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INI-CET MDS November 2026 Mega Recall Session LIVE | Exam Questions & Answers | DBMCI MDS — Transcript

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1:00Hello friends. Uh good morning everyone.
1:02This is Dr. Ashwara Koshik from DBMCI
1:05MDS. I'm your faculty for endodontics
1:08conservative dentistry and dental
1:09materials. Today we are going to do the
1:13recall of the INI November 2026 exam
1:17that happened yesterday. Right. So I'll
1:19be very um this is a very specific
1:22fact-based uh recall session.
1:25Um
1:27the idea of recall is to
1:30get to the most accurate version of the
1:33question and the options and as of today
1:35whatever our knowledge
1:39is there we try to tell you what the
1:42most accurate answer as per today is.
1:46That's that's the perspective. That's
1:47the idea. I'm going to be starting with
1:50endodontics and conservative dentistry
1:52and of course in the same session I'm
1:53going to be continuing with the
1:57dental materials recall as well. Uh yeah
2:00good morning once again everyone. I have
2:02my chat box also open but I'll be
2:04concentrating on the you know on my
2:06screen and everything. So uh yeah just
2:08stay with me. Okay. So we'll start with
2:10the endo and cons endo and
2:16cons recall. Okay. So the first is uh
2:19you had an IBQ and um pretty
2:23straightforward I IQ. It was actually um
2:26a case in which uh there was this miso
2:30distal section of a coral reconstruction
2:33coronal
2:35reconstruction
2:37of a micromputed
2:41CT scan. Okay. Microcomputed tomographic
2:45scan of a case in which the examiner
2:48tells us that um you can see the outline
2:52of the canal. You can see a radolucusen
2:55defect which is going right from the CJ
2:58to the middle third of the
3:01root on the dentine.
3:04There is an arrow which is marked red
3:07which is giving you that uncalcified
3:10predentine layer which does not have
3:12those receptors on which the odontolasts
3:14and the osteoclasts can bind. Okay. So
3:16there is a resopive lesion because of
3:19the predentine layer it is not
3:21encroaching it is not involving the root
3:23canal space and you have some oification
3:26somewhere in the middle third of the
3:29resorptive defect in relation to the
3:31middle third of the root that is that
3:32was marked by yellow arrow right now the
3:36diagnosis of course it's a case of
3:38cervical resorption so first of all what
3:41were the options external root
3:42absorption internal root resorption
3:44external cervical disorption an invasive
3:47cervical disorption. Now, unfortunately,
3:49you know, if you see the the the the the
3:52data, external cervical resorption and
3:54and invasive cervical resion are
3:56actually synonymous, isn't it? The only
3:59one thing that I want to clear here is
4:01that invasive does not mean that you're
4:04invading into the root canal system
4:06space. It's very rare for any cervical
4:08resorptive lesion. Usually the
4:10predentine layer stops any invasion of
4:13that resor resorption and its
4:15involvement of the root canal system.
4:18That's very rare. Okay.
4:20What I mean by this is that even if it
4:24is not involving the root canal space,
4:26it is still known as commonly known as
4:28the invasive cervical disorption. Right?
4:30So from that perspective, both C and D
4:32are correct. They're correct.
4:33Nomenclature.
4:35Is this a typo error in the exam in the
4:37options or is this or is there something
4:40else? Um if I were you, I would mark
4:44invasive cervical disorption as the
4:45answer. Again, the reason is simply
4:48because when Dr. Hither, who's the
4:50father of these cervical disorptive
4:52classifications, he actually used the
4:54term invasive cervical disorption.
4:55Again, I'm repeating not because it's
4:57invading into the root canal space
4:59simply because it is insidious. It it's
5:02asymptomatic. it just keeps happening
5:03and it and it's sometimes diagnosed very
5:06late. Okay. So external cervical option
5:09is also correct but um my hunch is that
5:13I would go with inverse invasive cvical
5:15option simply because Dr. Heathery used
5:17this term when he first classified this.
5:19Okay. So that uh it it did not that's
5:22that's that's why yeah it did not
5:23communicate with the peripheral area.
5:25Yeah. Anyways,
5:28uh so that's as far as the most accurate
5:30recall in my version of the answer goes.
5:32But yeah, we'll stay up to date as far
5:34as if there if there are any changes.
5:36Okay guys, next question is this was
5:38simple one guys. Multiple correct answer
5:40type question. Which of the following
5:42statement or statements is are true
5:44regarding the regenerative endonotic
5:46protocol? Uh regenerative endonotic
5:48procedures. The first statement was the
5:49indication nonvital open apex permanent.
5:52Second was details about triple
5:54antibiotic paste its composition
5:56cyprloxisin metronazol moninocycline and
5:58the fact that minoycline causes crown
6:01discoloration that's also true. Third
6:03statement was following induction of
6:04bleeding MTA is placed at the pulp canal
6:08interface. Now that that is a most
6:10likely a typo error. It's actually pulp
6:12chamber canal interface and helps in
6:14providing a coronal seal. That's pretty
6:18that's that's that's okay. That's that's
6:19that's that's that's
6:21that seems correct if not perfectly in
6:25line with what what actually happens
6:26because you ultimately you know give a
6:28give a composite restoration also but
6:31anyways that's right. Fourth is
6:33histoologgical studies show that
6:34definitely the tissue that is
6:36regenerated in the root canal system is
6:39always pulp tissue. That's the false
6:41statement. So the answer is that
6:44statements one two and three are
6:46correct. Okay. So that's the answer.
6:49That's a pretty simple one. That's the
6:52screenshot of our notes. This is
6:54basically for the information of all the
6:56non DBMCI students that we deliver
7:00lectures, we give you notes and uh most
7:03of what the examiner asks and you know I
7:06in need papers we would um
7:12um we usually teach it in our classes
7:15and it's incorporated in our notes.
7:16That's that's the perspective of putting
7:18the screenshot. Okay. Um, next question
7:22is again this is also directly this is
7:24also a pretty direct question. Ddas
7:26classification it was match the
7:28following. The codes were given as 0 2 4
7:30and six. Pretty simple. Zero is
7:32practically nothing. No evidence of
7:34carries neither with wet nor with you
7:37know desiccated enamel. two is that um
7:41you would have enamel you know um
7:44roughness even on
7:46wet condition also and even on dry
7:49conditions also so distinct visual
7:51change in enamel visible even when the
7:53tooth is wet okay so that's this was
7:56this was a straightforward question if
7:57you know the classification from 0 1 2 3
8:004 5 6 you would be able to answer this
8:02then code four is basically uh telling
8:05us about the underlying dentine
8:07discoloration that yes there is you
8:09carries which is encroached beyond the
8:12deej. So underlying dark shadow from
8:14dentine that's the hallmark of stage
8:17four. Stage six is extensive you know
8:20cavity in which more than half the tooth
8:23structure is involved. So that's that's
8:25pretty straightforward. Uh you would
8:28have to go with you know just be careful
8:30when you're matching the you know the
8:32answers. Pretty simple straightforward.
8:35Okay. Right guys, again this is a
8:37screenshot
8:39screenshot from our notes in which we
8:43extensively discuss while we are
8:44discussing andodontic diagnosis and
8:46kiology. Okay. Then guys simple question
8:49from vuchi classification. It was given
8:52in theory form. There's one canal which
8:54divides into two and then before exiting
8:56it again merges into one. So the
8:58configuration is 1 2 1 which is
9:01basically what vouchi type three right?
9:03So answer is vertuchi type three. Pretty
9:06simple, straightforward. Again,
9:08screenshot from our notes, my
9:10handwritten notes in which you can see
9:12here. Type three is 1, two, and one.
9:16Right? Yes. I hope everybody got that
9:19right. Now, what is the correct order
9:22regarding K's initiation and
9:24progression? So all of you who are at
9:26least our DBMCI students it's it's one
9:28of the favorite questions on our
9:29telegram groups are incipient enamel
9:31carries when does it happen? It happens
9:33at a pH below 5.5. Why does it happen?
9:36First there would be plaque accumulation
9:38then there would because there are
9:39bacteria they're eating up food they're
9:41releasing acid lactic acid pyroic acid
9:44because mostly they're the bad bacteria
9:46anorobic ones they're going to be
9:48causing mineral loss greater than
9:50mineral gain because of that subsurface
9:54demineralization will take place and if
9:55that is not treated timely there would
9:58be cavitation right so the correct order
10:00is plaque accumulation number one then
10:02mineral loss is greater than mineral
10:04gain then subsurface enamel
10:06demineralization and then cavity with
10:08chances of spreading into dentine.
10:09simple 1 2 3 4 right that's the order of
10:13course in the exam it can be jumbled up
10:14but that's the correct order pretty
10:17simple straightforward conceptual yes
10:19you would have to think twice before
10:21answering this but not very tough this
10:23is a screenshot of one of the as I said
10:26this is one of the favorite discussions
10:27in our telegram groups and morning
10:29motivations our DBMCI students would be
10:31knowing that and this is a screenshot of
10:33the similar question regarding the
10:35critical pH uh which I keep giving in my
10:39PCT TS and GTS right so I hope at least
10:44you know those studying well and RDBMSI
10:47students would get this right good guys
10:49this is a simple one guys periapical
10:51surgery IBQ you can very simply see that
10:54it's not a incision which is given right
10:56at the gingial margin right it's not an
10:59incision given right at the gingal
11:00margin it is an incision giving
11:02following the scalloping but it's given
11:04in the attached gingiva so it's the
11:07oceanbine lube cape flap flap or the
11:09lube K orbine flap. Right? So the
11:14question was during endurontic surgery
11:16the shown flap design which facilitates
11:18accurate and gentle repositioning of the
11:21flap. What is this flap called? Lube K
11:23orbine flap. What are the other options
11:26given? Rectangular papila blasted papila
11:28based and semi lunar. The answer is lube
11:31Kenbine
11:34flap. Okay, again this was not very
11:37tough if you would have been sincere in
11:39either you know your your entire BDS.
11:41It's it's pretty simple. All right guys,
11:45again this is something that we
11:47regularly teach multiple correct answer
11:49type question from endodonic surgery
11:51again. So what are the true statement or
11:54statements about endodonic surgery?
11:55First statement is root end resection is
11:57done at you know with a bevel angle of
11:59zero meaning exactly perpendicular to
12:02the long axis of the root. So that
12:04minimum exposure of dentinal tubules is
12:06there so that minimum leakage is there.
12:08Right? Correct statement. Second
12:09statement. 3 mm depth of root end
12:12preparation class one with ultrasonics
12:14should be done. Correct statement. Third
12:16MTA is the preferred root root end
12:18filling material. Of course even other
12:21calcium silicate based cements are
12:22right. Um
12:25beta
12:27the rectangular flap. Yes, it's a kind
12:29of rectangular flap but it's better
12:32answer is loop ka ocean bite right of
12:35course it's it's it's it's in in its
12:37design it's similar to rectangular but
12:39rectangular typical rectangular or
12:41triangular would be going into at the
12:43gingal margin would be following the
12:44gingerville margin okay anyways so uh
12:48the the MTA is the preferred root
12:50filling material that's so A b and c all
12:52three are correct fourth statement was
12:54that you would prefer apisctomy in any
12:56failing root canal treatment case
13:00and you would do actomy as a firstline
13:03treatment instead of attempting an
13:06orthograde redo RCD that's absolutely
13:09false that's a false statement so A B C
13:121 2 and three statements are correct so
13:14mark accordingly guys in the exam okay
13:18again a screenshot from the notes DBMCI
13:22notes guys this is my handwritten notes
13:24you can see here I made exactly
13:27perpendicular
13:28to the long axis of the root and you're
13:30doing these preps with the ultrasonic
13:32tips, right? You're doing these preps
13:35with the dedicated ultrasonic tips for
13:37root end prep, a box like class one
13:39cavity is prepared and so on and so
13:41forth. So, we keep teaching this stuff
13:43in our classes and as part of our GTS
13:45and PCTs that we keep taking, right
13:48guys?
13:50Uh,
13:52okay. Um a uh next question is was
13:56simple one guys there was this one
13:58statement based kind of a simple
13:59statement which was actually the
14:01definition of a full or or cervical
14:04pulpotomy complete pulp removal till the
14:08level of the orifice and placement of
14:10suitable cement to preserve the vital
14:11pulp is simple straightforward it's a
14:13full pulpotomy that's the answer uh
14:17someone has said in option D always was
14:19the word used at end okay guys okay
14:21thank you dear uh we Can I did that? All
14:24right. Uh, so complete pulp removal till
14:26the level of the orifice is full
14:28pulpotomy. That's perfect. Again, this
14:31is a screenshot from the vital pulp
14:34therapy notes. You can see here we keep
14:36talking about different types of
14:38pulpotoies in as part of our curriculum
14:40and our notes and our lectures in vital
14:43pulp therapy as well as during
14:45traumatology when we take lectures of
14:47traumatology. Okay guys? Okay. Next was
14:50another IBQ very uh limited in in the
14:54theory part that it was written. It was
14:56simply written it's a large pulp
14:58exposure.
15:00Yes. What is the most prudent approach?
15:03So um that was where is my live chat
15:07gone? It's buffering. No, no worries.
15:10Okay, guys. So um what is the most
15:12prudent approach in in um in a in a
15:16large pulp exposure? You can see it was
15:18a red pulp. It's it was not a necrotic
15:20pulp. So obviously the most prudent
15:22would be you would want to continue to
15:26retain the vitality of the pulp. Right?
15:29So the um best answer here would be and
15:33the other important thing was that was a
15:35very clean you know kind of a crown
15:37crown complicated crown fracture isn't
15:39it? It was a very clean complicated
15:41crown fracture. there was no evidence of
15:43carries, no darkening or carries in the
15:46image. So despite the fact that the
15:48examiner did not mention that it was
15:50whether it was a carious exposure or
15:51whether it was a traumatic uh exposure
15:54of the pulp, it is deemed understood
15:56that most likely it's traumatic
15:57exposure. Right? So um in traumatic
16:01exposure you would want you know to
16:03retain the vital pulp. You can do it
16:05with a DPC but that's not something that
16:08has a very high success rate in
16:09traumatic exposure. So the next best
16:11answer seems to be amongst the options
16:13partial pulpotomy. Okay. So pulp capping
16:16was there in the options partial
16:17pulpotomy extraction and pulpectctomy. I
16:20would go with partial pulpotomy
16:22as the best answer amongst the four. All
16:25right. Uh again a screenshot from the
16:29protocol that we discuss in the chapter
16:31of traumatic dental injuries. Uh in
16:34which we discuss what are the situations
16:36in which we're attempting a partial or
16:38shrek pulpotomy. What are the situations
16:40in which we are attempting a complete
16:43pulpotomy? Right? Open apex case versus
16:45a closed apex
16:48case. Right guys? So we keep discussing
16:51this extensively. We keep giving this as
16:53part of your um
16:56um GT questions etc. All right guys so
16:59wonderful. That is also something that
17:01we've taught and I expect my DBMCI
17:03students to at least get these you know
17:04these questions these straightforward
17:06trauma questions correct. Okay. Then the
17:0810th question is a 7-year-old 7year-old
17:12this was a very good question guys
17:1410year-old
17:16seven sevenyear-old 7year-old avalged
17:18maxillary right central incizer so you
17:22have a 7year-old very obvious it's a
17:25sevenyear-old maxillary right central
17:27incizer it has to be an open apex he has
17:30reported to you with history of trauma
17:3130 minutes back right so this is less
17:33than 1 hour so that's pretty good and
17:36the uh it happened in school with the
17:38tooth placed in milk. Now according to
17:40IT guidelines, milk is pretty good. In
17:42fact, best right. Clinical examination
17:45reveals that the tooth has open apex.
17:47Wonderful. Reimplantation and flexible
17:49splinting was done. Now this is where
17:51you you know the examiner has made life
17:53easier for us. What the examiner is
17:55saying is that replantation and flexible
17:57splinting was already done. Okay. Before
18:01he's asked the question, he's not asking
18:03you whether you know now you want to dip
18:04it in doxy, moninocy, etc., etc. You
18:08he's saying that this is done. Now you
18:10tell me what is the next course of
18:11action. Everything good has has already
18:14been done for the patient. So you so so
18:16you just keep the patient under
18:17follow-up, right? And observe for signs
18:19of spontaneous revascularization, right?
18:21So that's the answer. But in any case,
18:23let us discuss the other options. So you
18:25have follow-up and observe for signs of
18:26spontaneous revascularization. You have
18:28calcium hydroxide, pulpotomy, you have
18:30pulpecttomy opturation, extraoral
18:32epexification procedure. Why would you
18:33want to do any of these when all the
18:36good things have already been done by
18:37the examiner and she's just asking you
18:39whether you know whether I'm right or
18:41not. So yeah that's the
18:44uh uh
18:50yeah n [laughter]
18:52okay uh dear sonum that's a different
18:56question that the pedo that the pedo
18:58faculty is taking sonum um regarding the
19:025-year-old child uh in which IPC was
19:05attempted in a primary mola and um the
19:10um the bleeding did not stop with the
19:12moist cotton pellet even after 5 minutes
19:14then what would you do would you
19:16continue with formol pulpotomy or should
19:18you go with pulpctomy that the pedoph
19:19faculty is taking okay guys yeah uh
19:25which one sir the image canal visible
19:28that's like coronal pulp is gone uh
19:31honey no dear the in the image it's like
19:34um you know you have the it's not a
19:37fracture if you remember the image it
19:40was not a fracture at the level of the
19:41CJ it was coronal to the level of the
19:43CJ. Okay. So you had some pulp chamber
19:46there and there. Okay. So yeah that's
19:49why partial pulpottomy. Okay guys. Yeah.
19:52Uh no dear honey. Okay. Uh
19:58okay. Right. Okay. Fine. We get good
20:01till here. We're good till the 10th
20:03question. Right. Okay. Uh again um the
20:06uh the screenshot from our notes. The
20:08screenshot from our notes. extra dry
20:10time less than 1 hour and so on and so
20:13forth. Um we keep on discussing this uh
20:16this is a protocol that we that we uh
20:19that we're very serious about regarding
20:21trauma questions favorite of the INI
20:23people. Um okay uh next question very
20:27very clinical and straightforward very
20:29common sensical true about splinting you
20:31would want to do you know flexible
20:33splinting without any pressure on the
20:35teeth you would want to maintain good
20:37oral hygiene uh in the splint it should
20:40not interfere with occlusion. So all the
20:42first three statements are correct.
20:44Right? The fourth statement is it should
20:45be completely rigid. Absolutely wrong.
20:47So options A, B and C are correct.
20:50Right? So answer accordingly. Okay guys?
20:53Yes dear. Yeah. Okay. So you can see
20:56here this is a table again a screenshot
20:58from our notes in which we talk about
21:01flexible splinting versus semi- rigid
21:03splinting. And we talk about that
21:04flexible spinting is pretty mobile. It
21:07is most preferred. It is the most
21:09physiological but because it is not
21:11interfering with occlusion. It's not
21:12interfering with it is it is causing it
21:15is allowing adequate mobility of the
21:17teeth so that you know they don't become
21:18angily and so on and so forth. So again
21:21a screenshot from our notes 4.0 right
21:27excellent simple questions. Uh this was
21:29a very simple question guys match the
21:31following again from trauma. Uh
21:33basically knowledge based definition
21:35based direct question. It's just that
21:37these questions take eat up a lot of
21:39time, right? So you had lateral exation,
21:41you had concussion, you had subluxation,
21:43you had intrusion. Okay? So lateralation
21:46is you have an immo tooth with a
21:49metallic sound and percussion. Yes. Same
21:52as with intrusion, the tooth is locked.
21:55Metallic sound and percussion, but there
21:56is actual displacement, right? So that
21:59would be more appropriate for intrusion.
22:01Subluxation is there would be
22:02tenderness, but mobility would be there,
22:04but no displacement. and concussion
22:07tenderness would be there and no
22:09mobility and no displacement. So
22:14okay guys yeah uh so I think that's
22:18that's pretty straightforward. I hope
22:20all of us got that right. I think this
22:22our DBMI students as well as everybody
22:24who's who's serious about these exams
22:27would get should get this right. Right.
22:29Pretty simple straightforward. again um
22:32uh the timestamped notes screenshot of
22:35our timestamped notes
22:38uh version 4.0. You can see all this has
22:41been discussed extensively
22:44uh
22:47[laughter]
22:48extensively
22:50in uh our classes. Okay guys, the next
22:53question is yeah this was a good one
22:55guys. Match the following pulpal
22:57conditions with the correct treatment.
22:58So you had asymptomatic calcific
23:00metamorphosis, you had reversible
23:02pulpitis, you had irreversible pulpitis,
23:04you have pulpal necrosis. Okay,
23:07asymptomatic calcific metamorphosis, you
23:09would just uh follow it up, right? You
23:11would just follow it up because that's a
23:13good response. That's the response of a
23:17vital pulp. That's the response of the
23:19pulp that okay, I'm not succumbing to
23:21the injury. I'm fight I'm trying to
23:22fight. I'm still vital. Right?
23:25Reversible pulpitis is of course it's a
23:27simple restoration. You would want to go
23:29with a simple restoration here, right?
23:32Uh pulpal necrosis of course RCT and a a
23:37a slightly tricky one. Irreversible
23:39pulpitis you would go with a VPT. with
23:41irreversible pulpitis. Of course, what
23:44he means here is that you know if you
23:48see my lectures on vital pul therapy in
23:50detail, you would realize that yes, the
23:53classical protocol for symptomatic
23:54irreversible pulpitis of course is RCT.
