Sainavle, Author at Class Notes

Dysgeusia refers to a foul taste in the mouth
Dysgeusia Causes:
- Genetic factors
- Smoking
- Lower esophageal sphincter abnormalities
- Defective gastric emptying
- Increased abdominal pressure
- Dietary behavior

Dysgeusia Clinical Features:

It is more common in adults in the third decade of life
Water brash is a very common complaint
There is a sudden burst of salivation in the mouth

Dysgeusia Management:

Patients should be encouraged to consume small frequent meals along with antacids instead of large meals
They should be educated not to go to bed immediately after a heavy meal
H2blockers: cimetidine 400 mg QID for 4 weeks
Proton pump inhibitors: omeprazole 20 mg once daily for 4 weeks
Half a teaspoon of baking soda is added to 250 ml of water, this solution is used as mouth rinse

Read And Learn More: Oral Medicine Question and Answers

Question 2. Regional odontodysplasia.

Answer:

Regional Odontodysplasia

Regional Odontodysplasia is an uncommon but unique non-hereditary developmental disturbance of teeth characterized by defective formation of enamel and dentin in addition to abnormal pulp and follicle calcification

Etiology:

Local ischaemic changes in the tissue during odontogenesis

Regional Odontodysplasia Clinical Features:

Both the dentition and are affected
There is no sex predilection
The maxilla is more affected than the mandible
It frequently occurs unilaterally
The centra! and lateral incisors arc rfTrrtrd
They have a soft leathery surface
They are yellowish-brown in color

Regional Odontodysplasia Radiographic Features:

There is a marked decrease in radiodensity
The enamel and dentin are very thin
Pulp chambers are extremely large and open
They often contain pulp stones

Question 3. Enamel hypoplasia.

Answer

Enamel Hypoplasia

Enamel Hypoplasia is an incomplete defective formation of organic enamel matrix

Enamel Hypoplasia Classification:

Mild: There may be only a few small grooves, pits, and fissures on the enamel surface
Moderate: They exhibit rows of deep pits arranged horizontally across the surface
Severe: A considerable portion of enamel may be absent

Enamel Hypoplasia Types:

Hypoplasia Due To Nutritional Deficiency
- Horizontal pitting occurs in rows on the teeth undergoing matrix formation at the time of dietary deficiency or during a febrile episode
- Pitting picks up stains and discoloration occurs
Hypoplasia Due To Exanthematous Disease
- There is a temporary elevation of body temperature
- Ameloblasts may be adversely affected
Syphilitic Hypoplasia
- It involves maxillary and mandibular permanent incisors and 1!’ molars
- Upper incisors are screw-shaped with a central notch called” Hutchinson’s incisors”
Hypoplasia Due To Hypocalcemia
- Tetany induced by decreased level of calcium in the blood
- There is a defective formation of the enamel
- It is usually a pitting type
Hypoplasia Due To Birth Injury
- Involves maxillary primary ln< Isom
- It is due to T.i r rlisturbarx or mrtahollf dhordet
- A wide band or line of enamel affects the primary truth of children associated with premature birth or low birth weight
- It may affect the process of amelogenesis
Turner’s Hypoplasia
- Turner’s Hypoplasia results in Hue to focal enamel hypoplasia
- Tire trauma or the infection in the existing deciduous tooth may cause damage to the ameloblast cells forming the crown of the underlying permanent suc¬cessor
- The tooth affected in this process is called “Turner’s tooth”

Enamel Hypoplasia Types: Based On The Severity Of The Defect

Slight pitting observed
Smooth surface with pitted areas
Grossly deformed with yellowish or brownish discoloration of the surface
Dental fluorosis:
- It is due to disturbance in tootle formation caused by excessive intake of fluoride, during the formation period of dentition
Tetracycline hypoplasia
- Tetracycline may be Inrorpocatcd in calcifying enamel matrix by the formation of tetracycline calcium orthophosphate complex
- Varying degree of hypocakificatlon of teeth exists

Enamel Hypoplasia Management:

Restoration: to confine the area of involvement
Crown: in severe hypoplasia
Bleaching with 30% H₂O₂
Calcium sucrose phosphate gel
Desensitizing paste

Question 4. Anodontla.

Answer:

Anodontla Types:

True: It is a congenital absence of teeth
False: It is due to the extraction of teeth
Pseudo: It is due to multiple unerupted teeth in the jaw

Anodontla Etiology:

Genetic causes: Hereditary syndrome
Radiation

Anodontla Clinical Features:

Sex: it is common in women
Site: it may be unilateral or bilateral
Commonly missing teeth are 3rd molar, maxillary lateral incisor, maxillary or mandibular 2nd premolar

Anodontla Features:

Microdontia
Reduced alveolar development
Increase freeway space
Retained primary teeth

Anodontla Management:

Orthodontic treatment: to correct malocclusion
Prosthesis:
- Traditional fixed prostheses and resin-bonded bridges are given

Question 5. Glossopyrosis.

Answer:

Glossopyrosis

Glossopyrosis refers to a burning sensation in the tongue

Etiology:

Local factors:
- Habits: excessive use of tobacco Dental causes- ill-fitted dentures
- Referred pain from infected teeth Local tongue disorders Electrogalvanic discharge
- Allergy to denture base materials
Systemic factors
- Multiple myeloma
- Amyloidosis
- Pernicious anemia
- Diabetes
- Vitamin B deficiency
Neurological disorders
- Trigeminal neuralgia
- Damage to the lingual nerve

Glossopyrosis Management:

Removal of local cause
Muscle relaxants
Management of systemic causes
Topical analgesics 0.5% of Diphenhydramine
A mixture of 0.5% dyclonine or lidocaine with Diphenhydramine.

Oral Medicine Developmental Disorders

Question 6. Hairy tongue.

Answer:

Hairy Tongue Etiology:

Formation of excess keratin causes elongation of the filiform papillae on the dorsal tongue
May be infected with Candida albicans

Hairy Tongue Features:

Elongation of the filiform papillae
White to yellow
Located on the posterior dorsal tongue
Patients often have poor oral hygiene
Patients may complain of bad taste

Hairy Tongue Treatment:

Elimination of predisposing factors
Cleaning the dorsal tongue with a soft toothbrush
Treat Candidiasis if present

Question 7. Dentigerous imperfect.

Answer:

Dentigerous Imperfect

Dentigerous Imperfect Classification:
- Shield Type 1: It occurs with osteogenesis imperfecta
- Shield Type 2: It is not associated with osteogenesis imperfect
- Shield Type 3: It has got shell teeth appearance and multiple pulp exposure
Dentigerous Imperfect Clinical Features:
- Shield Type 1:
  - Multiple bone fractures hyperextensible joints
  - Blue sclera Progressive deafness
  - Deciduous teeth are more affected
  - The color of the teeth varies from blue to brownish-violet to yellowish brown
  - Amber translucency of both the dentition
  - Rapid attrition of the teeth is seen
  - There is scalloping of DEJ
  - In the incisor region the crowns are more squarish The posteriors are flatter
- Shield Type 2:
  - Similar features but not associated with osteogenesis imperfect
- Shield Type 3:
  - Both the dentition are affected
  - The thickness of the enamel is normal
  - Dentin is very thin
  - Opalescent color, bell-shaped crown, and multiple pulp exposure

Question 8. Geographic tongue.

Answer:

Geographic Tongue

Geographic Tongue is defined as an irregularly shaped reddish area of depopulation and thinning of dorsal tongue epithelium which is surrounded by a narrow zone of regenerating papillae that are whiter than the surrounding tongue surface

Geographic Tongue Etiology:

Immunological reaction
Allergic reaction
Emotional factors
Hereditary factors
Infections
Nutritional deficiency

Geographic Tongue Classification:

Type 1- Lesions are confined to the tongue
Type 2- Lesions are also seen elsewhere in the mouth
Type 3- Lesions on the tongue that are not typical and that may be accompanied by lesions elsewhere in the mouth
Type 4- No tongue lesions are present but geographic areas are present in the mouth

Geographic Tongue Clinical Features:

Age-5-84 years
Sex- slight predilection to females
Site- dorsal surface and lateral margins of the tongue
Size- varies in diameter

Geographic Tongue Presentation

It is asymptomatic
The patient may complain of a burning sensation on spicy foods or intake of citrus fruits
It appears as an erythematous, non-indurated, atrophic lesion
Bordered by slightly elevated distinct rim
Multiple areas of desquamation of filiform papilla in an irregular fashion are seen
The central portion appears inflamed
Fungiform papilla persists as elevated red dots

Geographic Tongue Differential Diagnosis:

Psoriasis- skin lesions are present
Lichen planus

Geographic Tongue Management:

Topical application of anesthetic agents
Balanced diet
Elimination of irritants
Psychological reassurance
Topical corticosteroids

Question 9. Amelogenesis imperfecta.

