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NEET MDS Synopsis - Lecture Notes

📚 NEET MDS Lecture Notes

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FACIAL MUSCLES SPECIFIC IN EMOTIONAL EXPRESSION
Anatomy

Muscle

 

Emotion

 

Epicranius

 

Surprise

 

Orbicularisoculi

 

Squinting

 

Orbicularisoris

Pouting

Nasalis

 

Smelling

 

Zygomaticus

 

Smiling

 

Buccinator

 

Chewing

 

Mentalis

 

Doubt

 

Triangularis

 

Sadness

 

Platysma

 

Sadness

 

Masseter

 

Chewing

 

Temporalis

 

Sternness

 

Pterygoid

 

Conternation

 

Genioglossus and Styloglossus

 

Swallowing, Speaking, Chewing

 

 

Zinc Phoshate Cement

Dental Materials

Zinc Phoshate Cement

Uses. Zinc phosphate cement is used both as an intermediate base and as a cementing medium. 

(1) Intermediate base. A thick mix  is used under permanent metallic restoration. This layer of cement protects the pulp from sudden temperature changes that may be transmitted by the metallic restoration. 

(2) Cementing medium. Zinc phosphate cement is used to permanently cement crowns, inlays, and fixed partial dentures upon the remaining tooth structure. A creamy mix of cement is used to seat the restoration or appliance completely into place. The cementing medium does not cement two objects together. Instead, the cement holds the objects together by mechanical interlocking, filling the space between the irregularities of the tooth preparation and the cemented restoration

c. Chemical Composition. 

(1) Powder. primary ingredients - zinc oxide and magnesium oxide. 
(2) Liquid. Phosphoric acid and water in the ratio of two parts acid to one part water. The solution may also contain aluminum phosphate and zinc phosphate Liquids exposed in open bottles will absorb moisture from the air in high humidity. The liquids will lose moisture if humidity is low. Water gain hastens setting; water loss lengthens setting time.
 
PROPERTIES OF ZINC PHOSPHATE CEMENT

a. Advantages. Some advantages of zinc phosphate cement as a cementing medium are:

o    Inconspicuous appearance. 
o    Speed and ease of usage. 
o    Sufficient flow to form a thin layer for the cementing of closely adapted crowns, fixed partial dentures, and inlays. 
o    Low thermal conductivity beneath a metallic restoration.

b. Disadvantages. Some disadvantages of zinc phosphate cement as a cementing medium are:

o    Low crushing strength that varies between 12,000 and 19,000 psi. 
o    Slight solubility in mouth fluids. 
o    Opaque material not suitable for visible surfaces. 

c. Strength. The ratio of powder to liquid increases the strength of phosphate cements to a certain point. For this reason, the dental specialist must use as thick a mix as practical for the work being performed. 

SETTING REACTIONS OF ZINC PHOSPHATE CEMENT 

a. Chemical Reaction. The chemical reaction that takes place between the powder and liquid of setting phosphate cement produces heat. The amount of heat produced depends upon the rate of reaction, the size of the mix, and the amount of heat extracted by the mixing slab. 

b. Powder to Liquid Ratio. The less powder used in ratio to the liquid, the longer the cement will take to harden. Good technique minimizes the rise in temperature and acidity of the setting cement that can injure the pulp. Generally, for increased strength, decreased shrinkage, and resistance to solubility, it is advisable to blend as much powder as possible to reach the desired consistencies. 

c. Setting Time. The setting time of zinc phosphate cement is normally between 5 and 9 minutes. 
 Lower the temperature of the glass mixing slab to between 65° and 75° F (18° to 24° C), if the glass mixing slab is not already cooled below the temperature at which moisture will condense on it. → Blend the powder slowly. →  Mix the powder over a large area of the cool slab. →  Use a longer mixing time, within optimum limits. 
 
Precautions.
The following precautions should be observed. 

o    Prevent loss or gain of moisture in liquid cement by keeping bottles tightly stoppered. 
o    Dispense drops only when ready to mix. 
o    Use a cool, dry glass slab (65° to 75° F). 
o    Use the same brand of powder and liquid. 
o    Add increments of powder slowly. 
o    Use the maximum amount of powder to obtain the desired consistency. 