23:57But these days the latest guidelines
23:59from AAPD say that if you are really
24:01wanting to save the pulp then you can
24:04attempt a even if the patient has
24:06nocturnal pain andor lingering pain
24:09andor spontaneous pain but you continue
24:12with your coronal pulpotomy and you feel
24:14that on the IOP X-ray there's no PDL
24:17changes and the pulps is at the orifice
24:21is still vital and the bleeding stops
24:23within 6 minutes according to AAPD and
24:2510 to 15 minutes according a coherent
24:27angle
24:29you might just give the tooth a chance
24:31despite the fact that you're getting
24:33signs and symptoms of irreversible
24:35pulpitis
24:37you just remove that coronal pulp
24:39thinking that okay fine my reversibly
24:41inflamed pulp I've removed by doing a
24:44full pulpotomy and I'm trying to retain
24:47or preserve my radicular pulp which is
24:50either normal or reversibly inflamed by
24:52doing a VPT okay so that is one logical
24:56way of answering this and of course the
24:57simple way of answering is that the rest
24:59of the three answers are pretty obvious.
25:02So this is the only one remaining so
25:04this becomes the answer. So either ways
25:07um so either ways guys um ah thank you
25:12Shabi. So either way guys um
25:17um uh I hope you got this right. Okay.
25:21Uh so again um this is the screenshot
25:25from the vital pul therapy. I spent in
25:28fact the last round of live classes that
25:30we had I spent a lot of time discussing
25:32the vital pul therapy based on the
25:34latest APD guidelines. So I hope that
25:36helped. I'm pretty happy if you got
25:39these questions right and uh yeah. Okay.
25:42Okay. Next one was again um not very
25:45tough guys. This was basically your
25:47hisystological kind of observation under
25:51the microscope of the various clinical
25:53pulpal conditions. So pulp necrosis
25:55you'll be having enzyatic dissolution of
25:57the pulp tissue with the presence of you
25:59know all these bad ketones and you know
26:02amino acids. So scattleal kavine indole
26:05etc. Reversible pulpitis would be focal
26:08hypermia or palpal hypermia. That's the
26:10age-old Sheaer oral pathology. You know
26:13reversible pulpitis is also known as
26:15pulpal hypermia or focal hypermia. In
26:18irreversible pulpitis you would be
26:20having irreversible
26:22irreversible
26:25pulpitis right irreversible pulpitis you
26:28would be having vaso dilotation
26:30increased vascular per permeability and
26:32some areas of um
26:39yeah but some areas would start to
26:41develop necrosis. Okay, so that's
26:42irreversible pulpitis and chronic
26:44hyperoplastic pulpitis is again very
26:46simple from your oral pathology
26:47granulation tissue with cover with
26:49coverage by stratified squamus
26:51epithelium simple enough just match the
26:53following and you get the right answer
26:55yes right shabby yeah perfect so that's
26:58the again the screenshot from the notes
27:02endodonic diagnosis in which you see in
27:04pulpitis you have vasoddilation and
27:06extravisation of blood and proteins and
27:09strangulation of blood vessels
27:11So you get these right if you are RDBMCI
27:14student. And uh yeah next question is
27:17now this was a good one guys. If the
27:20initial response seen in the infected
27:21root canal is respiratory burst by the
27:24recruited neutrfils then the
27:26antibacterial effect is. So this is
27:29again one of those favorites right in
27:30which we talk about the endotoxin and
27:32extoxin and endodonic microbial right
27:34that the direct damage versus indirect
27:36damage. the indirect damage caused by
27:38endotoxin is more important than added
27:40damage. Right? So this was an advanced
27:42question from that concept. So basically
27:44what happens is that when you have these
27:45neutrfils they fagocytos these these
27:48these these these bacteria
27:50they they get they get an overdrive they
27:53they they really start to you know their
27:56glycolysis really starts to [sighs]
27:58happen at a very higher rate. So they
28:01have a lot of oxygen consumption. When
28:03that oxygen consumption is more that is
28:05known as respiratory burst and they
28:07release oxygen free radicals which are
28:10detrimental to the bacteria which kill
28:12the bacteria. So the answer is
28:15generation
28:17of oxygen derived free radicals
28:20according to me this this is the answer.
28:22Okay, as far as the other options were
28:25concerned, production of memory
28:26lymphosytes, okay, that can happen. But
28:27is that the
28:29is that the direct consequence of the
28:32respiratory burst? As far as the
28:33antibacterial effect is concerned, no,
28:34that's a long-term consequence, right?
28:36Then you have antigen antibbody
28:38interaction. Of course, that's also
28:39going to happen as part of innate
28:40immunity. But again, better answer,
28:42direct answer is generation of oxygen
28:43derived free radicals. D option, I don't
28:46recall. If you have, you can please post
28:48it on the YouTube channel here and we
28:51can add this. Okay guys, so you can see
28:53here there's a proper see here this is
28:56the note screenshot of the note. See
28:58here see guys
29:00virulence when I'm discussing virulence
29:03in end and endotic microbiology
29:05you know indirect damage
29:08neutrfils are recruited causing
29:10respiratory burst right and uh you have
29:15as a result of that there's a lot of
29:16dissolution there a lot of damage and
29:18sometimes there is acute collapses due
29:21to these these these faggoytos and
29:24ultimately you know the neutrfils also
29:25they also burst open and along with the
29:27bacteria they they're also killed. Okay,
29:30so that's that's the screenshot of the
29:32relevant theory. Okay guys, uh just a
29:36sec I think
29:39uh just
29:41come back. Sometimes you know even just
29:43like respiratory burst my iPad also
29:47sometimes goes in overdrive. Okay,
29:50[snorts]
29:51you know too much data in this right.
29:54Anyways,
29:55uh have we Yeah. Coming back.
30:01Yeah.
30:02Okay, guys. Now, this was a good one,
30:04guys. What do you do with this? Yeah.
30:07What do you do with this? In a tooth
30:08with a traumatic dental injury in which
30:10RCT is not indicated, what is the
30:12earliest follow-up recall appointment?
30:14Now, very surprisingly,
30:16if you see the options, 1 week, 3 week,
30:191 month, 3 months. If I'm not mistaken,
30:21these were the options. Right? Now, the
30:23thing is that usually the reference is
30:26ID. Now, in IDT,
30:29uh the classical follow-ups are 2 weeks
30:32and 4 weeks. IAD refers the classical
30:36followup as 2 week and 4 weeks. Okay,
30:41that option is not there,
30:44right? Then, so forget about ID then.
30:47probably this question has been picked
30:48up or referenced from not from IDT. Then
30:52if you read your cohen it very clearly
30:54mentions that for any traumatic dental
30:56injury irrespective of whatever I mean
30:59irrespective whether it's a crown
31:00fracture irrespective whether you are
31:03planning RCT or not planning RCD you
31:05need to keep on keep on following up the
31:07patient. Now according to Kohhen the
31:09followup is 3 weeks, 3 months, 6 months,
31:16right? One year and yearly thereafter,
31:22right? So from that perspective, I don't
31:24know. I mean, I'm I would say I'm still
31:27searching for a proper IAT reference
31:30which is not there. But from this Cohen
31:32reference, I would go with 3 weeks as
31:33the answer.
31:35Right guys? Um so yeah I mean I don't
31:38know doc many of you have marked one
31:41week um yeah yeah so that's what I'm
31:43saying dear one week was there 1 week 3
31:45weeks 1 month 3 month now my only thing
31:48is that as far as reference for one week
31:52follow-up is there
31:54hardly there is you know you would call
31:56a patient back one week after a
32:00uncomplicated crown root fracture in
32:02which you would want to see whether
32:04epithelial junctional epithelium has
32:06formed or not. You might want to see
32:08your patient one week after evulsion and
32:12splinting. Okay. Although the splinting
32:13time according to ID IDT is 2 weeks but
32:16Coen says that you can call the patient
32:18after one week just to see whether
32:19junctional epithelium is formed or not.
32:21But apart from that there's no solid
32:22reference for one week. So based on
32:25reference I would say 3 weeks but yes
32:28one week can be the answer. So I would
32:29say I'm still searching for this. Uh
32:31okay guys.
32:33Right. So my answer is 3 weeks. But
32:36yeah, this was a tricky one. This was a
32:38tricky one. All right, that's the See
32:41here in fact in my notes also I have if
32:44you see my notes the timestamped notes
32:47see I've taken this reference from Cohen
32:50right so followup protocol for any
32:53traumatic dental injury 3 weeks 3 months
32:546 months and one year and yearly
32:56thereafter you know so I this is
32:58directly from Cohen so I don't know
33:01there's no point in you know reporting
33:04these questions dear. I don't think um I
33:07mean you can but I don't know I mean you
33:09have a solid reference right you have
33:11Koha's reference so I don't think
33:13there's any point in reporting but
33:14anyways this was a good one guys
33:179year-old suffered intrusion injury 5
33:19days ago so you have a 9year-old okay
33:24you have a maxillary central incizer 5
33:28days ago okay so you're talking of
33:309year-old most likely this incizer is
33:32erupting at 6 and 1/2 7 right 6 and 1/2
33:357 7 and 1/2. So obviously it's still an
33:37open apex. If this is an open apex for
33:40any intrusion injury, irrespective of
33:42the level of intrusion, you would always
33:44wait for 4 weeks for spontaneous
33:47readuption. You understand? For open
33:50apex, this was not an open apex.
33:52Definitely you would uh the protocol is
33:56different. Okay. So you wait for
33:58spontaneous
34:00eruption. That's my answer. Right. Um as
34:05far as the screenshot is concerned, very
34:06detailed I have written open apex you
34:09wait for 4 weeks irrespective. If it's a
34:12closed apex permanent tool then if it's
34:14less than 3 mm you wait for 8 weeks. If
34:16it's between 3 to 7 mm you wait for you
34:18don't wait you do orthorontic
34:20repositioning. If it's greater than 7 mm
34:22you go for surgical repositioning.
34:23Pretty simple straightforward. Okay. So
34:27the other options were surgical
34:29repositioning orthorontic repositioning
34:31combined surgical orthorontic
34:32repositioning. Wait for spontaneous
34:35eruption is the best. Okay.
34:41RCT initially in which RCT initially I
34:44don't know dear I feel that it was that
34:47RCT is not indicated
34:49but anyways we'll check that. Okay. Okay
34:52guys still here we are good. Okay. Then
34:54there was this very non-specific type of
34:56question which you can report. 34 year
34:58old sustained intrusive injury in the
35:00maxillary central incizer. What is the
35:02treatment? Now obviously it's a you have
35:05the treatment would completely depend on
35:06whether the intrusion was less than 3 mm
35:09or 3 to 7 mm or more than 7 mm. So it's
35:12a big
35:14question mark for all of us. I think
35:17this is incomplete. I think this
35:18question was
35:20incomplete. Right.
35:24Right guys. Okay.
35:26Okay. Next question is a 9-year-old
35:29suffered recent trauma in a maxillary
35:31central incizer. Yes. 9year-old. So
35:34again it's an open apex case right. The
35:38pulp was exposed. It is vital and the
35:39tooth has open apex with no peripal
35:41pathosis. What is the treatment? So what
35:43are the options? Partial pulpotomy with
35:44a suitable calcium silicate based cement
35:46extraction apexification pulpctomy. Of
35:49course guys it's an open apex. The
35:50examiner is writing no peripal pathosis.
35:54The pulp is exposed. It's vital. So
35:56obviously you're going to go with and
35:57it's a recent trauma. It's a recent
35:59trauma. So you're going to go with
36:01partial pulpotomy with a calcium
36:02silicate based cement. Right? So A is
36:05the answer. Yes, A is the answer.
36:07Simple. That's again the screenshot of
36:10the entire protocol.
36:13Screenshot from our timestamped notes of
36:15the entire protocol of what you would do
36:18if the trauma is recent, if the trauma
36:20is late, if it's an open apex case
36:23versus it's a closed apex case. Of
36:24course, I'm I'm not doing primary
36:26teaching here. I'm just discussing the
36:28questions. I'm not telling you the
36:30concepts here. So yeah, we would jump
36:32onto the next question. Yeah, this is a
36:34good one guys. Difference between
36:36selective carries removal and complete
36:39carries removal is that in selective
36:40carries removal. So he's asking that
36:42what basically whether you know what is
36:45selective carries removal or not. Simple
36:47enough selective carries removal is
36:49remove the affected infected dentine let
36:51the affected dentine remain behind. And
36:55if you are taking this risk, you are
36:56definitely after a few months going to
36:58recall the patient and see whether
37:01necrosis or irreversible pulpitis has
37:03not taken place. Right? So basically you
37:06are always going to do a two visit and
37:09that the second visit can happen after 2
37:11months. It can happen after 6 months
37:12also. Different references tell us
37:14different things but it has to be a two
37:17visit thing. Right? So two appointments
37:19are always required. That's my answer.
37:21Let's discuss the other options. Sushi
37:24timestamp notes is that uh the lectures
37:26that we take um we convert them into
37:29notes and based on what time at what
37:32time we taught what you can directly in
37:34your app you can go to that time and go
37:36to that topic okay so anyways the other
37:39option was preparation is extending
37:41extended beyond the carries right that
37:43is more like extension for prevention
37:45that's not the answer leathery soft
37:48infected dentine is left to prevent pulp
37:51exposure you know what what is right
37:53here. If it would have been softer
37:56dentine which is affected leathery or
37:58whatever but affected dentine is left
38:01behind to prevent pulp exposure. It was
38:03infected dentine. The examiner had made
38:05this clear. It was infected dentine. You
38:08cannot leave behind infected dentine.
38:10You leave behind affected dentine.
38:12Excavation is done until hot dentine
38:14layer is reached. That is true for
38:15complete carries removal. Okay. So the
38:17answer is very simple guys. Two
38:19appointments are always required. Okay.
38:20When you're doing selective carries
38:22removal, two appointments are always
38:25required. No dear uh Prem Shanka dear
38:28you chose hard dentine that is true for
38:31uh until you reach that hard dentine.
38:33No, that's true for complete carries.
38:35That's not true for selective carrot.
38:37Okay. So that's the uh that's the that's
38:41the thing there. Okay guys, so again um
38:44IPC you can see here that's the time
38:46stamp notes IPC selective carries
38:49excavation right very clearly I've
38:51discussed this in the class includes the
38:53removal of infected dentine affected
38:55dentine is left intact which is
38:56remmineralizable
38:58and so on and so forth right
39:03okay oh now this was a good one guys a
39:05good one rather not a good one
39:07calcification in both the coral and
39:08epical fragments of a root fracture case
39:11is because of so let's discuss what the
39:13options were healing by interposition of
39:14granulation tissue healing by
39:15interposition of connective tissue
39:17healing by interposition of bone healing
39:19with calcified tissue okay so guys um
39:22beta why not so why can't option D
39:25shrishi con beta excavation is done
39:28until hard dentine is reached is true
39:30for complete carries removal it's not
39:33true for selective carries the examiner
39:35is asking for selective carries removal
39:37in complete carries removal you remove
39:39the infected as well as affected dentine
39:41until unless you reach that hard
39:42dentine. Okay, that's complete carries
39:45removal. That's what we do usually
39:47clinically, isn't it? That's not wrong.
39:49It's not about what is right and what is
39:51wrong clinically. It's about what the
39:52examiner is asking us. Okay. Okay guys,
39:54so um calcification in both the cornal
39:57and epical fragments of a root fracture
39:58case. So basically this is a root
40:01fracture case in which he's saying that
40:02the pulp chamber has calcified in the
40:04cornal segment also and in the epical
40:06segment also. Okay, is because of now
40:09this is a funny question. Why? Because
40:12uh yes calcification is an um indication
40:16that favorable pulpal healing has
40:18happened. Okay. And that can happen in
40:23favorable conditions. And what are those
40:25favorable conditions? When the healing
40:27of the fracture site is by connected
40:29tissue, is by bone is by calcified
40:31tissue. Right? Granulation tissue is
40:34failure. when there is granulation
40:36tissue at the fracture it is failure.
40:40Now according to me and according to
40:42what I have read you know calcification
40:45is a favorable pulpal response that can
40:47happen in either of these three
40:48conditions right. So I don't know for me
40:51this was yeah this was um
40:57what exactly the examiner is trying to
40:59ask us I don't understand but if I have
41:00to mark one obviously I would mark
41:02healing with calcified tissue. Okay. So,
41:06so that's my most appropriate answer
41:08based on whatever the examiner is trying
41:11to ask us. Okay guys, yes. So, that's my
41:16um yeah, so that's that's the root
41:19fracture screenshot in which we're
41:22talking of the various root fractures
41:25and um what all happens and how we
41:28supposed to manage these. Okay, next
41:30question. Again, straightforward guys.
41:32Um
41:34yeah, next question is straightforward
41:36guys. Endoperio again one of my
41:38favorites in the live class also and if
41:40those of you are taking my GTS I always
41:42try to put one question of endoperio
41:44detailed IBQ or something like that.
41:46This was straightforward guys definition
41:48true combined primary endo with
41:49secondary perio primary perio with
41:51secondary endo. The true combined is you
41:52know uh pulpal and periphyal disease is
41:55happening you know on its own but
41:57ultimately it has reached such an
41:58advanced stage that it co that it has
41:59coalesed it has it has it has come
42:01together it has made a continuum so
42:03that's correct primary endo with
42:05secondary perio is self-explanatory
42:07first the tooth has turned non vital you
42:10know it has you haven't treated it
42:12because of that there is you know um
42:17ultimately involvement of the parodonium
42:19also because of you know plaque
42:21accumulation etc etc. The patient is
42:23also not brushing his teeth and there's
42:25plaque accumulation due to which there's
42:27periodontal pockets also. So that's
42:29initially endo involvement with
42:32secondary perio involvement and primary
42:34perio with secondary endo simple initial
42:36pero involvement with the tooth turning
42:38non vital later. So that was pretty uh
42:42straightforward
42:45right guys pretty straightforward. Yes.
42:48So that's the screenshot of the uh of my
42:52lectures true combined conccommatant
42:54primary perio secondary endo and so on
42:57and so forth. So we discuss I spend a
42:59lot of time discussing this small topic
43:01as well and I'm pretty happy this
43:02question came right okay next question
43:05was simple guys order of pit and fisher
43:08sealant application right so first you
43:10clean the tooth with pumis then you acid
43:13you rinse and dry and then you apply
43:15raisin and light cure right so a b c and
43:19d that was the that was the uh this
43:21thing
43:27Yeah. Yeah. Oops. Aa. Okay. Okay. So,
43:32this was simple, guys. Pit and Fisher
43:33sealant was simple. You clean the tooth
43:36with pumis, which we normally don't, but
43:37you should. Okay. Then you apply your
43:39etchent, then you rinse it, you dry it,
43:43you apply your, you know, bonding agent,
43:46flowable composite, you cure it,
43:49etc. Right? Simple. Okay. about
43:52objuration of primary teeth. Zinc oxide
43:55is slow to absorb compared with root and
43:58remnants may be left behind. That's
44:00correct. Idoform resorbs readily that's
44:03also correct. GP should be used. That's
44:04wrong. Endoflass comprises of zinc oxide
44:08eugenol. Idoform and calcium hydroxide.
44:10That's also correct guys. So AB and D
44:12are correct. Okay. A B and D are
44:15correct.
44:16AB D are correct. Okay. AB D are
44:20correct.
44:21Uh this is a good one guys. Local
44:23anesthetic of choice for mandibular mer
44:24with symptomatic irreversible pulpitis.
44:27It has been quite a few years now.
44:28Basically this is talking about hot
44:30tooth and what should you do in a hot
44:32tooth? Don't attempt don't even attempt
44:34according to latest evidence talked by
44:36Dr. Malamment don't even attempt you
44:37know lignocine put two blocks two
44:40inferior alen blocks with 4% articine
44:42and adrenaline. So 4% articane was one
44:45of the options. That's the answer. Then
44:46you have 3% 5.5% bupcaine 2% lidocaine.
44:50The answer is basically 4% articine. The
44:53success rate with inferior alvar nerve
44:55block is higher also when you it's lipid
44:57soluble. So when you inject it locally
44:59as an infiltration it goes to the root
45:01right. So
45:10ah acha. Okay but the answer dental
45:13pearls the answer was pretty simple
45:15right? Okay
45:19good one guys. Um next is yeah this was
45:22a repeat guys this was a repeat pain on
45:25biting sensitivity is present no
45:27evidence of carries perodonium is fine
45:29uh you suspect a crack tooth syndrome
45:31what is the other diagnostic tests of
45:33course OPG is not that great tooth
45:36sleuth dilumination tie penetration and
45:38transillumination so BCD is the answer
45:41this was a repeat guys this was a repeat
45:43so you can see this is a screenshot from
45:46our timestamped notes you have the tooth
45:48sleuths
45:50Right. And rubber wheel, orange wood
45:52sticks, pain on biting, all of that
45:55happening in a cra crack tooth syndrome.
45:59Aa okay sir was V score. Yeah. Yeah.
46:03Yeah. Yeah. Correct. Visual analog score
46:05of nine. Yeah. That's also that
46:08basically means pretty bad pretty bad
46:10pain. Okay. Good one. Thank you guys.
46:14Okay. So, which of the following is not
46:16a longitudinal fracture? Again, repeat.
46:19Right. So all the in the last recall
46:22also I told you that all the fractures
46:24mentioned in the chapter of cracks and
46:25fractures whether it's a craze line
46:26cracked tooth
46:28cracked cusp vertical root fracture
46:30they're all longitudinal. Crown root
46:32fracture first runs you know kind of
46:34longitudinally then obliquely also okay
46:36so crown root fracture is the answer.
46:39Crack cast praise line VRF
46:42crack tooth split tooth they're all part
46:44of longit chapter of cracks and
46:46fractures. They're all longitudinal. And
46:48the answer is crown root fracture, guys.
46:50Excellent. Wonderful. That's the
46:52screenshot of the very extensively
46:55discussed cracks and fractures chapters
46:57which I always do. Right. Right. And you
47:00can see here the slightly oblique line
47:02of the crown root fracture. Isn't it? So
47:06that was the recall for endo and cons.
47:10Now let's just quickly discuss the
47:12dental materials also. Right? Very heavy
47:14duty subjects, right?
47:16So many questions almost more than 40 41
47:1942 questions out of 200 from DM
47:21endocons.
47:23Okay. Yeah. Thank you Andan. Yeah.
47:24Visual analog score score score was
47:26there. Okay. Now the dental materials
47:29recall guys according to first question
47:31itself was tough. According to ADA
47:33requirements the minimum radio opacity
47:35of commercial composite restorative
47:36material to ensure radioraphic detection
47:39of marginal defects and secondary
47:40carries. Now this is a new one guys
47:42brand new question. Uh if you could have
47:44left it. Wonderful. Okay. So, basically
47:48uh the minimum radioop opacity actually
47:51should be equivalent to aluminium,
47:53right? But the catch here was that you
47:57also want to detect marginal defects and
47:59secondary carries. For that you would
48:01even need a greater thickness of
48:03aluminium which would be like a 2 or 3
48:07mm thickness of aluminium in which when
48:10you talk of 2 or 3 mm thickness of
48:11aluminium it's actually the radio
48:14density is almost that of enamel. Okay.
48:17So equal to the equivalent thickness of
48:19aluminium is partially correct in the
48:22sense that yes that's the minimum
48:23requirement but if you want to diagnose
48:26but if you want to diagnose
48:28the um
48:34if you want to diagnose the marginal
48:36defects and secondary carries then I
48:37would say equal to enamel would be a
48:39better answer. Okay the other options
48:41were equal to copper 2 mm completely
48:43radioopa should block the x-rays that's
48:44obviously wrong. So according to me A
48:47and B between A and B I would go with B.
48:49Okay, that's a new question. So okay,
48:51that that adds to our data. Um
48:59beta uh Anban that in that invasive
49:01cervical resion seems to be a better
49:03answer than external but even external
49:05cervical resion is correct. Anyways,
49:07lowest formability is that off. Okay. So
49:10the so the least formable meaning you
49:12can't just you know bend it and it stays
49:14bent. That doesn't happen with the wire.
49:16Which wire? Night eye wire. Okay. So the
49:19lowest formability is that of night eye
49:21wire. Yes. Night eye wire. Gold's
49:24formability is pretty good. As good as
49:26beta titanium. So the options are aloy
49:28gold night eye beta titanium. Night eye
49:31is the answer. Lowest formability.
49:33Right. So we keep talking about this.
49:36Uh this is our time stamp note
49:38screenshot. You can see here highest
49:40formability is that of both gold and
49:43beta titanium. Uh lowest formability is
49:46that of nitai. You can see here in the
49:48notes that uh um
49:55uh
49:57ductility is pretty low under goes the
50:00lowest number of cold bends before
50:01fracture. So it's very less formable.
50:03Okay. Um next up is
50:09Yeah, arrange in decreasing order of
50:10modus of elasticity. Now guys, if you
50:13see my uh notes here, the modus of
50:17elasticity values
50:19uh is stainless steel is highest. Then
50:23you have
50:25beta titanium then nai. Okay. Now where
50:27is gold? The modus of elasticity is gold
50:29of gold is about 100 to 120. So the
50:32order would be stainless steel. Then you
50:35have gold.
50:37Okay. Then you would be having your beta
50:41titanium or titanium olive denim alloy.
50:44And then you would be having your nit
50:45eye. Okay. So that's the answer.
50:48So that's the answer. So
50:53uh a range in decreasing order of modus
50:54of elasticity would be
50:57highest would be stainless steel gold
51:00beta titanium and night eye. Okay this
51:03is the order decreasing order of modus
51:05of elasticity stainless steel gold
51:08beta titanium nit eye. All right guys.
51:12Yes.
51:14Conserv beta
51:18beta. Uh just as a general rule all the
51:21cracks and fractures
51:23uh
51:25cracked cusp line split tooth vertical
51:28root fracture cracked tooth they're all
51:30longitudinal. Okay. Right. Is that fine
51:32guys? So I've shared the screenshot of
51:35the notes as well.
51:38Next is a denture is being fabricated by
51:40heat cure compression molding technique
51:42following flasking. What is the correct
51:44order of denture processing? So anybody
51:45who's made a denture guys simple um you
51:49dewax it. Once the wax is eliminated you
51:52apply CMS that's your separating medium
51:55then you pack it and then you cure it in
51:57a water bath. Right? So wax elimination
52:00number one
52:02separating medium then pack with dough
52:05dough stage raisin and put in water
52:07bath. That's the order. Okay. So, A B CD
52:09is the order of 1 2 3 4. Right, guys?
52:12Simple enough.
52:16Okay. Good. Uh, this is a simple one,
52:18guys. Many a times we've discussed in
52:20our Telegram group as well as PYQ. This
52:25is a very repeat multiple repeat times
52:28PQ that in a heat cured denture base,
52:30internal voids are seen in the thickest
52:32part, but they're not seen in the thin
52:34flanges. Why? Because you when you're
52:35doing rapid heating because raisin and
52:38stone are not good conductors of heat
52:40the temperature increases rapidly beyond
52:42the boiling point of the monomer which
52:44is what methile methacrylate which is
52:45what 100.8° C and it evaporates. So
52:49rapid heating led to temperature
52:51increase above the boiling point of
52:52monomer leading to evaporation of
52:54monomer. Right? That's the answer. Right
52:56guys that's the answer. Next question
52:59is, which of the following statements
53:01are correct regarding thickotropy and
53:02pseudoplasticity respectively? Now, this
53:04is one of my favorites. You know, I
53:06always teach this. So, I hope you got
53:08this right. Viscosity decreases with
53:10increase in sheer strain rate. That's
53:12pseudo plastic. Fluid viscosity
53:15decreases on increased vibration,
53:16stirring or patting. Right? That's
53:19thickotropy, right? That's thickotropy.
53:23So, that's the answer. Okay? So A is
53:26pseudoplasticity, B isixotropy, right?
53:29Uh you know what the C and D statements
53:33are regarding viscosity increases with
53:36increase in sheer strain rate. Shear
53:37thickening is dilated, right? So there
53:40was one option with dilated also. But
53:41the examiner clearly mentioned which of
53:43the following statements are correct
53:44regarding and pseudoplasticity. You
53:46understand? Um
53:52h okay. And material remains rigid until
53:55a given value of stress is there that is
53:57plastic. So again that was also not
53:59asked. So the answer is this. Yeah.
54:02Okay. Time dependent aa.
54:07All right. So that's that that makes it
54:09even easier. Fluid viscosity decreases
54:10on increased vibration and stirring and
54:12it was time dependent. So that's right.
54:15Correct. Okay guys. Thank you. So that's
54:18your screenshot for your diagram for
54:23pseudoplastic plastic thickotropic etc.
54:27That's the screenshot from our time
54:29stamp notes. Now this was a good one
54:31guys. Regarding mild self-fetch adhesive
54:33like clear fill I see the significant
54:34attribute is now guys. What do you mean
54:37by mild? The acid is not very acidic.
54:41Meaning the pH is not less than one.
54:43It's it's just about two. So basically
54:46the what the examiner is trying to ask
54:47us is that when you are using self-etch
54:51in isolation not doing etching and
54:52rinsing
54:54then it's good with dentine you know why
54:57it's good with dentine because dentine
55:00is not that highly mineralized but when
55:02you're doing it with enamel
55:05uh the weak acid may not be good enough
55:09to create adequate micro undercuts with
55:11enamel.
55:13Okay. So what are the options? Strong
55:15enamel bond with a compromised dentine
55:16bond. Next option was strong dentine
55:18bond with relatively unpredictable or
55:21relatively weak enamel bond. Both enamel
55:23and dentine bonds are equally strong and
55:25better bonding than aggressive self-ed
55:27systems. Better bonding than aggressive
55:29self systems. Okay. The answer would be
55:33that the there is more predictable
55:34bonding with dentine but not so much
55:37that with enamel because it's a weak
55:38acid. It's a mild self fetch like clear
55:42fill se. So the answer here is strong
55:45enamel strong dentine bond with weak
55:48enamel bond or with unpredictable. I
55:50think the option was unpredictable. So
55:52weak or unpredictable. Weak or
55:57unpredictable
55:58bond with enamel. That's the answer
56:00guys.
56:02Okay that is the answer. strong dentine
56:06bond with weaker
56:11enamel or unpredictable enamel bond.
56:16Okay. Yeah, this was a good one guys.
56:19That's the table in which I have talked
56:22about this clear fill you know self
56:25fetch system which is basically uh uh
56:29clear SE which is the by QR which is a
56:33seventh generation self-fetch additive
56:34right but yes this was a new one tricky
56:38one okay this was also a new one guys so
56:40I would suggest that if you've left it
56:42it's fine the requirement of wax used
56:44for inter occlusion record so that you
56:47are able to mount your cast back on the
56:49articulator accurately. Right? So the
56:52answer the options were 2 mm deep
56:54indentation should be there with
56:55extensions beyond the buckle cusp of mer
56:57uniform pressure on soft tissues at
56:58gingal margin brittle when it gets hard
57:00so that it breaks when bent should
57:02remain soft and flexible after cooling.
57:04See the answer is that you should have 2
57:06mm deep indentation. You know why? So
57:08that you have a good index so that when
57:10you're mounting it back on the
57:12articulator
57:14you know the positioning is is is is
57:17precise. So that's the answer guys. 2 mm
57:20deep indentation should be there with
57:21extension beyond cusp mer. So this is a
57:24perfect accurate uh you know this is a
57:27new question. So even if you've left
57:29this that's okay guys two two to three
57:32questions you can always leave better
57:34not to do negative marking and those of
57:36you who have because of some common
57:38sense have got this right
57:40congratulations to you. I mean
57:42you know expect a good rank if you are
57:45doing your repeats correctly and such
57:47new questions are also you know here and
57:48there you're getting them correct so
57:49that that is when you know
57:53that is when you realize that it's your
57:55day okay all right guys so
58:00that's a screenshot of our
58:01classification impression waxes you know
58:03bite registration wax right we talk
58:06about this but yeah no doubt this was a
58:07new question um there's no solid
58:10reference in your standard textbook
58:12Philips or Craig is something that is
58:15given from articles. Okay. So that's
58:17okay. Okay. Um this was again a new
58:20question. What is the reason for your
58:21cold cure or autopolymerizing tray
58:23formed that remains too soft and
58:25flexible? Basically too much or too less
58:28monomer. So I think in one of the
58:30options excessive monomer was there.
58:32Excessive monomer is there. So I I feel
58:34that that should be the answer. So one
58:36option was excessive monomer. uh then
58:39curing was done by covering the by
58:43covering with a bowl under normal
58:44atmospheric pressure. That's a good
58:45thing. You are preventing evaporation of
58:48monomer. Right? During curing it was
58:50immersed in water. Um I don't know
58:53tricky one. And D option we don't
58:55recall. We still searching. So um I
58:58think the option which has excessive
59:00monomer seems to be the most appropriate
59:01answer as of today. But um we are
59:04keeping our minds open as far as this
59:06question is concerned. This is a brand
59:07new question again. no solid reference
59:09from any textbook, but most likely we
59:11we're dealing with the answer. I I feel
59:13that the closest answer is excessive
59:15monob. All right guys um okay this was
59:19simple guys again this was something
59:21this is one of my favorites physical and
59:22mechanical properties you had this graph
59:24in which there was x here and there was
59:27this y here okay so he asked what is x
59:32right so the area under the straight
59:34line portion is resilience the other
59:35options were formability ductility and
59:37malleability the answer is resilience I
59:40hope everyone got that right yes
59:44dilatant tixotrope Y beta dilotent and
59:47thricotropy were matching but Rohit
59:50partail the examiner had mentioned talk
59:53about pseudoplasticity and thricotropy.
59:55So you had a one option in which the
59:58correct matching of pseudoplasticity and
1:00:01thickotropy was there. That was the
1:00:02answer. He did not ask us dilated. Yes
1:00:04the statement regarding dilated was
1:00:06right but he but he did not ask us. Okay
1:00:11acha. Okay. A heat cure monomer was used
1:00:13for autocure powder.
1:00:16Okay, I'll have to check that there. But
1:00:18anyways, here I hope everyone got this
1:00:20right. Area under the straight line
1:00:24portion of the stress train curve
1:00:25resilience. Next question is to create
1:00:27surface irregularities on enamel for
1:00:29bonding orthonoric metal brackets.
1:00:30Basically guys in this you use
1:00:32unbuffered. You have to use unbuffered
1:00:35so that because buffered is you're
1:00:37reducing the activity of the acid. So
1:00:39the micromechanical undercuts that
1:00:41you're creating are less. So the answer
1:00:43is unbuffered 37% phosphoric acid. The
1:00:47answer is this is a good one guys. New
1:00:49question. Unbuffered 37% phosphoric
1:00:52acid. Then the other option was buffered
1:00:5337% phosphoric acid. Then the other
1:00:55option was unbuffered 50% phosphoric
1:00:58acid. And then the other option was 5%
1:01:00sodium hypoparide. The answer is
1:01:02unbuffered 37% phosphoric acid. Okay,
1:01:05that's the answer. That's the screenshot
1:01:08of the etching and priming etc that we
1:01:12discussed in the class. True about C
1:01:14factor and polymerization shrinkage
1:01:15stress. Repeat question. Yes. Multiple
1:01:17correct answer types. C factor is the
1:01:19ratio of bonded over free surfaces.
1:01:20That's the definition correct. Class one
1:01:22box form has the highest C factor value.
1:01:24That's correct. If incremental buildup
1:01:26is done, the effective C factor is less.
1:01:28That's also correct. D option is that if
1:01:30bulk fill composite restoration is done
1:01:32that then it ensures that polymerization
1:01:34shrinkage is zero. No, that's not right.
1:01:37Yes, it can be less because of modern
1:01:39techniques, modern chemistry, but it
1:01:41cannot be zero. So, answer is A, B, and
1:01:43C. Okay, answer is A, B, and C. Answer
1:01:47is A, B, and C. Correct guys?
1:01:51That's the screenshot of the detailed
1:01:54comparative analysis that I do with you
1:01:56guys. You know, that's the image from
1:01:58the screenshot from our notes. That's
1:02:00the image from Sturdivan. That's the
1:02:02image from Summit Robbins. And I give a
1:02:05lot of time in discussing C factor. So I
1:02:07hope at least our students got this
1:02:09correct. Okay guys. Yeah. Fine.
1:02:14You guys stay connected with us on the
1:02:16telegram group and I hope and I wish you
1:02:20all the very best guys. Keep studying
1:02:21hard and keep taking your God's name and
1:02:24best wishes to all of you. Next up is
1:02:27Dr. Roi with the prostadontics recall.
1:02:30Right. Thank you guys. Bye. Take care.
1:02:32See you.
1:03:26Hello and good afternoon dear students.
1:03:28I am Dr. Ruchi Raj your procedontics
1:03:30mentor and I welcome you to this mega
1:03:33recall session of INIC November 2026
1:03:36session questions. I'll be discussing
1:03:39all the questions pertaining to
1:03:40prostadontics and I can see uh lot of
1:03:44students have joined in for today's
1:03:46session. I was just seeing sessions
1:03:48right now when there was an active
1:03:50interaction going on between students
1:03:51and s and uh let us discuss pros now. So
1:03:56before we start with the questions per
1:03:58se, uh the review or feedback that I got
1:04:01from majority of students pertaining to
1:04:03prosto is that I feel the gods were
1:04:05little in your favor this time. Prosto
1:04:08could be considered moderate. Majority
1:04:10students said that the paper was lengthy
1:04:13but the proto questions as such were
1:04:15mainly from your previous year topics
1:04:17and some things that we have already
1:04:19studied and seen and done in our
1:04:21classes. It is there in our notes or in
1:04:23our other sessions also. The questions
1:04:26as such were easy but they were lengthy.
1:04:28That is the major feedback that I
1:04:30received from majority of students. Now
1:04:33good afternoon everyone to all those who
1:04:34are joining right now and
1:04:39let us start with the first question. So
1:04:42a 66 year old male patient was given
1:04:44denture a week ago. Uh patient complains
1:04:47of denture falling on the opening mouth
1:04:50wide while yawning but is all right
1:04:52while speaking and eating. What could be
1:04:54the reason? Is it overextended destrole
1:04:57flange in the coronoid process, under
1:04:59extended labial flange, increased
1:05:02vertical dimension and inadequate
1:05:04posterior pal seal area? And the reason
1:05:06why I'm smiling is that probably at
1:05:08least close to 100 times I would have
1:05:11taught this either in our classes
1:05:12through doubt solving in groups or
1:05:14through our GTs or I don't know what
1:05:16not. I've added screenshots of it. So
1:05:19the correct answer is overextended
1:05:21distocical flange in the coronoid
1:05:23process. Now basically what happens is
1:05:25that right now also you can try and see
1:05:28when you try and close your mouth the
1:05:30coronoid process comes anteriorly and
1:05:32this is how the width of the distbuckle
1:05:34flange of maxilla reduces. Now if you've
1:05:37not molded it in this area while doing
1:05:40this process that is asking your patient
1:05:42to slightly close the mouth then what
1:05:44happens is every time the patient either
1:05:46opens the mouth wide or closes right at
1:05:49that point there is a good chance that
1:05:51the coronoid process will interfere with
1:05:53the width of the flange of the maxillary
1:05:56denture particularly in the distrobuckle
1:05:59region and that is how the denture gets
1:06:00dislodged. Very classic complaint is the
1:06:03denture falls down while opening the
1:06:05mouth wide
1:06:07or while yawning but otherwise it is
1:06:10fine. Now another close question
1:06:13pertaining to this is the denture
1:06:14falling down while smiling and that is
1:06:16where majority students get confused but
1:06:18as you can see here the correct answer
1:06:20is there in our notes. It is there. See
1:06:22this is a screenshot of a telegram group
1:06:24where I have mentioned it there also.
1:06:26This is a screenshot of where I have
1:06:28taught it during a live class also. So
1:06:31this was totally covered. I think
1:06:35probably one of the most discussed thing
1:06:37I used to begin our anatomical landmarks
1:06:39class and impression and border molding
1:06:41and inevitably teach this. I'm sorry for
1:06:44the call in between. So that is what it
1:06:47is and I think uh this question you
1:06:51should never or definitely would not be
1:06:53wrong. So correct answer question number
1:06:55one. Option number A, you have your
1:06:58coronoid process interfering with the
1:07:00distbuckle flange and that is how the
1:07:02denture falls down. Right? Yes, lot of
1:07:05students are agreeing to it. It has been
1:07:07discussed several times. Now let's let
1:07:10us come to question number two. So when
1:07:11you go through all of these questions,
1:07:13you'll realize the theme of it is such
1:07:15the question has such a simple to
1:07:17moderate but it is so lengthy that it
1:07:19wears someone off and probably that is
1:07:21where you will make a mistake. I hope
1:07:23you agree to what I'm saying and that is
1:07:25what majority of you may have felt but
1:07:27remember focus and read the question
1:07:29well let us do it for second question
1:07:31now 56 year old male is wearing
1:07:33maxillary denture since 9 years against
1:07:36mandibular anterior natural teeth and
1:07:39doesn't have mandibular prostthesis
1:07:41clinical finding shows anterior flabby
1:07:43ridge hyperlastic pallet overgrowth of
1:07:46maxillary tuberosity flared anterior
1:07:48teeth what could be the diagnosis all of
1:07:50these are diagnosis pertaining to either
1:07:53denture wearing squa or something that
1:07:55is relevant to some faulty denture. The
1:07:57correct answer here is combination
1:07:59syndrome. Now tell me students how many
1:08:01times have we discussed this window
1:08:03technique and all of this that is
1:08:05relevant to combination syndrome and
1:08:07flabby ridges and whatnot. Right? This
1:08:09is a screenshot of one of the questions
1:08:11pertaining to it from our Qbank. This
1:08:14particular topic also has been discussed
1:08:16through our live classes through our
1:08:18notes through our interactive sessions.
1:08:21uh as sir mentioned also this session is
1:08:23not primarily uh aimed at teaching the
1:08:26particular topic so I won't go uh and
1:08:28discuss the details of this topic as
1:08:30such over here but when you see a
1:08:33situation where there is a maxillary
1:08:35denture and it is opposed by mandibular
1:08:37natural dentician
1:08:39the first thing that should cross your
1:08:41mind is anterior flabby ridge and
1:08:43combination syndrome look for things
1:08:45that are relevant to it because some or
1:08:47other question comes from this sector
1:08:49either window technique choice choice of
1:08:51impression material for window technique
1:08:52or maybe the syndrome itself. Right? So
1:08:56that is there and
1:08:59let us come to question number three.
