NEET MDS Synopsis
Behavioral Traits Associated with Parenting Styles
PedodonticsBehavioral Traits Associated with Parenting Styles
Various behavioral traits that can be associated with different parenting
styles:
Overprotective: Children may become dominant, shy,
submissive, or anxious due to excessive protection.
Overindulgent: This can lead to aggressive, demanding
behavior, and frequent temper tantrums, but may also foster affectionate
traits.
Rejecting: Children may appear well-behaved but can
struggle with cooperation, often being shy and crying easily.
Authoritarian: This style may result in aggressive,
overactive, and disobedient behavior, with children being evasive and
dawdling.
RESPIRATORY DISORDERS - Bronchitis
Physiology
Bronchitis = Irreversible Bronchioconstriction
. Causes - Infection, Air polution, cigarette smoke
a. Primary Defect = Enlargement & Over Activity of Mucous Glands, Secretions very viscous
b. Hypertrophy & hyperplasia, Narrows & Blocks bronchi, Lumen of airway, significantly narrow
c. Impaired Clearance by mucocillary elevator
d. Microorganism retension in lower airways,Prone to Infectious Bronchitis, Pneumonia
e. Permanent Inflamatory Changes IN epithelium, Narrows walls, Symptoms, Excessive sputum, coughing
f. CAN CAUSE EMPHYSEMA
Denture Teeth
Dental Materials
Denture Teeth
Use-complete or partial dentures
Type
a. Porcelain teeth
b. Acrylic resin teeth
c. Abrasion-resistant teeth (microfilled composite)
Structure and properties
1. Porcelain teeth (high-fusing porcelain)
Only bonded into denture base mechanically. Harder than natural teeth or other restorations and abrades those surfaces. Good aesthetics.Used when patients have good ridge support and sufficient room between the arches
2. Acrylic resin teeth (PMMA [polymethyl methacrylate])
Bonded pseudochemically into the denture base. Soft and easily worn by abrasive foods . Good initial aesthetics
Used with patients with poor ridges and in cases where they oppose natural teeth
3. Abrasion-resistant teeth (microfilled resins)
Bonded pseudochemically into the denture base.Better abrasion resistance then acrylic resin teeth
Urinary tract infection
General Pathology
Urinary tract infection
Most often caused by gram-negative, rod-shaped bacteria that are normal residents of the enteric tract, especially Escherichia coli.
Clinical manifestations:
frequent urination, dysuria, pyuria (increased PMNs), hematuria, and bacteriuria.
May lead to infection of the urinary bladder (cystitis) or kidney (pyelonephritis).
Glass Ionomer Cement
Conservative DentistryComposition of Glass Ionomer Cement (GIC) Powder
Glass Ionomer Cement (GIC) is a widely used dental material known for its
adhesive properties, biocompatibility, and fluoride release. The powder
component of GIC plays a crucial role in its setting reaction and overall
performance. Below is an overview of the typical composition of GIC powder.
1. Basic Components of GIC Powder
A. Glass Powder
Fluorosilicate Glass: The primary component of GIC
powder is a specially formulated glass, often referred to as fluorosilicate
glass. This glass is composed of:
Silica (SiO₂): Provides the structural framework of
the glass.
Alumina (Al₂O₃): Enhances the strength and
stability of the glass.
Calcium Fluoride (CaF₂): Contributes to the
fluoride release properties of the cement, which is beneficial for
caries prevention.
Sodium Fluoride (NaF): Sometimes included to
further enhance fluoride release.
Barium or Strontium Oxide: May be added to improve
radiopacity, allowing for better visibility on radiographs.
B. Other Additives
Modifiers: Various modifiers may be added to the glass
powder to enhance specific properties, such as:
Zinc Oxide (ZnO): Can be included to improve the
mechanical properties and setting characteristics.
Titanium Dioxide (TiO₂): Sometimes added to enhance
the aesthetic properties and opacity of the cement.
2. Properties of GIC Powder
A. Reactivity
The glass powder reacts with the acidic liquid component (usually
polyacrylic acid) to form a gel-like matrix that hardens over time. This
reaction is crucial for the setting and bonding of the cement to tooth
structure.
