Haemophilia

The laboratory findings in haemophilia will be as follows.

APTT (activated partial prothrombin time) -prolonged

PT (prothrombin time)-normal

BT (bleeding time)-normal [1] or increased [2]

Factor VIII-C- low

Factor VIIIR:Ag [von Willebrand factor] and factor VIIIR:RCo [Ristocetin cofactor]-normal

Ref:

  1. Crispian Scully, Roderick A. Cawson Medical problems in dentistry page 142 5th Ed. 
  2. https://www.cdc.gov/ncbddd/hemophilia/diagnosis.html


Oral Erythroplakia

Oral Erythroplakia


Erythroplakia is a clinical term for a potentially malignant fiery red lesion that cannot be attributed to any particular condition.


Signs and Symptoms


Lesions are usually asymptomatic and isolated, and commonly appear on the floor of the mouth, tongue, soft palate and buccal mucosa. Lesions may appear as smooth, velvety, granular or nodular plaques, often with clear margins.

Antimicrobials used in dentistry

Antimicrobials used in dentistry

Chemotherapy is the use of chemicals to destroy or inhibit the growth of cells. Two broad classes of chemotherapeutic agents are used in pharmacology: 

  1. antimicrobials and 
  2. anticancer drugs. 

The basis of antimicrobial chemotherapy is a differential sensitivity of the patient and microbe cells to the action of the drug. The drug may affect a structural component of the target cell which is not found in the patient, for example, the bacterial cell wall. Alternatively, a chemotherapeutic agent may inhibit a metabolic pathway peculiar to the microbe cells, for example, synthesis of folate.

ADC Exam Coaching in India- Prelims & Practical explained


Introduction

The Australian Dental Council conducts a series of assessment exams for accreditation of the scientific knowledge, technical and clinical skills and ability to make a clinical judgement in relation to patient care of an overseas dentist whose dental graduate degree is not recognised by the Dental Board of Australia.

Once an overseas dentist successfully clears the assessment process, he or she can register with DBA as a GP and can practice Dentistry in Australia.

Australian Dental Council assessment process is a three-stage process. The first is the initial assessment that I have already explained in the episode 1 of our video series. Now, in episode 2 of the video series, I shall explain written as well as practical exams. After going through this video, you will become familiar and confident with every aspect of the exams.

New Blue Print of ADC Written Examination

The success in examination of Australian Dental Council depends on the rigorous practice. Once you understand the format of the written part 1 examination, the type & pattern of questions, you can easily crack it.

Video lecture on ADC written examination is given below. If you do not want to read the article, you can see the video.


ADC Written Examination Format

The part 1 ADC exam will have 4 sections that will be conducted in 2 days. Two section will be held in one day. There will be a break for rest between two sections. The whole ADC part 1 exam will be conducted in two consecutive days. To make it further clear you can see below in fig 1 in a diagrammatic representation.

___________________________________________________________

Fig 1. Structure and timings of ADC written examination format.

Each section will have 70 questions of which 56 will be scenario based. Remaining 14 question may vary in type that you will come to know later on in our various courses. There will be five options and you will have to chose one best correct option as your answer. Thus, there will be total 280 questions in ADC part 1 written examination. Out of 280 questions, 40 questions will have no marks which means they will not be scored. The ADC has put them there for calibration and testing purpose. It means 240 questions will be marked or scored and you will be declared pass or fail based on the marks obtained on scored questions. Scored and unscored questions will be unknown to you. This means you should treat all 280 questions as scored questions, as you do not know which question will contribute towards your success. The duration of each section will be of 70 minutes.

Blue Print of Written Exam

The written examination blueprint describes the content covered and the approximate percentage of questions allocated to each content area. The written examination blueprint is shown in fig 2 given below.

Fig 2. ADC written exam blue print. (Source: ADC handbook for written examination) Click to see full image.


Passing Requirements of ADC Written Examination

To pass the written exam, you must pass in each of four cluster separately. See below to understand the clusters in a better way.

