Classification of indices

Poojitha SurgiLeave a comment

In general, there are two types of Dental indices.

The first type of index measures the ‘number’ or ‘proportion ‘ of people in a population with or without a specific condition at a specific point in time or interval of time.

The send type of Dental index measures the ‘number of people affected’ and the ‘severity’ of a specific condition at a specific time or interval of time.

1.Based upon the direction in which their scores can fluctuate:

▪️Irreversible index:

An index that measures conditions whose scores will not decrease on subsequent examinations. Eg: DMFT index.

▪️Reversible index:

An index that measures conditions that can increase or decrease on subsequent examinations. Eg: Loe and Silness gingival index.

2.Depending upon the extent to which areas of oral cavity are measured

▪️Full mouth indices:

These indices measure the patient’s entire periodontium or dentition. Eg: Russell’s Periodontal Index

▪️Simplified indices:

These indices measure only a representative sample of the dental apparatus. Eg: Greene and Vermillion’s Oral Hygiene index – Simplified

3.Indices may be classified under certain general categories according to the entity which they measure

▪️Disease index:

The ‘D’ (decay) portion of the DMFT index best exemplifies a disease index.

▪️Symptom index:

The indices measuring gingival/sulcular bleeding are essentially symptom indices.

▪️Treatment index:

The ‘F’ (filled) portion of the DMFT index best exemplifies a treatment index.

4.Dental indices can also be classified under special categories as,

▪️Simple index

An index that measures the presence or absence of a condition. Eg: Silness and Loe Plaque Index

▪️Cumulative index:

Am index that measures all the evidence of a condition, past and present. Eg:DMFT index for dental caries.

References:

Textbook of Public Health Dentistry – Soben Peter 6th edition.

FREY SYNDROME

Poojitha SurgiLeave a comment

Also known as Auriculotemporal syndrome or Gustatory sweating, it is an unusual phenomenon which arises as a result of damage to the auriculotemporal nerve and subsequent reinnervation of sweat glands by parasympathetic salivary fibers.

Etiology: This syndrome follows some surgical operation (area involving auriculotemporal nerve) , during which the damaged nerve regenerates, parasympathetic nerve supply develops, interacting sweat glands, which then function after salivary, gustatory, or psychic stimulation.

Clinical features: Patient typically exhibits flushing and sweating of the involved face, mainly temporal region, during eating.

Profused sweating can be evoked by parenteral administration of pilocarpine or eliminated by administration of atropine or a prominent block of auriculotemporal nerve.

The syndrome is a possible complication of parotitis, parotid tumor, ramus resection, mandibular resection for correction of prognathism. It has been reported as a complication in as high as 80% of cases following parotidectomy.

Treatment: Intracranial division of auriculotemporal nerve.

Reference: Shafer’s Textbook of Oral Pathology, 9th edition.

PARRY-ROMBERG SYNDROME

Tanmayee Sripada1 Comment

INTRODUCTION

Parry-Romberg syndrome is also called as facial hemiatrophy. It is slowly progressive atrophy of the soft tissues of half of the face and also progressive wasting of subcutaneous fat with atrophy of skin,cartilage,bone and muscle.

ETIOLOGY

  • The primary factor being the cerebral disturbances which leads to increased and unregulated activity of the sympathethic nervous system,which inturn leads to localized atrophy.
  • the other factors include:

extraction of teeth

local trauma

infection

genetic factors

disruption of stapedial artery

CLINICAL FEATURES

SEX: females are more affected than males with ratio of 3:2

AGE: occurs generally in the first decade

SITE: Mostly occurs on the left than the right side

CLINICAL PRESENTATION-

  • COUP DE SABRE

It is a painless cleft near the midline of the face or forehead.

Marks the boundary between normal and atrophic tissue.

  • ATROPHY

Bluish hue may appear in the skin overlying atrophic fat.

The affected area extends with atrophy of skin,cartilage,alveolar bone and soft palate on that side of the face.

facial wasting: ipsilateral salivary glands and hemiatrophy of the tongue,unilateral involvement of the ear,larynx,oseophagus,diaphragm,kidney and brain.

  • Pigmentation disorders
  • Facial naevi
  • Contralateral jacksonian epilepsy
  • Contralateral trigeminal neuralgia
  • occular abnormalities

ORAL MANIFESTATIONS

  • Incomplete root formation
  • delayed eruption of teeth
  • difficulty with mastication
  • hemiatrophy of lips and tongue
  • eruption of teeth on the affected side is retarded.

TREATMENT

No specific treatment but cosmetic surgeries are recommended.

ADAMS CLASP

sakshibhudeLeave a comment

Clasps are the retentive components of the removable appliances.

Mode of action-

  • Clasps act by engaging certain areas of teeth called the undercuts.
  • Two types of undercuts are found in natural dentition
  • Buccal and lingual cervical
  • Mesial and distal proximal
  • Adams clasp engages the mesial and distal proximal undercuts.

Adams clasp also called as universal clasp, liverpool clasp and modified arrowhead clasp.

Parts of adams clasp-

  • Two arrowheads
  • Bridge
  • Two retentive arms

Advantages of adams clasp-

  • Rigid and offers excellent retention
  • Fabricated on deciduous and permanent dentition
  • Can be fabricated on fully or partially erupted tooth
  • Can be used on molars, premolars and incisors.
  • Small and occupies minimum space
  • Can be modified in many ways.
  • Universal pliers can be used for fabricating.

Modifications of adams clasp-

  • Adams with single arrowhead
  • Adams with J hook
  • Adams with incorporated helix
  • Adams with additional arrowhead
  • Adams on incisor and premolars
  • Adams with distal extension

Reference- Bhalajhi 7th edition

BUDD-CHIARI SYNDROME

Tanmayee SripadaLeave a comment

INTRODUCTION

Its an uncommon condition which occurs from occlusion of hepatic vein or inferior vena cava . it may be acute but usually is chronic.

Budd-Chiari Syndrome may also cause other conditions, including:

  • Portal hypertension (increased pressure in the portal vein, which carries blood from the intestines to the liver).
  • Esophageal varices (twisted veins in the esophagus, or “food tube”).
  • Ascites (a buildup of fluid in the abdomen).
  • Cirrhosis (scarring of the liver).
  • Varicose veins (abnormal, swollen blood vessels) in the abdomen and/or rectum.

CAUSES

  • Myeloproliferative diseases such as polycythemia and thrombocythemia.
  • pregnancy
  • protein c or S deficiency
  • oral contraceptives
  • tumours
  • congenital venous webs
  • trauma
  • radiotherapy
  • Sickle cell disease 
  • Inflammatory bowel diseases

CLINICAL FEATURES

  • Massive splenomegaly
  • Intractable transudative ascites
  • Jaundice
  • Pain in the upper abdomen
  • enlarged and tender liver
  • bleeding in the esophagus
  • hepatic encephalopathy
  • vomiting
  • liver failure
  • fatigue

DIAGNOSIS

  • Doppler ultrasound – It demonstrates the obstruction of hepatic vein with reverse flow.
  • CT/MRI – They show enlargement of caudate lobe.
  • Liver biopsy – this confirms the diagnosis of cirrhosis.

TREATMENT

  • Drug therapy -blood-thinning drug warfarin (Coumadin®) is often prescribed to prevent future clots. When recent thromobolysis is suspected thrombolytic therapy followed by low molecular heparin therapy may be useful.
  • Non surgical procedures – ascites is managed with transjugular intrahepatic portosystemic shunt(TIPS) and percutaneous transluminal angioplasty
  • Surgery – If you have liver failure (the liver no longer functions adequately), a liver transplant is the usual treatment.

Overwhelmed about upcoming university exams?

Anisha ValliLeave a comment

As promised here is meself pretending like its Decemeber 2020 and there is nobody more fired up for fourth year exams than me. 🥲

It’s so very easy to get caught up in downward spiral of self doubt and past failures, even though I try to be as optimistic as I can..I am not immune to it. So, I lost few days to overthinking and worrying but not anymore.

I believe a lot of us are in the same position, we want to do our best, we want to study for many many hrs a day, we want to get done with our daily targets but there is some invisible force stopping us, making us give half hearted attempts at everything we try to do.

As for the identity of this invisible force, I believe its fear and self doubt and a feeling of being alone in our struggle, all these cloaked and disguised so that we cant figure out how to fight it.

But I have figured it out, like I mentioned before I have a superawsome brain, (it might not fetch me a cool rank in exam but it does other really wonderful things). 😂😂

So, here is my plan to fight off these invisible forces and make room for the possibility of a bright future –
.
🧠 Forget about strategies, just read, anything, all the time, if boring subjects are giving you a hard time, switch immediately, there is no time to waste.
🧠 7 hrs a day is a must!
🧠 I will focus on strengthening the 80% syllabus that will get me 70% scores
🧠 Watching 2 to 3 video lectures on a daily basis especially live classes or interactive classes, especially of your fav teachers or subjects will give you enough boost!
🧠 Encourage and support each other, that’s the best way to not succumb to despair.
YOSH!

thyroglossal cyst

dr swati mandhanLeave a comment

A thyroglossal cyst is a fibrous cyst that forms from a persistent thyroglossal duct. Thyroglossal cysts can be defined as an irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland during developmental stages