(To incorporate the most powder, the material should be mixed with a moderate circular motion over a large area of the slab, turning the spatula often.) 

Histology of the Periodontal Ligament (PDL)

Dental Anatomy

Histology of the Periodontal Ligament (PDL)

Embryogenesis of the periodontal ligament
The PDL forms from the dental follicle shortly after root development begins
The periodontal ligament is characterized by connective tissue. The thinnest portion is at the middle third of the root. Its width decreases with age. It is a tissue with a high turnover rate.

FUNCTIONS OF PERIODONTIUM

Tooth support
Shock absorber
Sensory (vibrations appreciated in the middle ear/reflex jaw opening)

The following cells can be identified in the periodontal ligament:
a) Osteoblasts and osteoclasts b) Fibroblasts,  c) Epithelial cells
 

Rests of Malassez
d) Macrophages
e) Undifferentiated cells
f) Cementoblasts and cementoclasts (only in pathologic conditions)
The following types of fibers are found in the PDL
-Collagen fibers: groups of fibers
-Oxytalan fibers: variant of elastic fibers, perpendicular to teeth, adjacent to capillaries
-Eluanin: variant of elastic fibers
Ground substance

PERIODONTAL LIGAMENT FIBERS

Principal fibers
These fibers connect the cementum to the alveolar crest. These are:

a. Alveolar crest group: below CE junction, downward, outward
b. Horizontal group: apical to ACG, right angle
c. Oblique group: numerous, coronally to bone, oblique direction
d. Apical group: around the apex, base of socket
e. Interradicular group: multirooted teeth

Gingival ligament fibers
This group is not strictly related to periodontium. These fibers are:

a. Dentogingival: numerous, cervical cementum to f/a gingiva
b. Alveologingival: bone to f/a gingiva
c. Circular: around neck of teeth, free gingiva
d. Dentoperiosteal: cementum to alv. process or vestibule (muscle)
 e. Transseptal: cementum between adjacent teeth, over the alveolar crest
 

Blood supply of the PDL
The PDL gets its blood supply from perforating arteries (from the cribriform plate of the bundle bone). The small capillaries derive from the superior & inferior alveolar arteries. The blood supply is rich because the PDL has a very high turnover as a tissue. The posterior supply is more prominent than the anterior. The mandibular is more prominent than the maxillary.

Nerve supply
The nerve supply originates from the inferior or the superior alveolar nerves. The fibers enter from the apical region and lateral socket walls. The apical region contains more nerve endings (except Upper Incisors)

Dentogingival junction

This area contains the gingival sulcus. The normal depth of the sulcus is 0.5 to 3.0 mm (mean: 1.8 mm). Depth > 3.0 mm is considered pathologic. The sulcus contains the crevicular fluid
 

 
The dentogingival junction is surfaced by:
1) Gingival epithelium: stratified squamous keratinized epithelium 2) Sulcular epithelium: stratified squamous non-keratinized epithelium The lack of keratinization is probably due to inflammation and due to high turnover of this epithelium.
3) Junctional epithelium: flattened epithelial cells with widened intercellular spaces. In the epithelium one identifies neutrophils and monocytes.
Connective tissue
The connective tissue of the dentogingival junction contains inflammatory cells, especially polymorphonuclear neutrophils. These cells migrate to the sulcular and junctional epithelium.
The connective tissue that supports the sulcular epithelium is also structurally and functionally different than the connective tissue that supports the junctional epithelium.

Histology of the Col (=depression)

The col is found in the interdental gingiva. It is surfaced by epithelium that is identical to junctional epithelium. It is an important area because of the accumulation of bacteria, food debris and plaque that can cause periodontal disease.
Blood supply: periosteal vessels
Nerve supply: periodontal nerve fibers, infraorbital, palatine, lingual, mental, buccal

AUTOCOIDS

Pharmacology

AUTOCOIDS

An  organic substance, such as a hormone, produced in one part of organism and transported by the blood or lymph to another part of the organism where it exerts a physiologic effect on that part.

TYPES OF AUTACOIDS:
 Amines : Histamine,5-Hydroxytryptamine.
 Lipids    : Prostaglandins, Leukotriens, Platelet activating factor.
 Peptide : Bradykinin , angiotensin.