  • Cluster 1: It encompasses professionalism and health promotion aspect.
  • Cluster 2: It is related to the clinical information gathering.
  • Cluster 3: It will check your ability of making diagnosis and management planning.
  • Cluster 4: it will check your ability to perform clinical treatment and its evaluation.

To pass each cluster separately, you need to achieve either “A” or “B” grade. If you get grade “C” or “D” it means you failed the ADC part 1 written exam. The meaning of different grades are as given below

Grade A: Your score was more than 10% above the passing score. You got a clear pass.
Grade B: Your score was within 10% above the passing score. You got a close pass.
Grade C: Your score was within 10% below the passing score. You got a close fail.
Grade D: Your score was more than 10% below the passing score. You got a clear fail.

So, getting a grade C or D means the ultimate result is same for you, as you need to retake the part 1 written exam to be eligible for part 2 practical examination.

The ADC does not set a passing mark and it has a complex mechanism of evaluation that you can see in the written examination hand book if you are interested.

Getting your results

Written examination results are usually available within six weeks of the examination but may take longer. You will be notified when your written examination results are available and how to access your results.

Cysts of the Jaws and Neck: Classification

 

Cysts of the Jaws and Neck 

Cysts can be classified in three types.

Odontogenic Cysts  

  1. Periapical (Radicular) Cyst  
  2. Lateral Periodontal Cyst  
  3. Gingival Cyst of the Newborn  
  4. Dentigerous Cyst  
  5. Eruption Cyst  
  6. Glandular Odontogenic Cyst  
  7. Odontogenic Keratocyst  
  8. Calcifying Odontogenic Cyst  

Nonodontogenic Cysts  

  1. Globulomaxillary Lesion  
  2. Nasolabial Cyst  
  3. Median Mandibular Cyst  
  4. Nasopalatine Canal Cyst  

Pseudocysts  

  1. Aneurysmal Bone Cyst  
  2. Traumatic (Simple) Bone Cyst  
  3. Static Bone Cyst (Stafne’s Bone Defect)  
  4. Focal Osteoporotic Bone Marrow Defect  
  5. Soft Tissue Cysts of the Neck  
  6. Branchial Cyst/ Cervical Lymphoepithelial Cyst  

Parotid Fistula

     Normally there is one opening of the parotid gland which is located in buccal vestibule opposite the upper 2nd molar tooth.

     Parotid fistula is a patent tract connecting a parotid gland or duct to the exterior apart from the parotid duct opening.

Photo 1. Pre-operative picture of parotid fistula with leakage of serous fluid from the fistulous tract and scarring of surrounding area (red circle) [1]

     Parotid fistula may be of two types

    1. Glandular: It arises directly from gland. It shows minimal discharge during rest or eating.
2. Ductal: It arises from duct. It shows profuse discharge during eating.

Parotid fistula may be extra oral or intraoral.

Extraoral fistulas are seen in the preauricular region or near the angle of mandible (see photo 1 and 2).

Photo 2. showing discharge of serous fluid from the right cheek in the angle of mandible region [2]



Causes
1. After superficial parotidectomy.
2. After drainage of parotid abscess.
3. After biopsy or Trauma.
4. Post surgical

Clinical Features
1.  Discharging fistula in the parotid region of the face, and discharge is more during eating.
2. Tenderness and induration.
3. Trismus if it gets infected

     Diagnosis
1.  Sialography to find out the origin of the fistula whether from the parotid gland or duct or ductules.
2. Fistulogram or CT fistulogram.
3. Culture of discharge if infection is suspected
4. MRI to assess soft tissues involvement

    Treatment
Ø Surgical stripping of the fistula tract
Ø Anticholinergics in post-operative period- Hyoscine bromide (Probanthine) reduce discharge
Ø Immediate post surgical fistulas can close spontaneously in such cases
Ø Newman Seabrock's operation: used for removal of anomalous arotid fistula
Ø If there is stenosis at the orifice of the Stenson's duct, papillotomy at the orifice may help.
Ø Total conservative parotidectomy is done in failed cases conserving the facial nerve
 
Ref: