bondable fibre posts are preferred. Avoid tapered posts (excessive wedging force). Bond with dual-cure resin cement. Fibre posts have an elastic modulus closer to dentine — distribute stress more evenly.", color: ACCENT1 },
    { icon: "✓", title: "Composite Resin Restorations", body: "When adequate coronal tissue exists: direct composite resin core + crown. In anterior teeth with satisfactory aesthetics: no crown may be needed if fracture is not visible. Adhesive composite restorations may help reinforce weakened roots.", color: ACCENT3 },
    { icon: "✓", title: "Crown Type Selection", body: "Full-coverage metal-ceramic or all-ceramic crown: standard after post placement. Consider zirconia for high-load areas. Endocrown (for molars): avoids post space, conservative, good long-term results.", color: "2563EB" }
  ];
  restPts.forEach((r, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    s.addShape(pres.ShapeType.rect, { x: 0.3 + col * 4.85, y: 1.2 + row * 2.1, w: 4.5, h: 1.95, fill: { color: MID_BG }, radius: 6 });
    s.addShape(pres.ShapeType.rect, { x: 0.3 + col * 4.85, y: 1.2 + row * 2.1, w: 4.5, h: 0.06, fill: { color: r.color } });
    s.addText(r.title, { x: 0.45 + col * 4.85, y: 1.32 + row * 2.1, w: 4.2, h: 0.35, fontSize: 12.5, bold: true, color: r.color });
    s.addText(r.body, { x: 0.45 + col * 4.85, y: 1.7 + row * 2.1, w: 4.2, h: 1.3, fontSize: 11.5, color: LIGHT_GREY, lineSpacingMultiple: 1.3 });
  });
  addSlideNumber(s, 19);
}

// ============================================================
// SLIDE 20 — PROGNOSIS
// ============================================================
{
  const s = pres.addSlide();
  addDarkSlide(s);
  addSectionHeader(s, "18  PROGNOSIS");
  s.addText("Prognosis of Root Fractures", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: WHITE });
  // Prognosis bars
  const progData = [
    { label: "Apical third RF", pct: 80, color: ACCENT1 },
    { label: "Middle third RF", pct: 60, color: ACCENT3 },
    { label: "Cervical third RF", pct: 35, color: ACCENT2 },
    { label: "VRF (single-rooted)", pct: 5, color: ACCENT2 }
  ];
  s.addText("Approximate Tooth Retention Rates (long-term)", { x: 0.3, y: 1.2, w: 6, h: 0.4, fontSize: 13, color: LIGHT_GREY, bold: true });
  progData.forEach((p, i) => {
    s.addText(p.label, { x: 0.3, y: 1.75 + i * 0.75, w: 2.8, h: 0.45, fontSize: 12.5, color: WHITE, valign: "middle" });
    s.addShape(pres.ShapeType.rect, { x: 3.2, y: 1.82 + i * 0.75, w: 6.3, h: 0.3, fill: { color: "1E2D3D" }, radius: 3 });
    s.addShape(pres.ShapeType.rect, { x: 3.2, y: 1.82 + i * 0.75, w: 6.3 * p.pct / 100, h: 0.3, fill: { color: p.color }, radius: 3 });
    s.addText(`${p.pct}%`, { x: 3.2 + 6.3 * p.pct / 100 + 0.1, y: 1.82 + i * 0.75, w: 0.5, h: 0.3, fontSize: 11, color: p.color, valign: "middle" });
  });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 4.7, w: 9.3, h: 0.04, fill: { color: ACCENT1 } });
  s.addText("Key Prognostic Factors", { x: 0.3, y: 4.8, w: 4, h: 0.35, fontSize: 13, bold: true, color: WHITE });
  const progFactors = [
    "Level of fracture: apical > middle > cervical",
    "Diastasis (separation between fragments) → worse prognosis",
    "Pulp status: vital pulp = better healing",
    "Patient age: younger = better PDL regenerative capacity",
    "Time to repositioning and splinting",
    "Mobility of coronal fragment"
  ];
  const progItems = progFactors.map((p, i) => ({ text: p, options: { bullet: { indent: 8 }, breakLine: i < progFactors.length - 1, fontSize: 11, color: LIGHT_GREY } }));
  // Display in two columns
  s.addText(progItems.slice(0, 3), { x: 0.3, y: 5.15, w: 4.5, h: 0.4, lineSpacingMultiple: 1.3 });
  s.addText(progItems.slice(3), { x: 5.0, y: 5.15, w: 4.5, h: 0.4, lineSpacingMultiple: 1.3 });
  addSlideNumber(s, 20);
}

// ============================================================
// SLIDE 21 — PREVENTION
// ============================================================
{
  const s = pres.addSlide();
  addMidSlide(s);
  addSectionHeader(s, "19  PREVENTION");
  s.addText("Prevention of Root Fractures", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: WHITE });
  const prevCats = [
    {
      title: "During Endodontic Procedures",
      pts: ["Conservative access cavity design (ninja/contracted access)", "Avoid over-instrumentation of the apical third", "Avoid large NiTi rotary instruments in narrow / oval canals", "Use warm vertical rather than cold lateral condensation", "Limit post-space preparation: preserve ≥5 mm apical gutta-percha seal"],
      color: ACCENT1
    },
    {
      title: "Occlusal Considerations",
      pts: ["Screen for bruxism and provide occlusal splint therapy", "Adjust occlusion to avoid premature contacts on restored teeth", "Avoid cantilever prostheses on compromised roots", "Consider crown coverage of endodontically treated molars/premolars"],
      color: ACCENT3
    },
    {
      title: "Trauma Prevention",
      pts: ["Custom-fitted mouthguards for contact sports (reduce trauma by up to 60%)", "Counselling for fall/accident risk in elderly patients", "Promote dental awareness campaigns"],
      color: "7DD3FC"
    }
  ];
  prevCats.forEach((cat, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3 + i * 3.22, y: 1.2, w: 3.0, h: 4.15, fill: { color: "162843" }, radius: 6 });
    s.addShape(pres.ShapeType.rect, { x: 0.3 + i * 3.22, y: 1.2, w: 3.0, h: 0.06, fill: { color: cat.color } });
    s.addText(cat.title, { x: 0.45 + i * 3.22, y: 1.32, w: 2.7, h: 0.45, fontSize: 12, bold: true, color: cat.color });
    const items = cat.pts.map((p, j) => ({ text: p, options: { bullet: { indent: 8 }, breakLine: j < cat.pts.length - 1, fontSize: 11.5, color: LIGHT_GREY } }));
    s.addText(items, { x: 0.45 + i * 3.22, y: 1.85, w: 2.7, h: 3.35, lineSpacingMultiple: 1.4 });
  });
  addSlideNumber(s, 21);
}

// ============================================================
// SLIDE 22 — FOLLOW-UP PROTOCOLS
// ============================================================
{
  const s = pres.addSlide();
  addLightSlide(s);
  addSectionHeader(s, "20  FOLLOW-UP & MONITORING");
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.08, h: 5.625, fill: { color: ACCENT1 } });
  s.addText("Follow-up Protocols & Long-Term Monitoring", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 20, bold: true, color: DARK_TEXT });
  const followUp = [
    { time: "4 weeks", actions: "Clinical: mobility, pain, soft tissue; Radiographic: periapical; EPT / cold test; Splint removal (mid/apical third)" },
    { time: "3 months", actions: "Repeat clinical + radiographic; Assess healing type; EPT; Look for signs of necrosis (resorption, periapical pathology)" },
    { time: "6 months", actions: "Clinical + PA radiograph; Pulp status; PCO (obliteration) is favorable sign; VRF: CBCT if diagnosis uncertain" },
    { time: "1 year", actions: "Full clinical + radiographic review; Confirm healing type; Splint removal if still present (cervical third)" },
    { time: "Annual × 5 years", actions: "Long-term surveillance; Late-onset necrosis can occur up to 5 years post-trauma; Any change in EPT warrants re-evaluation" }
  ];
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2, w: 1.5, h: 4.15, fill: { color: MID_BG }, radius: 5 });
  s.addText("TIME\nPOINT", { x: 0.3, y: 1.55, w: 1.5, h: 0.5, fontSize: 11, bold: true, color: ACCENT1, align: "center" });
  followUp.forEach((fu, i) => {
    s.addShape(pres.ShapeType.rect, { x: 2.0, y: 1.22 + i * 0.82, w: 7.7, h: 0.72, fill: { color: i % 2 === 0 ? MID_BG : "162843" }, radius: 4 });
    s.addText(fu.time, { x: 0.3, y: 1.25 + i * 0.82, w: 1.5, h: 0.65, fontSize: 12, bold: true, color: ACCENT1, align: "center", valign: "middle" });
    s.addShape(pres.ShapeType.ellipse, { x: 1.73, y: 1.47 + i * 0.82, w: 0.16, h: 0.16, fill: { color: ACCENT1 } });
    s.addText(fu.actions, { x: 2.15, y: 1.28 + i * 0.82, w: 7.4, h: 0.62, fontSize: 11.5, color: LIGHT_GREY, valign: "middle" });
  });
  addSlideNumber(s, 22);
}

// ============================================================
// SLIDE 23 — INTERDISCIPLINARY & MEDICOLEGAL
// ============================================================
{
  const s = pres.addSlide();
  addMidSlide(s);
  addSectionHeader(s, "21–22  INTERDISCIPLINARY & MEDICOLEGAL");
  s.addText("Interdisciplinary Considerations & Medicolegal Aspects", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 18, bold: true, color: WHITE });
  // Left column
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2, w: 4.5, h: 4.1, fill: { color: "162843" }, radius: 6 });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2, w: 4.5, h: 0.06, fill: { color: ACCENT1 } });
  s.addText("Interdisciplinary Management", { x: 0.45, y: 1.32, w: 4.2, h: 0.42, fontSize: 13, bold: true, color: ACCENT1 });
  const interdiscPts = [
    "Oral Surgery: extraction, socket management, implant planning for unrestorable VRF",
    "Periodontology: periodontal therapy for combined endo-perio lesions; crown lengthening for crown-root fractures",
    "Orthodontics: forced eruption of crown-root fractures; space management post-extraction",
    "Prosthodontics: implant-supported restorations; FPD design avoiding excessive stress on abutments",
    "Paediatric Dentistry: primary dentition management; monitoring of permanent successors",
    "Emergency Medicine: triage, acute pain management, referral pathways (IADT / Tintinalli guidelines)"
  ];
  const interItems = interdiscPts.map((p, i) => ({ text: p, options: { bullet: { indent: 8 }, breakLine: i < interdiscPts.length - 1, fontSize: 12, color: LIGHT_GREY } }));
  s.addText(interItems, { x: 0.45, y: 1.82, w: 4.2, h: 3.3, lineSpacingMultiple: 1.35 });
  // Right column
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.2, w: 4.6, h: 4.1, fill: { color: "162843" }, radius: 6 });
  s.addShape(pres.ShapeType.rect, { x: 5.1, y: 1.2, w: 4.6, h: 0.06, fill: { color: ACCENT2 } });
  s.addText("Medicolegal Considerations", { x: 5.25, y: 1.32, w: 4.3, h: 0.42, fontSize: 13, bold: true, color: ACCENT2 });
  const medlegalPts = [
    "VRF from endodontic / post procedures: potential iatrogenic liability",
    "Documentation: pre-op radiographs, informed consent, intra-op technique notes, post-op instructions — essential",
    "Failure to diagnose: delayed diagnosis of VRF has led to successful negligence claims",
    "Misattribution: clinicians must distinguish VRF from periodontal disease and document reasoning",
    "Expert witness standards: Tamse, Berman, and Katz (Ingle's Endodontics) provide the authoritative clinical benchmark",
    "IADT guidelines as standard of care: deviation requires justification and documentation"
  ];
  const medItems = medlegalPts.map((p, i) => ({ text: p, options: { bullet: { indent: 8 }, breakLine: i < medlegalPts.length - 1, fontSize: 12, color: LIGHT_GREY } }));
  s.addText(medItems, { x: 5.25, y: 1.82, w: 4.3, h: 3.3, lineSpacingMultiple: 1.35 });
  addSlideNumber(s, 23);
}

// ============================================================
// SLIDE 24 — KEY STUDIES & EVIDENCE
// ============================================================
{
  const s = pres.addSlide();
  addLightSlide(s);
  addSectionHeader(s, "23  KEY EVIDENCE & REFERENCES");
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.08, h: 5.625, fill: { color: ACCENT1 } });
  s.addText("Key Evidence & References", { x: 0.3, y: 0.55, w: 9.4, h: 0.55, fontSize: 22, bold: true, color: DARK_TEXT });
  const refs = [
    { auth: "Andreasen et al.", yr: "2004", title: "Landmark longitudinal cohort — healing patterns in 400 horizontal root fractures. Established 4 healing types.", journal: "Dental Traumatology" },
    { auth: "Tamse & Berman (Ingle's)", yr: "2019", title: "Comprehensive VRF chapter — epidemiology, etiology, diagnosis, and management. Definitive reference for VRF.", journal: "Ingle's Endodontics 7th Ed" },
    { auth: "Bourguignon et al.", yr: "2020", title: "IADT 2020 Guidelines for traumatic dental injuries. Current standard of care for root fracture management.", journal: "Dental Traumatology 36(4)" },
    { auth: "Patel, Bhuva & Bose", yr: "2022", title: "VRF prevalence and diagnosis in root-filled teeth — systematic review.", journal: "International Endodontic Journal" },
    { auth: "Haupt, Wiegand & Kanzow", yr: "2023", title: "Meta-analysis (14 studies, 2,877 teeth): VRF risk factors. No single factor independently predictive.", journal: "Journal of Endodontics" },
    { auth: "Cohen's Pathways of the Pulp", yr: "12th Ed", title: "Chapter on traumatic injuries; pulpal response; healing classifications. Primary textbook reference.", journal: "Elsevier" },
    { auth: "Tintinalli's Emergency Medicine", yr: "9th Ed", title: "Dentoalveolar trauma management; IADT-consistent management protocols.", journal: "McGraw-Hill" }
  ];
  refs.forEach((r, i) => {
    s.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.2 + i * 0.6, w: 9.3, h: 0.54, fill: { color: i % 2 === 0 ? MID_BG : "162843" }, radius: 3 });
    s.addText(`${r.auth} (${r.yr})`, { x: 0.45, y: 1.25 + i * 0.6, w: 2.5, h: 0.44, fontSize: 11, bold: true, color: ACCENT1, valign: "middle" });
    s.addText(r.title, { x: 3.05, y: 1.25 + i * 0.6, w: 4.5, h: 0.44, fontSize: 11, color: LIGHT_GREY, valign: "middle" });
    s.addText(r.journal, { x: 7.65, y: 1.25 + i * 0.6, w: 1.85, h: 0.44, fontSize: 10, color: SUBTITLE_CLR, valign: "middle", italic: true });
  });
  addSlideNumber(s, 24);
}

