How to read the genome and build a human being- a presentation by Riccardo Sabatin

A very interesting video with visual representations of the size of the human genome and the challenges to personalized medicine.

CARIES VS. EROSION

Claims and warnings of the ill effects of carbonated sweet drinks on dental health have occupied the minds of dentists and the concerned public for some time. In a recent, update one of the dental organizations warned of the harmful effect of the acidic drinks and the decay they can cause.

The acid that causes the demineralization in dental caries is a metabolic byproduct of cariogenic bacteria.  The acid that causes erosion, however, is either dietary, consumed as citrus fruits, vegetables, colas, carbonated drinks, or from the stomach as regurgitated acid, or vomit. Medications such as vitamin C and occupational and industrial exposure can also lead to dental erosion.

So are the two processes of dental caries and erosion interchangeable or does the similarity between these hard tissue lesions end at the involvement of acids?

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Dental Erosion - process by Mandana Donoghue is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

The acids that cause erosion are very strong, with an average pH of 2 for the colas, 2-2.5 for citrus fruits and 1 for gastric contents and acid.  Repeated exposure, to acids with pH much lower than 5.4 (critical pH for demineralization)  leads to surface demineralization.  The soft surface is susceptible to loss by abrasion from food, or a toothbrush. The surface lesions are resistant to remineralization. Repeated cycles of acid exposure will lead to smooth, cupped out cavities. These lesions have smooth edges.  Surfaces most susceptible to erosion are the palatal surfaces of maxillary anterior teeth, although, other teeth are also affected.  

Dental caries process by Mandana Donoghue is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

The acid that leads to demineralization in dental caries is a  metabolic product of the acidogenic bacteria of the dental plaque or biofilm. Although the caries process is a multifactorial one and carbohydrate exposure is not by itself a determinant of caries development, repeated carbohydrate exposure tilts the scale towards caries.  The cariogenic bacteria in the plaque, metabolize dietary carbohydrates and release acids. The H⁺ ions released in the bacterial plaque act on the underlying tooth surfaces and lead to subsurface demineralization of the tooth. Dental plaque has a dual role in the caries process. The first is the provision of a suitable microenvironment for attachment and multiplication of the acidogenic bacteria that cause caries.  The second role is the barrier effect it provides to the movement of the calcium and phosphate ions released from the tooth into the saliva, thus making it possible for the minerals to demineralize the surface after the pH level rises above 5.4. Although an argument can also be made that plaque delays the neutralization of acids on the tooth surface by slowing the ingress of saliva. Each carbohydrate exposure produces a cycle of acid production and neutralization.  Repeated exposures eventually lead to a carious lesion. The cavitated lesion develops due to the eventual breakdown of the unsupported enamel. The cavity is not smooth in outline, and the base which is softened dentin does not appear polished as in the erosion cavity.   

SOLITARY LYTIC BONE LESIONS - DIFFERENTIAL DIAGNOSIS ACRONYM

This one is from the multitude of notes I have made through the years. From an era, where we did not necessarily note  the source of everything for future citation. While, I do not know the source for the anagram, I would love to add it if anyone can help.

Just 8 hours later and actually found a source of the information, seems more recent than I remember . Still it is a  source, thanks to Google ...http://rad.washington.edu/about-us/academic-sections/musculoskeletal-radiology/teaching-materials/online-musculoskeletal-radiology-book/lucent-lesions-of-bone/

Solitary lytic bone lesions DDx

DENTAL CARIES- TOPIC MAP

This topic map on cariology (etiology to management) is designed to keep track of the main topics and concepts in cariology.

Cariology Topic Map by Mandana Donoghue is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Based on a work at www.oralpath.in.
Permissions beyond the scope of this license may be available at www.oralpath.in.

ORAL HISTOLOGY SALIVARY GLANDS(SUBLINGUAL GLAND)

MIXED SALIVARY GLAND (PREDOMINANTLY MUCOUS)- SUBLINGUAL

SUBLINGUAL SALIVARY GLAND

MSU- Mucous salivary unit

SD- Serous demilune

Note: There is an absence of serous secretory units, and only a few serous demilunes are seen. The intercalated ducts are hard to find.

sublingual salivary gland by Dr. Mandana Donoghue is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Based on a work at http://www.omfpcenter.com/.

ORAL HISTOLOGY- SALIVARY GLANDS ( SUBMANDIUBULAR)

MIXED SALIVARY GLAND- SUBMANDIBULAR

MIXED SALIVARY GLAND- SUBMANDIBULAR 

MSUSD- Mucous Secretory Unit with Serous Demilune 

SSU- Serous Secretory Unit

D- Demilune

ICD- Intercalated Duct

ED- Excretory Duct

BV- Blood Vessel          

Submandibular Gland by Mandana Donoghue is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Based on a work at www.oralpath.in.

FIBRO-OSSEOUS LESION IN THE WALL OF AN ODONTOGENIC TUMOR

Whole Slide Scan of AOT and FCOD Lesion

AOT - FCOD by Mandana Donoghue is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.orapath.in.

Case Presentation of Concomitant and Contiguous Adenomatoid Odontogenic Tumor and Focal Cemento-Ossifying Dysplasia

Gita Rezvani1, Mandana Donoghue2,*, Peter A. Reichart3 and Neda Pazuhi4


"The complex embryonic derivation of the maxillofacial structures causes a widerange of pathologies, particularly in the tooth-bearing areas of the jaws. The development of simultaneous lesions of differing cellular origin, has so far, not been reported in the English literature.".

Abstract: A 24 year-old male was presented for the diagnosis of an asymptomatic bony expansion in relation to the right maxillary canine and first premolar. The unilocular radiolucent lesion with central foci of calcification had caused divergence of canine and first premolar roots without any resorption. This case report details a diagnosis of two distinct disease processes of different cellular origin namely, focal cemento-ossifying dysplasia and adenomatoid odontogenic tumor in a previously unreported concomitant and contiguous relationship. The diagnosis was determined by a combination of clinical, radiographic, histopathological and surgical evidence. This case highlights two points, first the need to examine all mixed radiolucent-radiopaque lesions with advanced imaging techniques to assess the number and extent of the lesions prior to treatment planning. Second a likely role of periodontal ligament as the tissue source for odontogenic epithelial cells and mesenchymal stem cells required for the development of odontogenic tumors and cemento-osseous dysplasias.

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