Answer:

Amelogenesis Imperfecta

Amelogenesis imperfecta is a developmental defect of the enamel with heterogenous etiology that affects the enamel of both the primary and permanent denti¬tion

Amelogenesis Imperfecta Etiology:

Genetic mutation
It is an autosomal dominant trait

Amelogenesis Imperfecta Clinical Features:

It has a wide range of clinical appearance
Enamel appears pitted with horizontal and vertical ridges
There is defective maturation of the crystal structure
Affected teeth are mottled, and opaque with white-brown yellowish discoloration
They have enlarged pulp chambers

Amelogenesis Imperfecta Types:

Hypocalcified type
Hypomaturation type
Hypoplastic type

Amelogenesis Imperfecta Treatment:

Veneering or capping of teeth

Developmental Disturbances Of Oral And Paraoral Structures Short Question And Answers

April 29, 2024October 10, 2023 by Sainavle

Developmental Disturbances Of Oral And Paraoral Structures Short Question And Answers

Question 1. Gardener’s syndrome
Answer:

Gardener’s syndrome

It is a hereditary disorder characterized by colorectal polyps in association with various other lesions involving skin, eyes, teeth, and skeletal system

Gardener’s Syndrome Clinical Features:

Multiple intestinal polyps
Multiple osteomas of the skin, paranasal sinuses, and jaw
Facial deformity
Difficulty in mouth opening
Multiple supernumerary teeth, impacted teeth, and odontomas
Desmoid tumors of soft tissue and dermoid cysts of skin are present
Pigmented lesion in ocular fundus

Gardener’s Syndrome Treatment:

Prophylactic colectomy
Surgical removal of osteomas and dermoid cyst

Question 2. Ramsay Hunt syndrome
Answer:

Ramsay Hunt syndrome

It is a zoster infection of geniculate ganglion with involvement of external ear and oral mucosa

Read And Learn More: Oral Pathology Questions and Answers

Ramsay Hunt syndrome Clinical Features:

Facial paralysis
The pain of external auditory meatus
Pinna of the ear
Vesicular eruption in the oral cavity and oropharynx
Hoarseness of voice
Tinnitus
vertigo

Question 3. Melkersson-Rosenthal syndrome
Answer:

Melkersson-Rosenthal syndrome

The melkersson-Rosenthal syndrome consists of
- Recurrent attacks of facial paralysis identical to Bell’s palsy
- Nonpitting, non-inflammatory painless edema of the face
- Chelitis granulomatosa
- Scrotal tongue
- Persistent unilateral edema of orbit and eyelid

Developmental Disturbances Of Oral And Paraoral Structures.

Question 4. Hairy tongue
(or)
Black hairy tongue
Answer:

Black hairy tongue Etiology:

Formation of excess keratin
Infections- like candidiasis

Black hairy tongue Clinical Features:

Elongation of filiform papillae
Color- white to yellow
Located on the posterior dorsal surface of the tongue
Poor oral hygiene
Bad taste in the mouth

Black hairy tongue Treatment:

Elimination of predisposing factors
Cleaning of the dorsal surface of the tongue with a soft toothbrush
Treat candidiasis

Question 5. PeutJeghers syndrome
Answer:

PeutzJeghers syndrome Features:

Recurrent abdominal pain due to familial intestinal polyps
Cutaneous pigmentation in the perioral region
Precocious puberty
Gastrointestinal bleeding
Pigmentation of buccal mucosa

Question 6. Xerostomia
Answer:

Xerostomia

It refers to the subjective sensation of dry mouth associated with salivary hypofunction

Xerostomia Etiology:

Developmental- salivary aplasia
Water or metabolic imbalance
Iatrogenic causes
Medications- antihistamines, decongestants, antidepressants, antihypertensives
Radiation

Xerostomia Clinical Features:

Reduction in salivary secretion
Residual saliva is foamy or thick
Fissured dorsum of the tongue
Atrophy of filiform papilla
Difficulty in mastication and swallowing
Susceptibility to infection
Dry mouth
More prone to dental caries

Question 7. Turner’s hypoplasia
Answer:

Turner’s hypoplasia

Turner’s hypoplasia is enamel hypoplasia occurring due to trauma or infection to the deciduous dentition
Commonly affects incisors or premolars
Periapical infection of deciduous teeth affects the ameloblastic layer of underlying permanent teeth
As a result, permanent teeth get discolored or pitted

Question 8. Dilaceration
Answer:

Dilaceration

It refers to an angulation or sharp bend or curve anywhere along the root portion of the tooth

Dilaceration Clinical Features:

Involves both dentition
Seen at the coronal portion of the teeth
The tooth looks like hook-shaped due to bending in the root
Treatment:
Extraction of involved teeth

Question 9. Talons cusp
Answer:

Talons cusp

It is an anomalous projection from the lingual aspect of the maxillary and mandibular permanent incisors

