Serum alkaline phosphate

# Serum alkaline phosphate is increased in all EXCEPT:
A. Paget's disease
B. Fibrous dysplasia
C. Osteomyelitis
D. Hyperparathyroidism

- In Paget's disease and hyperparathyroidism the level of Serum alkaline phosphate is elevated.

- In fibrous dysplasia, the levels are elevated initially.

- In Osteomyelitis, the level stays normal, so is the answer.

Oral manifestations of osteogenesis imperfecta

- large head size

- frontal bossing

- maxillary hypoplasia

- bulbous crowns of teeth with Dentinogenesis imperfecta and blue or brown translucence (opalescent teeth)

- Class III mal occlusion with anterior and posterior cross bite.

- Severe attrition of deciduous teeth

- Multiple impacted permanent teeth

- Excessive bruising tendency

- increased incidences of development of osteitis and osteomyelitis following extraction of teeth. 

Periapical granuloma vs Periapical cemental Dysplasia

# Difference between periapical granuloma and periapical cemental dysplasia:
A. Vitality
B. Histologically
C. Radio graphically
D. Culture media

The correct answer is A. Vitality

Periapical granuloma

The tooth in Periapical granuloma is non vital and may be slightly tender to percussion but otherwise symptoms may be minimal.

- Periapical cemento-osseous dysplasia (osseous dysplasia; cemental dysplasia; cementomas).

→ Periapical cemento-osseous dysplasia predominantly involves the periapical region of the anterior mandible.

→ Solitary lesions may occur but multiple foci are present more frequently.

There is a marked predilection for female patients (ranging from 10: 1 to 14: 1) and approximately 70 % of cases affect blacks.

→ Most patients are diagnosed initially between the ages of 30 and 50, with the diagnosis almost never made in individuals under the age of 20 years. 

Teeth associated with the lesions are almost invariably vital and seldom have restorations.

→ Periapical cemento-osseous dysplasia is an asymptomatic condition that is discovered when radiographs are taken for other purposes.

→ Early lesions appear as circumscribed areas of radiolucency involving the apical area of a tooth. At this stage, the lesion cannot be differentiated radiographically from a periapical granuloma or periapical cyst.

With time adjacent lesions often fuse to form a linear pattern of radiolucency that envelopes the apices of several teeth.

Diabetes mellitus symptoms

# History of excessive thirst, hunger, micturition during nights and recent loosening of teeth usually indicate that the patient is suffering from:
A Hypertension
B Hyperthyroidism
C Diabetes mellitus
D Glomerulonephritis

The correct answer is C. Diabetes Mellitus.

Theories of Local Anesthesia

THEORIES OF LOCAL ANAESTHESIA are -
A. Calcium displacement theory:
LA molecules displaces calcium inside the nerve which in turn controls sodium channels.

B. Electrical potential theory: The cations RNH+ of LA align themselves on the nerve membrane and make outside potential more positive, thus the threshold potential is increases.

C. Membrane expansion theory: LA penetrates the membrane, expands it and narrows the sodium channels, thus decreases the permeability to sodium ions.

D. Specific receptor theory: The specific receptors are sodium channels which are bound by LA controls the sodium channels. It is the most acceptable theory which explains the actions of LA.