B. Fluoride Release
One of the key benefits of GIC is its ability to release fluoride ions
over time, which can help in the prevention of secondary caries and promote
remineralization of the tooth structure.
C. Biocompatibility
GIC powders are designed to be biocompatible, making them suitable for
use in various dental applications, including restorations, liners, and
bases.
Glass Ionomer Cement (GIC) Powder-Liquid Composition
Glass Ionomer Cement (GIC) is a widely used dental material known for its
adhesive properties, biocompatibility, and fluoride release. The composition of
GIC involves a powder-liquid system, where the liquid component plays a crucial
role in the setting and performance of the cement. Below is an overview of the
composition of GIC liquid, its components, and their functions.
1. Composition of GIC Liquid
A. Basic Components
The liquid component of GIC is primarily an aqueous solution containing
various polymers and copolymers. The typical composition includes:
Polyacrylic Acid (40-50%):
This is the primary component of the liquid, providing the acidic
environment necessary for the reaction with the glass powder.
It may also include Itaconic Acid and Maleic
Acid, which enhance the properties of the cement.
Tartaric Acid (6-15%):
Tartaric acid is added to improve the handling characteristics of
the cement and increase the working time.
It also shortens the setting time, making it essential for clinical
applications.
Water (30%):
Water serves as the solvent for the other components, facilitating
the mixing and reaction process.
B. Modifications to Improve Performance
To enhance the performance of the GIC liquid, several modifications are made:
Addition of Itaconic and Tricarboxylic Acids:
Decrease Viscosity: These acids help lower the
viscosity of the liquid, making it easier to handle and mix.
Promote Reactivity: They enhance the reactivity
between the glass powder and the liquid, leading to a more effective
setting reaction.
Prevent Gelation: By reducing hydrogen bonding
between polyacrylic acid chains, these acids help prevent gelation of
the liquid over time.
Polymaleic Acid:
Often included in the liquid, polymaleic acid is a stronger acid
than polyacrylic acid.
It accelerates the hardening process and reduces moisture
sensitivity due to its higher number of carboxyl (COOH) groups, which
promote rapid polycarboxylate crosslinking.
This allows for the use of more conventional, less reactive glasses,
resulting in a more aesthetic final set cement.
2. Functions of Liquid Components
A. Polyacrylic Acid
Role: Acts as the primary acid that reacts with the
glass powder to form the cement matrix.
Properties: Provides adhesion to tooth structure and
contributes to the overall strength of the set cement.
B. Tartaric Acid
Role: Enhances the working characteristics of the
cement, allowing for better manipulation during application.
Impact on Setting: While it increases working time, it
also shortens the setting time, requiring careful management during clinical
use.
C. Water
Role: Essential for dissolving the acids and
facilitating the chemical reaction between the liquid and the glass powder.
Impact on Viscosity: The water content helps maintain
the appropriate viscosity for mixing and application.
3. Stability and Shelf Life
Viscosity Changes: The viscosity of tartaric
acid-containing cement generally remains stable over its shelf life.
However, if the cement is past its expiration date, viscosity changes may
occur, affecting its handling and performance.
Storage Conditions: Proper storage conditions are
essential to maintain the integrity of the liquid and prevent degradation.
Antianginal Drugs
Pharmacology
Antianginal Drugs
Organic Nitrates :
Short acting: Glyceryl trinitrate (Nitroglycerine, GTN), Amyl Nitrate
Long Acting: Isosrbide dinitrate (Short acting by sublingual route), Erythrityl tetranitrate, penta erythrityl tetranitrate
Beta-adrenergic blocking agents : Propanolol, Metoprolol
Calcium channel blockers Verapamil, Nifedipine, Dipyridamole
Mechanism of action
– Decrease myocardial demand
– increase blood supply to the myocardium
COENZYMES
Biochemistry
COENZYMES
Enzymes may be simple proteins, or complex enzymes.
A complex enzyme contains a non-protein part, called as prosthetic group (co-enzymes).
