55 HUMAN ANATOMY, EMBRYOLOGY, HISTOLOGY & MEDICAL GENETICS
Special emphasis should be given throughout on the importance of various diseases as applicable to dentistry.
A) GOAL
PHYSIOLOGY
A) GOAL
♦
2. Morphology of permanent teeth :
• Description of individual teeth, along with their endodontic anatomy & including a note on their chronology of development, differences between similar class of teeth & identification of individual teeth.
• Variations & Anomalies commonly seen in individual teeth.
3. Morphology of Deciduous teeth :
Human dentition, types of teeth, & functions, Palmer's & Binomial notation systems, tooth surfaces, their junctions - line angles & point angles, definition of terms used in dental morphology, geometric concepts in tooth morphology, contact areas & embrasures - Clinical significance. ♦
Generalized differences between Deciduous & Permanent teeth. ♦
4. Occlusion :
Description of individual deciduous teeth, including their chronology of development, endodontic anatomy, differences between similar class of teeth & identification of individual teeth. ♦
Definition, factors influencing occlusion - basal bone, arch, individual teeth, external & internal forces & sequence of eruption. ♦
Inclination of individual teeth - compensatory curves. ♦
Centric relation & Centric occlusion - protrusive, retrusive & lateral occlusion. ♦
Clinical significance of normal occlusion. ♦
II. ORAL EMBRYOLOGY
Introduction to & Classification of Malocclusion. 71 1. Brief review of development of face, jaws, lip, palate & tongue, with applied aspects.
2. Development of teeth :
♦
Epithelial mesenchymal interaction, detailed study of different stages of development of crown, root & supporting tissues of tooth & detailed study of formation of calcified tissues. ♦
3. Eruption of deciduous & Permanent teeth :
Applied aspects of disorders in development of teeth. ♦
Mechanisms in tooth eruption, different theories & histology of eruption, formation of dentogingival junction, role of gubernacular cord in eruption of permanent teeth. ♦
4. Shedding of teeth :
Clinical or Applied aspects of disorders of eruption. ♦
Factors & mechanisms of shedding of deciduous teeth. ♦
III. ORAL HISTOLOGY
1. Detailed microscopic study of Enamel, Dentine, Cementum & Pulp tissue. Age changes & Applied aspects (Clinical and forensic significance) of histological considerations - Fluoride applications, transparent dentine, dentine hypersensitivity, reaction of pulp tissue to varying insults to exposed dentine ; Pulp calcifications & Hypercementosis.
2. Detailed microscopic study of Periodontal ligament & alveolar bone, age changes, histological changes in periodontal ligament & bone in normal & orthodontic tooth movement, applied aspects of alveolar bone resorption.
3. Detailed microscopic study of Oral Mucosa, variation in structure in relation to functional requirements, mechanisms of keratinization, clinical parts of gingiva, Dentogingival & Mucocutaneous junctions & lingual papillae. Age changes & clinical considerations.
4. Salivary Glands :
Complications of shedding. ♦
Detailed microscopic study of acini & ductal system. ♦
5. TM Joint : 72
Age changes& clinical considerations. ♦
6. Maxillary Sinus :
Review of basic anatomical aspects & microscopiuc study & clinical considerations. ♦
7. Processing of Hard & soft tissues for microscopic study :
Microscopic study, anatomical variations, functions & clinical relevance of maxillary sinus in dental practice. ♦
8. Basic histochemical staining patterns of oral tissues.
IV. ORAL PHYSIOLOGY
1. Saliva :
Ground sections, decalcified sections & routine staining procedures. ♦
2. Mastication :
Composition of saliva - variations, formation of saliva & mechanisms of secretion, salivary reflexes, brief review of secretomotor pathway, functions, role of saliva in dental caries & applied aspects of hyper & hypo salivation. ♦
3. Deglutition :
Masticatory force & its measurement - need for mastication, peculiarities of masticatory muscles, masticatory cycle, masticatory reflexes & neural control of mastication. ♦
4. Calcium, Phosphorous & fluoride metabolism :
Review of the steps in deglutition, swallowing in infants, neural control of deglutition & dysphagia. ♦
5. Theories of Mineralization :
Source, requirements, absorption, distribution, functions & excretion, clinical considerations, hypo & hypercalcemia & hyper & hypo phosphatemia & fluorosis. ♦
Definition, mechanisms, theories & their drawbacks. ♦
6. Physiology of Taste : 73
Applied aspects of physiology of mineralization, pathological considerations - calculus formation. ♦
7. Physiology of Speech :
Innervation of taste buds & taste pathway, physiologic basis of taste sensation, age changes & applied aspects - taste disorders. ♦
Review of basic anatomy of larynx & vocal cords. ♦
Voice production, resonators, production of vowels & different consonants - Role of palate, teeth & tongue. ♦
RECOMMENDED TEXT BOOKS
1. Orban's Oral Histology & Embryology - S.N.Bhaskar
2. Oral Development & Histology - James & Avery
3. Wheeler's Dental Anatomy, Physiology & Occlusion - Major.M.Ash
4. Dental Anatomy - its relevance to dentistry - Woelfel & Scheid
5. Applied Physiology of the mouth - Lavelle
6. Physiology & Biochemistry of the mouth - Jenkins 74
Effects of dental prosthesis & appliances on speech & basic speech disorders. GENERAL PATHOLOGY
Aim:
At the end of the course the student should be competent to:
Apply the scientific study of disease processes, which result in morphological and functional alterations in cells, tissues and organs to the study of pathology and the practice of dentistry.
Objectives:
Enabling the student
1. To demonstrate and apply basic facts, concepts and theories in the field of Pathology.
2. To recognize and analyze pathological changes at macroscopically and microscopical levels and explain their observations in terms of disease processes.
3. To Integrate knowledge from the basic sciences, clinical medicine and dentistry in the study of Pathology.
4. To demonstrate understanding of the capabilities and limitations of morphological Pathology in its contribution to medicine, dentistry and biological research.
