Sunday, August 31, 2014

Inferior alveolar nerve block- mcq review

During an inferior alveolar nerve block the needle ideally passes
a) posterior and medial to medial pterygoid.
b) anterior and lateral to medial pterygoid.
c) through medial pterygoid.
d) inferior to medial pterygoid.




Saturday, August 30, 2014

SAQS for Dentistry- Anatomical landmarks in maxilla


Anatomical landmarks in maxilla

 Limiting structures

Labial frenum
Single band of fibrous connective tissue, must be properly relieved.
Labial vestibule
Extends from labial frenum to buccal frenum. Proper lip support should be provided.
 Buccal frenum
Consist of one or more bands. Must be Relieved
Influenced by 3 muscles-  Orbicularis oris (forward), Buccinator (backward),  Caninus (position)
Buccal vestibule
Buccal frenum to hamular notch
Influenced by Buccinator, Modiolus, Coronid process of mandible
Hamular notch
Pterygomaxillary notch, Distal extension of denture ,Situated between the tuberosity and hamulus of the medial pterygoid plate.
Posterior palatal seal area
the soft tissues along the junction of the hard and soft palates on which pressure within the physiologic limits of the tissues can be applied by a denture to aid in the retention of the denture.
Synonyms: post dam area, postpalatal seal area

Supporting structures

Hard palate
Flat areas as secondary retentive areas.
Flat palate (not good support), V shaped palate (least favorable).
Residual ridge
Ridge left after the extraction of teeth. Mucosa is firmly attached to the periosteum of the bone. Consist of dense collagenous fibers.
Considered as a secondary stress-bearing area  because it is subject to resorption contrary to horizontal portion of hard palate.
Palatal rugae
Resist the horizontal forces against the denture, Should not be over  compressed.

Relief areas

 Incisive papilla
Pad of fiberous connective tissue over incisive foramen, Proper relief should be given.
Aid in arrangement of anterior teeth and jaw relation.
 Mid palatine raphe
Junction of palatine process of maxilla. Covered by a thin mucosa, Slightly elevated or raised.
Proper relief required.
Fovea palatine
Formed by coalescence of several mucous gland ducts. Landmark for location of vibrating line.

Maxillary Tuberosity
The medial & lateral walls resist the horizontal and torquing forces which would move the denture base in lateral or palatal direction.
Therefore, maxillary denture base should cover the tuberosities and fill the hamular notches.  

Sunday, August 24, 2014

MANDIBULAR FRACTURES MCQ REVIEW


TYPE OF FRACTURE
Simple
Includes a closed linear fractures of the condyle, coronoid, ramus and edentulous body of the mandible.
Compound
Fractures of tooth bearing portions of the mandible, into d mouth via the periodontal membrane and at times through the overlying skin.
Communited
Usually compound fractures characterized by fragmentation of bone
Pathological
Results from an already weakened mandible by pathological conditions.

SITE OF FRACTURE
Dentoalveolar
Condyle
Coronoid
Ramus
Angle
Body (molar and premolar areas)
Parasymphysis
Symphysis

CAUSES OF GINGIVAL RECESSION MCQ REVIEW


What  is Periodontal fremitus
Periodontal fremitus occurs in either of the alveolar bones when an individual sustains trauma from occlusion. It is a result of teeth exhibiting at least slight mobility rubbing against the adjacent walls of their sockets, the volume of which has been expanded ever so slightly by inflammatory responses, bone resorption or both. As a test to determine the severity of periodontal disease, a patient is told to close his or her mouth into maximum intercuspation and is asked to grind his or her teeth ever so slightly. Fingers placed in the labial vestibule against the alveolar bone can detect fremitus.

Thursday, August 21, 2014

Best of fives for dentistry- Sjögren's syndrome mcq review

                                                           Sjögren's syndrome




What is CREST?
CREST is a form of Systemic Sclerosis (scleroderma) which is characterized by Calcinosis (calcium deposits), usually in the fingers; Raynaud's;loss of muscle control of the Esophagus, which can cause difficulty swallowing; Sclerodactyly, a tapering deformity of the bones of the fingers; and Telangiectasia, small red spots on the skin of the fingers, face, or inside of the mouth. (Also see: What is Scleroderma?, Types of Scleroderma and Systemic Symptoms)
Calcinosis            Raynaud's              Esophagus            Sclerodactyly            Telangiectasia
It takes only two of the five CREST symptoms for a diagnosis of  CREST (either "pure" or "plus") to be made. For example, a patient with Calcinosis and Raynaud's would have CREST (which for precision may also be written as CRest, but it is CREST nonetheless.)

CALCINOSIS
The systemic forms of scleroderma can cause small white calcium lumps to form under the skin on fingers or other areas of the body.
This is called calcinosis . The lumps may break through the skin and leak a chalky white liquid.
These most commonly occur on the hands, or near joints such as elbows or knees, although they may appear anywhere.

