NEET MDS Synopsis
Modified Gingival Index
PeriodontologyModified Gingival Index (MGI)
The Modified Gingival Index (MGI) is a clinical tool used to assess the
severity of gingival inflammation. It provides a standardized method for
evaluating the health of the gingival tissues, which is essential for diagnosing
periodontal conditions and monitoring treatment outcomes. Understanding the
scoring criteria of the MGI is crucial for dental professionals in their
assessments.
Scoring Criteria for the Modified Gingival Index (MGI)
The MGI uses a scale from 0 to 4 to classify the degree of gingival
inflammation. Each score corresponds to specific clinical findings:
Score 0: Absence of Inflammation
Description: No signs of inflammation are present
in the gingival tissues.
Clinical Significance: Indicates healthy gingiva
with no bleeding or other pathological changes.
Score 1: Mild Inflammation
Description:
Slight change in color (e.g., slight redness).
Little change in texture of any portion of the marginal or
papillary gingival unit, but not affecting the entire unit.
Clinical Significance: Suggests early signs of
gingival inflammation, which may require monitoring and preventive
measures.
Score 2: Mild Inflammation (Widespread)
Description:
Similar criteria as Score 1, but involving the entire marginal
or papillary gingival unit.
Clinical Significance: Indicates a more widespread
mild inflammation that may necessitate intervention to prevent
progression.
Score 3: Moderate Inflammation
Description:
Glazing of the gingiva.
Redness, edema, and/or hypertrophy of the marginal or papillary
gingival unit.
Clinical Significance: Reflects a moderate level of
inflammation that may require active treatment to reduce inflammation
and restore gingival health.
Score 4: Severe Inflammation
Description:
Marked redness, edema, and/or hypertrophy of the marginal or
papillary gingival unit.
Presence of spontaneous bleeding, congestion, or ulceration.
Clinical Significance: Indicates severe gingival
disease that requires immediate intervention and may be associated with
periodontal disease.
Clinical Application of the MGI
Assessment of Gingival Health:
The MGI provides a systematic approach to evaluate gingival health,
allowing for consistent documentation of inflammation levels.
Monitoring Treatment Outcomes:
Regular use of the MGI can help track changes in gingival health
over time, assessing the effectiveness of periodontal treatments and
preventive measures.
Patient Education:
The MGI can be used to educate patients about their gingival health
status, helping them understand the importance of oral hygiene and
regular dental visits.
Research and Epidemiological Studies:
The MGI is often used in clinical research to evaluate the
prevalence and severity of gingival disease in populations.
Lip Bumper
OrthodonticsLip Bumper
A lip bumper is an orthodontic appliance designed to create
space in the dental arch by preventing the lips from exerting pressure on the
teeth. It is primarily used in growing children and adolescents to manage dental
arch development, particularly in cases of crowding or to facilitate the
eruption of permanent teeth. The appliance is typically used in the lower arch
but can also be adapted for the upper arch.
Indications for Use
Crowding:
To create space in the dental arch for the proper alignment of
teeth, especially when there is insufficient space for the eruption of
permanent teeth.
Anterior Crossbite:
To help correct anterior crossbites by allowing the anterior teeth
to move into a more favorable position.
Eruption Guidance:
To guide the eruption of permanent molars and prevent them from
drifting mesially, which can lead to malocclusion.
Preventing Lip Pressure:
To reduce the pressure exerted by the lips on the anterior teeth,
which can contribute to dental crowding and misalignment.
Space Maintenance:
To maintain space in the dental arch after the premature loss of
primary teeth.
Design and Features
Components:
The lip bumper consists of a wire framework that is typically made
of stainless steel or other durable materials. It includes:
Buccal Tubes: These are attached to the molars
to anchor the appliance in place.
Arch Wire: A flexible wire that runs along the
buccal side of the teeth, providing the necessary space and support.
Lip Pad: A soft pad that rests against the
lips, preventing them from exerting pressure on the teeth.
Customization:
The appliance is custom-fitted to the patient’s dental arch to
ensure comfort and effectiveness. Adjustments can be made to accommodate
changes in the dental arch as treatment progresses.
Mechanism of Action
Space Creation:
The lip bumper creates space in the dental arch by pushing the
anterior teeth backward and allowing the posterior teeth to erupt
properly. The lip pad prevents the lips from applying pressure on the
anterior teeth, which can help maintain the space created.
Guiding Eruption:
By maintaining the position of the molars and preventing mesial
drift, the lip bumper helps guide the eruption of the permanent molars
into their proper positions.
Facilitating Growth:
The appliance can also promote the growth of the dental arch,
allowing for better alignment of the teeth as they erupt.
SULPHONAMIDES
Pharmacology
SULPHONAMIDES
Derivative of sulphonilamide (Para-amino Benzene (PABA ) sulphonamide).
Anti-bacterial spectrum
Bacteriostatic to gram + and gram - bacteria. but bactericidal concentrations arce attained in urine. S pyogencs. H influenzae.E coli, few- Staph aureus. gonococci. pneumococci, proteus, shigella and Lymphogranuloma venereum.
Mechanism of action
Inhibits bacterial folate synthetase as they compete with PABA
Less soluble in acid urine and may precipitate to cause crystalluria.
Accumulate in patients with renal failure and can cause toxicity
Classification
Shart Acting (4-8 Hrs) sulphadiazine, sulphamethizole.
Intermediate acting(8-16 Hrs): sulphamethoxazole , sulphaphenazole
Long Acting(l-7days): sulphamethoxypyridazine.