// ============================================================
// SLIDE 25 — CONCLUSIONS
// ============================================================
{
  const s = pres.addSlide();
  addDarkSlide(s);
  // Decorative geometry
  s.addShape(pres.ShapeType.ellipse, { x: 7.5, y: 2.5, w: 4, h: 4, fill: { color: "0D2540" }, line: { color: ACCENT1, width: 0.5 } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0.6, w: 0.08, h: 4.5, fill: { color: ACCENT1 } });
  s.addText("CONCLUSIONS &", { x: 0.3, y: 0.6, w: 8, h: 0.65, fontSize: 30, bold: true, color: WHITE, charSpacing: 1 });
  s.addText("FUTURE PERSPECTIVES", { x: 0.3, y: 1.25, w: 8, h: 0.65, fontSize: 30, bold: true, color: ACCENT1, charSpacing: 1 });
  s.addShape(pres.ShapeType.rect, { x: 0.3, y: 2.0, w: 4.5, h: 0.05, fill: { color: ACCENT1 } });
  const conclusions = [
    "Root fractures range from easily managed apical fractures to devastating VRFs requiring extraction",
    "Biological healing is possible — correct repositioning and splinting are the cornerstones of horizontal RF management",
    "CBCT has transformed VRF diagnosis; AI-assisted imaging is the next frontier",
    "MTA and bioceramic materials have expanded treatment options for immature teeth",
    "Prevention through conservative endodontics is more powerful than any treatment strategy",
    "IADT 2020 guidelines provide the current evidence-based standard of care",
    "Future: regenerative endodontics, nanotechnology-enhanced bioceramics, and AI-driven diagnosis will reshape the field"
  ];
  const concItems = conclusions.map((c, i) => ({ text: c, options: { bullet: { indent: 10 }, breakLine: i < conclusions.length - 1, fontSize: 12.5, color: LIGHT_GREY } }));
  s.addText(concItems, { x: 0.3, y: 2.15, w: 7.0, h: 3.15, lineSpacingMultiple: 1.35 });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 5.25, w: 10, h: 0.375, fill: { color: "0A1520" } });
  s.addText("Thank you  |  Questions Welcome  |  Root Fractures & Their Management — Seminar 2026", { x: 0.3, y: 5.28, w: 9.4, h: 0.32, fontSize: 10, color: SUBTITLE_CLR, align: "center" });
}

// ============================================================
// WRITE FILE
// ============================================================
pres.writeFile({ fileName: "/home/daytona/workspace/root-fractures-pptx/Root_Fractures_Management.pptx" })
  .then(() => console.log("DONE: presentation saved"))
  .catch(e => console.error("ERROR:", e));

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/root-fractures-pptx/build.js'

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/root-fractures-pptx/build.js'

from pptx import Presentation
from pptx.util import Inches, Pt, Emu
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN
from pptx.util import Inches, Pt
import os

IMGS = [f"/home/daytona/workspace/root-fractures-pptx/images/img{i}.png" for i in range(8)]

# Colors
DARK_BG   = RGBColor(0x0D, 0x1B, 0x2A)
MID_BG    = RGBColor(0x1B, 0x2B, 0x3D)
LIGHT_BG  = RGBColor(0xEE, 0xF3, 0xF9)
ACCENT1   = RGBColor(0x2E, 0xC4, 0xB6)  # teal
ACCENT2   = RGBColor(0xE7, 0x6F, 0x51)  # coral
ACCENT3   = RGBColor(0xF4, 0xA2, 0x61)  # amber
WHITE     = RGBColor(0xFF, 0xFF, 0xFF)
LGREY     = RGBColor(0xCB, 0xD5, 0xE1)
DARK_TXT  = RGBColor(0x1E, 0x29, 0x3B)
SUB_CLR   = RGBColor(0x94, 0xA3, 0xB8)
BLUE_ACC  = RGBColor(0x37, 0x7D, 0xDC)

prs = Presentation()
prs.slide_width  = Inches(13.33)
prs.slide_height = Inches(7.5)

W = 13.33
H = 7.5

def inch(v): return Inches(v)
def rgb(r,g,b): return RGBColor(r,g,b)

def blank_slide(prs):
    blank_layout = prs.slide_layouts[6]  # completely blank
    return prs.slides.add_slide(blank_layout)

def fill_bg(slide, color):
    bg = slide.background
    fill = bg.fill
    fill.solid()
    fill.fore_color.rgb = color

def add_rect(slide, x, y, w, h, color, alpha=None):
    from pptx.util import Inches
    shape = slide.shapes.add_shape(
        1,  # MSO_SHAPE_TYPE.RECTANGLE
        inch(x), inch(y), inch(w), inch(h)
    )
    shape.fill.solid()
    shape.fill.fore_color.rgb = color
    shape.line.fill.background()
    return shape

def add_text(slide, text, x, y, w, h, size=14, color=WHITE, bold=False, italic=False, align=PP_ALIGN.LEFT, wrap=True):
    txBox = slide.shapes.add_textbox(inch(x), inch(y), inch(w), inch(h))
    tf = txBox.text_frame
    tf.word_wrap = wrap
    p = tf.paragraphs[0]
    p.alignment = align
    run = p.add_run()
    run.text = text
    run.font.size = Pt(size)
    run.font.color.rgb = color
    run.font.bold = bold
    run.font.italic = italic
    return txBox

def add_multiline(slide, lines, x, y, w, h, size=12, color=WHITE, bold=False, line_spacing=1.2, bullet=False):
    from pptx.util import Pt
    from pptx.oxml.ns import qn
    from lxml import etree
    txBox = slide.shapes.add_textbox(inch(x), inch(y), inch(w), inch(h))
    tf = txBox.text_frame
    tf.word_wrap = True
    for i, line in enumerate(lines):
        if i == 0:
            p = tf.paragraphs[0]
        else:
            p = tf.add_paragraph()
        p.alignment = PP_ALIGN.LEFT
        if bullet:
            pPr = p._p.get_or_add_pPr()
            buChar = etree.SubElement(pPr, qn('a:buChar'))
            buChar.set('char', '•')
        run = p.add_run()
        run.text = line
        run.font.size = Pt(size)
        run.font.color.rgb = color
        run.font.bold = bold
    return txBox

def add_image(slide, path, x, y, w, h):
    if os.path.exists(path):
        slide.shapes.add_picture(path, inch(x), inch(y), inch(w), inch(h))

def slide_num(slide, n):
    add_text(slide, f"{n} / 25", W-1.5, H-0.45, 1.3, 0.35, size=9, color=SUB_CLR, align=PP_ALIGN.RIGHT)

def section_bar(slide, label):
    add_rect(slide, 0, 0, 0.1, H, ACCENT1)
    add_text(slide, label, 0.2, 0.12, 12, 0.35, size=10, color=ACCENT1, bold=True)

# ============================================================
# SLIDE 1 — TITLE
# ============================================================
s = blank_slide(prs)
fill_bg(s, DARK_BG)
add_rect(s, 0, 0, 0.1, H, ACCENT1)
add_rect(s, 0.3, 2.6, 5.5, 0.06, ACCENT1)
add_text(s, "ROOT FRACTURES", 0.4, 0.8, 8, 1.1, size=48, bold=True, color=WHITE)
add_text(s, "AND THEIR MANAGEMENT", 0.4, 1.9, 9, 0.75, size=28, color=ACCENT1, bold=True)
add_text(s, "A Comprehensive Review for the Seminar", 0.4, 2.75, 7, 0.5, size=14, color=SUB_CLR, italic=True)
add_text(s, "Drawing from Cohen's Pathways of the Pulp, Ingle's Endodontics\nand Contemporary Peer-Reviewed Literature", 0.4, 3.35, 7.5, 0.8, size=12, color=SUB_CLR)
add_rect(s, 0, H-0.6, W, 0.6, rgb(0x0A,0x15,0x20))
add_text(s, "June 2026  |  Endodontics Seminar", 0.4, H-0.55, 12, 0.45, size=11, color=SUB_CLR)
if os.path.exists(IMGS[0]):
    add_image(s, IMGS[0], 8.5, 0.6, 4.5, 3.5)
slide_num(s, 1)

# ============================================================
# SLIDE 2 — TABLE OF CONTENTS
# ============================================================
s = blank_slide(prs)
fill_bg(s, MID_BG)
section_bar(s, "OVERVIEW")
add_text(s, "Table of Contents", 0.25, 0.5, 12, 0.65, size=28, bold=True, color=WHITE)
topics_L = [
    "01  Introduction & History", "02  Definitions & Classification",
    "03  Epidemiology & Etiology", "04  Anatomy & Pathophysiology",
    "05  Types of Root Fractures", "06  Healing Responses",
    "07  Pulpal Response & Sequelae", "08  Clinical Diagnosis",
    "09  Radiographic Diagnosis", "10  CBCT & Advanced Imaging",
    "11  Differential Diagnosis", "12  AI in VRF Detection",
]
topics_R = [
    "13  Management: Horizontal Fractures", "14  Splinting Protocols",
    "15  Endodontic Intervention", "16  Management: Vertical Fractures",
    "17  Crown-Root Fractures", "18  Pediatric & Immature Teeth",
    "19  Post-Endodontic Restoration", "20  Prognosis",
    "21  Prevention Strategies", "22  Follow-up & Monitoring",
    "23  Interdisciplinary Considerations", "24  Medicolegal Aspects / References",
    "25  Conclusions"
]
for i, t in enumerate(topics_L):
    add_rect(s, 0.25, 1.3 + i*0.46, 0.42, 0.38, ACCENT1)
    add_text(s, t[:2], 0.25, 1.32 + i*0.46, 0.42, 0.35, size=10, bold=True, color=DARK_TXT, align=PP_ALIGN.CENTER)
    add_text(s, t[4:], 0.75, 1.32 + i*0.46, 5.5, 0.38, size=11, color=LGREY)
for i, t in enumerate(topics_R):
    add_rect(s, 6.8, 1.3 + i*0.46, 0.42, 0.38, ACCENT2)
    add_text(s, t[:2], 6.8, 1.32 + i*0.46, 0.42, 0.35, size=10, bold=True, color=WHITE, align=PP_ALIGN.CENTER)
    add_text(s, t[4:], 7.3, 1.32 + i*0.46, 5.7, 0.38, size=11, color=LGREY)
slide_num(s, 2)

# ============================================================
# SLIDE 3 — INTRODUCTION
# ============================================================
s = blank_slide(prs)
fill_bg(s, MID_BG)
section_bar(s, "01  INTRODUCTION")
add_text(s, "Introduction & Historical Perspective", 0.25, 0.5, 12, 0.65, size=26, bold=True, color=WHITE)
add_rect(s, 0.25, 1.25, 8.5, 0.05, ACCENT1)
pts = [
    "Root fractures involve simultaneous disruption of dentine, cementum, pulp, and the periodontal ligament",
    "Earliest treatment: gold wire & silk ligature splinting (referenced in Ingle's Endodontics)",
    "Grossman (early 20th c.): horizontal/diagonal mid-root fractures; coronal third = unfavorable prognosis",
    "Ellis (1945): classification system — conceptual backbone of today's IADT classification",
    "Andreasen et al. (Denmark): landmark longitudinal studies → 4 healing types; shifted management from interventionist to biologically informed",
    "Tamse & Berman: recognition of VRF as a distinct iatrogenic entity (latter 20th century)",
    "Today: CBCT, MTA / bioceramic materials, regenerative endodontics, and AI are reshaping the field",
]
add_multiline(s, pts, 0.25, 1.35, 12.8, 5.9, size=14, color=LGREY, bullet=True)
slide_num(s, 3)

# ============================================================
# SLIDE 4 — DEFINITIONS
# ============================================================
s = blank_slide(prs)
fill_bg(s, LIGHT_BG)
section_bar(s, "02  DEFINITIONS")
add_text(s, "Definitions, Terminology & Classification", 0.25, 0.5, 12, 0.65, size=24, bold=True, color=DARK_TXT)
add_rect(s, 0.25, 1.25, 6.0, H-1.5, MID_BG)
add_rect(s, 0.25, 1.25, 6.0, 0.06, ACCENT1)
add_text(s, "INTRA-ALVEOLAR ROOT FRACTURE", 0.4, 1.35, 5.6, 0.45, size=12, bold=True, color=ACCENT1)
rf = [
    "Fracture perpendicular/oblique to the long axis of root",
    "Disrupts: dentine, cementum, pulp, periodontal ligament",
    "Classified by level: Apical third (best prognosis) | Middle third (most common) | Cervical third (worst prognosis)",
    "IADT Category 7 — Bourguignon et al. 2020",
    "Also called: transverse, horizontal, or intra-alveolar fracture"
]
add_multiline(s, rf, 0.4, 1.85, 5.7, 5.0, size=13, color=LGREY, bullet=True)
add_rect(s, 6.7, 1.25, 6.4, H-1.5, MID_BG)
add_rect(s, 6.7, 1.25, 6.4, 0.06, ACCENT2)
add_text(s, "VERTICAL ROOT FRACTURE (VRF)", 6.85, 1.35, 6.0, 0.45, size=12, bold=True, color=ACCENT2)
vrf = [
    "Runs parallel / sub-parallel to the long axis",
    "Overwhelmingly iatrogenic (endodontic & restorative procedures)",
    "Incomplete VRF: craze lines / partial crack",
    "Complete VRF: full root separation",
    "Orientation: Buccolingual (most common) or Mesiodistal",
    "Distinct from traumatic fractures in etiology, management & medicolegal implications"
]
add_multiline(s, vrf, 6.85, 1.85, 6.1, 5.0, size=13, color=LGREY, bullet=True)
slide_num(s, 4)

# ============================================================
# SLIDE 5 — EPIDEMIOLOGY
# ============================================================
s = blank_slide(prs)
fill_bg(s, MID_BG)
section_bar(s, "03  EPIDEMIOLOGY")
add_text(s, "Epidemiology & Etiology", 0.25, 0.5, 12, 0.65, size=26, bold=True, color=WHITE)
stats = [
    ("0.5–7%", "of dental trauma\ncases (permanent dentition)", ACCENT1),
    ("2nd Decade", "of life most\ncommonly affected", ACCENT1),
    ("Max. Central\nIncisor", "most frequently\nfractured tooth", ACCENT2),
    ("2–5%", "VRF prevalence in\nroot-filled teeth", ACCENT2),
]
for i,(val,lbl,col) in enumerate(stats):
    x = 0.25 + i*3.27
    add_rect(s, x, 1.3, 3.0, 2.0, rgb(0x16,0x28,0x43))
    add_rect(s, x, 1.3, 3.0, 0.07, col)
    add_text(s, val, x, 1.45, 3.0, 0.9, size=20, bold=True, color=col, align=PP_ALIGN.CENTER)
    add_text(s, lbl, x, 2.35, 3.0, 0.75, size=12, color=LGREY, align=PP_ALIGN.CENTER)
add_text(s, "Traumatic Root Fractures — Mechanism", 0.25, 3.55, 6.3, 0.4, size=14, bold=True, color=WHITE)
add_rect(s, 0.25, 3.98, 6.2, 0.05, ACCENT1)
add_multiline(s, [
    "Direct blow to labial surface of anterior teeth (sports, falls, road accidents)",
    "Males > Females; peak age 11–20 years (fully erupted but not yet narrowed pulp space)",
    "Force direction + alveolar morphology determine fracture level",
    "Immature roots: open apex allows revascularization → better pulpal prognosis",
], 0.25, 4.05, 6.3, 3.1, size=13, color=LGREY, bullet=True)
add_text(s, "VRF — Iatrogenic Risk Factors", 6.8, 3.55, 6.2, 0.4, size=14, bold=True, color=WHITE)
add_rect(s, 6.8, 3.98, 6.2, 0.05, ACCENT2)
add_multiline(s, [
    "Over-instrumentation of the apical third",
    "Lateral condensation of gutta-percha (wedging forces)",
    "Intracanal post placement (drilling + cementation stress)",
    "Excessive obturation pressure; bruxism/parafunctional habits",
    "Oval cross-section roots (mandibular incisors, MB roots of upper molars)",
], 6.8, 4.05, 6.2, 3.1, size=13, color=LGREY, bullet=True)
slide_num(s, 5)