Talons cusp Clinical Features:

It arises from the cingulum area of the tooth which extends to the incisal edge as a prominent T-shaped projection
- Asymptomatic
- Cosmetic problems
- Susceptible to caries
- Consist of normal-appearing enamel, dentin, and vital pulp tissue

Associated Syndrome:

Rubinstein Taybi syndrome

Talons cusp Treatment:

Restorative measures- to prevent caries

Question 10. Taurodontism
Answer:

Taurodontism

Taurodontism is a peculiar developmental condition in which the crown of the tooth is enlarged at the expense of its roots

Taurodontism Pathgenesis:

It occurs due to failure of the Hertwig’s epithelial root sheath to invaginate at the proper horizontal level

Taurodontism Clinical Features:

It involves both the sex
It commonly affects multi-rooted permanent molar teeth and sometimes premolar
It rarely occurs in primary dentition
Common in Neanderthal men
The affected tooth exhibits an elongated pulp chamber with rudimentary roots
Teeth are usually rectangular with minimum constriction at the cervical area
The furcation area of the teeth is more apically placed
Teeth often have a greater apical-occlusal height

Question 11. Unerupted teeth
Answer:

Unerupted teeth

It is an uncommon condition
Causes delayed eruption of permanent teeth

Unerupted teeth Causes:

Retained deciduous teeth
Failure of eruption of permanent teeth
Lack of eruptive force
Cleidocranial dysplasia

Question 12. Amelogenesis imperfecta
Answer:

Amelogenesis imperfecta

It is a developmental anomaly characterized by defective enamel formation

Amelogenesis imperfecta Clinical Features:

Affects both dentition
Color- chalky white to yellow
Prone to disintegration
Open contact points due to loss of enamel
Abraded occlusal surfaces and incisal edges
Abrasion of dentin
Cheesy consistency of enamel
Alteration in the eruption process
Anterior open bite
Presence of grooves and wrinkles on enamel surfaces
The presence of some white opaque flecks at incisal margins gives Snow-capped teeth appearance

Question 13. Shell teeth
Answer:

Shell teeth

In type 3 dentinogenesis imperfect the dentin appears very thin and pulp chambers and root canals are extremely large
Because of this, the teeth appear thin shells of enamel and dentin
Thus it is described as shell teeth
Seen in association with enamel aplasia

Question 14. Ghost Teeth
Answer:

Ghost Teeth

It is a radiographic feature of regional odontodysplasia
It involves both dentition
Permanent teeth show delayed eruption and defective mineralization
There is a marked decreased radiodensity
Enamel and dentin are very thin
Pulp chambers are extremely large and open
This results in the ghostly appearance of the involved teeth

Question 15. Tooth ankylosis
Answer:

Tooth ankylosis

Fusion between the tooth and bone is called ankylosis

Tooth ankylosis Clinical Features:

Asymptomatic
Produces dull, muffled sound on percussion
Loss of periodontal ligament
Mild sclerosis of the bone
Blending of bone with tooth root
This leads to difficulty in the extraction

Question 16. Submerged teeth
Answer:

Submerged teeth

Submerged teeth are ankylosed deciduous teeth

Submerged teeth Causes:

Trauma
Infection
Disturbed local metabolism
Genetic factor

Submerged teeth Clinical Features:

Commonly affects mandibular second molars
It prevents the exfoliation of deciduous teeth and the eruption of their successor
It is located below the occlusal level of other teeth
There is a lack of physiological mobility in the teeth
It imparts solid sound on percussion

Radiographic Features:

Absence of periodontal ligament
Blending of tooth root and bone

Question 17. Enameloma

Answer:

Enameloma

The ectopic formation of enamel in the form of globule on the root surface is referred to as Enameloma
It is usually located in the cementoenamel junction or the cervical third of the root surface

Enameloma Clinical features

It appears as yellowish white, spherical, or globular structure adherent to the furcation areas of the root surface
Diameter ranges from 1-3 mm
More common in the roots of maxillary molars
May produce localized periodontal destruction in molars
Radiological features
Appears as hemispherical dense radio parities projecting from the root surface.