Coenzymes are heat stable low molecular weight organic compound. The combined form of protein and the co-enzyme are called as holo-enzyme. The heat labile or unstable part of the holo-enzyme is called as apo-enzyme. The apo-enzyme gives necessary three dimensional structures required for the enzymatic chemical reaction.
Co-enzymes are very essential for the biological activities of the enzyme.
Co-enzymes combine loosely with apo-enzyme and are released easily by dialysis. Most of the co-enzymes are derivatives of vitamin B complex
Chronic Osteomyelitis
Oral Pathology
Chronic Osteomyelitis
As soon as pus drains intra or extraorally, condition ceases to spread and chronic phase commences.
Infection is localized but persistent as bacteria are able to grow in dead bone inaccessible to body’s defenses.
Clinical features
Primary – insidious in onset , slight pain , gradual increase in jaw size.
Secondary - Pain is deep pain and intermittent, temperature fluctuations , pyrexia , cellulitis eventually leading to abscess
New bone formation leads to thickening causing facial asymmetry.
Thickened or “wooden” character of bone in cr sec osteomyelitis.
Eventually cures itself as the last sequestra is discharged.
Radiographic Features
Trabeculae in the involved area become thin or appear fuzzy & then lose their continuity.
After some time “moth eaten” appearance is seen
Sequestra appear denser on radiographs.
Where the subperiosteal new bone formation , the new bone is superimposed upon that of jaw, “fingerprint” or “orange peel” appearance is seen
Cloacae seen as dark shadows passing through opacity.
Histologic features
Areas of acute and subacute inflammation in the cancellous spaces of the necrotic bone.
Foci of acute inflammation
Active osteoclastic resorption of bone noted in peripheral portions
Chronic Subperiosteal Osteomyelitis
Cortical plate deprived of its blood supply undergoes necrosis, underlying medullary bone is slightly affected.
Multiple small sequestra form, eventually discharged through sinuses with pus.
Following extrusion of sequestra, healing occurs.
Spontaneous drainage poor in submassetric area.
Much of body of mandible is lost due to poor central blood supply of the region.
D/D
Paget’s disease – particularly wen periosteal bone is involved
Fibrous dysplasia
Osteosarcoma
Chronic sclerosing osteomyelitis
– focal
- diffuse
Focal Sclerosing Osteomyelitis
Clinical features
Most commonly in children and young adults, rarely in older individuals.
Tooth most commonly involved is the mandibular third molar presenting with a large carious lesion.
No signs or symptoms other than mild pain associated with infected pulp.
Radiographic features
Entire root outline always visible with intact lamina dura.
Periodontal ligament space widened.
Border smooth & distinct appearing to blend into surrounding bone
D/D for focal sclerosing osteomyelitis
Local bone sclerosis
Sclerosing cementoma
Gigantiform cementoma
Treatment & prognosis
Affected tooth may be treated endodontically or extracted.
Sclerotic bone not attached to tooth and remains behind after tooth is removed.
This dense area may not get remodeled.
Recognizable on bone years later and is referred as bone scar.
Diffuse Sclerosing Osteomyelitis
May occur at any age, most common in older persons, esp in edentulous mandibles
vague pain, unpleasant taste.
Many times spontaneous formation of fistula seen opening onto mucosal surface to establish drainage
Slowly progressive, not particularly dangerous since it is non destructive & seldom produces complications
Radiographic features
Diffuse patchy, sclerosis of bone – “cotton wool” appearance
Radiopacity may be extensive and bilateral.
Due to diffuse nature, border between sclerosis & normal bone is often indistinct
D/D for DIFFUSE sclerosing osteomyelitis
FLORID OSSEOUS DYSPLASIA
SCLEROTIC CEMENTAL MASSES
TRUE CHR DIFFUSE SCLEROSING OSTEOMYELITIS
FIBROUS DYSPLASIA
Treatment & Prognosis
Resolution of adjacent foci of chronic infection often leads to improvement.
Usually too extensive to be removed surgically,
Acute episodes treated with antibiotics.