5. To demonstrate ability to consult resource materials outside lectures, laboratory and tutorial classes.
COURSE CONTENT
A. General Pathology –
1. Introduction to Pathology
Terminologies
The cell in health
The normal cell structure
The cellular functions
2. Etiology and Pathogenesis of Disease
Cell Injury
Types – congenital
Acquired
Mainly Acquired causes of disease
(Hypoxic injury, chemical injury, physical injury, immunological injury)
3. Degenerations
Amyloidosis
Fatty change
Cloudy swelling
Hyaline change, mucoid degeneration
4. Cell death & Necrosis
Apoptasis
75 Def, causes, features and types of necrosis
Gangrene - Dry, wet, gas
Pathological Calcifications
(Dystrophic and metastatic)
5. Inflammation
- Definition, causes types, and features
- Acute inflammation
a. The vascular response
b. The cellular response
c. Chemical mediators
d. The inflammatory cells
e. Fate
- Chronic inflammation
Granulomations inflammation
6. Healing
- Regeneration
- Repair
a. Mechanisms
b. Healing by primary intention
c. Healing by secondary intention
d. Fracture healing
e. Factors influencing healing process
f. Complications
7. Tuberculosis
- Epidemiology
- Pathogenesis ( Formation of tubercle)
- Pathological features of Primary and secondary TB
- Complications and Fate
8. Syphilis
- Epidemiology
- Types and stages of syphilis
- Pathological features
- Diagnostic criterias
- Oral lesions
9. Typhoid
- Epidemiology
- Pathogenesis 76
- Pathological features
- Diagnostic criterias
10. Thrombosis
- Definition, Pathophysiology
- Formation, complications & Fate of a thrombus
11. Embolism
- Definition
- Types
- Effects
12. Ischaemia and Infraction
- Definition, etiology, types
- Infraction of various organs
13. Derangements of body fluids
- Oedema – pathogenesis
Different types
14. Disorders of circulation
- Hyperaemia
- Shock
15. Nutritional Disorders
- Common Vitamin Deficiencies
16. Immunological mechanisms in disease
- Humoral & cellular immunity
- Hypersensitivity & autommunity
17. AIDS
18. Hypertension
- Definition, classification
- Pathophysiology
- Effects in various organs
19. Diabetes Mellitus
- Def, Classification, Pathogenesis, Pathology in different organs
20. Adaptive disorders of growth
- Atrophy & Hypertrophy, Hyperplasia, Metaplasia and Dysplasia
21. General Aspects of neoplesia
a. Definition, terminology, classification
b. Differences between benign and malignant neoplasms
c. The neoplastic cell
d. Metastasis
e. Etiology and pathogenesis of neoplasia, Carcinogenesis
f. Tumour biology
g. Oncogenes and anti-oncogenes
h. Diagnosis
i. Precancerous lesions
j. Common specific tumours, Sq papilloma & Ca, Basal cell Ca, Adenoma & Adenoca, Fibroma & Fibrosarcoma, Lipoma and liposarcoma
B. Systemic Pathology
22 Anaemias
- Iron Deficiency anaemia, Megaloblastic anaemia
23.Leukaemias
- Acute and chronic leukaemias, Diagnosis and clinical features
24. Diseases of Lymph nodes
- Hodgkin’s disease, Non Hodgkins lymphoma, Metastatic carcinoma
25. Diseases of oral cavity
- Lichen planus, Stomatitis, Leukoplakia, Sq cell Ca, Dental caries, Dentigerious cyst, Ameloblastoma
26. Diseases of salivary glands
- Normal structure, Sialadenitis, Tumours
27. Common diseases of Bones
- Osteomyelitis, Metabolic bone diseases, Bone Tumours, Osteosarcoma, Osteocalstoma, Giant cell Tumour, Ewing’s sarcoma, Fibrous dysplasia, Aneurysmal bone cyst
28.Diseases of Cardiovascular system 78
- Cardiac failuare
- Congenital heart disease – ASD, VSD,PDA
Fallot’s Tetrology
- Infective Endocarditis
- Atherosclerosis
- Ischaemic heart Disease
29. Haemorrhagic Disorders
Coagulation cascade
Coagulation disorders
- Platelet funtion
- Platelet disorders
Practicals
1.Urine – Abnormal constitutients
- Sugar, albumin, ketone bodies
2. Urine – Abnormal consittuents
- Blood, bile salts, bile pigments
3. Haemoglobin (Hb) estimation
4. Total WBC count
5. Differential WBC Count
6. Packed cell volume(PCV,) rythrocyte sedimentation Rate (ESR)
7. Bleeding Time & clotting Time
8. Histopathology
Tissue Processing
Staining
9.Histopathology slides
- Acute appendicitis, Granulation tissue, fatty liver
10. Histopathology slides
CVC lung, CVC liver, Kidney amyloidosis
11. Histopathology slides
Tuberculosis, Actionomycosis, Rhinosporidiosis
12. Histopathology slides
Papilloma, Basal cell Ca, Sq cell Ca
13. Histopathology slides 79
Osteosarcoma, osteoclastoma, fibrosarcoma
14. Histopathology slides
Malignant melanoma, Ameloblastoma, Adenoma
15. Histopathology slides
Mixed parotid tumour, metastatic
carcinoma in lymph node
List of Textbooks
1. Robbins – Pathologic Basis of Disease Cotran, Kumar, Robbins
2. Anderson’s Pathology Vol 1 & 2 Editors – Ivan Damjanov & James Linder
3. Wintrobe’s clinical Haematolog Lee, Bithell, Foerster, Athens, Lukens
MICROBIOLOGY
AIM:
To introduce the students to the exciting world of microbes. To make the students aware of various branches of microbiology, importance, significance and contribution of each branch to mankind and other fields of medicine. The objectives of teaching microbiology can be achieved by various teaching techniques such as :
a) Lectures
b) Lecture Demonstrations
c) Practical exercises
d) Audio visual aids
e) Small group discussions with regular feed back from the students.
OBJECTIVES
A. Knowledge and Understanding
At the end of the Microbiology course the student is expected to :
1. Understand the basics of various branches of microbiology and able to apply the knowledge
relevantly.
2. Apply the knowledge gained in related medical subjects like General Medicine and
General Surgery and Dental subjects like Oral Pathology, Community Dentistry,
Periodontics, Oral Surgery, Pedodontics, Conservative Dentistry and Oral medicine in
higher classes.
3. Understand and practice various methods of Sterilisation and disinfection in dental clinics.
4. Have a sound understanding of various infectious diseases and lesions in the oral cavity.
80 B. SKILLS
1. Student should have acquired the skill to diagnose, differentiate various oral lesions.
2. Should be able to select, collect and transport clinical specimens to the laboratory.
3. Should be able to carry out proper aseptic procedures in the dental clinic.
A brief syllabus of Microbiology is given as follows:
A. GENERAL MICROBIOLOGY:
1. History, Introduction, Scope, Aims and Objectives.
2. Morphology and Physiology of bacteria.
3. Detail account of Sterlisation and Disinfection.
4. Brief account of Culture media and Culture techniques.
5. Basic knowledge of selection, collection, transport, processing of clinical
Specimens and identification of bacteria.
6. Bacterial Genetics and Drug Resistance in bacteria.
B. IMMUNOLOGY:
1. Infection - Definition, Classification, Source, Mode of transmission and types of
Infectious disease.
2. Immunity
3. Structure and functions of Immune system
4. The Complement System
5. Antigen
6. Immunoglobulins - Antibodies - General structure and the role played in defense
mechanism of the body.
7. Immune response
8. Antigen - Antibody reactions - with reference to clinical utility.
9. Immuno deficiency disorders - a brief knowledge of various types of immuno deficiency
disorders - A sound knowledge of immuno deficiency disorders relevant to dentistry.
10. Hypersensitivity reactions
11. Autoimmune disorders - Basic knowledge of various types - sound knowledge of
autoimmune disorders of oral cavity and related structures.
12. Immunology of Transplantation and Malignancy
13. Immunehaematology
C. SYSTEMATIC BACTERIOLOGY:
1. Pyogenic cocci - Staphylococcus, Streptococcus, Pneumococcus, Gonococcus,
Meningococcus – brief account of each coccus - detailed account of mode of spread,
laboratory diagnosis, Chemo therapy and prevention - Detailed account of Cariogenic
Streptococci.
2. Corynebacterium diphtheriae - mode of spread, important clinical feature, Laboratory
81 diagnosis, Chemotherapy and Active immunisation.
3. Mycobacteria - Tuberculosis and Leprosy
4. Clostridium - Gas gangrene, food poisoning and tetanus.
5. Non-sporing Anaerobes - in brief about classification and morphology, in detail about
dental pathogens - mechanism of disease production and prevention.
6. Spirochaetes - Treponema pallidum - detailed account of Oral Lesions of syphilis,
Borrelia vincentii.
7. Actinomycetes.
D. VIROLOGY:
1. Introduction
2. General properties, cultivation, host - virus interaction with special reference to
Interferon.
3. Brief account of Laboratory diagnosis, Chemotherapy and immuno prophylaxis in
general.
4. A few viruses of relevance to dentistry.
• Herpes Virus
• Hepatitis B Virus - brief about other types
• Human Immunodeficiency Virus (HIV)
• Mumps Virus
• Brief - Measles and Rubella Virus
5. Bacteriophage - structure and Significance
E. MYCOLOGY
1. Brief Introduction
2. Candidosis - in detail
3. Briefly on oral lesions of systemic mycoses.
F. PARASITOLOGY:
1. Brief introduction - protozoans and helminths
2. Brief knowledge about the mode of transmission and prevention of commonly seen
parasitic infection in the region.
RECOMMENDED BOOKS FOR REGULAR READING:
1. Text book of Microbiology – R.Ananthanarayan & C.K.Jayaram Paniker.
2. Medical Microbiology – David Greenwood etal.
BOOKS FOR FURTHER READING/REFERENCE.
vi) Microbiology – Prescott, etal.
vii) Microbiology – Bernard D. Davis , etal.
viii) Clinical & Pathogenic Microbiology – Barbara J Howard, etal.
ix) Mechanisms of Microbial diseases – Moselio Schaechter, etal.
x) Immunology an Introduction – Tizard
xi) Immunology 3rd edition – Evan Roitt , etal.
DENTAL MATERIALS
The science of Dental Material has undergone tremendous changes over the years. Continued research has led to new material systems and changing concepts in the dental field. Interlinked with various specialised branches of chemistry, practically all engineering applied sciences and biological characteristics, the science of dental material emerged as a basic sciences in itself with its own values and principles.
1). INTRODUCTION
AIMS ,OBJECTIVES & SCOPE.
AIMS:
Aim of the course is to present basic chemical and physical properties of Dental materials as they are related to its manipulation to give a sound educational background so that the practice of the dentistry emerged from art to empirical status of science as more information through further research becomes available. It is also the aim of the course of Dental materials to provide with certain criteria of selection and which will enable to discriminate between facts and propaganda with regards to claims of manufactures.
OBJECTIVES:
To understand the evolution and development of science of dental material.