Anatomy Question and Answers

November 4, 2024July 18, 2023 by Sainavle

Section 1: Upper Limb

Upper Limb Introduction Question and Answers
Pectoral Region Question and Answers
Axilla Question and Answers
Back of the Body Question and Answers
Arm Question and Answers
Antebrachium/Forearm Question and Answers
Wrist and Hand Question and Answers
Joints of Upper Limb Question and Answers
Blood Supply and Lymphatic Drainage of Upper Limb Question and Answers
Nerves of Upper Limb Question and Answers

Section 2 Lower Limb

Lower Limb Introduction Question and Answers
Front of Thigh Question and Answers
Medial side of Thigh Question and Answers
Gluteal Region Question and Answers
Bank of Thigh Question and Answers
Leg and Dorsum of Foot Question and Answers
Sole of Foot Question and Answers
Joints of Lower Limb Question and Answers
Blood Supply and Lymphatic Drainage of Lower Limb Question and Answers
Never Supply of Lower Limb Question and Answers

Anatomy Question And Answers

Section 3: Thorax

Wall of Thorax and Thoracic Cavity Question and Answers
Pleurae Question and Answers
Lungs Question and Answers
Mediastinum Question and Answers
Pericardium and Heart Question and Answers
Superior Vena Cava and Aorta Question and Answers
Traches, Esophagus and Thoracic Duct Question and Answers

Section 4: Abdomen and Pelvis

Anterior Abdominal Wall Question and Answers
Male Genital Organs Question and Answers
Abdominal Cavity and Peritoneum Question and Answers
Stomach Question and Answers
Small and Large Intestines Question and Answers
Spleen, Pancreas and Liver Question and Answers
Billary Apparatus Question and Answers
Kidney, Ureter and Suprarenal Gland Question and Answers
Posterior Abdominal Wall Question and Answers
Urinary Bladder and Urethra Question and Answers
Male and Female Reproductive Organs Question and Answers
Perineum and True Pelvis Question and Answers
Rectum and Anal Canal Question and Answers
Large Blood Vessels of the Gut Question and Answers

Section 5: Head and Neck

Scalp, Temple and Face Question and Answers
Side of Neck Question and Answers
Structures in Anterior Median Region of Neck Question and Answers
Deep Structures of Neck Question and Answers
Back of Neck Question and Answers
Parotid Region Question and Answers
Submandibular Region Question and Answers
Temporal and Infratemporal Region Question and Answers
Nose and Paranasal Sinuses Question and Answers
Contents of Orbit and Eye Question and Answers
Ear Question and Answers
Oral Cavity and Tongue Question and Answers
Pharynx Question and Answers
Larynx Question and Answers
Vertebral Canal and Contents Question and Answers
Cranial Cavity Question and Answers
Blood Vessels of Head and Neck Question and Answers
Nerves of Head and Neck Question and Answers

Section 6: Neuroanatomy

Cerebrospinal Fluid Question and Answers
Spinal Cord Question and Answers
Brainstem Question and Answers
Celebellum and Fourth Ventricle Question and Answers
Cerebrum Question and Answers
Ventricles of Brain Question and Answers
Blood Supply of Brain and Spinal Cord Question and Answers
Cranial Nerves Question and Answers

Dental Caries Short Essays

November 7, 2024June 30, 2023 by Sainavle

Dental Caries

Question 1. Zinc polycarboxylate cement.
Answer:

Zinc polycarboxylate cement Composition:

1. Powder:

Zinc oxide Basic ingredient
Magnesium oxide
- Modifier
- Aids in sintering
Bismuth and aluminum oxide occur in small amounts
Stannous fluoride
- Increase strength
- Modifies setting time
- Imparts anti-cariogenic properties

2. Liquid:

Polyacrylic acid
The copolymer of acrylic acid with other unsaturated carboxylic acids

Zinc Polycarboxylate Cement Properties:

1. Physical Properties:

Dental Caries Zinc polycarboxylate cement Physical properties

2. Biocompatibility:

Mild pulpal response

3. Adhesion:

Excellent adhesion
Polyacrylic acid reacts with calcium ions via car¬boxyl groups on the surface of enamel and dentin
The bond strength of enamel is greater

4. Optical Properties:

Optical Properties are very opaque

5. Thermal Properties:

Thermal Properties is a thermal insulator

Zinc Polycarboxylate Cement Uses:

Cementation of restoration
As bases and liners
As intermediate restoration
Luting of permanent restoration
In orthodontics cementation of bands
In endodontics as root canal filling material

Question 2. Define and classify caries. Add a note on the diagnosis of caries.