1:09:01Before that I have the live chat also in
1:09:03front of me. So if you want to interact
1:09:05with me, you can always put your queries
1:09:07through it and I'll be more than happy
1:09:08to solve it. Now one of our students
1:09:11here is asking please explain how to
1:09:13overcome the problem of distbuckle
1:09:15extension. So Anna what you do is when
1:09:17you're doing border molding in the
1:09:19distbuckle flange you have to ask your
1:09:21patient to open the mouth wide and close
1:09:23take the mandible to side to side
1:09:25movement that will mold the distbuckle
1:09:27flange in this region as per the
1:09:30movement of the coronoid process. Now
1:09:32for example if you have already have a
1:09:34denture which is falling down like this
1:09:35and you have a thicker flange likewise
1:09:38what you need to do is reduce the width
1:09:39of the flange over here by trimming the
1:09:42outer part of the acrylic and hopefully
1:09:44that will solve your problem.
1:09:46Okay. Now come to question number three.
1:09:4950-year-old lady complains of cheek
1:09:52biting. Okay. It's not getting it is
1:09:54cheek biting
1:09:57and trapped in preolomar region. What
1:10:00could be the problem amongst all? So it
1:10:03was a multiple combination kind of a
1:10:05question. Again two things that we
1:10:07observed in these papers and then as a
1:10:09trend in the recent years is uh multiple
1:10:12combination kind of questions are asked
1:10:14and this time match the following was
1:10:16also predominant lesser I would say not
1:10:18IBQ in pro we didn't find any IBQs but
1:10:21match the following was there so now
1:10:23when in this particular case and
1:10:25scenario mainly you are asked the
1:10:27reasons for cheek biting now tell me
1:10:29again how many times have you discussed
1:10:31this it is there in our nodes also when
1:10:33posterior teeth are set end to bend and
1:10:35there is overclosure of mandible. Right?
1:10:38So both of the options were there over
1:10:40here. In fact, let us have a look. So
1:10:43inadequate overjet in the posterior
1:10:45teeth that means posterior teeth set
1:10:47edge to edge is one of the reasons and
1:10:50decrease in vertical dimension leading
1:10:52to overclosure of mandible. Again is one
1:10:54of the reasons right mandibular teeth
1:10:56arranged lingual to the crest of the
1:10:58ridge cannot lead to cheek biting. And
1:11:00I'm sorry actually uh one of the options
1:11:05uh I'm missing over here which is option
1:11:08number four. So if you can suggest me
1:11:10what exactly it was I'll just keep it
1:11:12with me for the final paper. Uh what was
1:11:16the option but yes the correct answer
1:11:18which I have gotten to know after
1:11:20discussion with students also was two
1:11:22options were correct in it and they were
1:11:24one and two. So going by that this
1:11:27option is correct and see exactly the
1:11:29same is mentioned in our loads also over
1:11:31here overclosure of mandible which is
1:11:33when vertical dimension is lesser video
1:11:36is less and overjet is less both of the
1:11:38reasons are there for cheek biting
1:11:41right. So students I hope this part is
1:11:43clear
1:11:45and uh yes one of our students has
1:11:49mentioned option four was thick material
1:11:50on palatal side and less on buckle side.
1:11:53I think that would not lead to cheek
1:11:55biting. So we stand by our answer over
1:11:57here which is option number one and two.
1:12:00Right? So quickly tell me I hope first
1:12:03three questions is something where you
1:12:05have not made a mistake because all
1:12:07these three questions were such that we
1:12:09have discussed I think dozens of time
1:12:12through different different sessions and
1:12:14in our groups and everything and you
1:12:16should be more than happy to see them in
1:12:18front of you on the screens when
1:12:19attempting. Now question number four.
1:12:22The theme of the question was something
1:12:23that what helps you determine centric
1:12:26jaw relation. I don't have the exact
1:12:27line for it. So if you do recollect
1:12:30please share it in the live chat and
1:12:31I'll refine my questions. But what it
1:12:33was asking is something that is relevant
1:12:35to CR and what helps you determine it or
1:12:38probably
1:12:40what is related to centric jaw relation.
1:12:43So then
1:12:45the answer here becomes temporal
1:12:47mandibular joint. MIP tooth contact and
1:12:49occlusial plane were not related to it.
1:12:52Right? Let us come to the chats also
1:12:53over here. So
1:12:58why why not uh option number three in
1:13:02the previous question you are asking
1:13:04when mandibular teeth are arranged
1:13:05slightly lingual to the crest of the
1:13:07ridge that will contribute to actually
1:13:09having your overjet it when you set it
1:13:12too far buckly and your maxillary teeth
1:13:15will always be slightly buckled to the
1:13:17crest of the ridge there is a
1:13:18probability that you will miss out on
1:13:20the overjet that you're supposed to
1:13:22develop when you keep it slightly
1:13:23lingual to the crest of the ridge there
1:13:25is a chance of cramping the tongue or if
1:13:28you keep it too far lingual to the crest
1:13:30of the ri there's a chance of cramping
1:13:32the tongue but the over tissue will not
1:13:34occur and it will definitely not lead to
1:13:36cheek biting. So third option is not
1:13:38correct and fourth option is something
1:13:40where
1:13:42uh we had to some of our students is
1:13:45saying something related to thickness of
1:13:46the denture base is probably there that
1:13:48is also not related to cheek biting. So
1:13:51the correct answer is definitely option
1:13:52one and two over here. Right? I hope
1:13:54there is no confusion on it.
1:14:13Okay. So I hope your doubts are solved.
1:14:16Now let us come to question number four.
1:14:19So students please help me with the
1:14:21exact question over here. But what I
1:14:23have gotten is which of the following
1:14:25helps to determine CR centric jaw
1:14:28relation as such is a product or a
1:14:31figure of the inter relationship of TMG
1:14:33only. We have studied the definition.
1:14:35You have the screenshots. You would have
1:14:36gone through my lectures also. What
1:14:38exactly CR is? What is MIP? What is
1:14:41centric relation? Centric occlusion. I
1:14:43have explained it before almost every
1:14:45class on jaw relation. Right? So correct
1:14:49answer would be option number A. TMG.
1:14:51TMG primarily is going to determine what
1:14:54exactly your CR is going to be. So that
1:14:58is our answer. Language is the same.
1:15:03Okay. So when students are saying
1:15:04language is the same then I think TMJ is
1:15:07the correct answer because MIP tooth
1:15:09contact rather CR is independent of
1:15:12tooth contact. It is not relevant to it.
1:15:14is not related to occlusial plane also
1:15:16and MIP is where maximum teeth
1:15:18intercuspate. So if you see all three
1:15:21are related to teeth and the definition
1:15:23of CR as such mentions that it is
1:15:25independent of tooth contact or not
1:15:27related to it only we have mentioned it
1:15:29in our notes also it is written over
1:15:33here it is independent of tooth contact
1:15:35and it is a bonetobone relationship then
1:15:38if that is the same uh language of
1:15:40question 100% the answer is uh
1:15:45TMJ
1:15:51Now let us come to question number five.
1:15:53Students first to four. I hope doubts
1:15:56are clear. Everything is fine. Now
1:16:00during fabrication of mandibular denture
1:16:02anterior ridge is flat. It needs to be
1:16:04reinforced with the wire. Where would
1:16:06the wire be added? This is something
1:16:08new. It has not been asked in the
1:16:10previous year. It is something that is
1:16:12easy but it and you do it clinically in
1:16:15your postings also with dentures but
1:16:17something like this has not been asked
1:16:18in at least in the last 5 years I can
1:16:21say so where do you add the wire and
1:16:23logically or clinically if you have some
1:16:26experience and you've done dentures you
1:16:28would know that you will not put it on
1:16:29the crest of the ridge also it will not
1:16:31be in some vertical attachment to the
1:16:33prostthesis or you definitely for a
1:16:35mandular denture don't put it in the PPS
1:16:37of maxilla it is lingual to the uh crest
1:16:41of the ridge from the preolar to preolar
1:16:44region to reinforce it. Now uh I'll say
1:16:47how do you apply this or if you
1:16:49technically understand it mandibular
1:16:51denture because it is U-shaped it will
1:16:53fracture from the center only like this
1:16:55it can snap in two pieces so you are
1:16:57supposed to reinforce the area that is
1:16:59going to snap and now let me take you to
1:17:01RPD classes of U-shaped connector where
1:17:04I've told you that it is flexible and it
1:17:06moves like this and at that time also we
1:17:08had discussed that when you have a
1:17:10U-shaped connector like this you add
1:17:12some thickness or some more material
1:17:15over here so that it does not flex or
1:17:17bend or break eventually if you have
1:17:20heard that in RPD classes and apply the
1:17:22same logic. I'm dead sure you would be
1:17:24able to apply it over here and choose
1:17:27the option B. So questions are going to
1:17:30be integrated like this but it is a
1:17:32fairly moderate question. I will not
1:17:34call it a tough question. So question
1:17:36number five, when the U-shaped denture
1:17:38fractures like this, you reinforce it
1:17:40with a wire in the center from the
1:17:42preolar to preolar region.
1:17:48Now question number six
1:17:51students first five questions I hope no
1:17:53doubts and uh everything is
1:17:58clear. Now question six during border
1:18:00molding which amongst these is correct?
1:18:02So again multiple combinations
1:18:05all the options were such pertaining to
1:18:07mandibular border molding that is what I
1:18:09have gotten to know. So tray should be
1:18:11of adequate thickness of 2 to 3 mm. Yes,
1:18:14this statement is correct. Posterior
1:18:16lingual flange is recorded after
1:18:18recording anterior lingual flange. Yes,
1:18:21technically not a norally
1:18:25a norm. Generally that is what we do. We
1:18:27record the anterior lingual flange and
1:18:29the sublingual crescent and then
1:18:32progressively move towards posterior. So
1:18:34you can call this correct. During
1:18:36recording of the lingual flange, tongue
1:18:37is protruded out. Definitely yes, it is
1:18:40protruded and a lot of plethora of other
1:18:42movements are also done. And during
1:18:44recording of labial flange of mandible,
1:18:47lower lip is moved outwards, upwards and
1:18:48inwards. So this is also correct. So
1:18:51your answer will be 1 2 3 and four. 1 2
1:18:563 and four. So if you come over here in
1:18:59notes also you will find a total
1:19:02sequence of how mandibular border
1:19:03molding is done. We even have clinical
1:19:05videos if you would have seen I
1:19:07explained all these steps of bottom
1:19:08molding showing it to you also in the
1:19:11video. This is from our notes. We have
1:19:13done and discussed this in our live
1:19:15classes also. Again I would say fairly
1:19:18easy question. It's just that the paper
1:19:20was lengthy a bit. Now let us take up
1:19:24one or two doubts from the chat section.
1:19:28Uh please explain second question.
1:19:32Shria is asking second question. Let me
1:19:34just scroll back to second question.
1:19:36Shri uh second question is pertaining to
1:19:38combination syndrome where if there is a
1:19:40maxillary denture that is opposed by
1:19:43mandibular natural dention there's a
1:19:46whole cycle why it happens and
1:19:48eventually you have anterior ridge
1:19:50resorption and flabby ridge and all of
1:19:52these different signs it is called
1:19:53combination Kelly syndrome if you want
1:19:55details of it you can just refer to my
1:19:57notes or one of my classes I'm sure it
1:19:59will help you but it is a very
1:20:01straightforward question on combination
1:20:03syndrome
1:20:06Now let us come to question number
1:20:09seven.
1:20:12In ARPD the supportive and non-retentive
1:20:15clasp should not contact the tooth
1:20:17occlusially but at what? So supportive
1:20:20and non-retentive they are trying to
1:20:22tell you your reciprocal clasp over
1:20:24here. Where does the reciprocal clasp
1:20:27contact? And in fact, this has been
1:20:30asked before in some other format. But
1:20:32where does reciprocal clasp contact
1:20:34essentially has been asked before also,
1:20:36right? So what are they trying to tell
1:20:37you is that where does actually
1:20:39reciprocal clasp contacttor or sit and
1:20:42the previous question that was asked
1:20:44pertaining to this topic was the first
1:20:46component that comes in contact with the
1:20:48tooth when seating a framework is what
1:20:50again that is reciprocal clasp. So where
1:20:52should it contact? Correct answer is
1:20:54middle third. Now when we have done
1:20:58uh your class on direct retainer at that
1:21:03time I have explained both of these
1:21:06images in details to you and if you're
1:21:09my student you should know that I've
1:21:11explained you how to differentiate
1:21:13between a retentive and a reciprocal
1:21:15clasp pump even just by this particular
1:21:17picture also if you want to see right.
1:21:19So when you have a look at this picture
1:21:21you will be able to determine what is a
1:21:23retentive clasp and what is a reciprocal
1:21:25clasp. So what exactly it is that for
1:21:27example if this is a tooth and we have
1:21:29one buckle view and we have a lingual
1:21:31view the retentive clasp palm it goes
1:21:34and tapers like this from the point of
1:21:36origin but the reciprocal clasp has
1:21:39uniform thickness throughout. That is
1:21:41how you differentiate. And when you have
1:21:42a look at these drawings of macraans,
1:21:44you'll realize that only the retentive
1:21:47tip it goes below the height of contour
1:21:50as such and engages the undercut restore
1:21:52stays above the height of contour.
1:21:54Whereas in the reciprocal clasp palm as
1:21:56it is written over here also it contacts
1:21:59or sits in the middle third of the tooth
1:22:01and that is where it is. So the correct
1:22:02answer here would be middle third. That
1:22:05is question number seven. Answer would
1:22:08be B. Middle third. your reciprocal
1:22:11class contacts the middle third. We have
1:22:14discussed this in our live and recorded
1:22:15classes and this is a fairly important
1:22:18concept in RPD.
1:22:31Now question number eight. Match the
1:22:34following clasps with their indications.
1:22:37again uh very important topic direct
1:22:40retainers very very important topic from
1:22:42RPD when we discuss uh different
1:22:45components of RPD and what they've done
1:22:47is they have put the entire crux of the
1:22:49topic in one table and it's a very good
1:22:51question because as such if you studied
1:22:53the topic you will be able to answer
1:22:55it's an easy question they have not
1:22:57asked very tricky uh options over here
1:22:59so even if you have a 50% knowledge of
1:23:02it you would be able to attempt this but
1:23:04a very good question because you're
1:23:06trying to attempt attempt and take the
1:23:08knowledge of an entire topic through one
1:23:09MCQ over here.
1:23:11Right? So question number eight is
1:23:14embraasure class first where is it
1:23:17indicated? So like we have mentioned
1:23:20embraasure class is generally indicated
1:23:22in cases where one half of the arch is
1:23:24missing. Very classic indication of it
1:23:26is Kennedy class two situation with one
1:23:29modification space or when one half of
1:23:31the arch is missing. So that is the
1:23:35indication for it. Now ring clasp is
1:23:37typically indicated where you have
1:23:40tilted mers misolingually tilted mers
1:23:43sorry not a uh not c a over here. So
1:23:47ring clasp is indicated where you have
1:23:49misolingually tilted mers. So ring clasp
1:23:52goes over there. Combination clasp you
1:23:54are aware that one arm of it or rather
1:23:56the retentive clasp of it is made of rot
1:23:58wire right. So distal abutment present
1:24:03where which can be clasped with rot
1:24:05wire. So even if you know this much you
1:24:07should be able to link it to combination
1:24:09class set three would be D and RPI
1:24:11assembly is indicated where adequate
1:24:14vertical space and II bar can be given.
1:24:16So even if you know the full form of RPI
1:24:18the option only mentions I bar so B or
1:24:22rather the fourth option will be B.
1:24:28So this is where mistakes happen when
1:24:30you're relating three four things like
1:24:33this and when you have to match it with
1:24:34the options mistakes in a hurry can
1:24:36happen over there the question was
1:24:38relatively easier but mistakes can
1:24:41happen like this okay
1:24:47now these are my notes very specifically
1:24:50we've mentioned ring class measally and
1:24:52lingually tilted mandibular isolated
1:24:55mers is the indication over here. Now
1:24:58when you open this again I bar assembly
1:25:01entire IRA assembly has been mentioned
1:25:03indication distal extension cases for
1:25:06IAR combination clasp again rot wire
1:25:08retentive arm indicated in all of these
1:25:11cases has been mentioned and most
1:25:14importantly for embraasure clasp it is
1:25:16mentioned it is used in a quadrant where
1:25:18no entulous area exists and opposing
1:25:20half of the arch is missing like this
1:25:22even a photo of it has been shared like
1:25:24this fine
1:25:27So that is your
1:25:30uh answer. Now let me take up some
1:25:34questions. Seventh question, why not C?
1:25:37Let me open up seventh question.
1:25:41Okay. Seventh question. Why not C?
1:25:43Exactly because the reciprocal arm per
1:25:45sits in the middle third of the tooth
1:25:47not at the junction of the middle and
1:25:49gingial third. It is present in the
1:25:51middle third of the tooth. So typically
1:25:53if I tell you the correct answer would
1:25:54be above the height of contour of the
1:25:56tooth. It does not go below the height
1:25:58of contour and that is generally in the
1:26:00middle third. So reciprocal uh clasp or
1:26:03supportive and non-retentive clasp is
1:26:05the word that you had to use is in the
1:26:07middle third of the tooth. It contacts
1:26:09over there also. Junction of middle and
1:26:12gingial third is where the arm of the
1:26:14retentive tip class will be there and
1:26:17then below the height of the contour the
1:26:19terminus will go. So that is probably
1:26:22relevant to still retentive clasp palm
1:26:24not reciprocal 100% open your mraen see
1:26:27the image see my nodes it sits in the
1:26:28middle third of the tooth only
1:26:32this is my answer of course it can clash
1:26:35with other cubangs but this is my answer
1:26:37with 100% confidence it sits in the
1:26:39middle third of the tooth come to
1:26:41question number nine again a very
1:26:42clinical question it has not appeared in
1:26:45last I think five years paper also but
1:26:47if you have some basic knowledge of the
1:26:49thickness and you want to take a risk
1:26:52you can attempt it. So thickness of
1:26:53pallet of complete denture ideally it
1:26:55should be 2 mm. They're asking how much
1:26:58it should be for a thin palatal contour.
1:27:01At the most you can reduce 1.5. If you
1:27:03reduce it to 1 mm again the denture will
1:27:05fracture and break. So correct answer
1:27:07should be 1.5 mm. Now you know for sure
1:27:11that 2.5 and 4 mm cannot be the answer
1:27:14because it is standard and more than 2
1:27:15mm. So it will in fact make it thicker
1:27:17not thinner and 1 mm is too thin. In
1:27:20fact the denture can fracture at that
1:27:22point. So correct answer should be 1.5
1:27:25mm. I hope you are aware that standard
1:27:27thickness is 2 mm. And if you want a
1:27:30thinner contour you can take it up to
1:27:321.5 not lesser than 1.5.
1:27:40Now patient presence with mandibular
1:27:42teeth 3141 missing 3637
1:27:464647 missing third mers are also absent
1:27:49and not indicated for replacement
1:27:51according to Kennedy's classification
1:27:53how would this be extremely easy
1:27:55question but why I have included this
1:27:57screenshot is we practice this in live
1:27:59classes in live classes we do all of
1:28:02these different combinations of Kennedys
1:28:04and then we do it so see this is a
1:28:06Kennedy classic class one bilaterally
1:28:09distal uh uh distal extension cases. So
1:28:13bilaterally missing teeth posterior to
1:28:15remaining natural teeth. Additionally
1:28:17one more edentulous space is present
1:28:19anteriorly. So correct answer becomes
1:28:20Kennedy class 1 mod 1 that becomes your
1:28:25correct answer and I think it should be
1:28:28uh correct for everyone. This is a very
1:28:31easy question. The basics of RPD start
1:28:33with this and this is what we routinely
1:28:36discuss in our classes to learn the
1:28:39different combinations of Kennedy. So I
1:28:41hope question 10 students you have not
1:28:43made a mistake right
1:28:49now during fabrication of cast partial
1:28:52denture which of the following steps are
1:28:53involved? So go back to past papers and
1:28:56there was a very tricky question
1:28:58regarding the steps of surveying. They
1:29:00simplified it this time. That is what
1:29:02the feedback I told you. It was not
1:29:03exactly regarding steps of surveying but
1:29:06the steps of CPD construction. And have
1:29:08a look over here. This is what we
1:29:10discuss in our live classes. The
1:29:11different steps of CPD construction. So
1:29:14have a look what are exactly the steps.
1:29:17Surveying receipt preparation
1:29:18determining the height of contour
1:29:20blocking undesirable undercuts. I'm
1:29:22assuming on a reciprocal uh uh on your
1:29:27cast or model right on a refractory
1:29:29model. So first step would be what? The
1:29:32first step would be ideally surveying.
1:29:34So one surveying in fact involves your
1:29:38location of height of contour or
1:29:39determining height of contour. So then
1:29:41you go to three. Then you in fact
1:29:43prepare your rest seat. Right? You
1:29:45prepare your rest seat after that. And
1:29:48uh so two and once you have your receipt
1:29:51prepared you have your impression you
1:29:53have your master cast you duplicate it
1:29:55you have a refractory model on that you
1:29:57block undesirable undercuts. So the
1:30:00answer here becomes 1324 which is option
1:30:03number a
1:30:061324.
1:30:17So let me take up some feedback from our
1:30:19students pertaining to this question.
1:30:21Some of you are saying that the option
1:30:23was pertaining to guide plane
1:30:25preparation. Guide plane was given. So
1:30:27you're saying that option D was not
1:30:29there and guide plane was there.
1:30:33I think it may not be rested
1:30:35preparation. It was guide uh guide plane
1:30:38preparation.
1:30:43Okay. guide plane was there but it was
1:30:47uh in exchange of which option receipt
1:30:49or undesirable undercuts
1:30:59guide plane was one option okay option
1:31:02four so in exchange of this okay so if
1:31:05it is in exchange of this guide plane
1:31:09then the answer becomes okay I'll tell
1:31:11you then what the answer becomes
1:31:13First will be surveying then determining
1:31:17the height of contour then you prepare
1:31:19your guide planes and then you do your
1:31:21seat preparation. That is what the
1:31:22answer would be. If guide plane was
1:31:24there over there right then you first
1:31:27survey the cast then you determine the
1:31:29height of contour then you prepare the
1:31:31guide planes and then you prepare the
1:31:33rest seat. Rest is all rest seat is
1:31:36always prepared after the guide plane
1:31:37preparation is done. Again that is an
1:31:39MCQ from our Q bankank also the
1:31:41preparation of rest seat is along with
1:31:43guide plane or it follows the guide
1:31:45plane. So that should have assisted you
1:31:47right? So then the sequence becomes this
1:31:51in either way whether undercuts was
1:31:53there or this was there I informed you
1:31:55about both of them right. So then the
1:31:58answer becomes surveying height of
1:31:59contour guide plane rest seat. I think
1:32:02that is what you would have attempted.
1:32:04Yes students can you please confirm?
1:32:11Then the answer becomes surveying.
1:32:16Let me just quickly survey then you do
1:32:18your height of contour.
1:32:23Oh just a second. surveying then you do
1:32:27your height of contour
1:32:29then you do your guide planes and then
1:32:31you do your rest seat right
1:32:35fine an you should have attended the
1:32:37breakout with me yesterday
1:32:40you're telling all the corrections in
1:32:41the chat box right now
1:32:48fine so then this becomes your final
1:32:50answer survey then you do your height of
1:32:55contour then you do your guide planes
1:32:57and then you do your uh rest seat. So
1:33:01then this becomes our final. See
1:33:05obviously it is a recall session. So you
1:33:08act as my eyes in the exam and whatever
1:33:10you come up with as a recall 10 students
1:33:13are 10 different opinions about it. So
1:33:15obviously some changes will be there
1:33:16here and there. That is why we teach you
1:33:18all of this that so that you're equipped
1:33:21with the knowledge and then you go and
1:33:23attempt the question in the exam. But
1:33:25what I've gotten as a feedback is it was
1:33:27not as tricky as the surveying PQ that
1:33:30was there. This was relatively easier
1:33:31and this time the whole sequence of CPD
1:33:34was asked not the sequence pertaining to
1:33:35surveying. So that made it easier.
1:33:38Right. Now come to question number 12.
1:33:42So for rehabilitation of maxillary
1:33:44central incizer with PFM crown, which
1:33:46type of finish line is prepared? Simple
1:33:48and straightforward. Is it feather edge
1:33:50and lingual shame for labial knife edge
1:33:52and lingual shoulder? Labial shoulder
1:33:54and lingual shame or labial shamfer and
1:33:56lingual feather edge. Feather edge knife
1:33:58edge are not correct. The correct answer
1:34:00is labial shoulder and lingual shame.
1:34:03Two things from here. Maxillary central
1:34:05incizer and PFM is mentioned already. So
1:34:08we have already learned it in our class
1:34:10over here. It is indicated in these
1:34:14cases. C. Used in facial margins of
1:34:16crowns like these. There was another
1:34:19screenshot but fine. Okay. So, PFM
1:34:21crowns where facially you have
1:34:23porcelain. You're going to prepare heavy
1:34:25shame for shoulder option shoulder on
1:34:28the lingual side metal will come. So, at
1:34:30that point we have shame for fairly easy
1:34:33question for the exam. Question number
1:34:3412. Come to question number 13. Now
1:34:36rehabilitation of missing mandibular
1:34:38first mer with a fixed dental prosthesis
1:34:41in a patient with poor oral hygiene and
1:34:44no aesthetic requirements mainly poor
1:34:46oral hygiene no aesthetic requirement
1:34:48missing mandibular first mer which type
1:34:51of pontic design the correct answer here
1:34:53again is sanitary pontic or hygienic
1:34:55pontic [snorts] we have studied it in
1:34:57our notes and in our sessions and
1:35:00classes posterior mandible good access
1:35:02for hygiene it has poor aesthetics
1:35:05specifically they have mentioned
1:35:06mentioned that patient has poor oral
1:35:07hygiene. You should go for sanitary
1:35:09pontic. Here no aesthetic requirement
1:35:11was there. Again
1:35:13correct answer is your sanitary pontics
1:35:16again has made a comeback. Now there was
1:35:19a long stretch where modified ridgelap
1:35:20used to come a lot and questions
1:35:22pertaining to modified ridge lap and
1:35:24your oate used to come. This time
1:35:25posterior pontic has come but it has
1:35:28reinforced what we have taught you.
1:35:29Pontics is an important topic and has
1:35:31come in your exam. Now question number
1:35:3414. Patient with hypertension requires
1:35:36an elastoic impression for a fixed
1:35:38dental prosthesis. So main keyword is
1:35:41hypertension. Patient does not have a
1:35:43cardiac pacemaker. Which of the
1:35:45following gingal retraction methods can
1:35:47be used and it was multiple combination
1:35:49type? We are aware epinephrine cannot be
1:35:52used. So what all can be used?
1:35:56I think what some students have given me
1:35:58a feedback just now is that probably
1:36:00here a zinc based solution was mentioned
1:36:03but I'm not sure but some solution was
1:36:05there that is what I've gotten as a
1:36:07feedback so first I'm assuming it was
1:36:10some solution that could be used
1:36:12students are not able to recollect what
1:36:13it was electrocotty can be used because
1:36:16as it has been mentioned patient does
1:36:18not have a cardiac pacemaker aluminium
1:36:20chloride can be used the main thing
1:36:21which cannot be used is epinephrine it
1:36:24cannot be used. So with that logic the
1:36:26correct answer becomes 1 2 and three.
1:36:30Gingial cord with recemic epinephrine
1:36:32cannot be used in hypertensive patient
1:36:34because of cardiovascular events. But
1:36:36apart from that what I've gotten to know
1:36:38is that either zinc chloride was there
1:36:40in the options. I'm not 100% sure. So
1:36:42I've not mentioned it in the first
1:36:44option. Right? But cotty and aluminium
1:36:46chloride was there and both can be
1:36:48indicated specifically when pacemaker
1:36:50situation has been clarified. Right? Now
1:36:52this here what you see is a easy tole
1:36:54learn table that is there in our notes
1:36:56which gives you a summary of all these
1:36:58retraction methods. Students if you
1:37:01remember what the fourth agent was do
1:37:03let me know and I can just modify my
1:37:06paper. Now again a very good question
1:37:09from FPD match the following
1:37:11complications in FPD with the respective
1:37:13causes. So when retainer is not
1:37:16retentive
1:37:18excessive taper of the eggial walls can
1:37:20lead to it. If you have fracture
1:37:24from the uh connector region then
1:37:27generally it is due to in inadequate
1:37:29thickness in the connector. You need 3x3
1:37:32at least if there is inadequate
1:37:33thickness. If there is discoloration or
1:37:36grayish hue in cervical margin either
1:37:38you have not prepared the tooth
1:37:39sufficiently or sufficient thickness of
1:37:41porcelain is not there. So the metallic
1:37:43hue is coming and if there is gingial
1:37:45inflammation in pontic probably you
1:37:47might have a convex soft tissue. So I've
1:37:50arranged it in this 1 A, 2 B, 3 C and 4
1:37:52D. But these were certain complications
1:37:54that were mentioned and the relevant
1:37:56answer. Again I'll tell you if you go
1:37:58through all of the different sections of
1:38:00notes it is always mentioned that as
1:38:02taper increases tapered walls lead to
1:38:04loss of retention or if you study over
1:38:07here in pontic also it is very clearly
1:38:09mentioned the size is 3x3 and size of
1:38:12the connector should be such that
1:38:14strength of the connector is maintained
1:38:16but it should not interfere with
1:38:18aesthetics and other functions relevant
1:38:20to it. Rest all has been clinically
1:38:23discussed in classes right. So this was
1:38:26again a very good question from FPD and
1:38:31what I have been telling a lot to our
1:38:33students in our classes is somehow I
1:38:35feel maxel facial is making a comeback
1:38:37because every exam I see questions
1:38:39coming from maxelo facial. So we do take
1:38:41up a good hour at the end of our classes
1:38:43to discuss maxillo facial and two
1:38:45questions came from it this time. One of
1:38:47it is new not asked in last 5 years.
1:38:50This has been asked and discussed.
1:38:52Patient underos a leftsided
1:38:54mandiblectomy presence with deviation of
1:38:56chin towards the left side. Which
1:38:58prosthesis is most appropriate for the
1:39:00mandible to guide it in the correct
1:39:02acclusal position and facilitate
1:39:04mandibular training? I have three
1:39:06options of it and out of that the
1:39:07correct answer is mandibular guide
1:39:09flange prostthesis.
1:39:12Now this is a screenshot from my
1:39:14classes. The basic regimen that we
1:39:17follow for treating all of these
1:39:19patients and you can even see a
1:39:20screenshot from one of our live classes
1:39:22also where I've discussed what a ramp
1:39:24and a guide flange is. Basically what
1:39:26happens is that because of the
1:39:27unobstructed pull of muscle there's a
1:39:29tendency for mandible to deviate and if
1:39:32we can sooner construct a prostthesis
1:39:34like this that prevents this deviation
1:39:36it can help keep the mandible in its
1:39:38position to some extent not completely
1:39:41but to some extent because there's an
1:39:43imbalance of muscular forces so some
1:39:45deviation is bound to happen the sooner
1:39:48you give it the better once if at all it
1:39:50has happened that the deviation is
1:39:52established and no matter how much you
1:39:54try to guide your patient they will not
1:39:56come to its original position. Then you
1:39:57construct what is called as a palatal
1:39:59ram. Again we have discussed the
1:40:00indications of this in our classes. So
1:40:02this is a guide flange prosthesis and
1:40:05that is the relevant answer. And the
1:40:08last question which is fairly new this
1:40:10time because not single question I've
1:40:12seen from orbital prosthesis in the
1:40:14exams was multiple combination type and
1:40:18patient reports to procedontic
1:40:20department following surgical excision
1:40:21of an eyelid tumor. orbital contents are
1:40:24lost. Orbital silicon prosthesis is
1:40:26planned for rehabilitation. Which of
1:40:28this is an appropriate method of
1:40:30retention or retaining the prosthesis?
1:40:33All orbital prosthesis can be retained
1:40:36by spectacles. Can be retained by
1:40:38implants that are placed in the lateral
1:40:40wall of orbit and then you put a bar
1:40:43over it. Can be retained smaller
1:40:45processes by a skin friendly adhesive.
1:40:48can be written with opturators also with
1:40:50the help of a titch button or with the
1:40:53help of a magnet if it is a continuous
1:40:55defect. But in our options the first
1:40:58line had mentioned clasp attached to
1:41:01magilla. Now this is a fairly incomplete
1:41:04option. These three are 100% correct 2 3
1:41:06and four. But one was a fairly
1:41:08incomplete option and quite frankly it
1:41:10did not give a sense that it is
1:41:12mentioning anything about an opturator.
1:41:14So then excluding that 2, three and four
1:41:17becomes the correct answer. This option
1:41:20number A becomes your correct answer.
1:41:22And I hope you were able to attempt this
1:41:24with some clinical insight and
1:41:26knowledge. But this was a fairly new
1:41:28question for your exam. Right. So with
1:41:32this we come to and end. No, no, no. We
1:41:35have one more question. Sorry. Question
1:41:37number 18. Again an integrated question
1:41:40from I I could say integrated with oral
1:41:42surgery or medicine. It is asking
1:41:44patient reporting for implant placement
1:41:46in mandibular first mer region. Which of
1:41:48the following conditions is least likely
1:41:51to affect implant placement and not
1:41:53contribute to implant failure? Is it
1:41:55controlled hypothyroidism managed with
1:41:57thyroxine replacement therapy? Is it
1:42:00uncontrolled diabetes malitis with HB1C
1:42:02greater than 10.7%.
1:42:04Now 10.7% there's an established article
1:42:07that says anything above 10 is difficult
1:42:09to manage and will lead to strong
1:42:11complications. Bxism local factor
1:42:13affects it over there. Smoking also
1:42:15affects it. The correct answer to this
1:42:18question will be controlled hypert
1:42:20hypothyroidism managed with thyroxine
1:42:22replacement therapy. Again, it is an
1:42:25integrated question with I would say
1:42:26oral surgery or medicine and I hope you
1:42:28were able to attempt it with the basic
1:42:30knowledge from these two subjects. There
1:42:32was not anything uh critically I would
1:42:34say prostadontic in this question as
1:42:36such. It was more about medicine
1:42:38knowledge. Right? But still implants
1:42:41question and I hope you were able to
1:42:43attempt it. So all in all I have a
1:42:45recall of 18 questions. If you have
1:42:47anything else you can always reach out
1:42:48to us via telegram or any other medium
1:42:51just to share your questions and
1:42:53suggestions or any better recall if you
1:42:55have. As always if you have any doubt I
1:42:58can always help you solve those doubts.
1:43:01Connect with us on telegram via our uh
1:43:04chats and groups or any other medium.
1:43:06I'll be more than happy to solve you.
1:43:08With this I think let me have a quick
1:43:10look at our chat box. Students I hope
1:43:12this recall session was helpful to you.
1:43:15With this we bring an end to it and I
1:43:18wish you all the very best for your
1:43:19results of the exam.
1:44:20Okay. So before we end,
1:44:26I would like to introduce our next
1:44:27faculty, Dr. Susan Sunni. He'll be
1:44:29taking taking a path micro recall right
1:44:32now. Thank you.
1:44:36Okay. Okay. So, hi, afternoon friends.
1:44:39Afternoon everybody. Afternoon
1:44:41everybody. And uh firstly I sincerely
1:44:44hope that your paper went well. And uh
1:44:47let us start with path micro recall as
1:44:50compared to Ashwaria and Roshi ma'am's
1:44:54endodm and proto recalls. Path Micro I
1:44:58should say personally it was a
1:45:00heartbreaker because I and I previous
1:45:02papers we always had lots of questions
1:45:05>> and firstly I
1:45:07your paper went well and uh let us start
1:45:11getting as compared
1:45:17and protocols path micro I should say
1:45:21personally it was a heartbreaker because
1:45:23I previous
1:45:26Okay. Okay. So I was getting an eco. So
1:45:29let us start. First of all say we just
1:45:32had uh two questions from pathology and
1:45:35this time micro was uh not asked. So uh
1:45:41let us start let us start with the first
1:45:43straightforward easiest one. Uh yes the
1:45:47glitch uh [snorts]
1:45:49uh I know is fungi fungi and we had so
1:45:55many questions earlier but
1:45:59what is going on with respect to the
1:46:03path questions
1:46:06this was simple straightforward both
1:46:08parents have thealismia trait you very
1:46:11well know that is autotosomal recessive
1:46:13in nature that is what we mean bymia
1:46:15trait So both the parents have talismia
1:46:19trait that is they are hetererozygous
1:46:22for talismia. One al is normal the other
1:46:25is abnormal. So who will be the four
1:46:27kids? This beta goes with both beta beta
1:46:30beta beta 0. This beta goes with both.
1:46:35This beta 0 goes with both that is beta
1:46:38beta 0
1:46:40beta 0 beta 0. So what percentage will
1:46:43be thal major? that is 25% we always did
1:46:46this examiner asked you which is true
1:46:49for 50% children of this couple this was
1:46:52I ini repeat path micro we always get
1:46:55simple straightforward questions so 50%
1:46:58they have a high risk of developing
1:47:00disease of developing these without
1:47:04symptoms that is 50% children have these
1:47:07minor they have these minor which is
1:47:10asymptomatic so can any one of Uh bum
1:47:15nus I have had recall saying uh the 50%
1:47:20children were asked if one of the four
1:47:22was asked ash no worries yes it is saki
1:47:26you are right it is high risk for
1:47:27taliscemia trait that is without
1:47:29symptoms any one of us can be talismia
1:47:31so it is asymptomatic what majority of
1:47:33the students have told me was that 50%
1:47:35children were asked if it was asked for
1:47:3825% that is if thal major was asked if
1:47:42you were saying that then it will be a
1:47:43high risk of developing these major that
1:47:45is severe talismia. So
1:47:49uh Koagnney Koagnney I know path migro
1:47:52you would have done very well and I was
1:47:55extremely happy with the classes and
1:47:56everything also but no worries no
1:47:58worries this is exactly from the notes
1:48:01part that if both the if mother has
1:48:04talismia minor father is normal risk of
1:48:07child to bemia major 0% 0% if both
1:48:12parents are theismia minor this is the
1:48:15picture that we get 25% % have thalismia
1:48:18major 50% have the minor plain and
1:48:22simple plain and simple. Next the next
1:48:25question was a very factual question
1:48:28that is quantity of factor 8 in
1:48:30commercially available vial of plasma
1:48:32factor 8. Uh this quantity which this is
1:48:35a fact that it is 250 to 500
1:48:37international units. Some students told
1:48:39me that option was 700 to 900. Some said
1:48:42700 international units but does not
1:48:45matter because the commercially
1:48:46available while is that of 250 to 500
1:48:50international units which was the answer
1:48:52to be marked.
1:48:55Such such questions are best to be left
1:48:58because when you are sitting in the
1:49:00paper see normal is 100 international
1:49:02units. We have discussed this in class.
1:49:05Whenever we talk of any normal
1:49:07concentration of any any coulation
1:49:11factor normal in the body is 100
1:49:13international units. So the
1:49:15concentration if the options were
1:49:17genuinely 90 to 110 110 to 150 and 70 to
1:49:2090 international units in if these were
1:49:23the set of options then the answer sort
1:49:26of is obvious because normal is 100. So
1:49:28you have to give more than normal when
1:49:30you are giving a concentrate you have to
1:49:32give more than normal. But if this
1:49:34option becomes 700 in that case huh it's
1:49:38the same thing those it's the same thing
1:49:40but if the option becomes 700 to 900
1:49:44then you become confused between C and
1:49:46D. So but it's okay even if with this
1:49:50set you left this question I'm
1:49:51comfortable with it. Uh it would you
1:49:54could have marked 250 to 500 again 70 to
1:49:5790 but just tell me was it 70 to 90 or
1:50:01was it 700 to 900 but please tell me
1:50:04that other than that though it's just a
1:50:06technicality and it won't matter but uh
1:50:09other than that which happiest Diwali
1:50:12and all the festivities I know that we
1:50:16are right now in the mindset of the
1:50:18paper and everything but we have to
1:50:20maintain a good personal life
1:50:22professional life balance and this is
1:50:23our biggest festival. Uh 650 to 700 I
1:50:27was earning my 80. In that case leaving
1:50:29that question now makes sense. It is
1:50:32absolutely okay. No worries about it and
1:50:35things will work out much better than
1:50:37what you feel. So best of luck best of
1:50:40luck for everything. It was just our two
1:50:43minutes interaction but as usual it's
1:50:45always nice to meet you guys and come.
1:50:49So thank you. Thank you and uh take care
1:50:52everybody. Take care. Thank you.
1:52:38All right. So, uh very good afternoon
1:52:41everyone.
1:52:42So, let me just start with
1:52:46the recall of general medicine
1:52:48questions. So, I'm my I'm myself Dr.
1:52:51Rajes. So there are nearly around five
1:52:53to six questions of the general
1:52:55medicine. So now in that again like uh
1:52:58there are some stock questions which
1:53:00definitely they are very much expected.
1:53:02One of the very important area where we
1:53:05definitely expect the questions are from
1:53:08the diabetes militus. So without
1:53:10diabetes militus you will never have a
1:53:12question paper. That is one important
1:53:14thing. And the second thing if you take
1:53:16in the analysis of the question paper
1:53:19there were like two questions out of
1:53:21like six questions that I have in the
1:53:22recall there are two questions which I
1:53:25have from endocrinology. So that means
1:53:28so like the paper had little good
1:53:30weightage on the endocrinology then
1:53:32compared to that of the other subjects
1:53:34and one question was on the pulmonology
1:53:37that is the inhaler what are the steps
1:53:39that you need to take care and the uh
1:53:41fourth question was in the neurology
1:53:43where they have asked mainly about the
1:53:46parkinsonism right and one more question
1:53:49that they have asked is the lidocaine uh
1:53:52intoxication what will be the earliest
1:53:53manifestation of the lidocaine
1:53:56intoxication So basically if you see the
1:53:58entire analysis of the paper they have
1:54:00just mixed and matched. One is the
1:54:02fundamentals that they have asked that
1:54:03is one thing and second they have
1:54:07definitely asked the areas where we have
1:54:09expected the questions will come like
1:54:12for example endocrinology that is the
1:54:14first chapter usually I start with when
1:54:16I start my live sessions right so like
1:54:19diabetes which is the expected area so
1:54:22one question was asked on diabetes and
1:54:24one question was asked on the topic of
1:54:25the Cushing syndrome where they have
1:54:27given you the image based questions
1:54:29right so Now let us start with the
1:54:33session.