To explain purpose of course in dental materials to personnels concerned with the profession of the dentistry. Knowledge of physical and chemical properties. Knowledge of biomechanical requirements of particular restorative procedure. An intelligent compromise of the conflicting as well as co-ordinating factors into the desired Ernest. Laying down standards or specifications of various materials to guide to manufacturers as well as to help professionals.
Search for newer and better materials which may answer our requirements with greater satisfaction. To understand and evaluate the claims made by manufactures of dental materials 83
NEEDS FOR THE COURSE:
The profession has to rise from an art to a science, , the need for the dentist to possess adequate knowledge of materials to exercises his best through knowledge of properties of different types of materials. The growing concern of health hazards due to mercury toxicity, inhalation of certain vapour or dust materials, irritations and allergic reaction to skin due to contact of materials. Materials causing irritation of oral tissues, pH of restorative materials causing inflammation and necrosis of pulp which is a cause for the dentist to posses wider knowledge of physical, chemical and biological properties of materials being used. For the protection for the patient and his own protection certain criteria of selection are provided that will enable the dentist to discriminate between facts and propaganda, which will make a material biologically accept.
SCOPE:
The dental materials is employed in mechanical procedures including restorative dentistry such as Prosthodontics, endodontics, periodontal, orthodontics and restorative materials. There is scarcely a dental procedure that does not make use of dental materials in one form or another and therefore the application of dental material is not limited to any one branch of dentistry. Branches such as minor surgery and periodontics require less use of materials but the physical and chemical characters of materials are important in these fields.
The toxic and tissue reaction of dental materials and their durability in the oral cavity where the temperature is between 32 & 37 degree centigrade, and the ingestion of hot or cold food ranges from 0-70 degree centigrade. The acid an alkalinity of fluids shown pH varies from 4 to 8.5. The load on 1 sq. mm of tooth or restorative materials can reach to a level as high as many kilograms. Thus the biological properties of dental materials cannot be separated from their physical and chemical properties.
2 ). STRUCTURE OF MATTER AND PRINCIPLES OF ADHESION.
Change of state, inter atomic primary bonds, inter atomic secondary bonds, inter atomic bond distance and bonding energy, thermal energy, crystalline structure, non crystalline structures, diffusion, adhesion and bonding and adhesion to tooth structures.
3). IMPORTANT PHYSICAL PROPERTIES APPLICABLE TO DENTAL MATERIALS
Physical properties are based on laws of mechanics, acoustics, optics, thermodynamics, electricity, magnetism, radiation, atomic structure or nuclear phenomena. Hue, value, chroma and translucency physical properties based on laws of optics, dealing with phenomena of light, vision and sight. Thermal conductivity & coefficient of thermal expansion are physical properties based on laws of thermodynamics. Stress, strain, proportional limit, elastic limit yield strength, modulus of elasticity, flexibility, resilience, impact, impact strength, permanent deformation, strength, flexure strength fatigue, static fatigue, toughness, brittleness, ductility & malleability, hardness, abrasion resistance, 84
relaxation, rheology, Thixotropic, creep, static creep, dynamic creep, flow, colour, three dimensional colour – hue, values, chroma, Munsell system, metamersim, fluorescence, physical properties of tooth, stress during mastication
4). BIOLOGICAL CONSIDERATIONS IN USE OF DENTAL
MATERIALS.
Materials used are with the knowledge of appreciation of certain biological considerations for use in oral cavity. Requirement of materials with biological compatibility. Classification of materials from perspective of biological compatibility. eg. contact with soft tissues, affecting vitality of pulp, used for root canal fillings, affecting hard tissues of teeth, laboratory materials that could be accidentally be inhaled or ingested during handling. Hazards associated with materials: pH-effecting pulp, polymers causing chemical irritation, mercury toxicity, etc. Microleakage, Thermal changes, Galvanism, toxic effect of materials. Biological evaluation for systemic toxicity, skin irritation, mutagenecity and carcinogenicity. Disinfection of dental materials for infection control.
5). GYPSUM & GYPSUM PRODUCTS.
Gypsum – its origin, chemical formula, Products manufactured from gypsum.
Dental plaster, Dental stone, Die stone, high strength, high expansion stone.
Application and manufacturing procedure of each, macroscopic and microscopic structure of each . Supplied as and Commercial names.
Chemistry of setting, setting reaction, theories of setting, gauging water, Microscopic structure of set material.
Setting time: working time and setting time, Measurement of setting time and factors controlling setting time .
Setting expansion , Hygroscopic setting expansion – factors affecting each
Strength :wet strength, dry strength, factors affecting strength, tensile strength
Slurry – need and use.
Care of cast.
ADA classification of gypsum products
Description of impression plaster and dental investment
Manipulation including recent methods or advanced methods.
Disinfection : infection control, liquids, sprays, radiation
Method of use of disinfectants
Storage of material – shelf life
6) IMPRESSION MATERIALS USED IN DENTISTRY
Impression plaster, Impression compound, Zinc oxide eugenol impression paste & bite registration paste incl., non eugenol paste, Hydrocolloids, reversible and irreversible, Elastomeric impression materials. Polysulphide, Condensation silicones, Addition silicones, Polyether, Visible light cure polyether urethane dimethacrylate 85
Historical background & development of each impression material,
Definition of impression , Purpose of making impression, Ideal properties required and application of material
Classification as per ADA specification, general & individual impression material.
Application and their uses in different disciplines
Marketed as and their commercial names, Mode of supply & mode of application bulk/wash impression.
Composition, chemistry of setting ,Control of setting time , Type of impression trays required, Adhesion to tray, manipulation, instruments & equipments required. Techniques of impression, storage of impression, (Compatibility with cast and die material). Any recent advancements in material and mixing devices.
Study of properties: Working time, setting time, flow, accuracy, strength, flexibility, tear strength, dimensional stability, compatibility with cast & die materials incl., electroplating Biological properties: tissue reaction , Shelf life & storage of material.
Infection control – disinfection
Advantages & disadvantages of each material.
7). SYNTHETIC RESINS USED IN DENTISTRY.
Historical background and development of material, Denture base materials and their classification and requirement
Classification of resins
Dental resins – requirements of dental resins, applications, polymerisation, polymerisation mechanism stages in addition polymerisation, inhibition of polymerisation, co polymerization, molecular weight, crosslinking, plastixizers, Physical properties of polymers, polymer structures types of resins.
ACRYLIC RESINS:
Mode of polymerisation: Heat activated, Chemically activated, Light activated
Mode of supply, application, composition, polymerisation reaction of each.
Technical considerations:
Methods of manipulation for each type of resin.
Physical properties of denture base resin
Miscellaneous resins & techniques: Repair resins, Relining and rebasing.
Short term and long-term soft-liners, temporary crown and bridge resins,
Resin impression trays, Tray materials, Resin teeth, materials in maxillofacial prosthesis, Denture cleansers, Infection control in detail, Biological properties and allergic reactions.
RESTORATIVE RESINS
Historical background, Resin based restorative materials, Unfilled & filled,
Composite restorative materials, Mode of supply, Composition, Polymerisation mechanisms: 86
Chemically activated, Light activated, Dual cure: Degree of conversion, Polymerisation shrinkage
Classification of Composites: Application, composition and properties of each
Composites of posterior teeth, Prosthodontics resins for veneering.
Biocompatibility – microleakage, pulpal reaction, pulpal protection
Manipulation of composites:
Techniques of insertion of Chemically activated, light activated, dual cure
Polymerisation, Finishing and polishing of restoration, Repair of composites
Direct bonding
Bonding: Need for bonding, Acid - etch technique, Enamel bonding, Dentin bonding agents.
Mode of bonding, Bond strength, Sandwich technique its indication and procedure
Extended application for composites:
Resins for restoring eroded teeth, Pit and fissure sealing, Resin inlays system – Indirect & direct, Core build up, Orthodontic applications.
8). METAL AND ALLOYS:
Structure and behaviour of metals, Solidification of metals, mechanism of crystallisation amorphous & crystalline. Classification of alloys, Solid solutions, Constitutes or equilibrium phase diagrams:Electric alloys, Physical properties, Peritectic alloys, Solid state reaction other binary systems:
Metallography & Heat treatment
Tarnish and corrosion
Definition, causes of corrosion , protection against corrosion., Corrosion of dental restorations, clinical significance of galvanic current.
Dental Amalgam
History:
Definition of dental amalgam, application, Alloy classification, manufacture of alloy powder composition - available as.
Amalgamation : setting reaction & resulting structure , properties , Microleakage
Dimensional stability, Strength, Creep, Clinical performance
Manipulation: Selection of alloy, proportioning, mechanism of trituration, condensation, carving & finishing.
Effect of dimensional changes, Marginal deterioration., Repair of amalgam, mercury toxicity, mercury hygiene.
Direct filling gold:
Properties of pure gold, mode of adhesion of gold for restoration forms of direct filling gold for using as restorative material
Classification : Gold Foil, Electrolytic precipitate, powdered gold. 87
Manipulation: Removal of surface impurities and compaction of direct filling gold.
Physical properties of compacted gold, Clinical performance.
DENTAL CASTING ALLOYS:
Historical background, desirable properties of casting alloys.
Alternatives to cast metal technology: direct filling gold, amalgam, mercury free condensable intermetallic compound - an alternative to metal casting process. CAD-CAM process for metal & ceramic inlays - without need of impression of teeth or casting procedure, pure titanium, most bio compatible metal which are difficult to cast can be made into crowns with the aid of CAD- CAM technology . Another method of making copings - by copy milling (without casting procedures).
Classification of casting alloys: By function & description.
Recent classification , High noble (HN), Noble (N) and predominantly base metal (PB)
Alloys for crown & bridge, metal ceramic & removable partial denture.
Composition, function, constituents and application, each alloy both noble and base metal.
Properties of alloys: Melting range, mechanical properties, hardness, elongation, modulus of elasticity, tarnish and corrosion.
Casting shrinkage and compensation of casting shrinkage.
Biocompatability - Handling hazards & precautions of base metal alloys, casting investments used.
Heat treatment : Softening & hardening heat treatment. Recycling of metals.
Titanium alloys & their application , properties & advantages.
Technical considerations In casting .
Heat source, furnaces.
9). DENTAL WAXES INCLUDING INLAY CASTING WAX
Introduction and importance of waxes. Sources of natural waxes and their chemical nature.
Classification of Waxes:
Properties: melting range, thermal expansion, mechanical properties, flow & residual stresses, ductility.
Dental Wax: Inlay wax: Mode of supply : Classification & composition, Ideal requirements: Properties of inlay wax: Flow, thermal properties Wax distortion & its causes.
Manipulation of inlay wax: Instruments & equipment required, including electrically heated instruments metal tips and thermostatically controlled wax baths.
Other waxes: Applications, mode of supply & properties.
Casting Wax, Base plate wax, Processing wax, Boxing wax, Utility wax, Sticky wax, Impression wax for corrective impressions
Bite registration wax. 88
10). DENTAL CASTING INVESTMENTS.
Definition, requirements, classification
Gypsum bonded - classification. Phosphate bonded, Silica bonded
Mode of Supply: Composition, application , setting mechanism, setting time & factors controlling.
Expansions :Setting expansion, Hygroscopic Setting expansion, & thermal expansion : factors affecting.
Properties : Strength, porosity, and fineness & storage.
Technical considerations: For Casting procedure
Preparation of die, Wax pattern, spruing, investing, control of shrinkage compensation, wax burnout, and heating the invested ring, casting.
Casting machines, source of heat for melting the alloy .
Defects in casting.
11). SOLDERING, BRAZING AND WELDING
Need of joining dental appliances
Terms & Definition
Solders: Definition, ideal requirement, types of solders – Soft & hard and their fusion temperature, application
Mode of supply of solders, Composition and selection, Properties.
Tarnish & corrosion resistance mechanical properties, microstructure of soldered joint.
Fluxes & Anti fluxes: Definition, Function, Types, commonly used fluxes & their selection
Technique of Soldering & Brazing : free hand soldering and investment, steps and procedure.
Welding,: Definition, application, requirements, procedure, weld decay - causes and how to avoid it.
Laser welding.
WROUGHT BASE METAL ALLOYS
Applications and different alloys used mainly for orthodontics purpose
1. Stainless steel
2. Cobalt chromium nickel
3. Nickel titanium
4. Beta titanium
Properties required for orthodontic wires, working range, springiness, stiffness, resilience, Formability, ductility, ease of joining, corrosion resistance, stability in oral environment, bio compatibility
Stainless steels: Description, type, composition & properties of each type. Sensitisation & stabilisation , Mechanical properties – strength, tensile, yield strength, KHN. 89
Braided & twisted wires their need , Solders for stainless steel, Fluxes, Welding
1. Wrought cobalt chromium nickel alloys, composition, allocation, properties, heat treatment, physical properties
2. Nickel – Titanium alloys, shape, memory & super elastic
3. Titanium alloys, application, composition, properties, welding, Corrosion resistance
12) . DENTAL CEMENTS
Definition & Ideal requirements:
Cements: Silicate, Glass ionomer, metal modified glass ionomer, resin modified glass ionomer, zinc oxide eugenol, modified zinc oxide eugenol, zinc phosphate, zinc silico phosphate, zinc poly carboxylate
Cavity liners and cement bases
Varnishes Calcium hydroxide
Gutta percha
Application, classification (general and individual ), setting mechanism, mode of supply, Properties, factors affecting setting, special emphasis on critical procedures of manipulation and protection of cement, mode of adhesion, biomechansim of caries inhibition.
Agents for pulpal protection., Modifications and recent advances, Principles of cementation. Special emphasis on cavity liners and cement bases and luting agents.
13). DENTAL CERAMICS
Historical background & General applications.
Dental ceramics : definition, classification, application, mode of supply, manufacturing procedure, methods of strengthening.
Properties of fused ceramic: Strength and factors affecting, modulus of elasticity, surface hardness, wear resistance, thermal properties, specific gravity, chemical stability, esthetic properties, biocompatability, technical considerations.
Metal Ceramics (PFM):
Alloys - Types and composition of alloys
Ceramic - Type and Composition.
Metal Ceramic Bond - Nature of bond.
Bonding using electro deposition, foil copings, bonded platinum foil, swaged gold alloy foil coping.
Technical considerations for porcelain and porcelain fused metal restorations.
Recent advances - all porcelain restorations, Manganese core, injection moulded, castable ceramics, glass infiltrated alumina core ceramic (In ceram), ceramic veners, inlays and onlays, and CAD - CAM ceramic.
Chemical attack of ceramic by fluoride.
Porcelain furnaces. 90
14). ABRASION & POLISHING AGENTS
Definition of abrasion and polishing
Need of abrasion and polishing
Types of abrasives: Finishing, polishing & cleaning
Types of abrasives: Diamond, Emery, aluminium oxides garnet, pumice, Kieselgurh, tripoli, rouge, tin oxide, chalk, chromic oxide, sand, carbides, diamond, zirconium silicate Zinc oxide
ABRASIVE ACTION :
Desirable characteristics of an abrasive, Rate of abrasion, Size of particle, pressure and speed.
Grading of abrasive & polishing agents.
Binder,
Polishing materials & procedures used.
Technical consideration - Material and procedure used for abrasion and polishing
Electrolytic polishing and burnishing.
15). DIE AND COUNTER DIE MATERIALS INCLUDING ELECTROFORMING
AND ELECTROPOLISHING.
Types – Gypsum products, Electroforming, Epoxy resin, Amalgam.
16). DENTAL IMPLANTS : Evolution of dental implants, types and materials.
17). MECHANICS OF CUTTING : Burs and points.
At the end of the course the student should have the knowledge about the composition, properties, manipulative techniques and their various commercial names. The student should also acquire skills to select and use the materials appropriately for laboratory and clinical use.
RECOMMENDED BOOKS:
1. Phillips Science of Dental Materials – 10th edn.- Kenneth J. Anusavice
2. Restorative Dental Materials - 10 edn. Robert G.Craig
3. Notes on Dental Materials - E.C. Combe
GENERAL AND DENTAL PHARMACOLOGY AND THERAPEUTICS
1. OBJECTIVES: At the end of the course the student shall be able to:
i) Describe the pharmacokinetics and pharmacodynamics of essential and commonly used drugs in general and in dentistry in particular.
ii) List the indications, contraindications; interactions, and adverse reactions of commonly used drugs with reason.
iii) Tailor the use of appropriate drugs in disease with consideration to its cost, efficacy, safety for individual and mass therapy needs.
iv) Indicate special care in prescribing common and essential drugs in special medical situations such as pregnancy, lactation, old age, renal, hepatic damage and immuno compromised patients.
v) Integrate the rational drug therapy in clinical pharmacology.
vi) Indicate the principles underlying the concepts of "Essential drugs".
4. SKILLS: At the end of the course the student shall be able to:
1) Prescribe drugs for common dental and medical ailments.
2) To appreciate adverse reactions and drug interactions of commonly used drugs.
3) Observe experiments designed for study of effects of drugs.
4) Critically evaluate drug formulations and be able to interpret the clinical pharmacology of marketed preparations commonly used in dentistry.
5. INTEGRATION: Practical knowledge of use of drugs in clinical practice will be acquired through integrated teaching with clinical departments.
Histamine, antihistamines, prostaglandins, leukotriens and bronchodilators.
6. Drugs acting on blood : coagulants and anticoagulants, hematinics.
7. G.I.T. Drugs, Purgatives, anti-diarrhoeal, antacids, anti-emetics.
8. Endocrines; Emphasis on treatment of diabetes and glucocorticoids, thyroid and antithyroid agents, drugs affecting calcium balance and anabolic steroids.
9. Chemotherapy: Antimicrobial agents ( against bacteria, anaerobic infections, fungi, virus and broad spectrum). Infection management in dentistry. Phamacotherapy of Tuberculosis, leprosy and chemotherapy of malignancy in general.
10. Vitamins: Water soluble vitamins, Vit. D, Vit.K. and Vit. E.
11. Pharmacotherapy of emergencies in dental office and emergency drugs tray.
12. Chealating agents – BAL,EDTA and desferrioxamine.
II. DENTAL PHARMACOLOGY
1. Anti - septics, astrigents, obtundents, mummifying agents, bleaching agents, styptics, disclosing agents, dentifrices, mouth washes, caries and fluorides.
2. Pharmacotherapy of common oral conditions in dentistry.
Practicals and Demonstrations: To familiarise the student with the methodology: prescription writing and dispensing. Rationale of drug combinations of marketed drugs.
Lectures 60
Practicals & Demonstrations 20 Total 80 hours.
LIST OF BOOKS RECOMMENDED FOR READING AND REFERENCE
1.R.S.Satoskar, Kale Bhandarkar’s Pharmacology and Pharmacolherapentics, 10th Edition, Bombay Popular Prakashan 1991.
2.Bertam G Katzung, Basic and Clinical pharmacology 6th ed. Appleton & Lange 1997
3.Lauerence D.R. Clinical Pharmacology 8th ed. Churchill Livingstone 1997
4.Satoskar R.S. & Bhandarkar S.D., Pharmacology and Pharmacotherapeutics part I & part ii, 13th Popular Prakashan Bombay 1993
5.Tripathi K.D., Essentials of Medical Pharmacology 4th ed Jaypee Brothers 1999. 93
1.
GOAL: The broad goal of teaching under graduate students in pharmacology is to inculcate rational and scientific basis of therapeutics keeping in view of dental curriculum and Profession. 2.
I. GENERAL PHARMACOLOGY:
1. General principles of pharmacology; sources and nature of drugs dosage forms; prescription writing; pharmacokinetics (absorption, distribution, metabolism and excretion of drugs), mode of action of drugs, combined effects of drugs, receptor mechanism of drug action , factors modifying drug response, adverse drug reactions; drug interactions.
2. CNS drugs; General anaesthetics, hypnotics, analgescis psychotropic drugs, anti – epileptics, muscle relaxants, local anaesthetics.
3. Autonomic drugs; sympathomimetics, antiadrenergic drugs parasympothomimetics and parasympatholytics.
4. Cardiovascular drugs; Cardiac stimulants ; antihypertensive drugs, vasopressor agents , treatment of shock, Antianginal agents and diuretics.
5. Autocoids:
LECTURE: PRE CLINICAL CONSERVATIVE DENTISTRY
LABORATORY EXERCISES
1
trimmers, excavators and hatchet.
2. Identification and use of rotary cutting instruments in contra angle hand pieces
burs (Micromotor)
3. Preparation class I and extended class I and class II and MOD’s and class V
amounting to 10 exercises in plaster models.
4. 10 exercises in mounted extracted teeth of following class I , 4 in number
class I extended cavities 2, class II 4 in number and Class V 2 in number.
Cavity preparation base application matrix and wedge placement restoration
with amalgam.
5. Exercises on phantom head models which includes cavity preparation base
and varnish application matrix and wedge placement followed by amalgam
restoration
Class I 5
Class I with extension 2
Class II 10
Class II Mods 2
Class V and III forglass ionmers 4
Class V for amalgam 2
6. Polishing of above restorations.
7. Demonstration of Class III and Class V cavity preparation. For composites on
extracted tooth completing the restoration.
8. Polishing and finishing of the restoration of composites.
9. Identification and manipulation of varnish bases like Zinc Phosphate, Poly
carboxylate, Glass Ionomers, Zinc Oxide, Euginol cements.
10. Identification and manipulation of various matrices, tooth separators and
materials like composites and modified glassionomer cements.
11. Cast Restoration
1. Preparation of Class II inlay cavity
2. Fabrication of wax pattern
3. Sprue for inner attachment investing
4. Investing of wax pattern
5. Finishing and cementing of class II inlay in extracted tooth.
12. Endodontics 94
1. Identification of basic endodontic instruments
2. Cornal access cavity preparation on extracted.
Upper central incisiors
3. Determination of working length.
4. Biomechanical preparation of root canal space of central incisor
5. Obfuration of root canal spaces. Absens of cornal access cavity.
6. Closure of acess cavity
. Identification and study of handcutting instruments chisles, gingival margin GENERAL MEDICINE
Guidelines:
1. Special precautions/ contraindication of anaesthesia and various dental procedures in different systemic diseases.
2. Oral manifestations of systemic diseases.
3. Medical emergencies in dental practice.
A dental student should be taught in such a manner he/she is able to record the arterial pulse, blood pressure and be capable of suspecting by sight and superficial examination of the body – diseases of the heart, lungs, kidneys, blood etc. He should be capable of handling medical emergencies encountered in dental practice.
Theory syllabus CORE TOPICS (Must Know) 1. Aims of medicine Definitions of signs, symptoms, diagnosis, differential diagnosis treatment & prognosis. | COLLATERAL TOPICS (Desirable to Know) |
2. Infections. Enteric fever, AIDS, herpes simplex, herpes zoster, syphilis diphtheria. | Infectious mononucleosis mumps, measles, rubella, malaria. |
3. G.I.T. Stomatitis, gingival hyperplasia, dysphagia, acid peptic disease, jaundice, acute and chronic hepatitis, cirrhosis of liver ascites. | Diarrhea Dysentery Amoebiasis Malabsorhtion |
4. CVS Acute rheumatic fever rheumatic valvular heart disease, hypertension, ischemic heart disease, infective | |
The broad goal of the teaching undergraduate students in Physiology aims at providing the student comprehensive knowledge of the normal functions of the organ systems of the body to facilitate an understanding of the physiological basis of health and disease.
OBJECTIVES
a) KNOWLEDGE
At the end of the course, the student will be able to :
1. Explain the normal functioning of all the organ systems and their interactions for well co-ordinated total body function.
2. Assess the relative contribution of each organ system towards the maintenance of the milieu interior.
3. List the physiological principles underlying the pathogenesis and treatment of disease.
b) SKILLS
At the end of the course, the student shall be able to :
1. Conduct experiments designed for the study of physiological phenomena.
2. Interprete experimental and investigative data
3. Distinguish between normal and abnormal data derived as a result of tests which he/she has performed and observed in the laboratory.
c) INTEGRATION
At the end of the integrated teaching the student shall acquire an integrated knowledge of organ structure and function and its regulatory mechanisms.
Lectures : 120 Hrs
Practicals : 30 Hrs
Tutorials : 30 Hrs
B) COURSE CONTENTS THEORY
1. GENERAL PHYSIOLOGY
1. Homeostasis: Basic concept, Feed back mechanisms
2. Structure of cell membrane, transport across cell membrane
3. Membrane potentials
2. BLOOD:
Composition & functions of blood.
Specific gravity, Packed cell volume, factors affecting & methods of determination.
Plasma proteins - Types, concentration, functions & variations.
Erythrocyte - Morphology, functions & variations. Erythropoiesis & factors affecting erythropoiesis.
ESR- Methods of estimation, factors affecting, variations & significance.
Haemoglobin - Normal concentration, method of determination & variation in concentration.
Blood Indices - MCV, MCH, MCHC - definition, normal values, variation.
Anaemia - Definition, classification, life span of RBC’s destruction of RBC’s , formation & fate of bile pigments, Jaundice - types.
Leucocytes
Thromobocytes - Morphology, , number, variations, function & thrombopoiesis.
Haemostatsis - Role of vasoconstriction, platelet plug formation in haemostasis, coagulation factors, intrinsic & extrinsic pathways of coagulation, clot retraction.
Tests of haemostatic function, platelet count, clotting time, bleeding time, prothrombin time - normal values, method & variations. Anticoagulants - mechanism of action. Bleeding disorders.