Answer:

Caries Definition:

Dental caries is defined as a multifactorial, transmissible, infectious oral disease caused primarily by the complex interaction of cariogenic oral flora with fermentable dietary carbohydrates on the tooth surface over time

Caries Classification:

1. According To Location

Primary Caries
- Pit and fissure caries
- Smooth surface caries
- Root caries
Secondary Caries

2. According To The Direction

Forward caries
Backward caries

3. According To The Extent

Incipient caries
Cavitated caries

4. According to Rate

Acute caries
Chronic caries

5. According To A Histological Depth Of Penetration

Enamel caries
Dentinal caries

Diagnosis Of Caries

1. Visual Tactile Examination:

Visual Method:
- Cavitation
- Opacification
- Discoloration
- Surface roughness
Tactile Method:
- Softness of enamel
- Catch obtained by an explorer
Illumination:
- UV light creates decreased fluorescent in carious lesions as compared to healthy tissue
- Cavitation produces echoes of higher amplitude

2. Caries Detecting Dyes:

Dyes For Enamel Caries:
- Procion Staining is irreversible
- Reacts with nitrogen and hydroxyl groups
- Calcein Bounds with calcium
- Zyglo ZL22 Visible by UV illumination
Dyes For Dentin Caries:
- Infected and affected dentin layers are present
- Basic Fuschia in propylene glycol stains only the infected dentin
Radiographic Methods:
- Requires 50% tooth destruction
- Seen as a radiolucent lesion

Caries Types

1. Caries Conventional:

IOPA
Bitewing For proximal caries
Occlusal
Xeroradiography
Edge enhancement

2. Caries Advanced:

Digital radiography
Subtraction radiography
RVG

3. Caries Electrical Conductance:

Electrical conductivity is directly proportional to the amount of demineralization

4. Lasers:

Question 3. Methods of Diagnosis of Proximal Caries.

Answer:

1. Bitewing Radiograph:

It includes occlusal surfaces of both arches in the same radiograph
It must be differentiated from cervical bum out
It describes the extent of the carious lesion
- 0 Normal
- 1 – Only enamel is involved
- 2- Caries extends upto DEJ/Dentinoenamel junction
- 3 – Caries involve the whole of the enamel and the outer half of the dentin
- 4 – Caries involve complete enamel and dentin

2. – Separation Of Teeth:

With the help of separators, teeth are moved apart and viewed for carious lesions

3. Dental Floss:

Dental floss is used through the proximal surface
Fraying of it indicates the presence of a lesion

4. Transillumination:

It is based on the refractory index between the carious and sound tooth
Carious tooth appears as a dark shadow when compared to normal tooth

Question 4. Pit and fissure Caries.

Answer:

The shape of pit and fissure make it more susceptible to caries

Pit And Fissure Caries Features:

Initial Brown/Black in color
Catch with an explorer
DecalciFication of enamel
Enamel involvement in the direction of the rod
Shape Triangular, base towards DE
Progress to the involvement of dentinal tubules
Result in cavitation
Undermining of enamel

Dental Caries Magnified schematic presentation of smooth surface caries

Question 5. Root Caries/Cemental Caries.

Answer:

Root Caries is a soft, progressive lesion that is found anywhere on the root surface that has lost its connective tissue attachment and is exposed to the environment

Root Caries Features:

Periodontal attachment loss
Soft, irregular lesion
Round or oval in shape
Irregular outline
Common in males
Common in mandibular molars

Root Caries Etiology:

Streptococcus mutants
Lactobacillus
Actinobacillus

Root Caries Prevention:

Plaque removal
Diet modification
Use of topical fluoride
Soft tissue management
Use of xylitol-containing chewing gum

Question 6. Roles of fluoride in caries prevention

Answer:

1. Increased Enamel Resistance/ Reduction In enamel Solubility

Dental caries involves the dissolution of enamel by acid formation
This dissolution is inhibited by fluoride as the fluoride forms fluorapatite which reduces enamel solubility
Fluoride reduces enamel solubility also by promoting the precipitation of hydroxyapatite and phosphate mineral
Fluoride inhibits demineralization by
Reducing bacterial acid production
Reducing equilibrium solubility of apatite
By fluoridation of apatite crystal

2. Increased Rate Of Post-Eruptive Maturation

Newly erupted teeth have hypomineralised areas and the enamel surface is also prone to dental caries
Fluoride increases the rate of mineralization of these areas
Organic material is also deposited over the enamel surface which increases its resistance to dental caries

3. Remineralization Of Incipient Lesions

Fluoride enhances remineralization by the deposition of minerals into the damaged areas
This reduces enamel solubility through the growth of crystals which are more resistant to acid
Fluoride enhances remineralization from calcium phosphate solution by the formation of calcium fluoride which prevents hydroxyapatite crystal growth

4. Interference With Microorganisms

In Two Ways

In High-Concentration Bacteriocidal
- By reducing plaque
In low-concentration bacteriostatic
- Inhibits enzymes responsible for acid metabolism