1:54:35Okay. So this was the first question
1:54:40right? So this was the first question.
1:54:42Which of these is true for the pathology
1:54:45in Parkinson's disease? The first option
1:54:47was Levi Levi bodies. Then the second
1:54:50option was reduced dopamine secretion
1:54:53lesion in the cortical spinal tract
1:54:54leion in the substantia So these
1:54:59were the points related to Parkinson's.
1:55:02Now you need to mix and match like which
1:55:04options are correct. That is what they
1:55:06have given you. Now Levi bodies. Yes,
1:55:09these are the inclusion bodies that we
1:55:11have in patients with Parkinsonism. That
1:55:13is number one. Next what exactly is the
1:55:17biochemical abnormality in parkinsonism?
1:55:19Two things actually. One is decrease in
1:55:21the dopamine levels and second important
1:55:23thing is increase in the acetyloline
1:55:26levels. These are the two important
1:55:27abnormalities that you'll have and
1:55:29reduced dopamine secretion is the
1:55:32important feature that you'll have and
1:55:34next important is the lesion in
1:55:37corticospinal tract. So lesion in the
1:55:39cortical spinal tract will result in
1:55:41what is called as upper motor neuron
1:55:43signs.
1:55:46Okay, lesion in the cortical spinal
1:55:48tract will result in what is called
1:55:49upper motor neuron signs. It will not
1:55:51result in parkinsonism.
1:55:54Now in case of parkinsonism where
1:55:56exactly the pathology you'll have you'll
1:55:58have the pathology ina in the substantia
1:56:01that is the place where you have
1:56:03the problem in case of the parkinsons.
1:56:06So inclusion bodies like levi bodies
1:56:08reduced dopamine secretion and as well
1:56:11as the substantia. So these are the
1:56:13correct options that you have related to
1:56:17parkinsonism. Okay demination was given.
1:56:21Okay no problem. So if demalination is
1:56:23given sorry
1:56:30right right
1:56:44so no problem. So if demilination was
1:56:46given remember deination
1:56:49okay it is not the part of the
1:56:51Parkinson's at all h demilination is not
1:56:55the part of the parkinson's at all right
1:56:58yeah that's what demalination of the
1:57:00cortical spinal tract is not the part of
1:57:02your parkinson's disease okay so
1:57:04presence of inclusion bodies like levi
1:57:06bodies reduced dopamine secretion and as
1:57:09well as leion and substantia parse
1:57:11compact these three are like what you
1:57:13see in case of the Parkinson's disease.
1:57:16Right. Right. So we'll move on to the
1:57:18next question. So this was the question
1:57:19asked from the neurology and this
1:57:21particular question is discussed in the
1:57:23live session and this particular uh
1:57:25question is also is there as a part of
1:57:27the recorded lectures also in our uh uh
1:57:31DBMC.
1:57:32Right now I just want to get an input
1:57:37right. So I just want to get an input
1:57:40from uh for this question. So for this
1:57:43question please tell me is the age of
1:57:46the lady given or not? So a lady had her
1:57:49breakfast at 8:00 a.m. She started
1:57:51leaving her her office. Just before
1:57:53leaving she checked her blood glucose at
1:57:5510:30 a.m. which was like 220 mg per
1:57:57deciliter. Which [cough]
1:57:59[clears throat]
1:58:00which of the following uh homeostatic
1:58:03mechanisms
1:58:05[cough and clears throat]
1:58:06are faulty in her case? insulin
1:58:08resistance, thyroid metabolism,
1:58:10autoimmunity and as well as the
1:58:12seizures.
1:58:17Yeah. So if age 34 years was given right
1:58:21then definitely at the age of 34 years
1:58:24what is the type of diabetes we expect
1:58:26is we expect type 2 diabetes militus
1:58:30right? So we expect type 2 diabetes
1:58:33militus. So in case of your type 2
1:58:36diabetes militus right what exactly the
1:58:39problem is the problem is about the
1:58:41insulin resistance h the problem will be
1:58:43related to insulin resistance
1:58:46right so
1:58:50the [clears throat]
1:58:52I did not get this question from
1:58:54anywhere it was the question which you
1:58:56people has given me as a feedback Right.
1:59:04So can you people tell me like what were
1:59:06the options? Insulin resistance.
1:59:13Yes. Insulin resistance was there or not
1:59:15there?
1:59:24Okay. Can anyone frame [laughter] the
1:59:25entire question properly? See
1:59:27question breakout session
1:59:32right that is how I will just frame the
1:59:34question
1:59:37insulin resistance option was not there
1:59:43okay then take out this insulin
1:59:46resistance then what were the other
1:59:48options
1:59:50so can anyone give me all the four
1:59:52options correctly [clears throat] one
1:59:54you people said is positive feedback
1:59:56defective
1:59:57Second, you people said like negative
1:59:59feedback was defective. Can can you tell
2:00:02me what are the two other options?
2:00:09Adaptive response, positive feedback,
2:00:12negative feedback,
2:00:17lack of negative feedback regulation.
2:00:21No, lack of negative feedback is the
2:00:24option right now like you give us the
2:00:26correct answer.
2:00:34Okay, I'll just come to this question in
2:00:36the last again. Right, by the time you
2:00:38just please send all the four options
2:00:40which were there. I am I am able to get
2:00:42only two options. One is positive
2:00:44feedback and the other one is negative
2:00:45feedback. By the end of the session,
2:00:47I'll come back to this question once
2:00:48again. Then we'll discuss it again.
2:00:50Okay, not a problem. Meanwhile, you just
2:00:52get the complete recall. Yeah, third
2:00:55option. Adaptive feedback affected. You
2:00:56just give me the fourth option also.
2:00:58I'll come back to this question again.
2:01:00Right now, this was the another
2:01:03question. Arrange the following steps in
2:01:04the correct sequence for administration
2:01:06of medication using the meter dose
2:01:09inhaler.
2:01:12Right? Using meter do inhaler. Right now
2:01:15you see if I'm not wrong this is what is
2:01:18the feedback uh I mean this is the
2:01:20recall that I have gotten in the
2:01:22breakout session. Just correct me
2:01:23whether I'm right or not.
2:01:29Okay. So
2:01:31remove the cap and shake the inhaler.
2:01:34Exhale completely before using the
2:01:35inhaler. Hold the inhaler upright. Place
2:01:38the mouthpiece between lips and uh seal
2:01:41tightly. Begin slow deep inhalation
2:01:43while pressing the cap. Then continue
2:01:46inhaling deeply. Hold the breath for
2:01:47approximately 10 seconds before
2:01:49exhaling. So tell me is this particular
2:01:53um uh the options correct or not? Okay,
2:01:56I'll tell you what is the correct
2:01:57sequence. H first is you need to remove
2:02:01the cap and you need to shake the
2:02:03inhaler. Well, that is first thing. Then
2:02:06attach the spacer. If the spacer is
2:02:09indicated, you need to attach the
2:02:10spacer.
2:02:12Then you need to exhale. The patient has
2:02:15to exhale completely. And next important
2:02:18step is hold the inhaler upright.
2:02:22Place the mouthpiece between the teeth
2:02:24and as well as the seal the lips around
2:02:27it and press the canister
2:02:31[clears throat] while inhaling. Then
2:02:34continue the slow inspiration for nearly
2:02:36around 3 to 5 seconds. Hold the breath
2:02:39for 10 seconds. Then exhale slowly. Wait
2:02:42for 30 to 60 seconds before the next
2:02:45puff if another puff is prescribed. So
2:02:48this is actually the correct sequence. H
2:02:51this is actually the correct sequence.
2:02:53Okay. Right. Now, [clears throat]
2:02:56now so if you take the options like what
2:02:59would be the best one? So first
2:03:01[clears throat]
2:03:07right so what would be the best one? So
2:03:09like uh this is the first one. Remove
2:03:11the cap and shake the inhaler. H remove
2:03:14the cap and shake the inhaler. Then
2:03:16followed by that this like you have only
2:03:18two answers now. either this A or B
2:03:23right and
2:03:26yeah so hold the breath approximately 10
2:03:29second this is the last step so in which
2:03:31one you have seven that is in the first
2:03:34option so first option is the correct
2:03:37one that is [clears throat] 1 2 3 all
2:03:39the steps which have which are the
2:03:41correct answers I have just put it in
2:03:43the form of steps and that was your
2:03:45option A whatever it might be either A B
2:03:47C D whatever it is so This is the
2:03:49sequence of steps that you need to
2:03:51follow
2:03:53right and like so I have also given you
2:03:56the steps here right this is the correct
2:03:59one definitely I hope this is what the
2:04:02steps that may have that might have
2:04:04given in the exam but in the breakout
2:04:07session the recall was not completely
2:04:09complete right we'll move on to the next
2:04:12one so which of these would be the first
2:04:15effect of toxicity from lidocaine
2:04:18infusion
2:04:19>> [clears throat]
2:04:19>> So remember in case of lidopane infusion
2:04:22CNS manifestations are first and what is
2:04:25the CNS manifestations first? CNS
2:04:28manifestations include the nestagmas
2:04:31first. After the nestagmas there will be
2:04:34development of seizures right and you
2:04:36take this hypotension as well as
2:04:39bradicardia. These are your
2:04:41cardiovascular system manifestations.
2:04:43These cardiovascular system manifest
2:04:46they appear later.
2:04:48Right? The cardiovascular system
2:04:49manifestations appear later. Done. So
2:04:52the answer to this particular question
2:04:54is nistagmas. Okay.
2:04:59Right. Then moving on to the next
2:05:02question. So
2:05:05can anyone recall the other two options?
2:05:09The image shown below depicts the which
2:05:12clinical condition. So this is the one
2:05:13which I usually tell when I start with
2:05:15the Cushing syndrome discussion. Lemon
2:05:18on maxic appearance. What exactly is
2:05:21this lemon?
2:05:23It is your central obesity.
2:05:26H it is your central obesity and central
2:05:29obesity with mastics. Where do you see
2:05:31that? You see that in case of Cushings.
2:05:34So chronic corticosteroid therapy is the
2:05:36one where you will have the irogenic
2:05:40Cushings, right? you'll have what is
2:05:42called irogenic cushions. So can anyone
2:05:45recall the other options
2:05:50okay ch like hypothyroidism whatever it
2:05:53is. So definitely the answer here is the
2:05:55chronic corticiposteroid therapy done
2:05:57right. So this was the question which
2:05:59was asked from the connective tissue
2:06:01disorders right where [clears throat] on
2:06:03one side they have given the antibodies
2:06:06and on on other side they have given the
2:06:09disorders related to connective tissue
2:06:11diseases right you take canka so cianka
2:06:15it is observed in case of granulomtosis
2:06:18with polyangitis
2:06:20okay granomosis with polyangitis then
2:06:23dsg3 observed in case of pimpigus varis
2:06:27anti TCCP it is the investigation of
2:06:30choice in case of the rheumatoid
2:06:31arthritis and anti-SCL70
2:06:35H anti-SCL70
2:06:38so this anti-SCL70
2:06:40it is the antibbody that you see in case
2:06:42of diffuse scleroderma which is nothing
2:06:44but systemic sclerosis
2:06:47okay so these were the medicine
2:06:50questions which have asked in INIC so if
2:06:53I if you just ask me to just analyze the
2:06:56paper let me tell you in 1 minute. So
2:06:59first important they have given
2:07:01weightage for endocrinology where they
2:07:03have given two questions out of six in
2:07:06the general medicine that is first
2:07:07point. Second they [clears throat] have
2:07:09asked the fundamental questions because
2:07:12what was the fundamental question
2:07:13parkinsonism in Parkinsonism what
2:07:15exactly the defect is that means your
2:07:17fundamentals also or the basics also you
2:07:19need to should be very strong that is
2:07:22the second point. Third point, what is
2:07:24that you need to learn from the general
2:07:26medicine questions is definitely yes,
2:07:29you will have a lengthy clinical based
2:07:31questions in the general medicine
2:07:33because if you see the steps in the uh
2:07:36like usage of meter dose inhaler, you
2:07:39need to know all the steps. Basically,
2:07:40what is that you need to learn is
2:07:42lengthy clinical based questions will
2:07:44definitely be asked from the general
2:07:45medicine point of view. Right? So, these
2:07:49are the questions. any doubts or any
2:07:51better recall you can just definitely
2:07:53text us on the Instagram sorry on the
2:07:56telegram also or even on the Instagram
2:07:59also right definitely we will be
2:08:00available to answer your questions back
2:08:03right so with this I will just wind up
2:08:05this particular session and I wish
2:08:07everyone a very happy and as well as
2:08:09safe Diwali thank you very
2:08:46Right. So a very good afternoon to all
2:08:48of you.
2:08:49So we people have come here for
2:08:51pharmarmacology discussion.
2:08:57So let me uh
2:09:02Okay.
2:09:04Yes.
2:09:07>> So a very good afternoon to all of you.
2:09:09>> Okay. Okay. So it's logged in now.
2:09:13So we are about to start the discussion
2:09:16of pharmacology with you people. So I'm
2:09:19there with you live. Uh so in case you
2:09:22have any uh further inputs in these
2:09:24questions. So you are always welcome. So
2:09:26like what I have heard from other
2:09:28students like approximately 14 15
2:09:29questions have been asked from
2:09:30pharmarmacology and now what we have
2:09:33done we have divided these topics in uh
2:09:35like some of the questions have been
2:09:36discussed by medicine faculty some
2:09:38questions will be discussed by your
2:09:39anesthesia faculty and I would be
2:09:41discussing approximately nine MCQs with
2:09:43you right
2:09:45so nine MCQs we'll discuss here
2:09:48so question number one this image was
2:09:50given to you where they have asked you
2:09:52about the fizers like so there's a brand
2:09:54name given to
2:09:56Lipur name is given
2:09:58right and there was a atorva statin
2:10:01tablet with no brand name written on it.
2:10:04So you can see this is a generic
2:10:06medicine. This is a generic name and
2:10:07this is a branded. So this is branded.
2:10:10This is generic. So it's very easy.
2:10:12Image one is showing the branded and
2:10:15image two is showing you the generic. So
2:10:16it's a very simple question.
2:10:19Yes. So uh question number one was easy
2:10:22was easily it it was easy for you to
2:10:25find out key which truck is branded
2:10:27which is generic. So if the brand is
2:10:29written you can see the company name
2:10:31also it's branded medicine so it's easy
2:10:32question right. So I would say general
2:10:36knowledge question number two a patient
2:10:40with suffering from MDRTV reported with
2:10:43decreased visual equity and red green
2:10:45color blindness. Which of these drug is
2:10:47responsible?
2:10:49So can you please confirm me are these
2:10:51options correct or not? Were the same
2:10:54was the question same or the options
2:10:56were correct because I'm just a little
2:10:57bit worried about this this point. Was
2:11:00the did did they mention about MDRTB or
2:11:03this was just a normal TB?
2:11:08Yes. So Dr. Salony you can see here also
2:11:12the atorin is written. So atvastatin
2:11:15lipid is a drug name. So it was a
2:11:18bandaid name. So but most of the time
2:11:21what happens MDRTB may we people don't
2:11:23give it all. So the only thing I am uh
2:11:27worried about is whether the question
2:11:28was based on MDRTB or just was just a TB
2:11:32because in MDRTB there is a one regimen
2:11:36where we have where we give high dose of
2:11:38isonia and when we give high dose of
2:11:40isonia in MDRTB there is a chance that
2:11:44patient will have
2:11:47uh there is a chance that patient will
2:11:50have
2:11:52uh this problem of blindness or red
2:11:56green color blindness. So this was the
2:11:57only thing it was a normal TB. That's
2:11:59why I'm asking. So it was not MDRTB. So
2:12:01it was just a TB case. It was just a
2:12:04case of TB. So TB patients. Okay. So as
2:12:08per Dr. Chintan, it was MDRTB. But most
2:12:11of the students are saying it's a normal
2:12:12TB. It was not mentioned it's MDRTB. So
2:12:14just a TB then answer is clearcut
2:12:16ethaml. If it is an MDRTB because eithol
2:12:20is not given for MDRTB then I would
2:12:22suggest the isit high dose will be the
2:12:24better answer
2:12:26right
2:12:28okay you people didn't pay attention
2:12:29whether it was normal TV or MDV because
2:12:32start with E so it will cause side
2:12:34effect on eyes okay so if it's a normal
2:12:36TVL is the answer okay okay next is so
2:12:40this was from our notes like you must be
2:12:42knowing the side effects of uh
2:12:46uh TV drugs are given here although they
2:12:49have taken the wrong image of the uh our
2:12:51notes. Question number three, which loop
2:12:54diuretic can be given for severe
2:12:56sulfonomide allergy? So if a person is
2:12:58having severe sulonomide allergy
2:13:02so ethranic acid so this was an outdated
2:13:04question like ethranic acid is the
2:13:06medicine that is already been not in
2:13:08practice. So this medicine is not used
2:13:09nowadays. So I don't know why as people
2:13:12do like this way. Sometimes they ask
2:13:13very recent or clinical question which
2:13:15are relevant for our clinics and
2:13:17sometimes they ask you this kind of
2:13:18questions which are totally outdated
2:13:20question. So if a patient is having
2:13:22severe sulf allergy like furicomide,
2:13:25torsomide, bubetanite these are the
2:13:27practically useful medicines. All these
2:13:28are sulfur drugs but ethagranic acid
2:13:31this is outdated because of the
2:13:32autotoxicity as a side effect. So this
2:13:35medicine is not a sulfonomide. So that
2:13:36is a answer in this MCQ it's a factbased
2:13:38question old MCQ like when I gave my
2:13:42entrance exam at that time these kind of
2:13:43questions were asked oneliner questions.
2:13:45So ethrrenic acid is a medicine which is
2:13:48not a a sulfur drug. Rest of the three
2:13:51medicines are sulfur drugs. So I think
2:13:53most of the most of you marked it
2:13:54correctly because the thing is this was
2:13:56the drug which we usually don't teach in
2:13:58our class because ethagranic acid is
2:14:00already been withdrawn. So you must be
2:14:02when you must have seen this medicine
2:14:04the exam you must have thought key
2:14:06medicine let's go for this medicine. So
2:14:09so now your intuitions internal
2:14:12intuitions are correct right. So answer
2:14:14is C. Question number three, answer is
2:14:16C. Okay, let's move on to question
2:14:18number four. Which is a long-term uh
2:14:21side effect of corticosteroid? So the
2:14:23the typist is in mood of Diwali, I think
2:14:25is not typing correctly. No problem at
2:14:27all. So which of these is a side effect
2:14:29of corticosteroid?
2:14:31So long-term side effect they're asking.
2:14:33So whenever we give corticosteroids to a
2:14:35patient, uh corticosteroids leads to
2:14:37basically more appetite. So whenever you
2:14:40are taking steroids, you people
2:14:41generally eat more food. The reason is
2:14:42corticosteroids are the catabolic
2:14:44medicines. So this will promote the
2:14:46catabolism in our body and this will
2:14:48inhibit the metabolic process can result
2:14:50in catabolism and because of catabolism
2:14:52people generally have more tendency to
2:14:54tendency to eat more food. So anorexia
2:14:57is not seen rather there is a uh rather
2:15:00there is a more appetite of the patient
2:15:02patient will consume more food and
2:15:04steroids are the medicines they will act
2:15:05like a minocorticcoid and once they will
2:15:07act like aminoid they retain sodium in
2:15:09water and once they retain sodium in
2:15:12water patient already have excess of
2:15:14sodium in his body so he does not have
2:15:16the salt cravings after that he already
2:15:17have excess of sodium so will he will
2:15:20not have the salt cravings after that
2:15:22and lymphocytosis no steroids are the uh
2:15:25imunosuppressor medicines. So they will
2:15:27not cause lymphocytosis. Although
2:15:29acutely they can cause like question
2:15:31asked to you whether these medicines can
2:15:33cause increase neutrfil count. So there
2:15:36is a possibility neutrfil count can
2:15:37increase acutely but in MCQ they have
2:15:40specifically mentioned the long-term
2:15:41side effect. So answer is going to be
2:15:43the lymphopenia. Steroids are
2:15:44imunosuppressants will cause lymphopenia
2:15:46not the lymphocytosis. So the answer is
2:15:48peptical disease. It's a long-term side
2:15:50effect of medicine. So question number
2:15:51four answer is C.
2:15:54Okay. Now this was the uh like
2:15:56screenshot of our notes. So peptic
2:15:58disease was given in our notes or
2:16:00directly taken from our notes. So
2:16:02question number five statins with long
2:16:04halflife of 20 20 hours and can be given
2:16:06any time of the day. So there are two
2:16:08options. These two medicines are longer
2:16:10acting medicines and these two medicines
2:16:11can be given any time of the day. But
2:16:13now the the main click is like why the
2:16:15as people are like very sadistic people
2:16:18I would say. So they have given this
2:16:19half life. You know that at 13 has a
2:16:22half life of approximately 13 to 14
2:16:24hours. Right? And this medicine has a
2:16:26half life of approximately 19 to 20
2:16:28hours. So nobody can remember this way.
2:16:30It is humanly not possible to remember
2:16:32the half life of all medicines. But
2:16:34generally we can say like this way the
2:16:35medicine which is longer acting. Statins
2:16:37which are longer acting are generally
2:16:38the medicines which are high efficiency.
2:16:40Right? So as roso statin being as most
2:16:43efficient medicine. So it is the longest
2:16:45halflife out of all. It's a 20our half
2:16:47life approximately and this medicine can
2:16:49be given any time of the day. So
2:16:51question number five answer is Bombay
2:16:53right? So this is again taken from our
2:16:54notes. You can see atva statin rose tin.
2:16:57So we mentioned both medicines atvostin
2:16:59rose statin they have a long half life.
2:17:01This is directly taken from our notes.
2:17:03But point is now they have given both
2:17:05options. So if they have given both
2:17:06options you have to choose one. Now this
2:17:08is a bit tricky. Now this is the one
2:17:09that you have to just use the logic
2:17:11which is the most efficient out of all.
2:17:13So rosoastin is a medicine which is most
2:17:17effective most uh efficient medicine. So
2:17:20this medicine is the longest halflife
2:17:21out of all. There's a reason like why
2:17:23this medicine longest acting because
2:17:24it's a long it's a most why this drug is
2:17:26most efficient because the medicine is
2:17:28longest acting out of all. So question
2:17:29number five answer is Bombay. Question
2:17:32number six which calcium channel blocker
2:17:34is a N type calcium channel blocker and
2:17:35having a L type activity also. So answer
2:17:37is selenipine. The medicine name is
2:17:39selenpin. So again the type is error. So
2:17:42no problem at all. He is in a mood of
2:17:43Diwali celebrating a Diwali right. So
2:17:45Diwali festival seasons says there in
2:17:47Delhi and also winter is coming. So
2:17:48maybe he's shivering while typing. The
2:17:50selen is a medicine that's a anti
2:17:52calcium channel blocker and this
2:17:53question was asked in neat exam also
2:17:55this year. This was a question of neat
2:17:572026 exam also I think not in need as
2:18:01examin this was the INAC May as
2:18:04question. So May as exam question which
2:18:06medicine is also an antiype blocker
2:18:08answerine. That's why this medicine will
2:18:10not cause reflexicardia. So this
2:18:12medicine will not cause reflexic cardia.
2:18:14Question number six. Answer is A.
2:18:15Selenipine is a perfect answer of this
2:18:17MCQ. Moving on to question number
2:18:22seven. A patient is taking etanavir. So
2:18:25this question is little bit tricky
2:18:26because first time they have asked
2:18:28started asking the properties of HIV
2:18:30drugs. So etanavir is a medicine. It's a
2:18:33protease enzyme inhibitor. So during our
2:18:35class we have discussed that any
2:18:37medicine that ends with the word navir.
2:18:40Any medicine that ends with the word
2:18:42navir is a proteus enzyme inhibitor and
2:18:44useful for HIV. So this medicine if
2:18:47given with proton pump inhibitor. If
2:18:49this medicine is given along with proton
2:18:51pump inhibitor this will reduce the
2:18:52acidic pH. Right? So uh this will reduce
2:18:55the acidic pH and once this will reduce
2:18:57the acidic pH. So by reducing the acidic
2:19:00pH this will reduce the oral absorption.
2:19:02So this medicine can reduce the oral
2:19:04absorption of etazanavir. So like one
2:19:07option was PPIs can inhibit cip 3a4
2:19:10enzyme. One option is it's inhibitor of
2:19:12cip 3a4 enzyme and uh inhibit the
2:19:16atazanavir metabolism. It's not like
2:19:18that. This medicine can reduce the
2:19:20acidic pH of the g and acidic pH is
2:19:23required for the absorption of so that's
2:19:25the perfect answer of this MCQ. Now uh
2:19:28can you please tell me uh okay uh Dr.
2:19:30like next time if you've come across
2:19:32with this kind of MCQ just think about
2:19:34PPIs PPIs drugs and they are very good
2:19:36medicines like they're very neutral type
2:19:38of medicine they will not cause any
2:19:40interaction they don't have any any big
2:19:42problem with them they don't have any
2:19:44drug interactions with them so they are
2:19:46very good medicines to be taken so these
2:19:47medicines generally will not interact
2:19:49with any other drug the only thing where
2:19:51the PPI will supervene the other
2:19:53medicines where they will be better than
2:19:55other medicines where they are very
2:19:56efficient is they they are the very good
2:19:58acid blocker so PP PKs are the very good
2:20:00acid blocker and because they block the
2:20:02asset of our JD. So this may interfere
2:20:05with the other drugs right so this was
2:20:06the only thing PPA can do like if if
2:20:09they will ask okay what Pakistan can do
2:20:10the Pakistan can only interfere with
2:20:12Indian uh politics and Indian things
2:20:14right so they can only that that country
2:20:16can only do that thing so PAP can only
2:20:17do one thing they can block only acidity
2:20:19of the g and by blocking the acidity
2:20:21this can interfere with the absorption
2:20:24okay according to Dr. Raghav there is a
2:20:26option eliminated by kidney and binding.
2:20:29So was there any option on kidney like
2:20:31if you give PPIs along with etazanavir?
2:20:35So what was the option that is based on
2:20:37elimination through kidney and binding?
2:20:38Maybe anything anyone anyone can answer.
2:20:43Uh no one. So if you come across with if
2:20:47you come come to know about if you are
2:20:49able to recall like what are the other
2:20:50options in this MCQ just send it to me
2:20:53or you can send it to our administrative
2:20:55team. So we will be happy to have that
2:20:58feedback from your side but check right.
2:21:00So question number eight this was
2:21:02clearly based on antibiotics and their
2:21:04indication. So we discussed during the
2:21:06class also that venkcomy is given only
2:21:08for gram positive bacteria. So
2:21:10venkcomyin is a medicine which cannot be
2:21:12given for gram negative bacteria and
2:21:13pseudominance is a gram negative
2:21:15bacteria. So this option is incorrect.
2:21:17Now meopenim is a best medicine for ESBL
2:21:21producing gram negative baseli like
2:21:23e.coli klepsilla like ecoli klepsilla
2:21:26can produce ESBL that is extended
2:21:28spectrum betalctomase. So this is the
2:21:31true statement. It's a drug of choice
2:21:32for extended spectrum betalacttois
2:21:34producing bacterias. Now metronidazol is
2:21:37also the drug of choice for anorobic
2:21:39bacteria that's a bacteriaides it's the
2:21:40best medicine for that fluconazole is
2:21:43mainly given for candida infection or
2:21:45mainly for teen infection not given for
2:21:47espigillos so this is false fluconazol
2:21:49is a narrow spectrum antifungal drug
2:21:51cannot be given for esperilosis for
2:21:53espilosis we give voriconazole and
2:21:55doxycyc is a drug of choice it's a best
2:21:58medicine for ricketetta infection it's a
2:22:00best medicine for infection caused by
2:22:02ricketetta again a spelling mistake but
2:22:04no problem we can excuse our typist for
2:22:05this. So rickets infection doxycycline
2:22:08is the best medicine to be given. So
2:22:10option number 2, three and five. 2,
2:22:12three and five. These three options are
2:22:14correct.
2:22:16Uh but Dr. Priam in the previous MCQ we
2:22:19can say uh PPIs can reduce the acidity
2:22:23of our GT and therefore this will reduce
2:22:26the oral absorption. This will reduce
2:22:28the oral absorption of the uh etanaviran
2:22:32which is an HIV drug. So Dr. Aner Aner
2:22:36Aner Ben Roy is saying complete match
2:22:38the following was given.
2:22:42Okay. But most of students are saying it
2:22:44is accordingly according to this MCQ the
2:22:46same way they have asked which is true
2:22:48which is false.
2:22:50Right. So this
2:22:54okay so even then if we talk about the
2:22:56match the following. So
2:23:00like
2:23:01you people were supposed to match with
2:23:03bacteroids. It's a drug of choice for
2:23:05this. Meopinim is drug of choice for
2:23:07ESPL. Fluconazole is the only antifungal
2:23:10here. We have only one antifungal and we
2:23:12have only the name of one fungus and
2:23:13that is not used here. So fluconazole
2:23:15not given for espigilosis. This is
2:23:17incorrect. Rakit CMA V people cannot use
2:23:21cell wall inhibitor. So venkcomy
2:23:23meopenim cannot be given for rakets.
2:23:25Doxycline is a drug of choice. This is
2:23:27also correct. Right. So one one
2:23:31possibility is there. Meopim can be
2:23:33given for sudonas also but I don't think
2:23:36so this this could be so much confusing
2:23:41uh fluconazole we people cannot give
2:23:44okay now I have just matched for you
2:23:46people right I have done the match for
2:23:48you people fluconazolo we cannot use for
2:23:50espigilosis this drug is narrow spectrum
2:23:52drug so it cannot be given for that
2:23:54purpose
2:23:57okay so question are rightly framed
2:23:58according to Dr.
2:24:01Okay fine no problem a just a feedback
2:24:05for you from you people and main main
2:24:07thing is like what what what is going to
2:24:09be our result right so last question is
2:24:11buprenorphine
2:24:13buprenorphine mechanism of action so we
2:24:15discussed already in class the
2:24:16buprenorphine is partially agonist this
2:24:18medicine is partially agonist of mure
2:24:20receptor so answer is Bombay is a
2:24:22clearcut question right so it's a
2:24:25partialist and we have discussed this in
2:24:28our class also so many times right so
2:24:31the medicine name is buprenorphine so
2:24:35they have taken a wrong screenshot of
2:24:37our notes so they have taken the notes
2:24:38of pureist but they should have taken
2:24:40the notes of partial egonist no problem
2:24:42we can excuse typist today no problem at
2:24:45all so question number nine answer is
2:24:47Bombay it's a partialist of mu receptor
2:24:49the drug name is buprenorphine the
2:24:50clearcut answer straightforward answer
2:24:52okay so we're not going through the
2:24:54discussion part because this this is not
2:24:55the session for the discussion so in
2:24:57case there is any controversy in any of
2:25:00the option that we discussed
2:25:03um that is always welcome. So can you
2:25:05please give your failural feedback and
2:25:08Dr. Dr. Syan got
2:25:12okay thanks doctor. Yeah, this is the
2:25:14poverty times. Yes. So we have left in
2:25:16only four or five days. So so many
2:25:17things are left, so many things to do,
2:25:19so many guests we have to attend and lot
2:25:22of gift distribution is there. So guys
2:25:25enjoy your Diwali and I wish this time
2:25:27the goddess Lakshmi and the Lord Ganesh
2:25:30will be uh will have their blessings on
2:25:32you people and all of you get selected
2:25:34in the exam, right? Okay, take care and
2:25:36be healthy and all the best for your
2:25:39future exams and future studies. Take
2:25:40care. Bye.
2:28:25Hello. Good afternoon everybody.
2:28:38Just a second.
2:28:50I'll get things.
2:29:02All right. So, good afternoon everybody.
2:29:05I hope oral medicine and radiology
2:29:07questions were uh moderate to easy. Uh
2:29:11all right. I hope you guys were able to
2:29:14solve as many questions as you can.
2:29:19Okay. So let us start with the first
2:29:22question.
2:29:24Okay. So this was a little unexpected
2:29:27question. Okay. Uh they had asked from
2:29:30CT scan. Okay. Uh so the pitch of the CT
2:29:34scan when it is less than one. Okay. So
2:29:38for this you need to first understand
2:29:40what is pitch. Correct. So we have
2:29:42studied about uh the CT scan machine.
2:29:46Correct? CT scan. So this is the CT scan
2:29:49machine. This is the gantry. This we
2:29:52have discussed. Okay. Gantry under we
2:29:54have the X-ray tube. Okay. Which rotates
2:29:57around the patient. Okay. Now what is
2:30:00pitch exactly? What is pitch? So imagine
2:30:04this patient lying on the table inside
2:30:07the CT scan. All right. And the X-ray
2:30:10tube rotates around the patient.
2:30:13Okay. While the table moves forward. So
2:30:16this is the table where patient uh is
2:30:19lying. When the patient moves forward
2:30:22when the table moves forward during the
2:30:25scan. Okay. So we calculate pitch with
2:30:30the help of this formula. We calculate
2:30:32pitch with the help of this formula.
2:30:34Table movement
2:30:37in one rotation.
2:30:41Table movement in one rotation. Okay.
2:30:45Divided by beam width. Okay. Divided by
2:30:50beam width.
2:30:53All right. Meaning this table is moving
2:30:55forward while this machine is rotating
2:30:58around the patient. So pitch is
2:31:00calculated with this formula. Okay.
2:31:03Table movement in one rotation divided
2:31:06by being width. Now let us see what
2:31:09happens when pitch is less than or more
2:31:12than one. Okay. To get ideal geometry
2:31:15and ideal image we need pitch of one.
2:31:17That means your patient is moving 10 cm
2:31:22forward and your beam width is also 10
2:31:26cm. Okay, this time you get pitch as 1.
2:31:32Okay, so this is ideal. You get ideal
2:31:36image out of this. If your patient moves
2:31:4020 cm forward and your beam width is
2:31:44just 10 cm then you are going to get
2:31:47pitch of two that means greater than one
2:31:51correct greater than one.
2:31:54And if your patient moves
2:31:575 cm
2:31:59forward but your beam width is 10 cm
2:32:05then your pitch is
2:32:08pitch will be less than 1 C or less than
2:32:11one. Correct? So what happens when pitch
2:32:14is more than one and less than one? When
2:32:17pitch is more than one, you are going to
2:32:19get no overlap
2:32:23or less overlap. Okay? But if your pitch
2:32:27is less than one, you are going to get
2:32:31more overlap. That's what question is.
2:32:36Okay. So, what should be your answer?
2:32:40The slice will overlap.
2:32:43Option B is the
2:32:46correct answer. Okay. I know this is
2:32:49little unexpected. We uh focus more on
2:32:52CBCT scan but they had this time asked
2:32:55from CT scan. Okay. So,
2:33:00all right.
2:33:02Moving on to the next question. This is
2:33:04very easy. I hope you guys were able to
2:33:08solve this based on SLOB rule. Can you
2:33:11all tell me the answer for this? 9 years
2:33:14old child with retained right primary
2:33:16canine and absent permanent canine
2:33:19showing labial bulge meaning the canine
2:33:21is impacted of course. Okay. You took
2:33:24two parapical radioraph.
2:33:27When second radioraph was done, the tube
2:33:30is shifted messially. Meaning second
2:33:32radioraph is taken by shifting the tube
2:33:35measially. And on radioraph second
2:33:38radioraph what it showed canine appears
2:33:42that is permanent canine appears measial
2:33:45to the root of dilio canine. Okay. Where
2:33:48is the location of permanent canine?
2:33:50Based on slob rule just simple. If your
2:33:54tube is moving measally,
2:33:57okay, then
2:34:01same side lingual. This rule applies
2:34:04over here. If your tube is shifted and
2:34:08your canine also shifted me, that means
2:34:13your canine is located lingually or
2:34:16palatally. So here what should be the
2:34:18answer? Pal to deciduous canine.
2:34:22All right.
2:34:25Palatal to decidious canine. All right.
2:34:28So this is very easy. I hope you guys uh
2:34:32solve this question. Ch. Question number
2:34:35three. And this is our SLO rule from the
2:34:38notes
2:34:39as we all have discussed. Correct. Ch.
2:34:44Ch. This is the exact PQ. This is the
2:34:47exact PQ. Last exam they had asked the
2:34:51same question. All right. Just you have
2:34:54to match the columns
2:34:56according to the first AV malfformation,
2:34:59Venus malfformation, infantile imag
2:35:01capillary malfform. Even if you don't
2:35:03know the exact meaning of it, just
2:35:05reading the features you'll be able to
2:35:07solve this question. Okay.
2:35:14Okay. So starting from AV malf for AV
2:35:17meaning artery and veins malf for during
2:35:21formation what happens is there is
2:35:23abnormality during formation that leads
2:35:26to direct communication between artery
2:35:28and veins. Okay. So AV malfformation is
2:35:31just nothing but abnormal ad mixture of
2:35:35dysmorphic arteries arterials and
2:35:37weights. Okay. So A corresponds to
2:35:41option two. Okay. Then comes to Venus
2:35:45malf for Venus vein is involved. Similar
2:35:50um mechanism happens here also but the
2:35:54vessel which is involved is vein. Okay.
2:35:57So you will get dilated venus space.
2:36:01Okay. Dilated venus space or dilated
2:36:04veins.
2:36:07All right. [clears throat] So
2:36:09this option irregularly dilated venus
2:36:13channels with thin discontinuous single
2:36:16layered endothelal cells or lining and
2:36:20defective or absent smooth muscle walls.
2:36:23Okay. So Venus malf for option B
2:36:27corresponds to
2:36:30third option.
2:36:33Third option. Okay. Moving on to
2:36:35infantile hemanga. What is heangioma?
2:36:37Heangioma is just a vascular tumor.
2:36:41Correct? So vascular tumor due to
2:36:44endothelial cell proliferation. Okay. So
2:36:47if you read option number first that is
2:36:50proliferation of endothelial cells and
2:36:52parasites. Parasites are the cells which
2:36:55are uh which lies in the basement
2:36:57membrane of the
2:37:00endothelial cells. Okay.
2:37:04So
2:37:05these parasites with inconspicuous lumen
2:37:08inconspicuous mean collapsed lumen or
2:37:11absent lumen. Okay. So this infantile
2:37:15hemangioma
2:37:17sorry this infantile heangioma matches
2:37:21with the first option. Remaining is
2:37:25remaining is which this one fourth.
2:37:29Okay. What is capillary malfformation?
2:37:32Just the vessel involve is different. So
2:37:34abnormally dilated capillaries and post
2:37:36capillary venules with thickened walls.
2:37:39All right. So option number A. Option
2:37:43number A matches with our answer. All
2:37:46right.
2:37:48CH moving on to the next question which
2:37:51is based on digital receptors, digital
2:37:54radiography. All right. We have
2:37:57discussed about this. This is from
2:38:00notes. Our screenshot from notes. Okay.
2:38:03Detector latitude. What is detector
2:38:06latitude? It is ability of detectors to
2:38:12record range of exposures. Correct?
2:38:15Ability of detectors to record range of
2:38:19exposures.
2:38:21So which has got highest or wide
2:38:24latitude? PSP. PSP has got highest
2:38:28latitude. Okay. So our answer here is
2:38:32PSP.
2:38:36All right.
2:38:39Okay. Uh moving on to the next question.
2:38:46Moving on to the next question. Okay.
2:38:49This is also very easy. Match the
2:38:51following. They have given the entities
2:38:53and you just have to match the correct
2:38:55columns. Correct. What is cherubism?
2:38:58Cherubism we have studied is it is
2:39:00multilocular radolucency. Correct.
2:39:02Multilocular radolucency and it involves
2:39:06or it shows bilateral involvement in
2:39:09posterior mandible. Correct. So multiple
2:39:12bilateral not multiple bilateral
2:39:15symmetrical radolucences
2:39:18that to multilocular
2:39:20is the characteristic feature of
2:39:22terobism. So first corresponds to C.
2:39:25Okay. Second pages disease. Pages
2:39:28disease may what radiographic feature do
2:39:31you see? Pages disease may cotton bull
2:39:33appearance. Very easy. So pages disease
2:39:37corresponds to B. All right.
2:39:42Then option number C or um central giant
2:39:47cell granuloma. Central giant cell
2:39:49granuloma shows multi-ucleated giant
2:39:51cells in hemmoragic
2:39:53um environment. Okay. So multi-ucleated
2:39:56giant cells
2:39:58and fourth cement blastto cement blasto
2:40:02uh attaches to the tooth correct tooth
2:40:05root or apex. Apex and it is surrounded
2:40:09by radolucent rim. Correct. Which is
2:40:11soft tissue capsule. Cementtoblasttoma
2:40:14also easy attached to
2:40:17B.
2:40:18Okay. So what is our correct answer
2:40:22here? Option B which is first
2:40:26corresponds to C, second D, third A and
2:40:29fourth B. All right.
2:40:33Okay. Moving on to this is also we have
2:40:37discussed many a times in our classes.
2:40:41Okay.
2:40:44Uh okay. Sixth question. A third a 3
2:40:46years old child presence with premature
2:40:48loss of deciduous incizers and lab
2:40:51investigations reveals elevated urinary
2:40:54phosphoethanoline.
2:40:56Okay.
2:40:58urine PEA levels and serum alkaline
2:41:03phosphatase activity they have given as
2:41:0790 IU per liter. Okay. So ALP alkaline
2:41:11phosphotase levels in 3 years old child
2:41:14should be high. So it should be greater
2:41:16than 100 but it is 90. So it is
2:41:19decreased. ALP is decreased. And just
2:41:22they have mentioned one clinical finding
2:41:25which is premature loss of deciduous
2:41:27incizers. Okay. Most probable diagnosis
2:41:31uh using this given parameters. Okay.
2:41:36Is hypophosphotamia.
2:41:38Hypophosphotamia is the one which shows
2:41:42decreased ALP levels that is alkaline
2:41:44phosphotase levels and related to this
2:41:48urine PA which is a quite different
2:41:51parameter they have given but premature
2:41:53loss of deciduous incizers uh is seen in
2:41:57hypophosphotia.