Ultralong Acting(3-8days): sulfaline
Adverse effects
I. nausea, vomiting and epigastric pain
2. crystalluria
3. hypersensitivity-like polyarthritis nodosa. Steven-Johnson Syndrome. photosenstivity
4.hemolysis in G-6PD deficiency
5. kernicterus
They inhibit metabolism of phenytoin. tolbutamide. methotrexate
Therapeutic Use
UTI Meningitis, Streptococcal pharyngitis, Bacillary Dysentery
Human tooth development - Permanent
Dental Anatomy
Maxillary (upper) teeth
Permanent teeth
Central
incisor
Lateral
incisor
Canine
First
premolar
Second
premolar
First
molar
Second
molar
Third
molar
Initial calcification
3–4 mo
10–12 mo
4–5 mo
1.5–1.75 yr
2–2.25 yr
at birth
2.5–3 yr
7–9 yr
Crown completed
4–5 yr
4–5 yr
6–7 yr
5–6 yr
6–7 yr
2.5–3 yr
7–8 yr
12–16 yr
Root completed
10 yr
11 yr
13–15 yr
12–13 yr
12–14 yr
9–10 yr
14–16 yr
18–25 yr
Mandibular (lower) teeth
Initial calcification
3–4 mo
3–4 mo
4–5 mo
1.5–2 yr
2.25–2.5 yr
at birth
2.5–3 yr
8–10 yr
Crown completed
4–5 yr
4–5 yr
6–7 yr
5–6 yr
6–7 yr
2.5–3 yr
7–8 yr
12–16 yr
Root completed
9 yr
10 yr
12–14 yr
12–13 yr
13–14 yr
9–10 yr
14–15 yr
18–25 yr
Serum Proteins
PhysiologySerum Proteins
Proteins make up 6–8% of the blood. They are about equally divided between serum albumin and a great variety of serum globulins.
After blood is withdrawn from a vein and allowed to clot, the clot slowly shrinks. As it does so, a clear fluid called serum is squeezed out. Thus:
Serum is blood plasma without fibrinogen and other clotting factors.
The serum proteins can be separated by electrophoresis.
The most prominent of these and the one that moves closest to the positive electrode is serum albumin.
Serum albumin
is made in the liver
binds many small molecules for transport through the blood
helps maintain the osmotic pressure of the blood
The other proteins are the various serum globulins.
alpha globulins (e.g., the proteins that transport thyroxine and retinol [vitamin A])
beta globulins (e.g., the iron-transporting protein transferrin)
gamma globulins.
Gamma globulins are the least negatively-charged serum proteins. (They are so weakly charged, in fact, that some are swept in the flow of buffer back toward the negative electrode.)
Most antibodies are gamma globulins.
Therefore gamma globulins become more abundant following infections or immunizations.
Spruing Technique
Dental Materials
Spruing Technique:
Direct Spruing:
The flow of the molten metal is straight(direct) from the casting crucible to pattern area in the ring. Even with the ball reservoir, the Spruing method is still direct. A basic weakness of direct Spruing is the potential for suck-back porosity at the junction of restoration and the Sprue.
Indirect Spruing:
Molten alloy does not flow directly from the casting crucible into the pattern area, instead the alloy takes a circuitous (indirect) route. The connector (or runner) bar is often used to which the wax pattern Sprue formers area attached. Indirect Spruing offers advantages such as greater reliability & predictability in casting plus enhanced control of solidification shrinkage .The Connector bar is often referred to as a “reservoir .
Armamentarium :
1 . Sprue
2 . Sticky wax
3 . Rubber crucible former
4 . Casting ring
5 . Pattern cleaner
6 . Scalpel blade & Forceps
7 . Bunsen burner
Nitrous Oxide
Pharmacology
Nitrous Oxide (N2O)
MAC 100%, blood/gas solubility ratio 0.47
- An inorganic gas., low solubility in blood, but greater solubility than N2
- Inflammable, but does support combustion.
- Excreted primarily unchanged through the lungs.
- It provides amnesia and analgesia when administered alone.
- Does not produce muscular relaxation.
- Less depressant to both the cardiovascular system and respiratory system than most of the other inhalational anesthetics.
- Lack of potency and tendency to produce anoxia are its primary limitations.
- The major benefit of nitrous oxide is its ability to reduce the amount of the secondary anesthetic agent that is necessary to reach a specified level of anesthesia.
Megaloblastic anaemia
General Pathology
Megaloblastic anaemia
Metabolism: B12(cyanocobalamin) is a coenzyme in DNA synthesis and for maintenance of nervous system. Daily requirement 2 micro grams. Absorption in terminal ileum in the presence gastric intrinsic factor. It is stored in liver mainly-
Folic acid (Pteroylglutamic acid) is needed for DNA synthesis.. Daily requirement 100 micro grams. Absorption in duodenum and jejunum
Causes of deficiency .-
- Nutritional deficiency-
- Malabsorption syndrome.
- Pernicious anaemia (B12).
- Gastrectomy (B12).
- Fish tapeworm infestation (B12).
- Pregnancy and puerperium (Folic acid mainly).
- Myeloproliferative disorders (Folic acid).
- Malignancies (Folic acid).
- Drug induced (Folic-acid)
Features:
(i) Megaloblastic anaemia.
(ii) Glossitis.
(iii) Subacute combined degeneration (in B12deficiency).
Blood picture :
- Macrocytic normochromic anaemia.
- Anisocytosis and poikilocytosis with Howell-Jolly bodies and basophilic stippling.
- Occasional megalo blasts may be-seen.
- Neutropenia with hypersegmented neutrophills and macropolycytes.
- Thrombocytopenia.
- Increased MVC and MCH with normal or decreased MCHC.
Bone marrow:
- Megaloblasts are seen. They are larger with a more open stippled chromatin. The nuclear maturation lags behind. the cytoplasmic maturation. Maturation arrest is seen (more of early forms).
- Immature cells of granulocyte series are also larger.
-Giant stab forms (giant metamyelocytes).