Raynaud's
Raynaud's is a vascular disorder commonly found in sclerodema. It is an extreme spasm of blood vessels in response to cold or stress. The fingers and/or toes become white and/or blue, and may become red on re-warming.

sclerodactyly
When the skin on the fingers become tight, stretched, wax-like, and hardened it is called sclerodactyly. Sclerodactyly is commonly associated with atrophy of the underlying soft tissues.

Telangiectasia are dilated superficial blood vessels

Sunday, August 17, 2014

Candidosis mcq review


ANTIFUNGAL AGENTS


ANTIFUNGAL  AGENTS

Most fungal infections in the oral cavity are due to Candida species,
most commonly Candida albicans.
Where candidosis is related to dentures, denture hygiene  instruction should be stressed. Non-metal dentures should be soaked regularly overnight in sodium hypochlorite 1% (Milton’s solution) and metal-containing dentures similarly in chlorhexidine 0.2% solution.
Nystatin and amphotericin (polyenes)
These agents attach to the fungal cell membrane and disrupt fluid and electrolyte permeability. They are not absorbed from the GI tract and hence act locally .
        Dosage regimens for nystatin and amphotericin
Nystatin
Pastilles 100 000 units
Oral suspension 100 000 units/ml
Ointment/cream 100 000 units/g
Amphotericin
Lozenges 10mg
Oral suspension 100 mg/ml
Miconazole (an imidazole)
Similar action to the polyenes. Effective against some Gram-positive
bacteria such as Staph. aureus. More effective than polyenes in angular cheilitis due to possible mixed fungal/bacterial infection.
Available as oral gel, cream and in combination with hydrocortisone.
Oral gel (25 mg/ml) 5–10 ml held over area affected (after food) or applied to fitting surface of upper denture for the treatment of denture stomatitis (chronic erythematous candidosis).
Cream (2%) Apply to angles of lips 2–3 times daily. Cream or ointment (2%) with hydrocortisone (1%) Apply to angles of lips 2–3 times daily. May be useful for clearing long-standing angular cheilitis but should not be used for longer than 10 days.
Fluconazole (a triazole)
This systemically acting agent inhibits fungal enzymes concerned
with ergosterol synthesis. It appears to have low systemic toxicity.
Form Capsules (50 mg) and oral suspension (50 mg/5 ml). Dose 50 mg daily for 7–14 days. Higher doses will be required in immune compromised patients.
Cautions Avoid in renal disease, pregnancy and lactation, children.
Side effects Nausea, diarrhea and allergic manifestations are the most serious effects.
Main interactions are with antihistamines, oral hypoglycaemic agents and warfarin.
Itraconazole is another potent triazole antifungal agent.

Saturday, August 16, 2014

Kaposi's sarcoma


giant cell arteritis


Orofacial granulomatosis MCQ review


Bilateral parotid swelling MCQ review




Trigeminal Neuralgia mcq review


best of five in dentistry review

Recurrent herpes(herpes labialis)

                                                  Giant cell arteritis


                                              Burning mouth syndrome



Thursday, August 14, 2014

Best of five Review - Angular cheilitis


Angular cheilitis

Angular cheilitis is a combined staphylococcal, streptococcal, and candidal infection, involving the tissues at the angle of the mouth, often with an underlying precipitating factor, e.g. iron deficiency and B12 deficiency anaemia. Therefore, haematological deficiency should be investigated with a FBC red cell folate, B12, and glucose.

Anecdote suggests an inadequate OVD can also predispose, but correction of this alone will not resolve the condition. Often associated with chronic atrophic candidosis. Clinically, see red, cracked, macerated skin at angles of the mouth, often with a gold crust.

Infecting organisms can be identified on culture of swabs of the area, although it is usual to make a clinical diagnosis.

Rx: miconazole cream, which is active against all three infecting organisms. Rx needs to be prolonged, up to 10 days after resolution of clinical lesion, and carried out in conjunction with elimination of any underlying factors.

Unless the classic golden yellow crusts associated with S. aureus are present, treatment should be commenced with antifungal drugs, e.g. a combined miconazole/hydrocortisone cream (miconazole has some antibacterial properties).

When clinical features indicate S. aureus infection, fusidic acid cream is appropriate. If intra-oral candidiasis is present, this must be treated concurrently or recurrence of the angular stomatitis will occur. Iron deficiency is a significant aetiological factor in angular cheilitis.



Patterson–Brown-Kelly syndrome (Plummer–Vinson syndrome)
Dysphagia (due to a post-cricoid candida web), microcytic
hypochromic anaemia, koilonychia and angular cheilitis (secondary to the anaemia)

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