Blood groups: ABO & Rh system, method of determination, importance,indications & dangers of blood transfusion, blood substitutes.
Blood volume: Normal values, variations.
Body fluids : distribution of total body water, intracellular & extracellular compartments, major anions & cations in intra and extra cellular fluid.
Tissue fluids & lymph : Formation of tissue fluid, composition, circulation & functions of lymph. Oedema - causes. 61
Functions of reticulo endotrelial system.
3. MUSCLE AND NERVE
Classification of nerves, structure of skeletal muscle - Molecular mechanism of muscle contraction, neuromuscular transmission. Properties of skeletal muscle. Structure and properties of cardiac muscle & smooth muscle.
4. DIGESTIVE SYSTEM :
Introduction to digestion : General structure of G.I. tract, Innervation.
Salivary glands: Structure of salivary glands, composition , regulation of secretion & functions of saliva.
Stomach: Composition and functions of gastric juice, mechanism and regulation of gastric secretion.
Exocrine Pancreas - Structure, composition of pancreatic juice, functions of each component, regulation of pancreatic secretion.
Liver : structure , composition of bile, functions of bile, regulation of secretion –
Gall bladder : structure, functions.
Small intestine - Composition, functions & regulation of secretion of intestinal juice.
Large intestine - Functions.
Motor functions of GIT: Mastication, deglutition, gastric filling & emptying, movements of small and large intestine, defecation.
5. EXCRETORY SYSTEM :
Structure & functions of kidney, functional unit of kidney & functions of different parts.
Juxta glomerular apparatus, renal blood flow.
Formation of Urine : Glomerular filteration rate - definition, determination , normal values, factors influencing G.F.R. Tubular reabsorption - Reabsorption of sodium, glucose, water & other substances. Tubular secretion - secretion of urea, hydrogen and other substances.
Mechanism of concentration & dilution of urine.
Role of kidney in the regulation of pH of the blood.
Micturition : anatomy & innervation of Urinary bladder, mechanism of miturition & abonrmalities.
6. BODY TEMPERATURE & FUNCTIONS OF SKIN
7. ENDOCRINOLOGY
General endocrinology - Enumeration of endocrine glands & hormones - General functions of endocrine system, chemistry, mechanism of secretion, transport, metabolism, regulation of secretion of hormones.
Hormones of anterior pituitary & their actions, hypothamic regulation of anterior pituitary function. Disorders of secretion of anterior pituitary hormones. 62
Posterior pituitary : Functions, regulation & disorders of secretion.
Thyroid: Histology, synthesis, secretion & transport of hormones, actions of hormones, regulation of secretion & disorders, Thyroid function tests.
Adrenal cortex & Medulla -synthesis, secretion, action, metabolism, regulation of secretion of hormones & disorders.
Other hormones - Angiotensin, A.N.F.
8. REPRODUCTION
Sex differentiation , Physiological anatomy of male and female sex organs,
Female reproductive system : Menstrual cycle, functions of ovary, actions of oestrogen & Progesterone, control of secretion of ovarian hormones, tests for ovulation, fertilisation, implantation, maternal changes during pregnancy, pregnancy tests & parturition.
Lactation, composition of milk, factors controlling lactation, milk ejection, reflex,
Male reproductive system :spermatogenesis, semen and contraception.
9. CARDIO VASCULAR SYSTEM
Functional anatomy and innervation of heart Properties of cardiac muscle
Origin & propagation of cardiac impulse and heart block.
Electrocardiogram - Normal electrocardiogram. Two changes in ECG in myocardial infarction.
Cardiac cycle - Phases, Pressure changes in atria, ventricles & aorta.
Volume changes in ventricles. Jugular venous pulse, arterial pulse.
Heart sounds: Mention of murmurs.
Heart rate: Normal value, variation & regulation.
Cardiac output: Definition, normal values, one method of determination, variation, factors affecting heart rate and stroke volume.
Arterial blood pressure: Definition, normal values & variations,determinants, regulation & measurement of blood pressure.
Coronary circulation.
Cardio vascular homeostasis - Exercise & posture.
10. RESPIRATORY SYSTEM
Physiology of Respiration : External & internal respiration.
Functional anatomy of respiratory passage & lungs.
Respiratory movements: Muscles of respiration, Mechanism of inflation & deflation of lungs.
Intra pleural & intra pulmonary pressures & their changes during the phases of respiration.
Mechanics of breathing - surfactant, compliance & work of breathing. 63
Spirometry: Lung volumes & capacities definition, normal values, significance, factors affecting vital capacity, variations in vital capacity, FEV & its variations.
Pulmonary ventilation - alveolar ventilation & dead space – ventilation.
Composition of inspired air, alveolar air and expired air.
Exchange of gases: Diffusing capacity, factors affecting it.
Transport of Oxygen & carbon dioxide in the blood.
Regulation of respiration – neural & chemical.
Hypoxia, cyanosis, dyspnoea, periodic breathing.
Artificial respiration, pulmonary function tests.
11. CENTRAL NERVOUS SYSTEM
1. Organisation of central nervous system
2. Neuronal organisation at spinal cord level
3. Synapse receptors, reflexes, sensations and tracts
4. Physiology of pain
5. Functions of cerebellum, thalamus, hypothalamus and cerebral cortex.
6. Formation and functions of CSF
7. Autonomic nervous system
12. SPECIAL SENSES
Fundamental knowledge of vision, hearing, taste and smell.
PRACTICALS
The following list of practical is minimum and essential. All the practical have been categorised as procedures and demonstrations. The procedures are to be performed by the students during practical classes to acquire skills. All the procedures are to be included in the University practical examination. Those categorised as demonstrations are to be shown to the students during practical classes. However these demonstrations would not be included in the University examinations but question based on this would be given in the form of charts, graphs and calculations for interpretation by the students.
PROCEDURES
1. Enumeration of Red Blood Cells
2. Enumeration of White Blood Cells
3. Differential leucocyte counts
4. Determination of Haemoglobin
5. Determination of blood group
6. Determination of bleeding time and clotting time
7. Examination of pulse
8. Recording of blood pressure.
DEMONSTRATION:
1. Determination of packed cell volume and erythrocyte sedimentation rate
2. Determination of specific gravity of blood
3. Determination of erythrocyte fragility
4. Determination of vital capacity and timed vital capacity
5. Skeletal muscle experiments.
Study of laboratory appliances in experimental physiology. Frog’s gastrocneminus sciatic
preparation. Simple muscle curve, effects of two successive stimuli, effects of increasing
strength of stimuli, effects of temperature, genesis of fatigue and tetanus.
Effect of after load and free load on muscle contraction, calculation of work done.
6. Electrocardiography: Demonstration of recording of normal Electro cardiogram
7. Clinical examination of cardiovascular and respiratory system.
TEXT BOOKS:
Guyton; Text book of Physiology, 9th edition.
Ganong; Review of Medical Physiology, 19th edition
Vander; Human physiology, 5th edition
Choudhari; Concise Medical Physiology, 2nd edition
Chaterjee; Human Physiology, 10th edition
A.K. Jain; Human Physiology for BDS students, 1st edition
BOOKS FOR REFERENCE:
i) Berne & Levey; Physiology, 2nd edition
ii) West-Best & Taylor’s, Physiological basis of Medical Practise, 11th edition
EXPERIMENTAL PHYSIOLOGY:
iii) Rannade; Practical Physiology, 4th edition
iv) Ghai; a text book of practical physiology
v) Hutchison’s; Clinical Methods, 20th edition
BIOCHEMISTRY
AIMS AND SCOPE OF THE COURSE IN BIOCHEMISTRY
The major aim is to provide a sound but crisp knowledge on the biochemical basis of the life processes relevant to the human system and to dental/medical practice. The contents should be organised to build on the already existing information available to the students in the pre-university stage and reorienting. A mere rehash should be avoided.
The chemistry portion should strive towards providing information on the functional groups, hydrophobic and hydrophilic moieties and weak valence forces that organise macromolecules. Details on structure need not be emphasised.
Discussion on metabolic processes should put emphasis on the overall change, interdependence and molecular turnover. While details of the steps may be given, the student should not be expected to memorise them. An introduction to biochemical genetics and molecular biology is a must but details should be avoided. The exposure to antivitamins, antimetabolites and enzyme inhibitors at this stage, will provide a basis for the future study of medical subjects. An overview of metabolic regulation is to be taught by covering hormonal action, second messengers and regulation of enzyme activities. Medical aspects of biochemistry should avoid describing innumerable functional tests, most of which are not in vogue. Cataloguing genetic disorders under each head of metabolism is unnecessary. A few examples which correlate genotype change to functional changes should be adequate.
