NOTES

Prepared by: Claire Dianne Nero Demotica, DDM

ORAL ANATOMY

 Md 1 – bilaterally symmetrical
 Md 2 and Md 3 – distolingual twist in distal half
 Mx 2 – most rounded line angle (distal); abnormal contact with adjacent; most concave lingual
 Mx 3 – most prominent lingual ridge with mesial and distal fossae

 Mx 6 – palatal root is the longest; greatest surface area at root trunk

 Longest root:
1. Mx 3
2. Mx 5
3. Mx 6 palatal root

 Number of cusps seen:

o Md 6 – 5 in the buccal
o Mx 6 – 2 in the buccal, lingual cusps smaller
o Md 5 – 2 in the mesial (ML big), 3 in the distal

 Curve of Spee – antero-posteriorly; convex Mx, concave Md

 Curve of Wilson – medio-laterally; lingual inclination of md molars

 Mx D – resembles Mx 4; smallest primary molar

 Mx E – resembles Mx 6
 Md D – weirdest tooth, doesn’t resemble any other tooth
o No central fossa or not prominent
o Mesial marginal ridge is large -> resembles a cusp
 Md E – resembles Md 6; except:
o Md E: Prominence of cervical ridge
o Md 6: Not very prominent
o Md E: Nearly equal sizes of cusps
o Md 6: Distal cusp smaller than the other cusps

 Calcification: ADBCE
 Eruption: ABDCE
 Last to exfoliate: Mx C

 Outline form from facial:

o PENTAGONAL – canine
 Outline form from proximal:
o TRIANGULAR – ant
o RHOMBOIDAL – md molars
 Outline form from occlusal:
o RECTANGULAR – mx D
o RHOMBOIDAL – mx molars
o TRAPEZOIDAL – md molars
o HEXAGONAL – mx 4 (bent to mesial)
o OVAL – mx 5 (most symmetrical occlusal outline)
 Fusion – fewer teeth
 Gemination – more teeth

 Jaw shift to the left:

o Working side – LEFT (Anterior Downward Lateral)
o Balancing side – RIGHT (Anterior Downward Medial)

 Width
o Mx 1 > Mx 3 > Mx 2
o Md 3 > Md 2 > Md 1

 Antagonist
o Mx – namesake + distal tooth
o Md – namesake + mesial tooth

 Occlusion

Mx 6 Md 6
MB cusp MB groove
DB cusp Buccal embrasure of 6 & 7
ML cusp Central fossa
DL cusp Marginal ridge of 6 & 7

 Functional lingual surface

o Mx Ant vs. Md Ant

 Number of teeth
o 7 y/o – 16 primary, 8 permanent
o 8.5 y/o – 12 primary, 12 permanent
o 9.5 y/o – 10 primary, 14 permanent

 All primary teeth present, no permanent teeth yet – 2.5 to 5.5 y/o

 Always 1 root and 1 canal – Mx 3

 Sometimes bifurcated – Md 3
 Most likely to have two canals in 1 root in ant – Md 2

 Concavity
o Coronal concavity – distal of Mx 6
 Hard to clean
 Hard to put matrix on
o Mesial root concavity – Mx 4
o Both mesial and distal root concavity – Mx 5

 Lever type
o I – Seesaw – fulcrum in between
o II – Wheelbarrow – load in between
o III – Tweezer – effort in between (e.g. Mandible – fulcrum is the TMJ)

 How many teeth have cingulum? 12

 Height of contour
o Ant teeth
  Labial – cervical 3rd
 Lingual cervical 3rd
o Post teeth
 Buccal – cervical 3rd
 Lingual – middle 3rd

 Pulp chamber shape in CEJ x-sec

o Oval, flattened M-D – Mx 4, Md 1, Md 2
o Most round – Mx 1
o Egg-shaped – Mx 2
o Rectangular – Md 6

 Working interferences- inner side of guiding cusp

 Balancing interferences – inner side of supporting cusp
 Protrusive interferences – distal mx post; mesial md post

 Only 1 antagonist – Md 1 and Mx 8

 Frequency of impaction:
o 8s
o Mx 3 (last non-molar tooth to erupt, insufficient arch space)
o Md 4, 5
 Frequency of congenital absence:
o 8s
o Mx 2
o Md 5
 Dens-in-dente incidence
o 2
o 1
o 4, 5
o 3
o 6, 7, 8

 1 triangular ridge of ML + 1 triangular ridge of MB = Transverse ridge

 1 triangular ridge of ML + 1 triangular ridge of DB = Oblique ridge

 Most likely absent in Mx 7:

o Cusp of carabelli
o DL cusp

 Size of cusps
o Mx 6: ML > MB > DB > DL > cusp of carabelli
o Md 6: MB > ML > DL > DB > D

 Centric relation: ligament-guided

 Centric occlusion: tooth-guided
 Postural position: muscle guided

 Grooves in buccal and lingual

o Mx 6 – (2) – Buccal, Lingual
o Md 6 – (3) – Buccal, Lingual, Distobuccal
 Fossae in occlusal
 o Mx 6 – (4) – Distal Triangular, Mesial Triangular, Central, Distal
o Md 6 – (3) – Distal, Mesial, Central

 Primate spaces
o Mesial of Mx 3 (also where Globulomaxillary cyst is commonly located)
o Distal of Md 3 (also where Lateral Periodontal cyst is commonly located)

 Distodens/Distomolar – 4th molar

 Paramolar – buccal or lingual to molars

 Longest root both primary and permanent – Mx 3

 Greatest root:crown ratio (short crown, long roots) – Md 6

 Zigzag occlusal pattern – Md 6

 Plus-sign occlusal pattern – Md 7

 Pulp canal configuration

o Type 1 – single canal, single exit (1:1)
o Type 2 – two canals, single exit (2:1)
o Type 3 – two canals, two exit (2:2)
o Type 4 – single canal, two exits (1:2)

 Centered cingulum
o Mx 3
o Mx 2
o Md 1
 Cingulum towards the distal
o Mx 1
o Md 2
o Md 3

 -donts
o Heterodont – different morphologies of teeth
o Diphyodont – two sets of teeth
o Hypsodont – camel; high crown, attrition-resistant
o Herbivora (horses, elephants) – prone to attrition
o Secodont – tiger (carnassial teeth)
o Protocone – reptilian, tritubercular
o Hypocone – transition of tritubercular to quadritubercular

 Mx C – mesial cusp ridge longer

 Md C – distal cusp ridge longer
 Mx and Md 3 – distal cusp ridge longer

 Most variability:
o Crown alignment: Mx 2
o Root alignment: Mx 8
o Crown size and form: Mx 2 and Md 8

 1st succedaneous tooth to erupt: Md 1

 1st non-succedaneous tooth to erupt: Md 6

 Biggest premolar – Mx 4
  Smallest premolar – Md 4
 Shallowest central fossa – Md 8
 Enamel pearl usually where – Mx 7
 Well-defined central groove – Md 6
 Equidistant B & L cusps from B & L surfaces – Mx molars
 Thinnest labial bone – Md 1

GENERAL AND ORAL PATHOLOGY

Keywords:

 Reed Sternberg cells – Hodgkin lymphoma

 Starry sky – Non-Hodgkin lymphoma
 EBV, B-cell defect, lymph nodes spared – Burkitt’s lymphoma

 Pautrier microabscess – Mycosis fungoides

 Anti-nuclear antibodies – Sjogren’s syndrome
 Iris/Bull’s eye lesions – Erythema multiforme
 Tzanck cells – Pemphigus vulgaris
 Chvostek and Trousseau sign test – Hypocalcemia
 Aschoff bodies, Anitschkow cells – Rheumatic fever
 Lewy bodies – Parkinson’s disease
 Inner Tangles, Outer Plaques – Alzheimer’s disease
 Butterfly rash – SLE
 Albinism – Vitiligo

 Cortisol – Addison’s
 Cortisol – Cushing’s
 Reid index, Blue bloater – Chronic bronchitis
 Pink puffer – COPD
 BP in pregnant women – Pre-eclampsia

 Bence-Jones protein – Multiple myeloma (low RBC, WBC, platelets; high plasma cells)
 Café-au-lait-macules:
o Mccune-Albright syndrome
o Neurofibromatosis
o Tuberous sclerosis
o Fanconi anemia
 Sulfur granules – Actinomycosis

 Tongue fasciculation – Werdnig-Hoffman disease

 Lower motor neuron damage – Poliomyelitis
 Chorea, Dementia – Huntington disease
 Air embolus in circulation – Caisson disease
 Peau d’ orange and enlarged axillary lymph nodes – Breast cancer

 Hunter – deficiency of L-iduronate sulfatase (mucopolysaccharide storage disease)

 Hurler – deficiency of a-L-iduronidase (mucopolysaccharide storage disease)
 Von Gierke (Type I Glycogenosis) – deficiency of G6P
 Pompe (Type II Glycogenosis) – deficiency of lysosomal glucosidase
 McArle (Type V Glycogenosis) – low exercise tolerance, no lactic acid produced -> muscle cramping

 Cl transporter defect – Cystic fibrosis

 Defect in Citrulline to Arginosuccinate – Citrullinemia
 Defect in Phe to Tyr – Phenylketonuria
 Defect in homogentisate to maleylacetoacetate – Alkaptonuria

 Severe Combined Immunodeficiency – Stem cell differentiation defect

 Ataxia telangiectasia – defective B-cells
 Isolated IgA deficiency – defective B-cells
 Bruton – pre-B cells cannot transform to mature B cells
 Common Variable Immunodeficiency – B cells cannot transform into plasma cells
 Wiskott-Aldrich – Combined B and T-cell defect
 Job – defective T cells

 Stephan Curve
o Normal salivary pH – 7.0
o Demineralization – 5.5
o Recovery – 40 mins.

 Chemical Injuries
o Methanol – Blindness
o Cyanide – Cellular oxidation/Oxidative phosphorylation
o Mercury – Pneumonitis
o CCl4 – Fatty liver

 Pigmentations
o Ceroid – kuppfer cells
o Lipofuscin – yellow-brown; wear and tear pigment
o Hemosiderin – golden brown; from heme/ferritin micelles
o Bilirubin – yellowish; from heme/bile
o Melanin – brown-black; from Tyrosine

 Active Immunity – stimulate body to produce antibodies; vaccine

o Live attenuated – TB, Tularemia
o Killed – Cholera, Typhoid fever, Pertussis
o Toxoid – Tetanus, Diptheria
o Capsular Polysaccharide – Pneumonia, Meningitis
 Passive Immunity – antibodies already given
o Tetanus, Botulism, Diptheria

 Most common skin cancer – Basal cell carcinoma (benign)

 Most common cancer in men:
1. Prostate
2. Lung
3. Colorectal
4. Urinary tract
 Cancer death in men:
1. Lung
2. Prostate
 3. Colorectal
 Most common cancer in women:
1. Breast

 Most common primary brain tumor – Glioblastoma

 Highly malignant cerebellar tumor – Medulloblastoma
 Rathke’s pouch – Craniopharyngioma
 4th ventricle – Ependymoma
 Posterior Cranial Fossa – Astrocytoma

 Teratoma – all 3 germ layers

 Choristoma – misplaced within another organ
 Adenoma – glandular
 Papilloma – surface epihelium

 Autograft – same person, diff sites

 Allograft – not a relative (same species)
 Isograft – relative (same species)
 Xenograft – other species

 Trisomy
o 13 – Patau
o 18 – Edward
o 21 – Down
o XO – Turner
o XXY – Klinefelter

 Thrombus
o Mural – Myocardial infarction, aortic atherosclerosis
o Agonal – Prolonged heart failure
o Red – RBC accumulation
o White – platelet accumulation
o Fibrin – fibrin accumulation

 Anemia
o Aplastic – decreased production of RBCs
o Hemolytic – decreased life span of RBCs
o Megaloblastic – immature RBCs
o Sickle cell – abnormal hemoglobin
o Plummer-vinson – Iron deficiency
o Pernicious/Bermier’s – Vitamin B12/ Cobalt deficiency
o Folate – folate deficiency

 Cooley’s anemia – Thalassemia

 Gee-Herter’s disease – Celiac disease

 Polycythemia – high RBC number

o True – high RBC mass
o Primary/Polycythemia vera – less sensitivity ton erythropoietin
o Secondary – due to other conditions
o Relative – less plasma volume (Gaisbock Syndrome)

 Infectious stages
o Acute – active growth short-term
o Chronic – active growth long-term
o Latent – no active growth, reactivation possible
o Carrier – active growth, with or without symptoms
o Subclinical – detected in serology, no clinical symptoms