# ============================================================
# SLIDE 6 — ANATOMY
# ============================================================
s = blank_slide(prs)
fill_bg(s, LIGHT_BG)
section_bar(s, "04  ANATOMY")
add_text(s, "Anatomy & Pathophysiology", 0.25, 0.5, 12, 0.65, size=26, bold=True, color=DARK_TXT)
add_rect(s, 0.25, 1.25, 8.8, H-1.5, MID_BG)
add_rect(s, 0.25, 1.25, 8.8, 0.07, ACCENT1)
add_text(s, "Root Structure & Mechanical Properties", 0.4, 1.38, 8.4, 0.5, size=15, bold=True, color=ACCENT1)
add_multiline(s, [
    "Root composed of dentine — highly organized mineralized tissue with dentinal tubules radiating from pulp to periphery",
    "Outer surface: cementum anchors PDL principal fibres via Sharpey's fibres",
    "Periodontal Ligament (PDL): suspends tooth, transmits occlusal forces, houses pluripotent stem cells critical for healing",
    "Dentine is anisotropic: high compressive strength, lower tensile/shear strength",
    "Microcracks initiate at areas of stress concentration: inner canal walls, apico-coronal midpoint, areas of reduced wall thickness",
    "Oval cross-section roots most susceptible to VRF — labial/lingual walls can be <1 mm thick",
    "Endodontic treatment removes vital pulp moisture → increased dentine brittleness and susceptibility to fracture",
], 0.4, 1.9, 8.5, 5.0, size=14, color=LGREY, bullet=True)
add_rect(s, 9.5, 1.25, 3.6, H-1.5, rgb(0x16,0x28,0x43))
add_text(s, "Critical\nWall Thickness", 9.6, 1.5, 3.3, 0.8, size=14, bold=True, color=ACCENT2, align=PP_ALIGN.CENTER)
add_text(s, "< 1 mm", 9.6, 2.4, 3.3, 0.8, size=36, bold=True, color=ACCENT2, align=PP_ALIGN.CENTER)
add_text(s, "in oval-shaped roots\n(labial/lingual walls)", 9.6, 3.25, 3.3, 0.65, size=12, color=LGREY, align=PP_ALIGN.CENTER)
add_rect(s, 9.8, 4.1, 3.0, 0.05, ACCENT1)
add_text(s, "PDL stem cells are the primary biological mediators of repair after root fracture", 9.6, 4.25, 3.3, 1.5, size=12, color=LGREY, align=PP_ALIGN.CENTER, italic=True)
slide_num(s, 6)

# ============================================================
# SLIDE 7 — TYPES (with image 0)
# ============================================================
s = blank_slide(prs)
fill_bg(s, DARK_BG)
section_bar(s, "05  TYPES OF ROOT FRACTURES")
add_text(s, "Types of Root Fractures", 0.25, 0.5, 7.5, 0.65, size=26, bold=True, color=WHITE)
if os.path.exists(IMGS[0]):
    add_image(s, IMGS[0], 7.5, 0.6, 5.6, 4.5)
types = [
    ("Horizontal / Transverse Root Fracture", "Perpendicular to long axis; traumatic; classified by third (apical, middle, cervical)", ACCENT1),
    ("Vertical Root Fracture (VRF)", "Parallel to long axis; usually iatrogenic; frequently missed on plain radiographs", ACCENT2),
    ("Crown-Root Fracture", "Involves crown AND root below CEJ; may expose pulp; complex management", ACCENT3),
    ("Oblique Root Fracture", "Diagonal orientation; intermediate biomechanical features between horizontal and VRF", BLUE_ACC),
]
for i,(name,desc,col) in enumerate(types):
    add_rect(s, 0.25, 1.35+i*1.3, 6.9, 1.15, rgb(0x16,0x28,0x43))
    add_rect(s, 0.25, 1.35+i*1.3, 0.08, 1.15, col)
    add_text(s, name, 0.45, 1.4+i*1.3, 6.4, 0.45, size=14, bold=True, color=col)
    add_text(s, desc, 0.45, 1.85+i*1.3, 6.4, 0.55, size=12.5, color=LGREY)
add_rect(s, 0.25, H-0.7, 7.0, 0.55, rgb(0x16,0x28,0x43))
add_text(s, "Fracture Level → Prognosis:  Apical (best)  |  Middle  |  Cervical (worst)", 0.4, H-0.67, 6.7, 0.48, size=13, color=ACCENT1)
slide_num(s, 7)

# ============================================================
# SLIDE 8 — HEALING RESPONSES (with image 6)
# ============================================================
s = blank_slide(prs)
fill_bg(s, MID_BG)
section_bar(s, "06  BIOLOGICAL HEALING")
add_text(s, "Biological Healing Responses at the Fracture Site", 0.25, 0.5, 12, 0.65, size=24, bold=True, color=WHITE)
if os.path.exists(IMGS[6]):
    add_image(s, IMGS[6], 7.4, 1.1, 5.7, 5.9)
healing = [
    ("Type 1: Hard Tissue Callus", "Calcified bridge forms between fragments — most favorable outcome. Seen in apical/mid-root fractures with intact pulp and adequate repositioning.", ACCENT1),
    ("Type 2: Connective Tissue Healing", "PDL fibres bridge fragments without calcification. Fragments remain separated but functionally stable. Good prognosis.", ACCENT3),
    ("Type 3: Bone & CT Interposition", "Alveolar bone grows into the fracture site, permanently separating fragments. Tooth remains functional.", BLUE_ACC),
    ("Type 4: Granulation Tissue", "Inflammatory/granulation tissue fills fracture — indicates pulp necrosis. Requires endodontic intervention or extraction.", ACCENT2),
]
for i,(title,body,col) in enumerate(healing):
    add_rect(s, 0.25, 1.35+i*1.5, 6.9, 1.3, rgb(0x16,0x28,0x43))
    add_rect(s, 0.25, 1.35+i*1.5, 0.08, 1.3, col)
    add_text(s, title, 0.45, 1.4+i*1.5, 6.3, 0.45, size=13.5, bold=True, color=col)
    add_text(s, body, 0.45, 1.87+i*1.5, 6.3, 0.7, size=12, color=LGREY)
slide_num(s, 8)

# ============================================================
# SLIDE 9 — PULPAL RESPONSE
# ============================================================
s = blank_slide(prs)
fill_bg(s, LIGHT_BG)
section_bar(s, "07  PULPAL RESPONSE")
add_text(s, "Pulpal Response & Sequelae", 0.25, 0.5, 12, 0.65, size=26, bold=True, color=DARK_TXT)
pulp_stats = [("~80%","Pulp remains vital\nafter horizontal RF",ACCENT1),
              ("~20%","Develop pulp necrosis\n(mostly coronal fragment)",ACCENT2),
              ("<1%","Apical fragment\nbecomes necrotic",ACCENT3)]
for i,(val,lbl,col) in enumerate(pulp_stats):
    x = 0.25 + i*4.35
    add_rect(s, x, 1.25, 4.1, 2.0, MID_BG)
    add_text(s, val, x, 1.35, 4.1, 0.9, size=36, bold=True, color=col, align=PP_ALIGN.CENTER)
    add_text(s, lbl, x, 2.25, 4.1, 0.75, size=13, color=LGREY, align=PP_ALIGN.CENTER)
add_rect(s, 0.25, 3.45, 12.8, 0.06, ACCENT1)
add_text(s, "Pulpal Sequelae and Histological Changes", 0.25, 3.55, 12.8, 0.5, size=15, bold=True, color=DARK_TXT)
add_multiline(s, [
    "Initial response: transient hyperemia, haemorrhage between fragments, disruption of neurovascular supply",
    "Revascularization possible in open-apex teeth — immature apex allows new vessels and nerve fibres to re-enter",
    "In mature teeth, revascularization is rare; survival depends on intact apical blood supply",
    "Coronal fragment more susceptible to necrosis — separated from main blood supply",
    "Pulp Canal Obliteration (PCO): increased secondary dentine deposition — common benign finding, no treatment needed",
    "Active inflammatory resorption = pulp necrosis → endodontic intervention mandatory",
], 0.25, 4.1, 12.8, 3.0, size=13, color=DARK_TXT, bullet=True)
slide_num(s, 9)

# ============================================================
# SLIDE 10 — CLINICAL DIAGNOSIS
# ============================================================
s = blank_slide(prs)
fill_bg(s, MID_BG)
section_bar(s, "08  CLINICAL DIAGNOSIS")
add_text(s, "Clinical Diagnosis", 0.25, 0.5, 12, 0.65, size=26, bold=True, color=WHITE)
quads = [
    ("History & Chief Complaint", ["Nature, mechanism, time of injury", "Prior trauma or dental treatment", "Symptoms: pain, mobility, bite sensitivity", "Medical history; tetanus status in trauma"], ACCENT1, 0.25, 1.3),
    ("Clinical Examination", ["Mobility: coronal fragment moves, apical does not (pathognomonic)", "Crown discoloration (grey/pink)", "Palpation of alveolus; soft tissue lacerations", "Sinus tract location — deep narrow = VRF"], ACCENT3, 6.9, 1.3),
    ("Vitality Testing", ["EPT: may be false negative acutely — repeat at 4, 8, 12 weeks", "Cold/thermal: more reliable", "Laser Doppler flowmetry: gold standard (rarely available)", "PCO on review = favorable pulp response"], BLUE_ACC, 0.25, 4.55),
    ("Periodontal Assessment", ["Deep narrow probing = VRF (sinus tract to fracture line)", "Furcation involvement in multi-rooted teeth", "Alveolar bone levels radiographically", "Mobility grading (Miller classification)"], ACCENT2, 6.9, 4.55),
]
for title, pts, col, x, y in quads:
    add_rect(s, x, y, 6.2, 2.85, rgb(0x16,0x28,0x43))
    add_rect(s, x, y, 6.2, 0.07, col)
    add_text(s, title, x+0.15, y+0.12, 5.8, 0.45, size=13.5, bold=True, color=col)
    add_multiline(s, pts, x+0.15, y+0.65, 5.8, 2.0, size=12.5, color=LGREY, bullet=True)
slide_num(s, 10)

# ============================================================
# SLIDE 11 — RADIOGRAPHIC DIAGNOSIS (with image 2)
# ============================================================
s = blank_slide(prs)
fill_bg(s, DARK_BG)
section_bar(s, "09  RADIOGRAPHIC DIAGNOSIS")
add_text(s, "Radiographic Diagnosis", 0.25, 0.5, 8, 0.65, size=26, bold=True, color=WHITE)
if os.path.exists(IMGS[2]):
    add_image(s, IMGS[2], 7.5, 1.0, 5.6, 4.5)
rad = [
    ("Periapical Radiography", "First-line investigation; paralleling technique preferred. Fracture line appears as a radiolucent line perpendicular to long axis.", ACCENT1),
    ("Multiple Angulations", "Single view may miss fracture. IADT: 3 views recommended (standard + 2 offset angulations). Fracture may be visible in one plane only.", ACCENT3),
    ("Bisecting Angle Limitation", "Can mask fractures by foreshortening/elongation. Paralleling technique more reliable for fracture detection.", BLUE_ACC),
    ("VRF on Radiographs", "Frequently undetectable on conventional 2D radiographs. Subtle signs: widened PDL space, 'halo' bone loss, J-shaped lesion.", ACCENT2),
]
for i,(title,body,col) in enumerate(rad):
    add_rect(s, 0.25, 1.35+i*1.45, 6.9, 1.3, rgb(0x16,0x28,0x43))
    add_rect(s, 0.25, 1.35+i*1.45, 0.08, 1.3, col)
    add_text(s, title, 0.45, 1.4+i*1.45, 6.3, 0.45, size=13.5, bold=True, color=col)
    add_text(s, body, 0.45, 1.87+i*1.45, 6.3, 0.7, size=12, color=LGREY)
slide_num(s, 11)

# ============================================================
# SLIDE 12 — CBCT (with image 3)
# ============================================================
s = blank_slide(prs)
fill_bg(s, MID_BG)
section_bar(s, "10  CBCT & ADVANCED IMAGING")
add_text(s, "CBCT & Advanced Diagnostic Methods", 0.25, 0.5, 12, 0.65, size=24, bold=True, color=WHITE)
if os.path.exists(IMGS[3]):
    add_image(s, IMGS[3], 7.5, 1.0, 5.6, 4.5)
cbct = [
    ("CBCT — Gold Standard for VRF", "3D volumetric imaging; detects fractures invisible on 2D. Essential for VRF and pre-surgical planning.", ACCENT1),
    ("Technical Parameters", "Small FOV (<5 cm); high resolution (0.076–0.125 mm voxel); follow ALARA principle.", ACCENT3),
    ("Diagnostic Accuracy", "Systematic reviews: sensitivity 80–90%, specificity >90% for VRF. Markedly superior to periapical radiographs.", BLUE_ACC),
    ("AI in VRF Detection", "CNNs applied to CBCT/periapical images. Early studies show accuracy comparable to specialists.", ACCENT2),
]
for i,(title,body,col) in enumerate(cbct):
    add_rect(s, 0.25, 1.35+i*1.45, 6.9, 1.3, rgb(0x16,0x28,0x43))
    add_rect(s, 0.25, 1.35+i*1.45, 0.08, 1.3, col)
    add_text(s, title, 0.45, 1.4+i*1.45, 6.3, 0.45, size=13.5, bold=True, color=col)
    add_text(s, body, 0.45, 1.87+i*1.45, 6.3, 0.7, size=12, color=LGREY)
add_rect(s, 0.25, H-0.85, 7.0, 0.7, rgb(0x16,0x28,0x43))
add_text(s, "Additional: Transillumination & staining  •  Optical Coherence Tomography  •  Periodontal probing ('halo' defect = pathognomonic for VRF)", 0.4, H-0.82, 6.7, 0.62, size=11.5, color=LGREY)
slide_num(s, 12)