At the end of the course the student would be able to acquire a useful core of information, which can be retained for a long time. Typical acid tests can be used to determine what is to be taught or what is to be learnt. A few examples are given below.
1. Need not know the structure of cholesterol. Should know why it cannot be carried free in plasma.
2. Mutarotation should not be taught. Student should know why amylase will not hydrolyse cellulose.
3. Need not know the details of alpha - helix and beta - pleats in proteins.
Should know why haemoglobin is globular and keratin is fibrous.
4. Need not know mechanism of oxidative phosphorylation.
Should know more than 90 % of ATP is formed by this process.
5. Need not know details of the conversion of pepsinogen to pepsin.
Should know hydrochloric acid cannot break a peptide bond at room temperature.
6. Need not remember the steps of glycogenesis.
Should know that excess intake of carbohydrate will not increase glycogen level
in liver or muscle.
7. Need not know about urea or cretinine clearance tests.
Should know the basis of increase of urea and creatinine in blood in renal 66
insufficiency.
8. Need not know the structure of insulin.
Should know why insulin level in circulation is normal in most cases of maturity
onset diabetes.
9. Need not know the structural details of ATP.
Should know why about 10 g of ATP in the body at any given time meets all the
energy needs.
10. Need not know the mechanism of action of prolylhydroxylase.
Should know why the gum bleeds in scurvy.
11. Need not know the structure of Vitamin K.
Should know the basis of internal bleeding arising due to its deficiency.
12. Need not remember the structure of HMGCoA.
Should know why it does not lead to increased cholesterol synthesis in starvation.
BIOCHEMISTRY AND NUTRITION
1. CHEMISTRY OF BIOORGANIC MOLECULES
Carbohydrates: Definition, biological importance and classification. Monosaccharides - Isomerism, anomerism. Sugar derivatives, Disaccharides. Polysaccharides. Structures of starch and glycogen.
Lipids : Definition, biological importance and classification. Fats and fatty acids. Introduction to compound lipids. Hydrophobic and hydrophilic groups. Cholesterol. Bile salts. Micelle. Bimolecular leaflet.
Proteins: Biological importance. Aminoacids: Classification. Introduction to peptides. Proteins : Simple and conjugated; globular and fibrous. Charge properties. Buffer action . Introduction to protein conformation . Denaturation.
Nucleic acids: Building units . Nucleotides. Outline structure of DNA and RNA.
High energy compounds: ATP , Phosphorylamidines, Thiolesters, Enol phosphates.
2. MACRONUTERIENTS AND DIGESTION
Energy needs: Basal metabolic rate. Dietary carbohydrates, fibres. Dietary lipids, essential fatty acids. Nitrogen balance. Essential amino acids. Protein quality and requirement (methods for evaluation of protein quality to be excluded). Protein calorie malnutrition. Balanced diet.
Enzymatic hydrolysis of dietary carbohydrates. Mechanism of uptake of monosaccharides. Digestion and absorption of triacylglycerols. Enzymatic hydrolysis of dietary proteins and uptake of amino acids. 67
3. MICRONUTRIENTS
Vitamins: Definition, classification, daily requirement, sources and deficiency symptoms. Brief account of water-soluble vitamins with biochemical functions. Vitamins A functions including visual process. Vitamin D and its role in calcium metabolism. Vitamin E. Vitamin K and gamma carboxylation. Introduction to antivitamins and hypervitaminosis.
Minerals :Classification, daily requirement. Calcium and phosphate: sources, uptake, excretion, function. Serum calcium regulation. Iron: sources, uptake and transport.
Heme and nonheme iron functions; deficiency. Iodine: Brief introduction to thyroxine synthesis. General functions of thyroxine. Fluoride: function, deficiency and excess. Indications of role of other minerals.
4. ENERGY METABOLISM
Overview: Outlines of glycolysis, pyruvate oxidation and citric acid cycle. Beta oxidation of fatty acids. Electron transport chain and oxidative phosphyorylation. Ketone body formation and utilisation. Introduction to glycogenesis, glycogenolysis, fatty acid synthesis, lipogenesis and lipolysis. Gluconeogenesis. Lactate metabolism . Protein utilisation for energy. Glucogenic and ketogenic amino acids. Integration of metabolism.
5. SPECIAL ASPECTS OF METABOLISM
Importance of pentose phosphate pathway. Formation of glucuronic acid. Outlines of cholesterol synthesis and breakdown. Ammonia metabolism. Urea formation. Phosphocreatine formation. Transmethylation. Amines. Introduction to other functions of amino acids including one carbon transfer.
Detoxication : Typical reactions. Examples of toxic compounds. Oxygen toxicity
6. BIOCHEMICAL GENETICS AND PROTEIN SYNTHESIS
Introduction to nucleotides; formation and degradation. DNA as genetic material. Introduction to replication and transcription. Forms and functions of RNA. Genetic code and mutation. Outline of translation process. Antimetabolites and antibiotics interfering in replication, transcription and translation. Introduction to cancer, viruses and oncogenes.
7. ENZYME AND METABOLIC REGULATION
Enzymes: Definition, classification, specificity and active site. Cofactors. Effect of pH, temperature and substrate concentration. Introduction to enzyme inhibitors, proenzymes 68
and isoenzymes. Introduction to allosteric regulation, covalent modification and regulation by induction/repression.
Overview of hormones. Introduction to second messengers, cyclic AMP, calcium ion, inositol triphosphate. Mechanism of action of steroid hormones, epinephrine, glucagon and insulin in brief. Acid base regulation. Electrolyte balance.
8. STRUCTURAL COMPONENTS AND BLOOD PROTEINS
Connective tissue: Collagen and elastin. Glycosaminoglycans. Bone structure. Structure of membranes. Membrane associated processes in brief. Exocytosis and endocytosis. Introduction to cytoskeleton. Myofibril and muscle contraction in brief.
Haemoglobin: functions. Introduction to heme synthesis and degradation. Plasma proteins: classification and separation. Functions of albumin. A brief account of immunoglobulins. Plasma lipoproteins: Formation, function and turnover.
9. MEDICAL BIOCHEMISTRY
Regulation of blood glucose. Diabetes mellitus and related disorders. Evaluation of glycemic status. Hyperthyroidism and hypothyroidism: Biochemical evaluation. Hyperlipoproteinemias and atherosclerosis, Approaches to treatment. Jaundice: Classification and evaluation. Liver function tests: Plasma protein pattern, serum enzymes levels. Brief introduction to kidney function tests and gastric function tests. Acid base imbalance. Electrolyte imbalance: evaluation. Gout. Examples of genetic disorders including lysosomal storage disorders, glycogen storage disorders, glucose 6- phosphate dehydrogenase deficiency, hemoglobinopathies, inborn errors of amino acid metabolism and muscular dystrophy ( one or two examples with biochemical basis will be adequate). Serum enzymes in diagnosis.
PRACTICALS: Contact hours 50
1. Qualitative analysis of carbohydrates 4
2. Color reactions of proteins and amino acids 4
3. Identification of nonprotein nitrogen substance 4
4. Normal constituents of urine 4
5. Abnormal constituents of urine 4
6. Analysis of saliva including amylase 2
7. Analysis of milk 2
Quantitative estimations
8. Titrable acidity and ammonia in urine 2
9. Free and total acidity in gastric juice 2
10. Blood glucose estimation 2
11. Serum total protein estimation 2
12. Urine creatinine estimation 2
Demonstration
13. Paper electrophoresis charts/clinical data evaluation 2
14. Glucose tolerance test profiles 2
15. Serum lipid profiles 1
16. Profiles of hypothyrodisim and hyperthyrodisim 1
17. Profiles of hyper and hypoparathyrodism 1
18. Profiles of liver function 1
19. Urea, uric acid creatinine profile in kidney disorders 1
20. Blood gas profile in acidosis/ alkalosis 1
RECOMMEDED BOOKS:
1. Concise text book of Biochemistry (3rd edition) 2001, T.N. Pattabiraman
2. Nutritional Biochemistry 1995, S. Ramakrishnan and S.V. Rao
3. lecture notes in Biochemistry 1984, J.K. Kandlish
Reference books:
4. Text book of Biochemistry with clinical correlations 1997, T.N. Devlin
5. Harper’s Biochemistry, 1996., R.K. Murray et.al
Basic and applied Dental Biochemistry, 1979, R.A.D. Williams & J.C.Elliot
ORAL BIOLOGY
Oral Biology course includes instructions in the subject of Dental Morphology, Oral Embryology, Oral Histology and Oral Physiology.