5. Modification In Tooth Morphology

If fluoride is ingested during tooth development it results in the formation of
More caries-resistant tooth
A tooth with smaller and shallow fissures
Smaller diameter and cusp depth
All these make them more self-cleansing

Question 7. Zones of enamel caries

Answer:

1. Zone 1 Translucent zone

It is the deepest zone
It is slightly more porous
Contains 1% by volume
Pores are larger than usual pores seen in normal enamel
Dissolution of mineral occurs at the junction of prismatic and interprismatic enamel

2. Zone 2 Dark zone

Located superficial to the translucent zone
Excessive demineralization of enamel occurs
It is narrow in rapidly advancing caries and wide in slowly advancing caries
Contains 24% pore volume
Pores are smaller than that of the translucent zone
There is some degree of remineralization

3. Zone 3 Body Of The Lesion

Present between dark zone and surface zone
Represents the area of greatest demineralization
Pore volume is between 525%
Contains larger apatite crystals
Reprecipitation of minerals occurs
Dissolution of minerals occurs
Lost minerals are replaced by unbound water and organic matters

4. Zone 4 Surface Zone

Zone 4 Surface Zone remains unaffected
Zone 4 Surface Zone is 40 pm thick
Surface remineralization occurs due to the active precipitation of mineral ions

Question 8. Zones of dentinal caries.

Answer:

Zone 1: Normal dentin
- Zone of fatty degeneration of odontoblast
- Represents thinner most layer of carious dentin
- No crystals are present in the lumen of tubules
- No bacteria present in tubules
- Intertubular dentin has normal collagen

Zone 2: Subtransparent dentin

- Zone of dentinal sclerosis characterized by deposition of calcium salts in dentinal tubules
- The superficial layer shows areas of demineralization and damage of odontoblastic processes
- Subtransparent dentin is capable of remineralization
- No bacteria is present in tubules

Zone 3: Transparent dentin

Zone of decalcification of dentin, a narrow zone preceding bacterial invasion
Transparent dentin is softer than normal dentin
Large crystals are present within the lumen of dentinal tubules
No bacteria is present in tubules
Transparent dentin is capable of self-repair and remineralization

Zone 4: Turbid dentin

Zone of bacteria] invasion of decalcified but intact dentin
Widening and distortion of dentinal tubules
Cannot undergo self-repair or remineralization
Must be removed before restorative treatment

Zone 5: Infected dentin

Zone of decomposed dentin
Infected dentin is the outermost zone of carious dentin
Characterized by complete destruction of dentinal tubules
Areas of decomposition of dentin occur along the direction of dentinal tubules called liquefaction foci of Miller
Transverse clefts are seen due to the decomposition of dentin
Bacteria invade and destroy peri and intertubular dentin

Dental Plaque Short Question and Answers

November 4, 2024June 30, 2023 by Sainavle

Question 1. Specific plaque hypothesis.
Answer:

The specific plaque hypothesis states that not all plaque is pathogenic and its pathogenicity depends on the presence of certain specific microbial pathogens in plaque
Specific microorganisms responsible for periodontal diseases release certain damaging factors called virulence factors which lead to host tissue destruction

Example: A.a. contains causes aggressive periodontitis

Question 2. Define dental plaque.
Answer:

It is soft deposits that form biofilm adhering to the tooth surface or other hard surface in the cavity including removable and fixed restoration

Read And Learn More: Periodontics Question and Answers

Question 3. Composition of dental plaque.
Answer:

1. Micro-organisms:

Bacteria
Mycoplasm
Fungi
Protozoa
Virus

2. Intracellular matrix:

Organic:
- Carbohydrates
- Glycoproteins
- Lipids
Inorganic:
- Calcium
- Phosphorous
- Magnesium
- Potassium
- Sodium

Question 4. Difference between Supragingival and Subgin. It is for the identification of causative agents given Plaque.
Answer:

Dental Plaque difference between supragingival and subgingival plaque

Question 5. Difference between Tooth associated and Epi- thelium-associated plaque.
Answer:

Dental Plaque difference between tooth associated and epithelium associated plaque

Question 6. Pellicle.
Answer:

Derived From:

Components of saliva
GCF
Debris, bacterial, and host tissue cell products

Formed by: Selective adsorption of environment macromolecules

Functions:

Acts as a protective barrier
Lubricates surfaces to prevent tissue desiccation
Provide substrate for bacterial attachment

Question 7. Socransky postulate.
Answer:

It is for the identification of causative agents
No. of etiologic organisms in the diseased site must be increased
While it should be reduced in healthy sites
If the etiologic organism is eliminated then disease pro-aggression ceases
Presence of antibodies in organisms
Presence of virulence factors
In vitro, experiments should demonstrate the disease process