# ============================================================
# SLIDE 13 — DIFFERENTIAL DIAGNOSIS
# ============================================================
s = blank_slide(prs)
fill_bg(s, LIGHT_BG)
section_bar(s, "11  DIFFERENTIAL DIAGNOSIS")
add_text(s, "Differential Diagnosis", 0.25, 0.5, 12, 0.65, size=26, bold=True, color=DARK_TXT)
headers = ["Condition", "Key Differentiating Features", "Clinching Test"]
widths = [2.8, 6.5, 3.7]
xs = [0.25, 3.15, 9.75]
add_rect(s, 0.25, 1.25, 13.05, 0.55, DARK_TXT)
for j,(h,w,x) in enumerate(zip(headers,widths,xs)):
    add_text(s, h, x+0.1, 1.28, w-0.2, 0.48, size=12, bold=True, color=ACCENT1)
rows = [
    ("Vertical Root Fracture", "Deep narrow sinus tract; 'halo' bone loss; cusp-specific bite pain", "CBCT; transillumination"),
    ("Periodontal Disease", "Generalized bone loss; multiple teeth; plaque/calculus", "Full perio chart; OPG"),
    ("External Root Resorption", "Radiolucency outside root; vital pulp early on", "PA radiograph; CBCT"),
    ("Internal Root Resorption", "Central radiolucency within canal; asymptomatic", "PA radiograph"),
    ("Cracked Tooth Syndrome", "Pain on biting/release; incomplete crack above CEJ", "Transillumination; bite stick"),
    ("Endo-Perio Lesion", "Combined origin; complex probing pattern", "Sequential treatment response"),
    ("Dens Invaginatus", "Anomalous anatomy from eruption; seen radiographically", "PA radiograph"),
]
for i,(c1,c2,c3) in enumerate(rows):
    bg = LIGHT_BG if i%2==0 else rgb(0xE2,0xEA,0xF4)
    add_rect(s, 0.25, 1.82+i*0.73, 13.05, 0.68, bg)
    for txt,w,x in zip([c1,c2,c3],widths,xs):
        add_text(s, txt, x+0.1, 1.85+i*0.73, w-0.2, 0.62, size=12, color=DARK_TXT)
slide_num(s, 13)

# ============================================================
# SLIDE 14 — MANAGEMENT HORIZONTAL (with image 4)
# ============================================================
s = blank_slide(prs)
fill_bg(s, DARK_BG)
section_bar(s, "12  MANAGEMENT: HORIZONTAL ROOT FRACTURES")
add_text(s, "Management of Horizontal Root Fractures", 0.25, 0.5, 12, 0.65, size=24, bold=True, color=WHITE)
if os.path.exists(IMGS[4]):
    add_image(s, IMGS[4], 7.5, 1.0, 5.6, 4.5)
steps = [
    ("1", "Emergency Management", "Reposition displaced coronal fragment gently (within hours). Stabilize. Irrigate, suture lacerations. Analgesia.", ACCENT1),
    ("2", "Repositioning & Splinting", "Rigid splint: cervical third (4 months). Semi-rigid/flexible: mid and apical third (4 weeks). Confirm fragment alignment radiographically.", ACCENT3),
    ("3", "Preferred Splint: TTS", "Titanium Trauma Splint (TTS) + composite resin. Wire-composite splint acceptable. Avoid rigid arch bars >4 weeks.", BLUE_ACC),
    ("4", "Follow-up Protocol (IADT 2020)", "Review: 4 weeks, 3 months, 6 months, 1 year, then annually × 5 years. EPT + radiograph at each visit.", ACCENT2),
]
for i,(num,title,body,col) in enumerate(steps):
    add_rect(s, 0.25, 1.35+i*1.45, 6.9, 1.3, rgb(0x16,0x28,0x43))
    add_rect(s, 0.25, 1.35+i*1.45, 0.55, 1.3, col)
    add_text(s, num, 0.25, 1.38+i*1.45, 0.55, 1.2, size=24, bold=True, color=DARK_TXT, align=PP_ALIGN.CENTER)
    add_text(s, title, 0.9, 1.4+i*1.45, 5.9, 0.45, size=13.5, bold=True, color=col)
    add_text(s, body, 0.9, 1.87+i*1.45, 5.9, 0.7, size=12, color=LGREY)
slide_num(s, 14)

# ============================================================
# SLIDE 15 — ENDODONTIC INTERVENTION (with image 5)
# ============================================================
s = blank_slide(prs)
fill_bg(s, MID_BG)
section_bar(s, "13  ENDODONTIC INTERVENTION")
add_text(s, "Endodontic Intervention After Root Fracture", 0.25, 0.5, 12, 0.65, size=24, bold=True, color=WHITE)
if os.path.exists(IMGS[5]):
    add_image(s, IMGS[5], 7.5, 1.0, 5.6, 5.0)
endo = [
    ("Indications for RCT", "Pulp necrosis (non-vital EPT, persistent symptoms, pathological resorption, periapical pathology). RCT of CORONAL fragment ONLY.", ACCENT2),
    ("Canal Preparation", "Conservative preparation. Avoid excessive enlargement of apical third. NaOCl + EDTA irrigation. Ca(OH)₂ dressing 1–3 months first.", ACCENT1),
    ("MTA Apical Plug", "Mineral Trioxide Aggregate: gold standard for open-apex barrier. Biocompatible, sealing, bacteriostatic. 4–5 mm plug. Single-visit option.", ACCENT3),
    ("Apical Fragment Management", "Usually vital and asymptomatic — retain and monitor. Extraction only if apical fragment also becomes necrotic (rare).", BLUE_ACC),
]
for i,(title,body,col) in enumerate(endo):
    add_rect(s, 0.25, 1.35+i*1.45, 6.9, 1.3, rgb(0x16,0x28,0x43))
    add_rect(s, 0.25, 1.35+i*1.45, 0.08, 1.3, col)
    add_text(s, title, 0.45, 1.4+i*1.45, 6.3, 0.45, size=13.5, bold=True, color=col)
    add_text(s, body, 0.45, 1.87+i*1.45, 6.3, 0.7, size=12, color=LGREY)
slide_num(s, 15)

# ============================================================
# SLIDE 16 — MANAGEMENT VRF (with image 7)
# ============================================================
s = blank_slide(prs)
fill_bg(s, DARK_BG)
section_bar(s, "14  MANAGEMENT: VERTICAL ROOT FRACTURES")
add_text(s, "Management of Vertical Root Fractures", 0.25, 0.5, 12, 0.65, size=24, bold=True, color=WHITE)
if os.path.exists(IMGS[7]):
    add_image(s, IMGS[7], 7.5, 1.0, 5.6, 4.5)
vrf_mgmt = [
    ("Single-Rooted Teeth", "Extraction is the standard of care. Poor prognosis with any conservative attempt — progressive periodontal destruction along the fracture line.", ACCENT2),
    ("Multi-Rooted Teeth: Hemisection", "Root resection / hemisection: remove fractured root, retain remainder. Requires sound periodontal support. Good long-term outcomes if well selected.", ACCENT1),
    ("Intentional Replantation + Bonding", "Tooth extracted; VRF bonded with MTA/bioceramic resin under magnification; replanted and splinted. Variable success; limited long-term data.", ACCENT3),
    ("Bioceramic Repair (Emerging)", "Orthograde internal sealing with MTA/BioAggregate. Very limited evidence; not yet standard of care.", BLUE_ACC),
]
for i,(title,body,col) in enumerate(vrf_mgmt):
    add_rect(s, 0.25, 1.35+i*1.45, 6.9, 1.3, rgb(0x16,0x28,0x43))
    add_rect(s, 0.25, 1.35+i*1.45, 0.08, 1.3, col)
    add_text(s, title, 0.45, 1.4+i*1.45, 6.3, 0.45, size=13.5, bold=True, color=col)
    add_text(s, body, 0.45, 1.87+i*1.45, 6.3, 0.7, size=12, color=LGREY)
slide_num(s, 16)

# ============================================================
# SLIDE 17 — CROWN-ROOT FRACTURES
# ============================================================
s = blank_slide(prs)
fill_bg(s, LIGHT_BG)
section_bar(s, "15  CROWN-ROOT FRACTURES")
add_text(s, "Management of Crown-Root Fractures", 0.25, 0.5, 12, 0.65, size=24, bold=True, color=DARK_TXT)
add_rect(s, 0.25, 1.3, 12.8, 0.85, MID_BG)
add_text(s, "Crown-root fractures involve both enamel/dentine of the crown AND the root below the CEJ, frequently extending subgingivally. The pulp may or may not be exposed. Goal: re-establish a biologically sound, restorable margin.", 0.4, 1.35, 12.4, 0.75, size=13, color=LGREY)
crf = [
    ("Orthodontic Extrusion", "Slow extrusion over 4–8 weeks brings fracture margin supragingival. Gold standard for single subgingival fractures. Preserves bone and aesthetics. Requires retention post-treatment.", ACCENT1, 0.25, 2.35),
    ("Surgical Crown Lengthening", "Osseous and soft tissue surgery to expose the fracture margin. Faster than ortho extrusion but may compromise aesthetics and periodontium anteriorly. Best for posterior teeth.", ACCENT2, 6.9, 2.35),
    ("Decoronation", "Crown removal; intentional root submergence for alveolar bone preservation in growing patients. Followed by implant once growth complete.", ACCENT3, 0.25, 5.15),
    ("Extraction + Implant", "When fracture is too apical for conservative approach. Immediate implant (if socket adequate) is definitive. Socket preservation if delayed implant planned.", BLUE_ACC, 6.9, 5.15),
]
for title,body,col,x,y in crf:
    add_rect(s, x, y, 6.2, 2.0, MID_BG)
    add_rect(s, x, y, 6.2, 0.07, col)
    add_text(s, title, x+0.15, y+0.15, 5.8, 0.45, size=14, bold=True, color=col)
    add_text(s, body, x+0.15, y+0.7, 5.8, 1.1, size=12.5, color=LGREY)
slide_num(s, 17)

# ============================================================
# SLIDE 18 — PEDIATRIC
# ============================================================
s = blank_slide(prs)
fill_bg(s, MID_BG)
section_bar(s, "16  PEDIATRIC & IMMATURE TEETH")
add_text(s, "Root Fractures in Pediatric & Immature Teeth", 0.25, 0.5, 12, 0.65, size=24, bold=True, color=WHITE)
add_rect(s, 0.25, 1.25, 6.2, H-1.5, rgb(0x16,0x28,0x43))
add_rect(s, 0.25, 1.25, 6.2, 0.07, ACCENT1)
add_text(s, "Primary Dentition", 0.4, 1.38, 5.8, 0.45, size=14, bold=True, color=ACCENT1)
add_multiline(s, [
    "Root fractures in primary teeth are rare",
    "If coronal fragment mobile & causing harm: remove it; apical fragment resorbs naturally",
    "Monitor permanent successor for developmental disturbance",
    "Ectopic eruption of permanent tooth: earliest sign of damage to the tooth germ",
], 0.4, 1.9, 5.8, 3.0, size=13, color=LGREY, bullet=True)
add_rect(s, 6.85, 1.25, 6.2, H-1.5, rgb(0x16,0x28,0x43))
add_rect(s, 6.85, 1.25, 6.2, 0.07, ACCENT2)
add_text(s, "Immature Permanent Teeth", 7.0, 1.38, 5.8, 0.45, size=14, bold=True, color=ACCENT2)
add_multiline(s, [
    "Open apex → revascularization possible → better pulpal prognosis",
    "Apexogenesis (vital pulp therapy): allows root development to continue — most desirable",
    "Ca(OH)₂ Apexification: dressing changes monthly until calcific barrier forms (9–18 months)",
    "MTA Apical Plug: faster alternative; 4–5 mm plug in single visit; allows immediate obturation",
    "Regenerative Endodontic Procedures (REPs): bleeding clot scaffold + MTA barrier → biological root maturation — biologically ideal approach",
], 7.0, 1.9, 5.8, 5.2, size=13, color=LGREY, bullet=True)
slide_num(s, 18)

# ============================================================
# SLIDE 19 — POST-ENDO RESTORATION
# ============================================================
s = blank_slide(prs)
fill_bg(s, LIGHT_BG)
section_bar(s, "17  POST-ENDODONTIC RESTORATION")
add_text(s, "Post-Endodontic Restoration After Root Fracture", 0.25, 0.5, 12, 0.65, size=22, bold=True, color=DARK_TXT)
rest = [
    ("Intracanal Posts — Risks", "Posts do NOT strengthen roots — they can weaken them. Post drilling is a major VRF risk factor. Use only when insufficient coronal tooth structure. Minimum remaining root: 2× clinical crown height. Preserve ≥5 mm apical gutta-percha seal.", ACCENT2, 0.25, 1.3),
    ("Passive Fibre Posts", "Parallel-sided, passive, bondable fibre posts preferred. Avoid tapered posts (wedging force). Bond with dual-cure resin cement. Elastic modulus close to dentine → more even stress distribution.", ACCENT1, 6.9, 1.3),
    ("Composite Resin Restorations", "When adequate coronal tissue exists: direct composite resin core + crown. Anterior teeth: crown may not be needed if fracture line invisible. Adhesive composite helps reinforce weakened root.", ACCENT3, 0.25, 4.5),
    ("Crown Type Selection", "Full-coverage metal-ceramic or all-ceramic crown standard after post placement. Zirconia for high-load areas. Endocrown (molars): avoids post space, conservative, excellent long-term results.", BLUE_ACC, 6.9, 4.5),
]
for title,body,col,x,y in rest:
    add_rect(s, x, y, 6.2, 2.85, MID_BG)
    add_rect(s, x, y, 6.2, 0.07, col)
    add_text(s, title, x+0.15, y+0.15, 5.8, 0.45, size=14, bold=True, color=col)
    add_text(s, body, x+0.15, y+0.7, 5.8, 1.9, size=12.5, color=LGREY)
slide_num(s, 19)

# ============================================================
# SLIDE 20 — PROGNOSIS
# ============================================================
s = blank_slide(prs)
fill_bg(s, DARK_BG)
section_bar(s, "18  PROGNOSIS")
add_text(s, "Prognosis of Root Fractures", 0.25, 0.5, 12, 0.65, size=26, bold=True, color=WHITE)
add_text(s, "Approximate Long-Term Tooth Retention Rates", 0.25, 1.3, 8.5, 0.45, size=13, color=LGREY, bold=True)
prog = [("Apical third RF",80,ACCENT1),("Middle third RF",60,ACCENT3),("Cervical third RF",35,ACCENT2),("VRF (single-rooted)",5,ACCENT2)]
for i,(lbl,pct,col) in enumerate(prog):
    add_text(s, lbl, 0.25, 1.85+i*0.88, 3.5, 0.55, size=13, color=WHITE)
    add_rect(s, 3.9, 2.0+i*0.88, 8.5, 0.35, rgb(0x1E,0x2D,0x3D))
    bar_w = 8.5 * pct / 100
    add_rect(s, 3.9, 2.0+i*0.88, bar_w if bar_w > 0.1 else 0.15, 0.35, col)
    add_text(s, f"{pct}%", 3.9+bar_w+0.1, 2.0+i*0.88, 0.7, 0.35, size=12, color=col, bold=True)
add_rect(s, 0.25, 5.55, 12.8, 0.05, ACCENT1)
add_text(s, "Key Prognostic Factors", 0.25, 5.65, 12.8, 0.45, size=14, bold=True, color=WHITE)
add_multiline(s, [
    "Level of fracture (apical > middle > cervical)  •  Diastasis between fragments → worse prognosis  •  Vital pulp = better healing",
    "Patient age (younger = better PDL regeneration)  •  Time to repositioning/splinting  •  Mobility of coronal fragment",
], 0.25, 6.15, 12.8, 1.1, size=13, color=LGREY)
slide_num(s, 20)