Introduction - Oral Biology - a composite of basic Dental Sciences & their clinical applications.
SKILLS
The student should acquire basic skills in :
1. Carving of crowns of permanent teeth in wax. 2. Microscopic study of Oral tissues. 3. Identification of Deciduous & Permanent teeth.
4. Age estimation by patterns of teeth eruption from plaster casts of different age groups. 70
OBJECTIVES
After a course on Oral Biology,
1. The student is expected to appreciate the normal development, morphology, structure & functions of oral tissues & variations in different pathological/non-pathological states.
2. The student should understand the histological basis of various dental treatment procedures and physiologic ageing process in the dental tissues.
3. The students must know the basic knowledge of various research methodologies.
I. TOOTH MORPHOLOGY
: Classification, number, percentage, distribution morphology, properties, functions & variation. Role of lymphocytes in immunity , leucopoiesis life span & fate of leucocytes. 1. Introduction to tooth morphology:
The students should gain the knowledge and insight into, the functional anatomy of the normal human head and neck, functional histology and an appreciation of the genetic basis of inheritance and disease, and the embryological development of clinically important structures. So that relevant anatomical & scientific foundations are laid down for the clinical years of the BDS course.
B) OBJECTIVES :
a) KNOWLEDGE & UNDERSTANDING:
At the end of the 1st year BDS course in Anatomical Sciences the undergraduate student is
Expected to:
1. Know the normal disposition of the structures in the body while clinically examining a patient and while conducting clinical procedures.
2. Know the anatomical basis of disease and injury.
3. Know the microscopic structure of the various tissues, a pre-requisite for understanding of the disease processes.
4. Know the nervous system to locate the site of lesions according to the sensory and or motor deficits encountered.
5. Have an idea about the basis of abnormal development, critical stages of development, effects of teratogens, genetic mutations and environmental hazards.
6. Know the sectional anatomy of head neck and brain to read the features in radiographs and pictures taken by modern imaging techniques.
7. Know the anatomy of cardio-pulmonary resuscitation.
b) SKILLS
1. To locate various structures of the body and to mark the topography of the living anatomy.
2. To identify various tissues under microscope.
3. To identify the features in radiographs and modern imaging techniques.
4. To detect various congenital abnormalities.
C) INTEGRATION
By emphasising on the relevant information and avoiding unwanted details, the anatomy taught integrally with other basic sciences & clinical subjects not only keeps the curiosity alive in the learner but also lays down the scientific foundation for making a better doctor, a benefit to the society.
This insight is gained in a variety of ways:
1) Lectures & small group teaching
2) Demonstrations
3) Dissection of the human cadaver
4) Study of dissected specimens
5) Osteology
6) Surface anatomy on living individual
7) Study of radiographs & other modern imaging techniques.
8) Study of Histology slides.
9) Study of embryology models
10) Audio-visual aids
Throughout the course, particular emphasis is placed on the functional correlation, clinical application & on integration with teaching in other bio dental disciplines.
Instructional period - Theory - 890 Hours -
Practical - 4835 Hours
D) AN OUTLINE OF THE COURSE CONTENT:
1. General anatomy: Introduction of anatomical terms and brief outline of various systems of the body.
2. Regional anatomy of head & neck with osteology of bones of head & neck, with emphasis on topics of dental importance.
3. General disposition of thoracic, abdominal & pelvic organs.
4. The regional anatomy of the sites of intramuscular & intra vascular injections, & lumbar puncture.
5 . General embryology & systemic embryology with respect to development
of head & neck.
6. Histology of basic tissues and of the organs of gastroinstenstinal, respiratory,
Endocrine, excretory systems & gonads.
7. Medical genetics. 57
E) FURTHER DETAILS OF THE COURSE.
I. INTRODUCTION TO :
1. Anatomical terms.
2. Skin, superficial fascia & deep fascia
3. Cardiovascular system, portal system collateral circulation and arteries.
4. Lymphatic system, regional lymph nodes
5. Osteology - Including ossification & growth of bones
6. Myology – Including types of muscle tissue & innervation.
7. Syndesmology – Including classification of Joints.
8. Nervous system
II. HEAD & NECK:
01. Scalp, face & temple, lacrimal apparatus 02. Neck - Deep fascia of neck, posterior triangle, suboccipital triangle, anterior triangle, anterior median region of the neck, deep structures in the neck. 03.Cranial cavity - Meninges, parts of brain, ventricles of brain, dural venous sinuses, cranial nerves attached to the brain, pituitary gland. 04. Cranial nerves - III, IV, V, VI, VII, IX,XII in detail. 05. Orbital cavity – Muscles of the eye ball, supports of the eye ball, nerves and vessels in the orbit. 06. Parotid gland. 07.Temporo mandibular joint, muscles of mastication, infratemporal fossa, pterygo - palatine fossa. 08. Submandibular region 09. Walls of the nasal cavity, paranasal air sinuses 10. Palate 11. Oral cavity, Tongue 12. Pharynx (palatine tonsil and the auditory tube) Larynx. OSTEOLOGY – Foetal skull, adult skull, individual bones of the skull, hyoid bone and cervical vertebrae
III.THORAX : Demonstration on a dissected specimen of
1. Thoracic wall 2. Heart chambers 3. Coronary arteries 4. Pericardium
5. Lungs – surfaces ; pleural cavity 6. Diaphragm
IV. ABDOMEN : Demonstration on a dissected specimen of
1. Peritoneal cavity 2.Organs in the abdominal & pelvic cavity.
V. CLINICAL PROCEDURES:
a) Intramuscular injections: Demonstration on a dissected specimen and on a living person of the following sites of injection.
1. Deltoid muscle and its relation to the axillary nerve and radial nerve.
2. Gluteal region and the relation of the sciatic nerve. 58
3. Vastus lateralis muscle.
b) Intravenous injections & venesection: Demonstration of veins in the dissected specimen and on a living person.
1. Median cubital vein 2. Cephalic vein 3. Basilic vein 4. Long saphenous vein
c) Arterial pulsations: Demonstration of arteries on a dissected specimen and feeling of
pulsation of the following arteries on a living person.
1. Superficial temporal 2. Facial 3. Carotid 4. Axillary 5. Brachial 6. Radial
7. Ulnar 8. Femoral 9. Popliteal 10. Dorsalispedis
d) Lumbar puncture: Demonstration on a dissected specimen of the spinal cord,
cauda equina & epidural space and the inter vertebral space between L4 & L5 .
VI. EMBRYOLOGY
Oogenesis, Spermatogenesis, Fertilisation, Placenta, Primitive streak, Neural crest, Bilaminar and trilaminar embryonic disc, Intra embryonic mesoderm - formation and fate, notochord formation & fate, Pharyngeal arches, pouches & clefts, Development of face, tongue, palate, thyroid gland, pituitary gland, salivary glands, and anomalies in their development, Tooth development in brief.
VII. HISTOLOGY :
The Cell :
Basic tissues - Epithelium, Connective tissue including cartilage and bone, Muscle
Tissue, Nervous tissue : Peripheral nerve, optic nerve, sensory ganglion, motor ganglion, Skin
Classification of Glands
Salivary glands (serous, mucous and mixed gland), Blood vessels, Lymphoid tissue Tooth, lip, tongue, hard palate, oesphagus, stomach, ,duodenum ,ileum, colon, vermiform appendix Liver, Pancreas, Lung, Trachea ,Epiglottis, Thyroid gland , para thyroid gland , supra renal gland and pituitary gland, Kidney, Ureter, Urninary bladder, Ovary and testis.
VIII. MEDICAL GENETICS
Mitosis, meiosis, Chromosomes, gene structure, Mendelism, modes of inheritance 59
RECOMMENDED BOOKS:
1. SNELL (Richard S.) Clinical Anatomy for Medical Students, Ed. 5, Llittle Brown & company, Boston.
2. RJ LAST’S Anatomy – McMinn, 9th edition.
3. ROMANES(G.J.) Cunningham Manual of Practical Anatomy : Head & Neck & Brain Ed.15.Vol.III, Oxford Medical publication.
4. WHEATER,BURKITT & DANIELS, Functional Histology, Ed. 2, Churchill Livingstone.
5. SADLER , LANGMAN’S, Medical Embryology, Ed. 6.
6. JAMES E ANDERSON, Grant’s Atlas of Anatomy. Williams & Wilkins.
7. WILLIAMS, Gray’s Anatomy, Ed.38. ,Churchill Livingstone.
8. EMERY,Medical Genetics.
No comments:
Post a Comment