Question 8. Nonspecific Plaque Hypothesis.
Answer:

It states that it is the total bulk of plaque that determines the pathogenicity rather than the individual species in it
According to it. If a small amount of plaque is present then the products released by it can be neutralized by the host
But if it is present in large quantity then it alters the host response
It forms the basis of recent treatment and prevention modalities

Question 9. P. Gingivalis.
Answer:

Porphyromonas gingivalis is a Gram-negative, anaerobic non-motile organism
It is coccal to short rod shape
It possesses fimbriae that facilitate adhesion and coag- aggregation

Virulence Factors:

Dental Plaque P.gingivalis virulence factors

Question 10. A.a. contains.
Answer:

Actinobaillus actinomycetemcomitans is also known as aggregatibacter actinomycetemcomitans
It is gram-negative, capnophilic,non-motile saccharolytic
It occurs singly, in clumps, or in pair
It is a small, short straight, or curved rod in shape

Virulence Factors:

Dental Plaque virulence factors

Question 11. Name the stages of plaque formation.
Answer:

Stages Of Plaque Formation:

Formation of pellicle on the tooth surface
Initial adhesion and attachment of bacteria
Colonization and plaque maturation

Question 12. Normal oral bacterial flora.
Answer:

Normal bacterial flora associated with clinically healthy periodontium comprises of
- Gram-positive cocci
- Fusiform bacilli
- Motile rods
- Filaments
- Spirochaetes

Question 13. Coaggregation.
Answer:

In the process of plaque formation, the bacterial adherence to one another is termed coaggregation
In the early stages of plaque formation there is coaggre It leads to food impaction nation between gram-negative and gram-positive organisms such as F. nucleatum and A. viscous followed by coaggregation in later stages between gram-negative organisms, F.nucleatum, and P. gingivalis

Question 14. Spirochaetes.
Answer:

Spirochaetes are corkscrew-like gram-negative anaerobic bacteria
They are capable of immunosuppression
They contain endotoxin that contributes to their path- Tends to accumulate on a gingival third of teeth genericity
Treponema vincentii is responsible for necrotizing ulcerative gingivitis
Increased levels of spirochetes occur in chronic and aggressive periodontitis
Treponema pallidum is important in the pathogenesis of periodontal diseases
A decrease in the levels of spirochaetes results in im- improvement in periodontal health

Question 15. Prevotella intermedia.
Answer:

It is a Gram-negative, anaerobic organism
It has short rods with rounded ends
Possess fimbriae

Virulence Factors:

Dental Plaque Prevotella intermedia

Question 16. Plunger Cusps.
Answer:

Cusps that tend to forcibly wedge food interproximal are called plunger cusps
It leads to food impaction
Further results in gingivitis, periodontitis, tooth mobility, and pocket formation

Question 17. Materia alba.
Answer:

Yellow/grayish-white, soft, sticky deposit, less adherent

Composition:

Micro-organisms, desquamated epithelial cells, leukocytes, a mixture of salivary proteins and lipids
They are capable of immunosuppression cytes, a mixture of salivary proteins and lipids
Clearly visible, flushed away easily with water
Tends to accumulate on the gingival third of teeth

Question 18. Bacterial Adherence/Formation.
Answer:

1. Via Electrostatic Interactions:

Negatively charged bacteria 11 calcium
↓↑
Negatively charged pellicle

2. Via Hydrophobic Interactions:

Based on the fit of molecules of pellicle and plaque
Lipoteichoic acid is responsible for this interaction by providing a long hydrophobic area

3. Via Lectin-like Substances:

Lectin recognizes specific carbohydrates in the pellicle and becomes linked to it.

Dental Plaque Bacterial attachment via hydrophbic interactions

Dental Plaque Bacterial attachment via specific lectin like interactions

Question 19. Plaque Hypothesis.
Answer:

Non-Specific Plaque Hypothesis:

States that the total bulk of plaque determines pathogenic- city rather than the species
When only a small amount of plaque is present, it gets neutralized
When a large amount of plaque is present, it causes disease

Specific Plaque Hypothesis:

States that not all plaque is pathogenic and its path- genericity depends on the presence of certain specific pathogens in plaque
Specific micro-organisms responsible for periodontal diseases release certain damaging factors
This mediates the destruction of host tissue

Proof: Presence of A.a. contains in localized juvenile periodontitis

Question 20. Red complex
Answer:

Secondary colonizers form red complex
- It consists of
- P. gingivalis
- T. denticola
- B. forsythias
It is responsible for bleeding on probing