# ============================================================
# SLIDE 21 — PREVENTION
# ============================================================
s = blank_slide(prs)
fill_bg(s, MID_BG)
section_bar(s, "19  PREVENTION")
add_text(s, "Prevention of Root Fractures", 0.25, 0.5, 12, 0.65, size=26, bold=True, color=WHITE)
prev_cols = [
    ("During Endodontic Procedures", [
        "Conservative access design (ninja/contracted access)",
        "Avoid over-instrumentation of the apical third",
        "No large NiTi rotaries in narrow/oval canals",
        "Warm vertical condensation preferred over cold lateral",
        "Post-space: preserve ≥5 mm apical gutta-percha seal",
    ], ACCENT1, 0.25),
    ("Occlusal Considerations", [
        "Screen for bruxism; provide occlusal splint therapy",
        "Adjust occlusion to avoid premature contacts",
        "Avoid cantilever prostheses on compromised roots",
        "Crown coverage of endodontically treated molars/premolars",
    ], ACCENT3, 4.6),
    ("Trauma Prevention", [
        "Custom mouthguards for contact sports (reduce trauma by up to 60%)",
        "Fall/accident risk counselling in elderly patients",
        "Dental awareness and education campaigns",
    ], BLUE_ACC, 8.95),
]
for title,pts,col,x in prev_cols:
    add_rect(s, x, 1.3, 4.15, H-1.55, rgb(0x16,0x28,0x43))
    add_rect(s, x, 1.3, 4.15, 0.07, col)
    add_text(s, title, x+0.15, 1.42, 3.8, 0.5, size=13, bold=True, color=col)
    add_multiline(s, pts, x+0.15, 2.0, 3.8, H-2.3, size=13, color=LGREY, bullet=True)
slide_num(s, 21)

# ============================================================
# SLIDE 22 — FOLLOW-UP
# ============================================================
s = blank_slide(prs)
fill_bg(s, LIGHT_BG)
section_bar(s, "20  FOLLOW-UP & MONITORING")
add_text(s, "Follow-up Protocols & Long-Term Monitoring (IADT 2020)", 0.25, 0.5, 12, 0.65, size=22, bold=True, color=DARK_TXT)
followup = [
    ("4 weeks", "Clinical: mobility, pain, soft tissue. Radiographic: PA. EPT/cold test. Splint removal (mid/apical third)."),
    ("3 months", "Repeat clinical + radiographic. Assess healing type. Look for resorption or periapical pathology."),
    ("6 months", "Clinical + PA radiograph. PCO (obliteration) is favorable sign. CBCT if VRF still suspected."),
    ("1 year", "Full clinical + radiographic review. Confirm healing type. Remove cervical third splint if still present."),
    ("Annual × 5 years", "Long-term surveillance. Late-onset necrosis can occur up to 5 years post-trauma."),
]
add_rect(s, 0.25, 1.3, 1.9, H-1.55, MID_BG)
add_text(s, "TIME\nPOINT", 0.25, 2.2, 1.9, 0.65, size=12, bold=True, color=ACCENT1, align=PP_ALIGN.CENTER)
for i,(time,actions) in enumerate(followup):
    bg = MID_BG if i%2==0 else rgb(0x16,0x28,0x43)
    add_rect(s, 2.35, 1.32+i*1.18, 10.9, 1.1, bg)
    add_text(s, time, 0.3, 1.38+i*1.18, 1.8, 0.95, size=13, bold=True, color=ACCENT1, align=PP_ALIGN.CENTER)
    add_text(s, actions, 2.5, 1.38+i*1.18, 10.5, 0.95, size=13, color=DARK_TXT)
slide_num(s, 22)

# ============================================================
# SLIDE 23 — INTERDISCIPLINARY & MEDICOLEGAL
# ============================================================
s = blank_slide(prs)
fill_bg(s, MID_BG)
section_bar(s, "21–22  INTERDISCIPLINARY & MEDICOLEGAL")
add_text(s, "Interdisciplinary Considerations & Medicolegal Aspects", 0.25, 0.5, 12, 0.65, size=22, bold=True, color=WHITE)
add_rect(s, 0.25, 1.3, 6.2, H-1.55, rgb(0x16,0x28,0x43))
add_rect(s, 0.25, 1.3, 6.2, 0.07, ACCENT1)
add_text(s, "Interdisciplinary Management", 0.4, 1.42, 5.8, 0.5, size=14, bold=True, color=ACCENT1)
add_multiline(s, [
    "Oral Surgery: extraction, socket management, implant planning",
    "Periodontology: perio therapy; crown lengthening for crown-root fractures",
    "Orthodontics: forced eruption; space management post-extraction",
    "Prosthodontics: implant restorations; FPD design",
    "Paediatric Dentistry: primary dentition; monitoring permanent successors",
    "Emergency Medicine: triage, acute pain management, referral (IADT / Tintinalli guidelines)",
], 0.4, 2.0, 5.8, 5.2, size=13, color=LGREY, bullet=True)
add_rect(s, 6.85, 1.3, 6.2, H-1.55, rgb(0x16,0x28,0x43))
add_rect(s, 6.85, 1.3, 6.2, 0.07, ACCENT2)
add_text(s, "Medicolegal Considerations", 7.0, 1.42, 5.8, 0.5, size=14, bold=True, color=ACCENT2)
add_multiline(s, [
    "VRF from endodontic / post procedures: potential iatrogenic liability",
    "Documentation is paramount: pre-op radiographs, informed consent, technique notes, post-op instructions",
    "Failure to diagnose: delayed VRF diagnosis has led to successful negligence claims",
    "Misattribution: document differential between VRF and periodontal disease",
    "IADT guidelines represent the standard of care — deviation requires documented justification",
    "Expert witness standard: Tamse, Berman & Katz (Ingle's Endodontics)",
], 7.0, 2.0, 5.8, 5.2, size=13, color=LGREY, bullet=True)
slide_num(s, 23)

# ============================================================
# SLIDE 24 — REFERENCES & EVIDENCE
# ============================================================
s = blank_slide(prs)
fill_bg(s, LIGHT_BG)
section_bar(s, "23–24  KEY EVIDENCE & REFERENCES")
add_text(s, "Key Evidence Base & References", 0.25, 0.5, 12, 0.65, size=26, bold=True, color=DARK_TXT)
refs = [
    ("Andreasen et al., 2004", "Landmark longitudinal cohort — healing patterns in 400 horizontal root fractures. Established 4 healing types.", "Dental Traumatology"),
    ("Tamse & Berman (Ingle's 7th Ed, 2019)", "Comprehensive VRF chapter — epidemiology, etiology, diagnosis & management. Definitive VRF reference.", "Ingle's Endodontics"),
    ("Bourguignon et al., 2020", "IADT 2020 Guidelines for traumatic dental injuries. Current standard of care for root fracture management.", "Dental Traumatology 36(4)"),
    ("Patel, Bhuva & Bose, 2022", "VRF prevalence and diagnosis in root-filled teeth — systematic review.", "Intl Endodontic Journal"),
    ("Haupt, Wiegand & Kanzow, 2023", "Meta-analysis (14 studies, 2,877 teeth): VRF risk factors. No single factor independently predictive.", "Journal of Endodontics"),
    ("Cohen's Pathways of the Pulp, 12th Ed", "Traumatic injuries chapter; pulpal response; healing classifications.", "Elsevier"),
    ("Tintinalli's Emergency Medicine, 9th Ed", "Dentoalveolar trauma management; IADT-consistent protocols.", "McGraw-Hill"),
]
for i,(auth,title,journal) in enumerate(refs):
    bg = rgb(0xEE,0xF3,0xF9) if i%2==0 else rgb(0xE2,0xEA,0xF4)
    add_rect(s, 0.25, 1.3+i*0.83, 12.8, 0.78, bg)
    add_text(s, auth, 0.35, 1.33+i*0.83, 3.5, 0.7, size=11.5, bold=True, color=rgb(0x2E,0x4A,0x7A))
    add_text(s, title, 3.95, 1.33+i*0.83, 6.5, 0.7, size=11.5, color=DARK_TXT)
    add_text(s, journal, 10.6, 1.33+i*0.83, 2.3, 0.7, size=11, color=SUB_CLR, italic=True)
slide_num(s, 24)

# ============================================================
# SLIDE 25 — CONCLUSIONS
# ============================================================
s = blank_slide(prs)
fill_bg(s, DARK_BG)
add_rect(s, 0, 0, 0.12, H, ACCENT1)
add_text(s, "CONCLUSIONS &", 0.3, 0.5, 12.5, 1.0, size=46, bold=True, color=WHITE)
add_text(s, "FUTURE PERSPECTIVES", 0.3, 1.5, 12.5, 1.0, size=46, bold=True, color=ACCENT1)
add_rect(s, 0.3, 2.65, 7.5, 0.07, ACCENT1)
add_multiline(s, [
    "Root fractures range from manageable apical fractures to devastating VRFs requiring extraction",
    "Biological healing IS possible — correct repositioning and semi-rigid splinting are cornerstones",
    "CBCT has transformed VRF diagnosis; AI-assisted imaging is the next frontier",
    "MTA and bioceramic materials have expanded treatment options, especially for immature teeth",
    "Prevention through conservative endodontics is more powerful than any treatment strategy",
    "IADT 2020 guidelines provide the current evidence-based standard of care",
    "Future: regenerative endodontics, nanotechnology-enhanced bioceramics, and AI will reshape the field",
], 0.3, 2.8, 12.5, 4.3, size=15, color=LGREY, bullet=True)
add_rect(s, 0, H-0.7, W, 0.7, rgb(0x0A,0x15,0x20))
add_text(s, "Thank you  |  Questions Welcome  |  Root Fractures & Their Management — Seminar 2026", 0.3, H-0.62, 12.5, 0.55, size=13, color=SUB_CLR, align=PP_ALIGN.CENTER)
slide_num(s, 25)

# ============================================================
# SAVE
# ============================================================
out_path = "/home/daytona/workspace/root-fractures-pptx/Root_Fractures_Management_v2.pptx"
prs.save(out_path)
print(f"Saved: {out_path}")
import os
size = os.path.getsize(out_path)
print(f"File size: {size/1024/1024:.1f} MB")
print(f"Slide count: {len(prs.slides)}")

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/root-fractures-pptx/build_pptx.py'

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/root-fractures-pptx/build_pptx.py'

"""
Build a printable PDF of the 25-slide Root Fractures presentation.
Uses ReportLab for reliable, PowerPoint-independent PDF generation.
Landscape A4 (841 x 595 pt) matches standard presentation print format.
"""

from reportlab.lib.pagesizes import A4, landscape
from reportlab.lib import colors
from reportlab.lib.units import mm, inch
from reportlab.pdfgen import canvas
from reportlab.pdfbase import pdfmetrics
from reportlab.pdfbase.ttfonts import TTFont
from reportlab.lib.utils import ImageReader
from reportlab.platypus import Paragraph
from reportlab.lib.styles import ParagraphStyle
import os, io
from PIL import Image as PILImage

# ── Page setup ──────────────────────────────────────────────
W, H = landscape(A4)   # 841.89 x 595.28 pt
IMGS = [f"/home/daytona/workspace/root-fractures-pptx/images/img{i}_sm.png" for i in range(8)]

# ── Color palette ────────────────────────────────────────────
DARK_BG   = colors.HexColor("#0D1B2A")
MID_BG    = colors.HexColor("#1B2B3D")
LIGHT_BG  = colors.HexColor("#EEF3F9")
ACCENT1   = colors.HexColor("#2EC4B6")   # teal
ACCENT2   = colors.HexColor("#E76F51")   # coral
ACCENT3   = colors.HexColor("#F4A261")   # amber
BLUE_ACC  = colors.HexColor("#377DDC")
WHITE     = colors.white
LGREY     = colors.HexColor("#CBD5E1")
DARK_TXT  = colors.HexColor("#1E293B")
SUB_CLR   = colors.HexColor("#94A3B8")
NAVY2     = colors.HexColor("#162843")
NEAR_BLK  = colors.HexColor("#0A1520")

out_path = "/home/daytona/workspace/root-fractures-pptx/Root_Fractures_Management_Print.pdf"
c = canvas.Canvas(out_path, pagesize=landscape(A4))
c.setTitle("Root Fractures and Their Management")
c.setAuthor("Endodontics Seminar 2026")
c.setSubject("Comprehensive Review — Seminar Presentation")

# ── Helper functions ─────────────────────────────────────────

def fill_bg(clr):
    c.setFillColor(clr)
    c.rect(0, 0, W, H, fill=1, stroke=0)

def box(x, y, w, h, fill_clr, stroke_clr=None, radius=0):
    c.setFillColor(fill_clr)
    if stroke_clr:
        c.setStrokeColor(stroke_clr)
        if radius:
            c.roundRect(x, y, w, h, radius, fill=1, stroke=1)
        else:
            c.rect(x, y, w, h, fill=1, stroke=1)
    else:
        c.setStrokeColor(fill_clr)
        if radius:
            c.roundRect(x, y, w, h, radius, fill=1, stroke=0)
        else:
            c.rect(x, y, w, h, fill=1, stroke=0)

def txt(text, x, y, size=12, clr=WHITE, bold=False, align="left", max_w=None):
    c.setFillColor(clr)
    fname = "Helvetica-Bold" if bold else "Helvetica"
    c.setFont(fname, size)
    if align == "center" and max_w:
        c.drawCentredString(x + max_w/2, y, text)
    elif align == "right" and max_w:
        c.drawRightString(x + max_w, y, text)
    else:
        c.drawString(x, y, text)

def wrap_text(text, x, y, max_w, size=11, clr=WHITE, bold=False, line_h=None):
    """Simple word-wrap text drawer. Returns final y position."""
    if line_h is None:
        line_h = size * 1.45
    fname = "Helvetica-Bold" if bold else "Helvetica"
    c.setFont(fname, size)
    c.setFillColor(clr)
    words = text.split()
    line = ""
    cy = y
    for word in words:
        test = (line + " " + word).strip()
        if c.stringWidth(test, fname, size) <= max_w:
            line = test
        else:
            if line:
                c.drawString(x, cy, line)
                cy -= line_h
            line = word
    if line:
        c.drawString(x, cy, line)
        cy -= line_h
    return cy

def bullet_list(items, x, y, max_w, size=11, clr=WHITE, line_h=None, bullet="•"):
    if line_h is None:
        line_h = size * 1.5
    fname = "Helvetica"
    cy = y
    for item in items:
        # Draw bullet
        c.setFillColor(clr)
        c.setFont(fname, size)
        c.drawString(x, cy, bullet + "  ")
        bw = c.stringWidth(bullet + "  ", fname, size)
        # Word-wrap the item text
        words = item.split()
        line = ""
        first = True
        for word in words:
            test = (line + " " + word).strip()
            if c.stringWidth(test, fname, size) <= max_w - bw:
                line = test
            else:
                if line:
                    ix = x + bw if first else x + bw
                    c.drawString(ix, cy, line)
                    cy -= line_h
                    first = False
                line = word
        if line:
            c.drawString(x + bw, cy, line)
            cy -= line_h
    return cy

def add_image(path, x, y, w, h):
    if os.path.exists(path):
        try:
            img = ImageReader(path)
            c.drawImage(img, x, H - y - h, w, h, preserveAspectRatio=True, mask='auto')
        except Exception as e:
            print(f"Image error {path}: {e}")

def section_bar(label):
    box(0, 0, 5, H, ACCENT1)
    txt(label, 8, H - 18, size=9, clr=DARK_BG, bold=True)

def left_accent_bar():
    box(0, 0, 5, H, ACCENT1)

def slide_num(n):
    txt(f"{n} / 25", W - 60, 12, size=9, clr=SUB_CLR)

def accent_line(x, y, w, clr=ACCENT1, thickness=2):
    c.setStrokeColor(clr)
    c.setLineWidth(thickness)
    c.line(x, H - y, x + w, H - y)

def card(x, y, w, h, fill=NAVY2, top_bar_clr=None, radius=4):
    """Draw a card. y measured from TOP."""
    box(x, H - y - h, w, h, fill, radius=radius)
    if top_bar_clr:
        box(x, H - y - 3, w, 3, top_bar_clr)

