# Gingival involvement is an unusual finding in one of the following conditions?
A. Recurrent aphthae
B. Pemphigoid
C. Primary herpes
D. Pyogenic granulomas
The correct answer is A. Recurrent aphthae.
The first episodes of RAS most frequently begin during the second decade of life. The lesions are confined to the oral mucosa and begin with prodromal burning or the sensation of a small bump in the mucosa from 2 to 48 hours before an ulcer appears. During this initial period, a localized area of erythema develops. Within hours, a small white papule forms, ulcerates, and gradually enlarges over the next 48–72 hours. The individual lesions are round, symmetric, and shallow (similar to viral ulcers), but no tissue tags are present from ruptured vesicles, which helps distinguish RAS from diseases that start as vesicles, such as pemphigus, and pemphigoid. Multiple lesions are often present, but the number, size, and frequency vary considerably.
The buccal and labial mucosae are most commonly involved. Lesions rarely occur on the heavily keratinized palatal mucosa or gingiva. In mild RAS, the lesions reach a size of 0.3–1.0 cm and begin healing within a few days. Healing without scarring is usually complete in 10–14 days.
Reference: Burket’s Oral Medicine, 12th Edition Page no 75
High blood pressure or Hypertension is blood pressure higher than normal. Blood pressure is expressed in A/B form where A is systolic pressure and B is diastolic pressure. High blood pressure is blood pressure above 140/90 mm Hg. Uncontrolled hypertension can lead to heart and kidney disease, stroke and blindness. But researches have shown that high blood pressure can be prevented by following the Dietary Approaches to stop Hypertension (DASH) eating plan. Dietary Approaches to Stop Hypertension (DASH) diet originated in the 1990s.
Many researches were conducted in 1992 by National Institute of Health to find the effectiveness of DASH eating plan. The research concluded that dietary interventions alone can lower systolic blood pressure by 6-11 mm Hg. The DASH diet offer an alternative to drug therapy in hypertensives and may prevent hypertension in normotensives. In a study done in 2014,the DASH diet was found to result in significant decreases in systolic BP ( − 5·2 mmHg, 95 % CI − 7·0, − 3·4; P< 0·001) and diastolic BP ( − 2·6 mmHg, 95 % CI − 3·5, − 1·7; P< 0·001). These changes predicted a reduction of approximately 13 % in the 10-year Framingham risk score for CVD.
DASH includes consumption of fruits and vegetables, lean meat and fat free or low fat dairy products, whole grains, fish, poultry, beans, seeds, and nuts and foods rich in nutrients —mainly potassium, magnesium, calcium, protein, and fiber. It also limits the intake of sodium in the diet to 1500 mg/day. DASH emphasizes on decrease consumption of processed food and increase consumption of fresh food.
DASH plan is as follows:
1.Vegetables: about five servings per day
2.Fruits: about five meals per day
3.Carbohydrates: about seven servings per day
Healthy carbohydrates included under DASH include:
Green leafy vegetables: kale, broccoli, spinach, mustards
Whole grains: cracked wheat, millets, oats
Low glycemic index fruits
Legumes and beans
4.Low-fat dairy products: about two servings per day
DASH includes good fats. Good fat prevent inflammation and help in promotion of health. These fats increase HDL and decrease LDL.
- Olive oil
- Avocados
- Nuts
- Hempseeds
- Flax seeds
- Fish rich in omega-3 fatty acids
5.Lean meat products: about two or fewer servings per day
6.Nuts and seeds: 2 to 3 times per week
The DASH diet contains large amount of fiber and can cause bloating and diarrhoea. To avoid these problems, gradually increase the fruit, vegetables and whole grains in your diet over the weeks. Make these changes over a couple of days or weeks.
1.Add a serving of vegetables at lunch one day and dinner the next, and add fruit at one meal or as a snack.
2.Increase your use of fat-free and low-fat milk products to two servings a day.
3.Limit lean meats to 6 ounces a day—3 ounces a meal.
DASH diet helps you to control blood pressure and stay healthy. It helps to keep metabolic syndromes in check. Compliance to DASH has been associated with improvements of outcomes in type 2 Diabetes.
Know about JNC-8 Recommendations for Hypertension in the following video:
The correct answer is C. Remove long wavelength X rays.
Although an x-ray beam consists of a continuous spectrum of x-ray photon energies, only photons with sufficient energy to penetrate through anatomic structures and reach the image receptor (digital or film) are useful for diagnostic radiology. Low-energy photons that cannot reach the receptor contribute to patient risk but do not offer any benefit. Consequently, it is desirable to remove these low-energy photons from the beam. This removal can be accomplished in part by placing a metallic disk (filter) in the beam path. A filter preferentially removes low-energy photons from the beam, while allowing high-energy photons that are able to contribute to making an image to pass through.
Energy of x-rays depends directly on its frequency (E~f) and inversely related to wavelength (E~1/λ). Electromagnetic waves with higher frequencies have proportionally higher energies. The wave with the shorter wavelength, will have higher frequency. Since we know that the energy scales directly with the frequency we know that the wave that has the shorter wavelength will have higher energy.
Reference: Oral Radiology Principles and Interpretation, 7th Edition, White and Pharoah, Page no 10
# Initial clinical sign of juvenile periodontitis:
A. Pathological tooth migration and midline diastema
B. Tooth mobility and bone loss
C. Gingival enlargement and pus formation
D. Pain and bleeding
The correct answer is A. Pathological tooth migration and midline diastema.
Pathologic migration may continue after a tooth no longer contacts its antagonist. Pressures from the tongue, the food bolus during mastication, and the proliferating granulation tissue provide the force.
Pathologic migration is also an early sign of localized aggressive periodontitis. Weakened by the loss of periodontal support,the maxillary and mandibular anterior incisors drift labially and extrude, thereby creating diastemata between the teeth.
# In initial stages, treatment of acute necrotizing ulcerative gingivitis without systemic involvement is:
A. Thorough debridement and H2O2 mouthwashes
B. Penicillin therapy
C. Metronidazole and penicillin therapy
D. Gingivectomy and gingivoplasty
The correct answer is A. Thorough debridement and H2O2 mouthwashes.
The oral cavity is examined for the characteristic lesion of NUG, its distribution, and the possible involvement of the oropharyngeal region. Oral hygiene is evaluated, with special attention to the presence of pericoronal flaps, periodontal pockets, and local factors (e.g., poor restorations, distribution of calculus). Periodontal probing of NUG lesions is likely to be very painful and may need to be deferred until after the acute lesions are resolved.
The goals of initial therapy are to reduce the microbial load and remove necrotic tissue to the degree that repair and regeneration of normal tissue barriers are reestablished.
# The extraoral radiograph that best shows the maxillary sinuses is:
A. AP skull
B. Lateral skull
C. Towne’s view
D. Waters’ view
The correct answer is D. Waters' view.
This technique is useful for the evaluation of maxillary sinuses and it also demonstrates frontal sinuses, ethmoidal sinuses, orbit, zygomaticofrontal suture and nasal cavity. In Waters’ technique the neck is hyperextended enough to place the dense petrosae immediately below the maxillary sinus floor.
