CHEMICAL NATURE OF AMYLOIDOSIS
PATHOGENESIS –
CLASSIFICATION OF AMYLOIDOSIS
Main organs involved-
Secondary amyloidosis– kidneys , liver, spleen, lymph nodes, adrenals , thyroid
Primary amyloidosis– heart , skin , peripheral nerves, tongue, respiratory tract
Source – textbook of pathology ( harsh mohan ) and pathology preparatory manual by ramdas nayak
Pictures – Google
Muhad Noorman P- Dentowesome 2020
During impacted teeth extraction process,Surgical managment of facial fractures with high speed rotary instruments like airotor, blowing of compressed air into root canal , airotor in middle face fractures with use of air-pushing machine such as airotor or even an air syringe, Due to air leakage inside the tissues can cause the phenomenon of confined air within tissues called Cervicofacial Emphysema and is the result of air trapping, so use the micromotor handpiece instead of the airotor, because it is a dangerous condition._The treatment is only to reassure the patient that it will go away after 3-4 days. However rarely can cause Venous Air Embolism, mediastenal emphysema and rarely pneumothorax.
Clinically presented as unilateral swelling of face/neck with or without dysphagia resembling Angioedoema,however crepitus on palpation is a positive diagnostic feautre.
Another type is PNEUMOPAROTID,entrapment of air in parotid duct either accidental or by profession in trumphet blowing artist etc.. presenting with painful swelling in face over parotid region with froathy saliva.and ctepitus on palpation.
References: Shafer’s Textbook of Oral Pathology
Muhad Noorman P – Dentowesome 2020
Papillon–Lefèvre syndrome (PLS) is a rare autosomal recessive disorder, characterized by diffuse palmoplantar keratoderma (hyperkeratosis) and precocious aggressive periodontitis, leading to premature loss of deciduous and permanent dentition at a very young age. Various etiopathogenic factors are associated with the syndrome, like immunologic alterations, genetic mutations, and the role of bacteria. Dentists play a significant role in the diagnosis and management of PLS as there are characteristic manifestations like periodontal destruction at an early age and an early eruption of permanent teeth. Here, we are presenting an elaborate review of PLS, its etiopathogenesis, clinical presentation, and management options.
Genetic studies of patients with Papillon-Lefèvre syndrome have mapped the major gene locus to chromosome 11q14-q21 and revealed mutation and loss of function of the cathepsin C gene. This gene is important in the structural growth and development of the skin and is critical for appropriate immune response of myeloid and lymphoid cells. Researchers believe that the loss of appropriate function of the cathepsin C gene results in an altered immune response to infection. In addition, the altered gene may affect the integrity of the junctional epithelium surrounding the tooth.
A closely related disease, Haim-Munk syndrome, also exhibits palmoplantar keratosis, progressive periodontal disease, recurrent skin infections, and several skeletal malformations. In this syndrome, the skin manifestations are more severe and the periodontal disease is milder. Studies have demonstrated that Haim-Munk syndrome and many examples of prepubertal periodontitis also exhibit mutation of the cathepsin C gene and represent allelic variants of the mutated gene responsible for Papillon-Lefèvre syndrome.
References: Shafer’s Textbook of Oral 9th edition
Photo credits: Dr Karthikeyan,PG final year Periodontics,Saveetha dental College, Chennai
HOW TO ENJOY THE PREPARATION
Graves’ disease is the most common cause of hyperthyroidism, or overactive thyroid. In Graves’, the body’s hyperactive immune system produces an antibody that attaches to the TSH receptors on the thyroid gland. Because TSH isn’t actually triggering the release of T3 and T4, the negative feedback system the body has in place doesn’t work and the thyroid continually makes and releases thyroid hormones. Since the antibodies consistently trigger the thyroid cells to produce more T3 and T4, the body responds by increasing the thyroid’s size, causing a classic thyroid symptom called goiter.
The other primary external symptom of Graves’ is called exophthalmos, or protrusion of the eyes. Exophthalmos has two causes. The first is due to a prolonged ‘fight or flight’ response – the widening of the eyes by a retraction of the upper lids. The second is due to that overactive immune system: the fat and muscles around the eyes become swollen due to an increase in the number of lymphocytes present and other symptoms of inflammation, pushing the eyes forward.
Internally, excess thyroid hormones are also stressing the sympathetic nervous system, constantly preparing us for a threat that’s not really there. Resting metabolic rate increases, causing weight loss. Resting heart rate jumps irregularly (arrhythmia) or increases to over 100 beats per minute (tachycardia). Heat intolerance and heavy perspiration are also symptoms.
Diagnosis of Graves’ through blood tests relies largely on high-circulating levels of T3 and T4 and low TSH levels, as well as antibodies for TSH receptors. Occasionally, an iodine uptake test is used for confirmation. In this test, the patient consumes a low dose of radioactive iodine. Since thyroid cells actively take up iodine, the degree and location of overactive cells present in radiography as darkened areas of the thyroid.
Pharmaceutical treatment for Graves’ consists of symptom relief through beta blockers, which dull sympathetic nervous system activity, and antithyroid medications that prevent the thyroid from making hormones, such as methimazole. In more severe cases, surgical removal of or destruction of the hyperactive cells through radioactive iodine is a treatment option.
– current approach in dentistry in Covid state Amidst the pandemic state with the high transmissibility of the disease through air & droplets and considering that routine dental procedures usually generate aerosols; alterations to dental treatment is of prime concern to maintain a healthy environment for patient & dental team.Here is where the approach of […]
Minimal Invasive Dentistry
Sources: Slideshare-Minimal invasive dentistry by Nabeela Basha , Minimal intervention dentistry by Dr.Nagamaheswari, Sturdvent’s South Asian edition,Clinical operative dentistry principles & practice by Ramya Raghu,textbook of preventive and community dentistry by SS Hiremath
Sources:
REFERENCES: GROSSMAN TEXTBOOK
References: GROSSMAN TEXTBOOK
Source: Dentest Clinical Sciences, 7th edition
– S Gowri Shankar
– Suresh Shenvi
(Reference Standard textbook: Handbook of local anaesthesia by Malamed’s, 4th Ed., Page no. 24)
Source: Contemporary Oral and Maxillofacial Surgery
By-
James Hupp, Myron Tucker and Edward Ellis.