# ── Margin helpers (all y coords from TOP of page) ──────────
M = 12  # margin points

# ================================================================
# SLIDE 1 — TITLE
# ================================================================
fill_bg(DARK_BG)
left_accent_bar()
# Decorative circle
c.setFillColor(colors.HexColor("#162843"))
c.circle(W - 150, H//2 + 30, 180, fill=1, stroke=0)
c.setFillColor(DARK_BG)
c.circle(W - 150, H//2 + 30, 140, fill=1, stroke=0)

add_image(IMGS[0], W - 310, 20, 290, 220)

txt("ROOT FRACTURES", 30, H - 110, size=46, clr=WHITE, bold=True)
txt("AND THEIR MANAGEMENT", 30, H - 165, size=28, clr=ACCENT1, bold=True)
accent_line(30, 185, 380)
txt("A Comprehensive Review for the Seminar", 30, H - 210, size=13, clr=SUB_CLR)
wrap_text("Drawing from Cohen's Pathways of the Pulp, Ingle's Endodontics and Contemporary Peer-Reviewed Literature",
          30, H - 240, 450, size=12, clr=SUB_CLR)

box(0, 0, W, 38, NEAR_BLK)
txt("June 2026  |  Endodontics Seminar", 30, 14, size=11, clr=SUB_CLR)
slide_num(1)
c.showPage()

# ================================================================
# SLIDE 2 — TABLE OF CONTENTS
# ================================================================
fill_bg(MID_BG)
section_bar("OVERVIEW")
txt("Table of Contents", 14, H - 55, size=26, clr=WHITE, bold=True)

topics_L = [
    "01  Introduction & History", "02  Definitions & Classification",
    "03  Epidemiology & Etiology", "04  Anatomy & Pathophysiology",
    "05  Types of Root Fractures", "06  Healing Responses",
    "07  Pulpal Response & Sequelae", "08  Clinical Diagnosis",
    "09  Radiographic Diagnosis", "10  CBCT & Advanced Imaging",
    "11  Differential Diagnosis", "12  AI in VRF Detection",
]
topics_R = [
    "13  Management: Horizontal Fractures", "14  Splinting Protocols",
    "15  Endodontic Intervention", "16  Management: Vertical Fractures",
    "17  Crown-Root Fractures", "18  Pediatric & Immature Teeth",
    "19  Post-Endodontic Restoration", "20  Prognosis",
    "21  Prevention Strategies", "22  Follow-up & Monitoring",
    "23  Interdisciplinary & Medicolegal", "24  Key Evidence & References",
    "25  Conclusions & Future Perspectives",
]
row_h = 37
start_y = 85
for i, t in enumerate(topics_L):
    y_pt = H - start_y - i * row_h
    box(14, y_pt - 14, 24, 18, ACCENT1, radius=2)
    txt(t[:2], 14, y_pt - 12, size=9, clr=DARK_TXT, bold=True, align="center", max_w=24)
    txt(t[4:], 42, y_pt - 12, size=10.5, clr=LGREY)

for i, t in enumerate(topics_R):
    y_pt = H - start_y - i * row_h
    box(430, y_pt - 14, 24, 18, ACCENT2, radius=2)
    txt(t[:2], 430, y_pt - 12, size=9, clr=WHITE, bold=True, align="center", max_w=24)
    txt(t[4:], 458, y_pt - 12, size=10.5, clr=LGREY)

slide_num(2)
c.showPage()

# ================================================================
# SLIDE 3 — INTRODUCTION
# ================================================================
fill_bg(MID_BG)
section_bar("01  INTRODUCTION")
txt("Introduction & Historical Perspective", 14, H - 55, size=24, clr=WHITE, bold=True)
accent_line(14, 75, W - 30)
pts = [
    "Root fractures involve simultaneous disruption of dentine, cementum, pulp, and periodontal ligament",
    "Earliest treatment: gold wire & silk ligature splinting (referenced in Ingle's Endodontics)",
    "Grossman (early 20th c.): horizontal/diagonal mid-root fractures; coronal third = unfavorable prognosis",
    "Ellis (1945): classification system — conceptual backbone of today's IADT classification",
    "Andreasen et al.: landmark longitudinal studies (400 teeth) → 4 healing types; shifted management from interventionist to biologically informed",
    "Tamse & Berman: recognized VRF as a distinct iatrogenic entity (latter 20th century)",
    "Today: CBCT, MTA/bioceramic materials, regenerative endodontics, and AI are reshaping the field",
]
bullet_list(pts, 14, H - 90, W - 30, size=13, clr=LGREY, line_h=20)
slide_num(3)
c.showPage()

# ================================================================
# SLIDE 4 — DEFINITIONS (two columns)
# ================================================================
fill_bg(LIGHT_BG)
left_accent_bar()
txt("Definitions, Terminology & Classification", 14, H - 55, size=24, clr=DARK_TXT, bold=True)

col_w = (W - 30) / 2 - 5
# Left card
card(12, 72, col_w, H - 84, fill=MID_BG, top_bar_clr=ACCENT1, radius=6)
txt("INTRA-ALVEOLAR ROOT FRACTURE", 20, H - 92, size=10.5, clr=ACCENT1, bold=True)
bullet_list([
    "Fracture perpendicular/oblique to the long axis of root",
    "Disrupts: dentine, cementum, pulp, periodontal ligament",
    "Classified by level: Apical (best prognosis) | Middle (most common) | Cervical (worst)",
    "IADT Category 7 — Bourguignon et al. 2020",
    "Also called: transverse, horizontal, or intra-alveolar fracture",
], 20, H - 115, col_w - 16, size=12, clr=LGREY, line_h=18)

# Right card
card(col_w + 20, 72, col_w, H - 84, fill=MID_BG, top_bar_clr=ACCENT2, radius=6)
txt("VERTICAL ROOT FRACTURE (VRF)", col_w + 28, H - 92, size=10.5, clr=ACCENT2, bold=True)
bullet_list([
    "Runs parallel / sub-parallel to the long axis of root",
    "Overwhelmingly iatrogenic — endodontic & restorative procedures",
    "Incomplete VRF: craze lines / partial crack",
    "Complete VRF: full root separation along long axis",
    "Orientation: Buccolingual (most common) or Mesiodistal",
    "Distinct from traumatic fractures in etiology, management & medicolegal context",
], col_w + 28, H - 115, col_w - 16, size=12, clr=LGREY, line_h=18)

slide_num(4)
c.showPage()

# ================================================================
# SLIDE 5 — EPIDEMIOLOGY
# ================================================================
fill_bg(MID_BG)
section_bar("03  EPIDEMIOLOGY")
txt("Epidemiology & Etiology", 14, H - 55, size=24, clr=WHITE, bold=True)

stats = [
    ("0.5–7%", "of dental trauma\ncases (permanent dentition)", ACCENT1),
    ("2nd Decade", "of life most\ncommonly affected", ACCENT1),
    ("Max. Central Incisor", "most frequently\nfractured tooth", ACCENT2),
    ("2–5%", "VRF prevalence in\nroot-filled teeth", ACCENT2),
]
sw = (W - 30) / 4
for i, (val, lbl, col) in enumerate(stats):
    bx = 14 + i * sw
    card(bx, 75, sw - 5, 100, fill=NAVY2, top_bar_clr=col, radius=6)
    txt(val, bx, H - 115, size=15, clr=col, bold=True, align="center", max_w=sw - 5)
    for j, line in enumerate(lbl.split("\n")):
        txt(line, bx, H - 140 + j * (-14), size=10.5, clr=LGREY, align="center", max_w=sw - 5)

accent_line(14, 188, W - 30)
txt("Traumatic Root Fractures — Mechanism", 14, H - 200, size=13, clr=WHITE, bold=True)
bullet_list([
    "Direct blow to labial surface of anterior teeth (sports, falls, road accidents)",
    "Males > Females; peak age 11–20 years",
    "Immature roots: open apex allows revascularization → better pulpal prognosis",
], 14, H - 218, (W - 30)/2 - 10, size=11.5, clr=LGREY, line_h=17)

txt("VRF — Iatrogenic Risk Factors", W/2 + 5, H - 200, size=13, clr=WHITE, bold=True)
bullet_list([
    "Over-instrumentation of apical third",
    "Lateral condensation of gutta-percha (wedging forces)",
    "Intracanal post drilling and cementation stresses",
    "Bruxism; oval cross-section roots (mandibular incisors)",
], W/2 + 5, H - 218, (W - 30)/2 - 10, size=11.5, clr=LGREY, line_h=17)

slide_num(5)
c.showPage()

# ================================================================
# SLIDE 6 — ANATOMY
# ================================================================
fill_bg(LIGHT_BG)
left_accent_bar()
txt("Anatomy & Pathophysiology", 14, H - 55, size=24, clr=DARK_TXT, bold=True)
card(12, 72, W * 0.65 - 8, H - 84, fill=MID_BG, top_bar_clr=ACCENT1, radius=6)
txt("Root Structure & Mechanical Properties", 20, H - 92, size=13, clr=ACCENT1, bold=True)
bullet_list([
    "Root composed of dentine — mineralized tissue with dentinal tubules radiating from pulp to periphery",
    "Outer surface: cementum anchors PDL fibres via Sharpey's fibres",
    "Periodontal Ligament (PDL): suspends tooth, transmits occlusal forces, houses pluripotent stem cells critical for healing",
    "Dentine is anisotropic: high compressive strength, lower tensile/shear strength",
    "Microcracks initiate at inner canal walls, apico-coronal midpoint, areas of reduced wall thickness",
    "Oval-section roots most susceptible to VRF — labial/lingual walls can be <1 mm thick",
    "Endodontic treatment removes vital pulp moisture → increased brittleness and fracture susceptibility",
], 20, H - 115, W * 0.65 - 30, size=12, clr=LGREY, line_h=18)

card(W * 0.65 + 5, 72, W * 0.35 - 17, H - 84, fill=NAVY2, radius=6)
txt("Critical Fact", W * 0.65 + 13, H - 92, size=12, clr=ACCENT2, bold=True)
txt("< 1 mm", W * 0.65 + 13, H - 160, size=34, clr=ACCENT2, bold=True, align="center", max_w=W * 0.35 - 26)
txt("labial/lingual wall thickness", W * 0.65 + 13, H - 195, size=10.5, clr=LGREY, align="center", max_w=W * 0.35 - 26)
txt("in oval-shaped roots", W * 0.65 + 13, H - 210, size=10.5, clr=LGREY, align="center", max_w=W * 0.35 - 26)
accent_line(W * 0.65 + 25, 240, W * 0.35 - 45)
wrap_text("PDL stem cells are the primary biological mediators of repair after root fracture",
          W * 0.65 + 13, H - 260, W * 0.35 - 26, size=11, clr=LGREY)

slide_num(6)
c.showPage()

# ================================================================
# SLIDE 7 — TYPES (with image)
# ================================================================
fill_bg(DARK_BG)
section_bar("05  TYPES OF ROOT FRACTURES")
txt("Types of Root Fractures", 14, H - 55, size=24, clr=WHITE, bold=True)
add_image(IMGS[0], W - 310, 20, 295, 235)
types = [
    ("Horizontal / Transverse Root Fracture", "Perpendicular to long axis; traumatic; classified by third (apical, middle, cervical)", ACCENT1),
    ("Vertical Root Fracture (VRF)", "Parallel to long axis; usually iatrogenic; frequently missed on plain radiographs", ACCENT2),
    ("Crown-Root Fracture", "Involves crown AND root below CEJ; may expose pulp; complex management", ACCENT3),
    ("Oblique Root Fracture", "Diagonal orientation; intermediate features between horizontal and VRF", BLUE_ACC),
]
for i, (name, desc, col) in enumerate(types):
    y_top = 80 + i * 110
    card(12, y_top, W - 330, 100, fill=NAVY2, radius=5)
    box(12, H - y_top - 3, 6, 100, col)
    txt(name, 26, H - y_top - 30, size=13, clr=col, bold=True)
    wrap_text(desc, 26, H - y_top - 52, W - 355, size=11.5, clr=LGREY)

box(12, H - (80 + 4*110) - 3 - 38, W - 330, 35, NAVY2, radius=4)
txt("Fracture Level → Prognosis:  Apical (best)  |  Middle  |  Cervical (worst)",
    20, H - (80 + 4*110) - 22, size=12, clr=ACCENT1)

slide_num(7)
c.showPage()

# ================================================================
# SLIDE 8 — HEALING RESPONSES (with image)
# ================================================================
fill_bg(MID_BG)
section_bar("06  BIOLOGICAL HEALING")
txt("Biological Healing Responses at the Fracture Site", 14, H - 55, size=22, clr=WHITE, bold=True)
add_image(IMGS[6], W - 295, 20, 280, 555)
healing = [
    ("Type 1: Hard Tissue Callus", "Calcified bridge between fragments — most favorable. Seen with intact pulp, adequate repositioning, apical/mid-root fractures.", ACCENT1),
    ("Type 2: Connective Tissue Healing", "PDL fibres bridge fragments without calcification. Good prognosis, functional stability maintained.", ACCENT3),
    ("Type 3: Bone & CT Interposition", "Alveolar bone grows into fracture site, permanently separating fragments. Tooth remains functional.", BLUE_ACC),
    ("Type 4: Granulation Tissue", "Inflammatory tissue = pulp necrosis. Requires endodontic intervention or extraction.", ACCENT2),
]
for i, (title, body, col) in enumerate(healing):
    y_top = 75 + i * 120
    card(12, y_top, W - 320, 110, fill=NAVY2, radius=5)
    box(12, H - y_top - 3, 6, 110, col)
    txt(title, 26, H - y_top - 28, size=13, clr=col, bold=True)
    wrap_text(body, 26, H - y_top - 50, W - 345, size=11.5, clr=LGREY)
slide_num(8)
c.showPage()

# ================================================================
# SLIDE 9 — PULPAL RESPONSE
# ================================================================
fill_bg(LIGHT_BG)
left_accent_bar()
txt("Pulpal Response & Sequelae", 14, H - 55, size=24, clr=DARK_TXT, bold=True)
pulp_stats = [
    ("~80%", "Pulp remains vital\nafter horizontal RF", ACCENT1),
    ("~20%", "Develop pulp necrosis\n(mostly coronal fragment)", ACCENT2),
    ("<1%", "Apical fragment\nbecomes necrotic", ACCENT3),
]
sw = (W - 30) / 3
for i, (val, lbl, col) in enumerate(pulp_stats):
    bx = 14 + i * sw
    card(bx, 72, sw - 6, 110, fill=MID_BG, top_bar_clr=col, radius=6)
    txt(val, bx, H - 120, size=32, clr=col, bold=True, align="center", max_w=sw - 6)
    for j, line in enumerate(lbl.split("\n")):
        txt(line, bx, H - 160 + j * (-14), size=11, clr=LGREY, align="center", max_w=sw - 6)

accent_line(14, 196, W - 30)
txt("Pulpal Sequelae and Histological Changes", 14, H - 208, size=14, clr=DARK_TXT, bold=True)
bullet_list([
    "Initial response: transient hyperemia, haemorrhage between fragments, disruption of neurovascular supply",
    "Revascularization possible in open-apex teeth — immature apex allows new vessels and nerve fibres to re-enter",
    "In mature teeth, revascularization is rare; survival depends on intact apical blood supply",
    "Coronal fragment more susceptible to necrosis — separated from main blood supply",
    "Pulp Canal Obliteration (PCO): secondary dentine deposition — common benign finding, no treatment needed",
    "Active inflammatory resorption = pulp necrosis → endodontic intervention mandatory",
], 14, H - 228, W - 30, size=12, clr=DARK_TXT, line_h=17)
slide_num(9)
c.showPage()

# ================================================================
# SLIDE 10 — CLINICAL DIAGNOSIS (4 quadrants)
# ================================================================
fill_bg(MID_BG)
section_bar("08  CLINICAL DIAGNOSIS")
txt("Clinical Diagnosis", 14, H - 55, size=24, clr=WHITE, bold=True)
quads = [
    ("History & Chief Complaint", ["Nature, mechanism, time of injury", "Prior trauma or dental treatment", "Symptoms: pain, mobility, bite sensitivity", "Medical history; tetanus status"], ACCENT1, 12, 72),
    ("Clinical Examination", ["Coronal fragment mobility pathognomonic", "Crown discoloration (grey/pink)", "Palpation of alveolus; lacerations", "Sinus tract location — deep narrow = VRF"], ACCENT3, W/2 + 3, 72),
    ("Vitality Testing", ["EPT: may be false-negative acutely; repeat at 4, 8, 12 weeks", "Cold/thermal: more reliable", "Laser Doppler: gold standard (rarely available)", "PCO on review = favorable pulp response"], BLUE_ACC, 12, H/2 - 18),
    ("Periodontal Assessment", ["Deep narrow probing defect = VRF (sinus tract)", "Furcation involvement in multi-rooted teeth", "Alveolar bone levels radiographically", "Mobility grading (Miller classification)"], ACCENT2, W/2 + 3, H/2 - 18),
]
for title, pts, col, bx, by in quads:
    qw = W/2 - 15
    qh = H/2 - 60
    card(bx, by, qw, qh, fill=NAVY2, top_bar_clr=col, radius=6)
    txt(title, bx + 8, H - by - 24, size=12.5, clr=col, bold=True)
    bullet_list(pts, bx + 8, H - by - 44, qw - 16, size=11, clr=LGREY, line_h=17)
slide_num(10)
c.showPage()

# ================================================================
# SLIDE 11 — RADIOGRAPHIC (with image)
# ================================================================
fill_bg(DARK_BG)
section_bar("09  RADIOGRAPHIC DIAGNOSIS")
txt("Radiographic Diagnosis", 14, H - 55, size=24, clr=WHITE, bold=True)
add_image(IMGS[2], W - 300, 20, 285, 540)
rad = [
    ("Periapical Radiography", "First-line investigation; paralleling technique preferred. Fracture line = radiolucent line perpendicular to long axis.", ACCENT1),
    ("Multiple Angulations", "Single view may miss fracture. IADT: 3 views recommended. Fracture visible in one plane only.", ACCENT3),
    ("Bisecting Angle Limitation", "Can mask fractures by foreshortening. Paralleling technique more reliable for fracture detection.", BLUE_ACC),
    ("VRF on 2D Radiographs", "Frequently undetectable. Subtle signs: widened PDL space, 'halo' bone loss, J-shaped periapical lesion.", ACCENT2),
]
for i, (title, body, col) in enumerate(rad):
    y_top = 75 + i * 120
    card(12, y_top, W - 325, 110, fill=NAVY2, radius=5)
    box(12, H - y_top - 3, 6, 110, col)
    txt(title, 26, H - y_top - 28, size=13, clr=col, bold=True)
    wrap_text(body, 26, H - y_top - 50, W - 350, size=11.5, clr=LGREY)
slide_num(11)
c.showPage()

# ================================================================
# SLIDE 12 — CBCT (with image)
# ================================================================
fill_bg(MID_BG)
section_bar("10  CBCT & ADVANCED IMAGING")
txt("CBCT & Advanced Diagnostic Methods", 14, H - 55, size=22, clr=WHITE, bold=True)
add_image(IMGS[3], W - 300, 20, 285, 540)
cbct = [
    ("CBCT — Gold Standard for VRF", "3D volumetric imaging; detects fractures invisible on 2D. Essential for VRF diagnosis and pre-surgical planning.", ACCENT1),
    ("Technical Parameters", "Small FOV (<5 cm); high resolution (0.076–0.125 mm voxel); follow ALARA radiation principle.", ACCENT3),
    ("Diagnostic Accuracy", "Sensitivity 80–90%, specificity >90% for VRF. Markedly superior to periapical radiographs.", BLUE_ACC),
    ("AI in VRF Detection", "CNNs applied to CBCT/periapical images. Early studies show accuracy comparable to specialists.", ACCENT2),
]
for i, (title, body, col) in enumerate(cbct):
    y_top = 75 + i * 120
    card(12, y_top, W - 325, 110, fill=NAVY2, radius=5)
    box(12, H - y_top - 3, 6, 110, col)
    txt(title, 26, H - y_top - 28, size=13, clr=col, bold=True)
    wrap_text(body, 26, H - y_top - 50, W - 350, size=11.5, clr=LGREY)
box(12, 10, W - 325, 38, NAVY2, radius=4)
wrap_text("Additional: Transillumination & staining  •  Optical Coherence Tomography  •  Periodontal 'halo' probing defect",
          20, H - (75 + 4*120) - 28 + 18, W - 345, size=11, clr=LGREY)
slide_num(12)
c.showPage()

# ================================================================
# SLIDE 13 — DIFFERENTIAL DIAGNOSIS (table)
# ================================================================
fill_bg(LIGHT_BG)
left_accent_bar()
txt("Differential Diagnosis", 14, H - 55, size=24, clr=DARK_TXT, bold=True)
headers = ["Condition", "Key Differentiating Features", "Clinching Test"]
col_widths = [175, 400, 230]
col_xs = [14, 195, 601]
row_h = 48

# Header row
box(14, H - 80, W - 28, row_h - 2, DARK_TXT)
for h, cw, cx in zip(headers, col_widths, col_xs):
    txt(h, cx + 4, H - 75, size=11, clr=ACCENT1, bold=True)

rows = [
    ("Vertical Root Fracture", "Deep narrow sinus tract; 'halo' bone loss; cusp-specific bite pain", "CBCT; transillumination"),
    ("Periodontal Disease", "Generalized bone loss; multiple teeth; plaque/calculus", "Full perio chart; OPG"),
    ("External Root Resorption", "Radiolucency outside root contour; vital pulp early on", "PA radiograph; CBCT"),
    ("Internal Root Resorption", "Central radiolucency within canal; asymptomatic", "PA radiograph"),
    ("Cracked Tooth Syndrome", "Pain on biting/release; incomplete crack above CEJ", "Transillumination; bite stick"),
    ("Endo-Perio Lesion", "Combined origin; complex probing pattern", "Sequential treatment response"),
    ("Dens Invaginatus", "Anomalous anatomy from eruption; visible radiographically", "PA radiograph"),
]
for i, (c1, c2, c3) in enumerate(rows):
    bg = LIGHT_BG if i % 2 == 0 else colors.HexColor("#E2EAF4")
    box(14, H - 82 - (i+1)*row_h, W - 28, row_h - 2, bg)
    for text, cw, cx in zip([c1, c2, c3], col_widths, col_xs):
        txt(text, cx + 4, H - 82 - (i+1)*row_h + row_h//2 - 5, size=11, clr=DARK_TXT)
slide_num(13)
c.showPage()

# ================================================================
# SLIDE 14 — MANAGEMENT HORIZONTAL (with image)
# ================================================================
fill_bg(DARK_BG)
section_bar("12  MANAGEMENT: HORIZONTAL ROOT FRACTURES")
txt("Management of Horizontal Root Fractures", 14, H - 55, size=22, clr=WHITE, bold=True)
add_image(IMGS[4], W - 300, 20, 285, 540)
steps = [
    ("1", "Emergency Management", "Reposition displaced coronal fragment gently (within hours). Stabilize. Irrigate, suture lacerations. Analgesia.", ACCENT1),
    ("2", "Repositioning & Splinting", "Rigid splint: cervical third (4 months). Semi-rigid/flexible: mid and apical third (4 weeks). Confirm alignment radiographically.", ACCENT3),
    ("3", "Preferred Splint: TTS", "Titanium Trauma Splint (TTS) + composite resin. Wire-composite splint acceptable. Avoid rigid arch bars >4 weeks.", BLUE_ACC),
    ("4", "Follow-up (IADT 2020)", "Review: 4 weeks, 3 months, 6 months, 1 year, annually x5 years. EPT + radiograph at each visit.", ACCENT2),
]
for i, (num, title, body, col) in enumerate(steps):
    y_top = 75 + i * 120
    card(12, y_top, W - 325, 110, fill=NAVY2, radius=5)
    box(12, H - y_top - 3, 40, 110, col)
    txt(num, 12, H - y_top - 65, size=30, clr=DARK_TXT, bold=True, align="center", max_w=40)
    txt(title, 60, H - y_top - 28, size=13, clr=col, bold=True)
    wrap_text(body, 60, H - y_top - 50, W - 390, size=11.5, clr=LGREY)
slide_num(14)
c.showPage()

# ================================================================
# SLIDE 15 — ENDODONTIC INTERVENTION (with image)
# ================================================================
fill_bg(MID_BG)
section_bar("13  ENDODONTIC INTERVENTION")
txt("Endodontic Intervention After Root Fracture", 14, H - 55, size=22, clr=WHITE, bold=True)
add_image(IMGS[5], W - 300, 20, 285, 540)
endo = [
    ("Indications for RCT", "Pulp necrosis (non-vital EPT, persistent symptoms, pathological resorption, periapical pathology). RCT of CORONAL fragment ONLY.", ACCENT2),
    ("Canal Preparation", "Conservative preparation. Avoid excessive enlargement of apical third. NaOCl + EDTA irrigation. Ca(OH)2 dressing 1-3 months first.", ACCENT1),
    ("MTA Apical Plug", "Mineral Trioxide Aggregate: gold standard for open-apex barrier. Biocompatible, sealing, bacteriostatic. 4-5 mm plug. Single-visit option.", ACCENT3),
    ("Apical Fragment Management", "Usually vital and asymptomatic — retain and monitor. Extraction only if apical fragment also becomes necrotic (rare).", BLUE_ACC),
]
for i, (title, body, col) in enumerate(endo):
    y_top = 75 + i * 120
    card(12, y_top, W - 325, 110, fill=NAVY2, radius=5)
    box(12, H - y_top - 3, 6, 110, col)
    txt(title, 26, H - y_top - 28, size=13, clr=col, bold=True)
    wrap_text(body, 26, H - y_top - 50, W - 350, size=11.5, clr=LGREY)
slide_num(15)
c.showPage()

# ================================================================
# SLIDE 16 — VRF MANAGEMENT (with image)
# ================================================================
fill_bg(DARK_BG)
section_bar("14  MANAGEMENT: VERTICAL ROOT FRACTURES")
txt("Management of Vertical Root Fractures", 14, H - 55, size=22, clr=WHITE, bold=True)
add_image(IMGS[7], W - 300, 20, 285, 540)
vrf_mgmt = [
    ("Single-Rooted Teeth", "Extraction is the standard of care. Progressive periodontal destruction along the fracture line. No reliable conservative option.", ACCENT2),
    ("Multi-Rooted Teeth: Hemisection", "Root resection / hemisection: remove fractured root, retain remainder. Requires sound periodontal support on remaining roots.", ACCENT1),
    ("Intentional Replantation", "Tooth extracted; VRF bonded with MTA/bioceramic resin under magnification; replanted and splinted. Variable success.", ACCENT3),
    ("Bioceramic Repair (Emerging)", "Orthograde internal sealing with MTA/BioAggregate. Very limited evidence; not yet standard of care.", BLUE_ACC),
]
for i, (title, body, col) in enumerate(vrf_mgmt):
    y_top = 75 + i * 120
    card(12, y_top, W - 325, 110, fill=NAVY2, radius=5)
    box(12, H - y_top - 3, 6, 110, col)
    txt(title, 26, H - y_top - 28, size=13, clr=col, bold=True)
    wrap_text(body, 26, H - y_top - 50, W - 350, size=11.5, clr=LGREY)
slide_num(16)
c.showPage()

# ================================================================
# SLIDE 17 — CROWN-ROOT FRACTURES
# ================================================================
fill_bg(LIGHT_BG)
left_accent_bar()
txt("Management of Crown-Root Fractures", 14, H - 55, size=24, clr=DARK_TXT, bold=True)
box(12, H - 88, W - 24, 48, MID_BG, radius=4)
wrap_text("Crown-root fractures involve enamel/dentine of the crown AND the root below the CEJ, frequently extending subgingivally. Goal: re-establish a biologically sound, restorable margin.",
          20, H - 105, W - 40, size=12, clr=LGREY)
crf = [
    ("Orthodontic Extrusion", "Slow extrusion over 4-8 weeks to bring fracture margin supragingival. Gold standard for anterior single subgingival fractures. Preserves bone and aesthetics.", ACCENT1, 12, 110),
    ("Surgical Crown Lengthening", "Osseous and soft tissue surgery to expose fracture margin. Faster than ortho extrusion but may compromise aesthetics anteriorly. Best for posterior teeth.", ACCENT2, W/2 + 3, 110),
    ("Decoronation", "Crown removal; intentional root submergence for alveolar bone preservation in growing patients. Followed by implant once growth complete.", ACCENT3, 12, H/2 - 20),
    ("Extraction + Implant", "When fracture is too apical for conservative management. Immediate implant (if socket adequate) is the definitive solution.", BLUE_ACC, W/2 + 3, H/2 - 20),
]
for title, body, col, bx, by in crf:
    qw = W/2 - 15
    qh = H/2 - 80
    card(bx, by, qw, qh, fill=MID_BG, top_bar_clr=col, radius=6)
    txt(title, bx + 8, H - by - 24, size=13, clr=col, bold=True)
    wrap_text(body, bx + 8, H - by - 46, qw - 16, size=12, clr=LGREY)
slide_num(17)
c.showPage()

# ================================================================
# SLIDE 18 — PEDIATRIC
# ================================================================
fill_bg(MID_BG)
section_bar("16  PEDIATRIC & IMMATURE TEETH")
txt("Root Fractures in Pediatric & Immature Teeth", 14, H - 55, size=22, clr=WHITE, bold=True)
card(12, 72, W/2 - 10, H - 84, fill=NAVY2, top_bar_clr=ACCENT1, radius=6)
txt("Primary Dentition", 20, H - 92, size=13, clr=ACCENT1, bold=True)
bullet_list([
    "Root fractures in primary teeth are rare",
    "Mobile coronal fragment: remove; apical fragment resorbs naturally",
    "Monitor permanent successor for developmental disturbance",
    "Ectopic eruption = earliest sign of damage to tooth germ",
], 20, H - 115, W/2 - 26, size=12.5, clr=LGREY, line_h=19)

card(W/2 + 5, 72, W/2 - 17, H - 84, fill=NAVY2, top_bar_clr=ACCENT2, radius=6)
txt("Immature Permanent Teeth", W/2 + 13, H - 92, size=13, clr=ACCENT2, bold=True)
bullet_list([
    "Open apex allows revascularization — better pulpal prognosis",
    "Apexogenesis (vital pulp therapy): allows continued root development — most desirable",
    "Ca(OH)2 Apexification: monthly dressing changes until calcific barrier forms (9-18 months)",
    "MTA Apical Plug: faster; 4-5 mm plug single visit; allows immediate obturation",
    "Regenerative Endodontic Procedures (REPs): bleeding clot scaffold + MTA barrier — biologically ideal",
], W/2 + 13, H - 115, W/2 - 30, size=12.5, clr=LGREY, line_h=19)
slide_num(18)
c.showPage()

# ================================================================
# SLIDE 19 — POST-ENDO RESTORATION
# ================================================================
fill_bg(LIGHT_BG)
left_accent_bar()
txt("Post-Endodontic Restoration After Root Fracture", 14, H - 55, size=22, clr=DARK_TXT, bold=True)
rest = [
    ("Intracanal Posts — Risks", "Posts do NOT strengthen roots — they can weaken them. Post drilling is a major VRF risk factor. Use only when insufficient coronal tissue. Minimum root: 2x clinical crown height.", ACCENT2, 12, 72),
    ("Passive Fibre Posts", "Parallel-sided, passive, bondable fibre posts preferred. Avoid tapered posts (wedging force). Bond with dual-cure resin cement. Elastic modulus close to dentine.", ACCENT1, W/2 + 3, 72),
    ("Composite Resin Restorations", "When adequate coronal tissue exists: direct composite core + crown. Adhesive composite restorations may reinforce weakened roots.", ACCENT3, 12, H/2 - 20),
    ("Crown Type Selection", "Full-coverage metal-ceramic or all-ceramic crown standard. Endocrown for molars: avoids post space, conservative, excellent long-term results.", BLUE_ACC, W/2 + 3, H/2 - 20),
]
for title, body, col, bx, by in rest:
    qw = W/2 - 15
    qh = H/2 - 78
    card(bx, by, qw, qh, fill=MID_BG, top_bar_clr=col, radius=6)
    txt(title, bx + 8, H - by - 24, size=13, clr=col, bold=True)
    wrap_text(body, bx + 8, H - by - 46, qw - 16, size=12, clr=LGREY)
slide_num(19)
c.showPage()

# ================================================================
# SLIDE 20 — PROGNOSIS (with bar chart)
# ================================================================
fill_bg(DARK_BG)
section_bar("18  PROGNOSIS")
txt("Prognosis of Root Fractures", 14, H - 55, size=24, clr=WHITE, bold=True)
txt("Approximate Long-Term Tooth Retention Rates", 14, H - 80, size=13, clr=LGREY, bold=True)
prog = [("Apical third RF", 80, ACCENT1), ("Middle third RF", 60, ACCENT3),
        ("Cervical third RF", 35, ACCENT2), ("VRF (single-rooted)", 5, ACCENT2)]
bar_start = 185
bar_max_w = W - bar_start - 80
for i, (lbl, pct, col) in enumerate(prog):
    y_bar = H - 105 - i * 55
    txt(lbl, 14, y_bar, size=12.5, clr=WHITE)
    box(bar_start, y_bar - 16, bar_max_w, 22, colors.HexColor("#1E2D3D"), radius=3)
    if pct > 0:
        box(bar_start, y_bar - 16, max(bar_max_w * pct / 100, 8), 22, col, radius=3)
    txt(f"{pct}%", bar_start + bar_max_w * pct / 100 + 8, y_bar, size=12, clr=col, bold=True)

accent_line(14, 340, W - 30)
txt("Key Prognostic Factors", 14, H - 355, size=14, clr=WHITE, bold=True)
bullet_list([
    "Level of fracture (apical > middle > cervical)  •  Diastasis between fragments = worse prognosis",
    "Vital pulp at time of injury = better healing  •  Younger patient = better PDL regeneration",
    "Time to repositioning and splinting  •  Mobility of coronal fragment",
], 14, H - 375, W - 30, size=12.5, clr=LGREY, line_h=18)
slide_num(20)
c.showPage()

# ================================================================
# SLIDE 21 — PREVENTION (3 columns)
# ================================================================
fill_bg(MID_BG)
section_bar("19  PREVENTION")
txt("Prevention of Root Fractures", 14, H - 55, size=24, clr=WHITE, bold=True)
prev_cols = [
    ("During Endodontic Procedures", [
        "Conservative access design (ninja/contracted access)",
        "Avoid over-instrumentation of apical third",
        "No large NiTi rotaries in narrow/oval canals",
        "Warm vertical condensation preferred over cold lateral",
        "Preserve >=5 mm apical gutta-percha seal",
    ], ACCENT1, 12),
    ("Occlusal Considerations", [
        "Screen for bruxism; provide occlusal splint therapy",
        "Adjust occlusion: avoid premature contacts",
        "Avoid cantilever prostheses on compromised roots",
        "Crown coverage of endodontically treated molars/premolars",
    ], ACCENT3, W/3 + 5),
    ("Trauma Prevention", [
        "Custom mouthguards for contact sports (reduce trauma up to 60%)",
        "Fall/accident risk counselling in elderly patients",
        "Dental awareness and education campaigns",
    ], BLUE_ACC, 2*W/3 + 2),
]
col_w = W/3 - 10
for title, pts, col, bx in prev_cols:
    card(bx, 72, col_w, H - 84, fill=NAVY2, top_bar_clr=col, radius=6)
    txt(title, bx + 8, H - 92, size=12.5, clr=col, bold=True)
    bullet_list(pts, bx + 8, H - 115, col_w - 16, size=12, clr=LGREY, line_h=18)
slide_num(21)
c.showPage()

# ================================================================
# SLIDE 22 — FOLLOW-UP
# ================================================================
fill_bg(LIGHT_BG)
left_accent_bar()
txt("Follow-up Protocols & Long-Term Monitoring (IADT 2020)", 14, H - 55, size=20, clr=DARK_TXT, bold=True)
followup = [
    ("4 weeks", "Clinical: mobility, pain, soft tissue. PA radiograph. EPT/cold test. Splint removal (mid/apical third)."),
    ("3 months", "Repeat clinical + radiographic. Assess healing type. Look for resorption or periapical pathology."),
    ("6 months", "Clinical + PA radiograph. PCO (obliteration) is favorable sign. CBCT if VRF still suspected."),
    ("1 year", "Full clinical + radiographic review. Confirm healing type. Remove cervical-third splint if still present."),
    ("Annual x5 years", "Long-term surveillance. Late-onset necrosis can occur up to 5 years post-trauma."),
]
row_h2 = 82
box(14, H - 80 - 5*row_h2, 95, 5*row_h2, MID_BG, radius=4)
txt("TIME\nPOINT", 14, H - 80 - 2*row_h2, size=12, clr=ACCENT1, bold=True, align="center", max_w=95)
for i, (time, actions) in enumerate(followup):
    bg = MID_BG if i % 2 == 0 else NAVY2
    box(115, H - 82 - i*row_h2, W - 129, row_h2 - 4, bg, radius=4)
    txt(time, 14, H - 82 - i*row_h2 + row_h2//2 - 5, size=12, clr=ACCENT1, bold=True, align="center", max_w=95)
    wrap_text(actions, 123, H - 82 - i*row_h2 + row_h2//2 + 4, W - 143, size=12, clr=DARK_TXT)
slide_num(22)
c.showPage()

# ================================================================
# SLIDE 23 — INTERDISCIPLINARY & MEDICOLEGAL
# ================================================================
fill_bg(MID_BG)
section_bar("21–22  INTERDISCIPLINARY & MEDICOLEGAL")
txt("Interdisciplinary & Medicolegal Aspects", 14, H - 55, size=22, clr=WHITE, bold=True)
col_w2 = W/2 - 15
card(12, 72, col_w2, H - 84, fill=NAVY2, top_bar_clr=ACCENT1, radius=6)
txt("Interdisciplinary Management", 20, H - 92, size=13, clr=ACCENT1, bold=True)
bullet_list([
    "Oral Surgery: extraction, socket management, implant planning",
    "Periodontology: perio therapy; crown lengthening for CRF",
    "Orthodontics: forced eruption; space management post-extraction",
    "Prosthodontics: implant restorations; FPD design",
    "Paediatric Dentistry: primary dentition; monitoring successors",
    "Emergency Medicine: triage, acute pain, referral (IADT / Tintinalli)",
], 20, H - 115, col_w2 - 16, size=12.5, clr=LGREY, line_h=19)

card(W/2 + 3, 72, col_w2, H - 84, fill=NAVY2, top_bar_clr=ACCENT2, radius=6)
txt("Medicolegal Considerations", W/2 + 11, H - 92, size=13, clr=ACCENT2, bold=True)
bullet_list([
    "VRF from endodontic / post procedures: potential iatrogenic liability",
    "Documentation: pre-op radiographs, informed consent, technique notes",
    "Failure to diagnose VRF: has led to successful negligence claims",
    "Misattribution: document differential between VRF and perio disease",
    "IADT guidelines = standard of care; deviation requires justification",
    "Expert witness standard: Tamse, Berman & Katz (Ingle's Endodontics)",
], W/2 + 11, H - 115, col_w2 - 16, size=12.5, clr=LGREY, line_h=19)
slide_num(23)
c.showPage()

# ================================================================
# SLIDE 24 — REFERENCES
# ================================================================
fill_bg(LIGHT_BG)
left_accent_bar()
txt("Key Evidence Base & References", 14, H - 55, size=24, clr=DARK_TXT, bold=True)
refs = [
    ("Andreasen et al., 2004", "Landmark longitudinal cohort — healing patterns in 400 horizontal root fractures. Established 4 healing types.", "Dental Traumatology"),
    ("Tamse & Berman (Ingle's 7th Ed, 2019)", "Comprehensive VRF chapter — epidemiology, etiology, diagnosis & management.", "Ingle's Endodontics"),
    ("Bourguignon et al., 2020", "IADT 2020 Guidelines for traumatic dental injuries. Current standard of care for root fracture management.", "Dental Traumatology 36(4)"),
    ("Patel, Bhuva & Bose, 2022", "VRF prevalence and diagnosis in root-filled teeth — systematic review.", "Intl Endodontic Journal"),
    ("Haupt, Wiegand & Kanzow, 2023", "Meta-analysis (14 studies, 2,877 teeth): VRF risk factors. No single factor independently predictive.", "Journal of Endodontics"),
    ("Cohen's Pathways of the Pulp, 12th Ed", "Traumatic injuries chapter; pulpal response; healing classifications.", "Elsevier"),
    ("Tintinalli's Emergency Medicine, 9th Ed", "Dentoalveolar trauma management; IADT-consistent management protocols.", "McGraw-Hill"),
]
row_h3 = 63
for i, (auth, title, journal) in enumerate(refs):
    bg = LIGHT_BG if i % 2 == 0 else colors.HexColor("#E2EAF4")
    box(14, H - 82 - i*row_h3, W - 28, row_h3 - 3, bg)
    txt(auth, 20, H - 82 - i*row_h3 + row_h3 - 22, size=11, clr=colors.HexColor("#2E4A7A"), bold=True)
    wrap_text(title, 20, H - 82 - i*row_h3 + row_h3 - 40, 500, size=11, clr=DARK_TXT)
    c.setFillColor(SUB_CLR)
    c.setFont("Helvetica-Oblique", 10)
    c.drawRightString(W - 20, H - 82 - i*row_h3 + row_h3 - 30, journal)
slide_num(24)
c.showPage()

# ================================================================
# SLIDE 25 — CONCLUSIONS
# ================================================================
fill_bg(DARK_BG)
box(0, 0, 10, H, ACCENT1)
# Decorative circle
c.setFillColor(colors.HexColor("#0D2540"))
c.circle(W - 130, H//2 - 20, 160, fill=1, stroke=0)
txt("CONCLUSIONS &", 18, H - 100, size=44, clr=WHITE, bold=True)
txt("FUTURE PERSPECTIVES", 18, H - 155, size=44, clr=ACCENT1, bold=True)
accent_line(18, 170, 550)
bullet_list([
    "Root fractures range from manageable apical fractures to devastating VRFs requiring extraction",
    "Biological healing IS possible — correct repositioning and semi-rigid splinting are cornerstones of care",
    "CBCT has transformed VRF diagnosis; AI-assisted imaging is the next clinical frontier",
    "MTA and bioceramic materials have expanded treatment options, especially for immature teeth",
    "Prevention through conservative endodontics is more powerful than any treatment strategy",
    "IADT 2020 guidelines provide the current evidence-based standard of care",
    "Future: regenerative endodontics, nanotechnology-enhanced bioceramics, and AI will reshape the field",
], 18, H - 195, W - 300, size=13.5, clr=LGREY, line_h=20)
box(0, 0, W, 42, NEAR_BLK)
txt("Thank you  |  Questions Welcome  |  Root Fractures & Their Management — Seminar 2026",
    0, 15, size=12, clr=SUB_CLR, align="center", max_w=W)
slide_num(25)
c.showPage()

# ================================================================
# SAVE
# ================================================================
c.save()
import os
size = os.path.getsize(out_path)
print(f"Saved: {out_path}")
print(f"Size: {size/1024/1024:.1f} MB")
print("Pages: 25")