2:41:59Okay, hypophosphotia
2:42:03and if uh the fourth option is hypo
2:42:07sorry C C option is hypophosphotmic
2:42:10ricketates. Okay, but ricketates may
2:42:12what happens is there is increased ALP
2:42:14levels. Okay, there is increased ALP
2:42:18levels. Okay, so here only we can rule
2:42:22out option number C because here ALP
2:42:25levels have been decreased.
2:42:28Okay. All right.
2:42:31Uh the last question from oral medicine
2:42:34radiology. 54 years old patient
2:42:36undergoing bisphosphonate therapy
2:42:39presence uh with pain in posterior
2:42:42mandible. Okay. And the clinical
2:42:44examination reveals ex exposed necrotic
2:42:47bone. What is the most likely diagnosis?
2:42:51Okay. in bisphosphonate therapy and I
2:42:54think some students mentioned about
2:42:56history of breast cancer also.
2:43:00uh some p some students mentioned. Okay.
2:43:03So, bisphosphinate therapy when one
2:43:07[snorts]
2:43:10uh when a patient underos bisphosphinate
2:43:12therapy is mainly in all these
2:43:15condition. This is screenshot screenshot
2:43:17from our notes. Okay, we have discussed
2:43:19this bronze bisphosphinate related
2:43:21osteone necrosis of the jaw. Okay, we
2:43:24use it in all these cases where um bes
2:43:29phosphonase basically inhibits
2:43:31osteoclast. Osteoclast is um help
2:43:36osteoclast helps in bone resorption. So
2:43:39to inhibit this abnormal bone resorption
2:43:42process, we uh give bisphosphonates.
2:43:46Okay. So uh patients taking
2:43:49bisphosphonate therapy have got higher
2:43:51chances of undergoing necrosis of the
2:43:55bone. Okay. So
2:43:59of course they have mentioned necrotic
2:44:01bone exposed necrotic bone. So what is
2:44:03most probable diagnosis here? Of course
2:44:06medication related osteoncosis of the
2:44:09job because they have already mentioned
2:44:11bisphosphinate here right. Osteorra
2:44:14necrosis
2:44:16radiation therapy is not mentioned.
2:44:20Okay. Yes, breast cancer was there.
2:44:23Okay. So, uh option A is the correct
2:44:27answer over here. Okay. So this
2:44:34I hope you guys have solved all the
2:44:37questions that we have discussed except
2:44:40the first question that was little
2:44:42unexpected. Okay.
2:44:46All right. So next session will be taken
2:44:49by Dr. Dya ma'am. Okay. So
2:44:57I hope this is clear. have got any doubt
2:44:59you can post it in the telegram group.
2:45:01Okay. Thank you so much.
2:49:38Oh
2:49:49Do those
2:49:56check. Yeah.
2:50:26Hello students, uh myself Dr. Dya Gupta
2:50:30and um we are here for the highic recall
2:50:36session November 2026.
2:50:39So
2:50:41from preview specifically four questions
2:50:44were asked and
2:50:47>> hello students uh my friend Dr.
2:50:51>> Yeah. So guys uh we have recalled four
2:50:54questions from Perio. If you feel that
2:50:56any other question was asked please do
2:50:58let us know in the comment section and
2:51:00the four questions which came were from
2:51:03repeated topics only. Nothing new was
2:51:06there. The questions were heard of we
2:51:08have taught them in our live classes as
2:51:11well as recorded sessions plus uh it is
2:51:14there in our notes as well. So without
2:51:16wasting much time let us start the
2:51:18discussion. So the first question is
2:51:22which perodontal instrument which
2:51:24periodontal instrument is
2:51:30which periodontal instrument is most
2:51:32appropriate for degradment of grade two
2:51:35fication defect in tooth 36.
2:51:39Options were universal curate. Uh option
2:51:43B is gracy curate and gracie curate 11
2:51:4612 and 13 14. Option number C is
2:51:49neighbors perodontal curate. There is
2:51:52nothing like neighbors perodontal curate
2:51:55guys. It is neighbors perodontal probe.
2:51:57There is nothing like neighbors
2:51:59perodontal curate. And option number D
2:52:01is quinting curate. So basically
2:52:03quinting curate is used for fcation for
2:52:06debridement of fcation areas in the
2:52:09molar regions. Okay. So the answer here
2:52:11will be option number
2:52:26answer here will be option number D
2:52:29quentin curate
2:52:33okay so it was neighbors probe so
2:52:36whether it is neighbors perodontal
2:52:37curate or neighbors perodontal probe
2:52:41Nothing can a neighbor's probe is used
2:52:43to check the fcation right it is not
2:52:45used to curate the fication so the
2:52:47answer here will be quinting curate
2:52:49quint curate is a instrument which is
2:52:54like this the instrument is like this
2:52:57tip of the instrument is like this it is
2:52:59very narrow tip it is curved tip it can
2:53:02go inside the fcation areas very nicely
2:53:05and curate the fcation areas very nicely
2:53:07so the answer will Okay,
2:53:12curvit was there. Uh, flea bag is asking
2:53:16me uh what about curvet? What whether
2:53:19curvet was there in the options? If
2:53:21curvet was there then it can also be the
2:53:25answer but I'm I think curvet was not
2:53:28there. I have already uh discussed this
2:53:31question with our students and I don't
2:53:33think kurvet was there. Gracie kurvet
2:53:35was not there in the options right.
2:53:39If Quinton curate was there then Quinton
2:53:43curate was will be the answer. Okay
2:53:45guys, next question.
2:53:49Uh the next question is from the 2017
2:53:52classification and exam. They told that
2:53:55it is 2018 classification but the
2:53:57classification was given in 2017.
2:54:01So
2:54:03okay, curvit was there ma'am it was
2:54:05there. I marked curvet.
2:54:08Okay. So students are saying that curvet
2:54:11was there. If curvet was there in this
2:54:13question, if curvet was there then
2:54:16gracing curvet will be the answer.
2:54:18Remember this. If curvet was there
2:54:22then curvet
2:54:25will be the answer. Okay guys, if curvet
2:54:30was there then curvet will be the
2:54:32answer. Remember this.
2:54:35Okay.
2:54:38Ch. Now the next question. Uh the next
2:54:41question is from the classification.
2:54:43There is uh the classification 2017 AAP
2:54:46classification of perodontitis. This I
2:54:49have repeatedly I'm repeatedly telling
2:54:51you guys that yes this is a very
2:54:53important topic. Since last 3 years in
2:54:56every INA exam they are asking for uh
2:54:58questions from staging and grading of
2:55:01perodontitis. So yes it is very
2:55:03important question. Uh a patient
2:55:05presents with a perodontal probing
2:55:07pocket depth of 6 to 7 mm. Clinical
2:55:09attachment loss.
2:55:14Uh pocket depth is 6 to 7 mm. Clinical
2:55:17attachment loss is greater than 5 mm.
2:55:20Vertical bone defect extending more than
2:55:223 mm. There is no history of tooth loss
2:55:24due to perodontitis. According to 2018
2:55:27classification of perodontal disease,
2:55:29what is the most appropriate perodontal
2:55:32stage? So this is a screenshot from our
2:55:36uh
2:55:38um notes and here you can see guys that
2:55:41um
2:55:44here you can see that
2:55:49uh it is more than 5 mm uh clinical
2:55:52attachment loss right and there is there
2:55:56is attachment loss of more than 5 mm and
2:56:00there is a pocket depth of 6 to 7 mm to
2:56:036 to 7 pocket depth is there. Plus there
2:56:07is no tooth loss. There is no tooth loss
2:56:10here.
2:56:12So more than six to uh 6 mm pocket mm uh
2:56:18uh six probing depth is there. Then see
2:56:21here you can see that here six more than
2:56:23equal to 6 mm pocket probing depth is
2:56:25there. Then vertical bone loss less than
2:56:28more than equal to 3 mm. vertical bone
2:56:32loss is there. So,
2:56:35uh there is a vertical bone defect
2:56:37extending more than 3 mm.
2:56:40Right? Vertical bone defect extending
2:56:44more than equal to 3 mm plus there is no
2:56:49tooth loss. So, it will be stage three.
2:56:52The answer to this question will be
2:56:54stage
2:56:57three of perodontitis.
2:56:59The answer to this question will be
2:57:01stage three of perodontitis.
2:57:08Okay.
2:57:10Now the next question uh many neighbors
2:57:13pro.
2:57:18Okay. Now the next question here
2:57:20students we have not recalled option
2:57:22number D. Uh so if anyone can help us
2:57:26with that please let us know in the
2:57:28comment section. Here question number
2:57:31three is a patient had an implant
2:57:32supported crown around which there was a
2:57:34deep pocket with uh 7 mm bone loss. So
2:57:38there was bone loss of 7 mm
2:57:42but the implant was not mobile.
2:57:46Which of these does this suggest?
2:57:48Options are option number A mucositis.
2:57:50In mucositis you will not see bone loss.
2:57:52In nucositis you will see that there is
2:57:54inflammation around the soft tissue
2:57:57right and there is plaque accumulation.
2:58:00In perimplantitis you will see bone loss
2:58:02pocket formation is there. In failed
2:58:05osteo integration the implant will be
2:58:08mobile. In failed osteo integration the
2:58:10implant will be mobile and in the
2:58:12question they have mentioned that the
2:58:13implant is not mobile. So the answer to
2:58:15this question will be option number B
2:58:17perry implantitis.
2:58:19uh if any of you can help us with the
2:58:25perimplantitis.
2:58:26Okay. Fourth one was bxism. Okay. Uh so
2:58:31bxism is not a uh like any condition of
2:58:34the implant. Yes. It can lead to implant
2:58:36failure but bxism is not a condition uh
2:58:41which depicts any of this scenario. So
2:58:43the correct answer here will be
2:58:44perimplantitis.
2:58:47Okay.
2:58:50Now the next question okay uh Salony is
2:58:53saying it is after 5 years they have
2:58:55mentioned
2:58:59Salony is saying after 5 years so they
2:59:02are saying that this condition was seen
2:59:04after 5 years even after five years if
2:59:07you are seeing a 7 mm bone loss it will
2:59:10be perimplantitis guys it's not like
2:59:12perimplantitis is seen immediately
2:59:13perimplantitis is seen after certain
2:59:15years only so this also we have disced
2:59:18discussed uh in our uh live classes as
2:59:22well as recorded session. This is the
2:59:24screenshot. In this you can see uh this
2:59:26is the screenshot from our notes and
2:59:28here you can see that we have clearly
2:59:30discussed about perry implant. Now the
2:59:32next question
2:59:36a [clears throat] person has an inter
2:59:37dental swelling with respect to anterior
2:59:39teeth. There is an inter dental swelling
2:59:42with respect to anterior teeth.
2:59:43Increased probing depth.
2:59:46No tenderness on percussion and no
2:59:48mobility of tooth. No radiographic
2:59:50changes are seen. So there is no TP.
2:59:52There is no mobility of teeth. There is
2:59:54no pocket depth present and there is no
2:59:56radiographic changes. Patient gives
2:59:58history of eating popcorn and the
3:00:01swelling is in the inter dental areas.
3:00:02Swelling is in the inter dental areas.
3:00:05Diagnosis is options are option number A
3:00:07gingal absess. Option number B is
3:00:09parapical absess. Option number C is
3:00:11ferodontal absess and option number D is
3:00:13radicular absess. Now guys whether it is
3:00:15perapol absis or perodontal absis you
3:00:17will definitely see radioraphic changes.
3:00:19In perodontal absis you will see that
3:00:21there is pocket formation which is not
3:00:23there in this case. In radicular absis
3:00:25also you will see radicularly uh there
3:00:27is absis formation the parapical area.
3:00:30Right. So the answer here this is
3:00:32because of the foreign body impaction
3:00:34into the gingal area into the marginal
3:00:35gingiva and the inter dental area which
3:00:37leads to absess formation. This is a
3:00:39localized reaction of the body. Right.
3:00:41So the correct answer here is option
3:00:43number A which is the gingible absess.
3:00:48So uh
3:00:50this also we have discussed this is the
3:00:52screenshot of our u
3:00:55notes. So guys these were the only four
3:00:58questions which which were asked from
3:01:00perodontics. If you think that any other
3:01:04uh question, okay, thank you. You all
3:01:07helped with that bxism uh option. But
3:01:10yes, if you feel any other questions
3:01:11were there, please do let us know in the
3:01:13comment section. And thank you so much
3:01:15guys. All the best.
3:05:39Good evening students. Good good
3:05:41afternoon. How are you all? Am I
3:05:44audible?
3:05:58I am audible to you all.
3:07:44Hi. Uh, is my SC screen visible? Am I
3:07:46audible?
3:07:50Am I audible?
3:07:58Uh, am I audible?
3:08:20Am I audible to all of you? Hi students,
3:08:23am I audible?
3:08:55Okay. Uh so good evening students. I
3:08:58can't hear you all nor can I see your
3:09:00comments. Uh
3:09:02okay. I got the message. Okay. Fine. So
3:09:06basically uh so I'll be reading your
3:09:08messages in the chat window. Okay. Uh is
3:09:12there any other way I can see your
3:09:15messages and I just see okay it's on
3:09:18YouTube as well. So basically um how was
3:09:21your exam? How was PhD? I received the
3:09:25feedback that most of the questions were
3:09:27from the GT and you all did a great job.
3:09:31So
3:09:33um
3:09:37so I'm just reading your
3:09:42Okay. So uh let's quickly start with the
3:09:45discussion. Okay. I think that team is
3:09:48trying.
3:09:52Okay.
3:09:56Yeah. Okay. So right basically uh let's
3:09:59quickly move towards your discussion.
3:10:02Okay. Uh so basically uh uh how was PhD?
3:10:06How did Okay, it was good. Were you able
3:10:09to answer all your questions?
3:10:12Is everything uh was it satisfactory for
3:10:15all of you?
3:10:23Yeah. Uh okay. Okay. So, uh we'll
3:10:29quickly start with the questions. Okay.
3:10:31The first one says that which of the
3:10:33following is not considered a major aim
3:10:36or of epidemiology? Okay. Ji, Ahmed,
3:10:40Bharti, Rahul, Aka, you say that you
3:10:42were able to solve it. That's okay. So,
3:10:46uh which which of the following Okay,
3:10:49that's good to know. Basic fill in the
3:10:51blank.
3:10:53We'll come to that. You mean the salt
3:10:55fluoridation right questions were very
3:10:57familiar Ram Shankar says that okay all
3:11:01right uh so
3:11:04I'm glad to know that okay let's quickly
3:11:07start with the discussion the first
3:11:09question says that which of the
3:11:10following is not considered a major aim
3:11:15of application of epide uh epidemiology
3:11:17okay so now what do we understand about
3:11:20the various aims of epidemiology is that
3:11:23whenever we speak of epidemiology
3:11:25according to the international
3:11:27epidemiological association. Okay, we
3:11:30have three major aims. What are they?
3:11:32First is that we want to study that what
3:11:35is the distribution and magnitude. Okay,
3:11:37like how much a disease is spread and
3:11:40how what is the magnitude and the
3:11:42severity. Second is what are the risk
3:11:44factors and the ideological factors and
3:11:47the third one is we get the data so that
3:11:50we can plan and implement that uh you
3:11:54know uh plan whatever data that you
3:11:57have. Okay. Uh how you can use that data
3:12:00to implement the services understood
3:12:03that? Okay. So basically uh and so uh so
3:12:07our so in order to fulfill these aims
3:12:10where you can understand that how much a
3:12:12disease is spread what are the factors
3:12:14causing the disease and when you use
3:12:16that data to plan the services okay now
3:12:19to implement these aims we have three
3:12:21types of studies descriptive analytical
3:12:24and uh experimental okay now uh so basic
3:12:29aim is that we want to eliminate the
3:12:31health problems which are present and we
3:12:33want to promote the well-being of the
3:12:35society as a whole. Understood? So now
3:12:38let us see that what basically uh like
3:12:42how do we fulfill these aims like uh in
3:12:46the given options uh what are the aims
3:12:49that are being fulfilled? Okay. So let's
3:12:52go to the various options we have. Okay.
3:12:55Uh one second. Yeah. So let's go at the
3:12:58various options we have. One sec. Yeah.
3:13:03Perfect. So can you look at the PPT? Uh
3:13:06we have various options here and the
3:13:08options say that
3:13:10uh I think the screen is my screen is
3:13:12minimized. Could you please enhance it a
3:13:14bit? Uh there is some okay.
3:13:20Yeah. So basically uh one second. Yeah.
3:13:25So various aims are basically what are
3:13:27they that one is that what are the
3:13:31ideological factors that is what we are
3:13:33studying okay what are the determination
3:13:35and prevalence of the distribution in
3:13:37the population that is there and the
3:13:40third one is to treat the dental carry
3:13:42so obviously the aim is not to
3:13:44specifically treat the dental carries
3:13:47okay and uh the other one is basically
3:13:52what is the fourth option the fourth
3:13:54option is basically what that study of
3:13:58the distribution and determinance. So
3:13:59obviously we are identifying the
3:14:02ideological factors we are determining
3:14:04the prevalence and distribution of the
3:14:05disease and we are studying the
3:14:07distribution. So answer which is not
3:14:09there is actually seen okay um uh the
3:14:13team can you please uh in the zoom can
3:14:15you maximize the screen which is there
3:14:17this R thing is uh you know what I see
3:14:20mainly on my screen.
3:14:23Okay. Yeah. So uh when I'm reading your
3:14:26comments you're saying arranging need
3:14:28and priorities what need and priorities
3:14:31was there can you please share that
3:14:33question uh related to me Prem Shankar I
3:14:36think the health education one you're
3:14:37talking about is value of death okay
3:14:40treatment of carries while option na so
3:14:42option C you are saying was not there
3:14:44okay option three maybe there was
3:14:48something related to treatment so
3:14:50probably treatment is not the main aim
3:14:52the main aim is you plan and implement
3:14:54ment you know the ideology that what are
3:14:56the causing factors what are the
3:14:58determinants in how much the disease is
3:15:00spread okay so now it's automatically
3:15:03out priority answer what priority answer
3:15:08okay I think that option was there okay
3:15:11anyways so you can just share it with me
3:15:14whatever options that you think were
3:15:16available okay uh one second
3:15:21uh
3:15:22Rishab there is a our screen I think
3:15:25maybe Dr. Ashwary's screen it is very
3:15:27much uh like you know on my zoom screen
3:15:30can you minimize that because I can't
3:15:32see these questions
3:15:34okay now coming to the next question
3:15:37okay determining the priority of needs
3:15:40and what were the options in that bunjan
3:15:42can you tell me priority of needs was
3:15:44related to epidemiology was it there in
3:15:46that
3:15:51prior was was priority of needs given in
3:15:54this question
3:15:57Rahul, can you tell me that
3:16:25Okay. Anyways, coming to the next
3:16:27question which is
3:16:31Okay. Uh, so we have the next question
3:16:35which is
3:17:00Yeah. So coming to the second question,
3:17:02this says that during the industrial
3:17:04preparation of fluoridated salt, okay,
3:17:07which is intended for human consumption,
3:17:10a specific manufacturing process is
3:17:12followed to ensure uniform incorporation
3:17:15into the edible oil. Okay. Uh I will
3:17:18come to that then uh about the value of
3:17:21death. We have that question. Okay. Uh
3:17:24next is treatment related whatever uh
3:17:27let me know. Okay. Okay. Okay. So coming
3:17:30to the sec second question we have
3:17:32taught this that you know whenever uh so
3:17:34this is a question which is from salt
3:17:35fluoridation. Okay. Now here we are
3:17:38talking where about salt fluoridation
3:17:40wherein fluoride is added to salt. Okay.
3:17:43The reason why salt like in the salt in
3:17:47the in the way of the diet the fluoride
3:17:49is being added. Okay. So in this process
3:17:52what happens is that so that uniformly
3:17:55the fluoride is added into the salt. The
3:17:58salt that you put should be in the form
3:18:00of an ion. Okay. So, ionic of course.
3:18:03So, answer would either be A or it would
3:18:06be it would be C, right? And when you
3:18:09transfer it, there are two ways to add
3:18:11the fluoride. How to mix the fluoride
3:18:14into the salt. Okay? So, you spray the
3:18:17fluoride in the form of a nozzle and you
3:18:19uh spread it continuously on the belt.
3:18:22Okay? So when you spray it continuously
3:18:24on the belt what happens is that is a
3:18:26continuous process. So when that is done
3:18:29continuously automatically it is mixed
3:18:31in a better manner. Okay. So basically
3:18:34uh these are the options. See I think I
3:18:38I'm not sure how magnesium chloride and
3:18:40sodium fluoride was there. Obviously the
3:18:42resultant mixture would be sodium
3:18:43fluoride but it is mainly the salt which
3:18:46contains uh fluoride. Okay. So that is
3:18:50basically there. No, it will not be
3:18:52batch. The right answer will be
3:18:54continuous. Okay. And the meth the form
3:18:57of fluoride which is preferred to mix
3:18:59would be potassium fluoride. So probably
3:19:02maybe what they asked is that which form
3:19:05of potassium should be filled. No bunjan
3:19:08it will be ionic and continuous method.
3:19:11Okay. When it is put on the conveyor
3:19:14belt it has to be in a continuous
3:19:16process. Okay. So this was uh taught to
3:19:20you in the notes. Okay. So basically in
3:19:22salt fluoridation what is done is that a
3:19:24fixed amount of fluoride is added to the
3:19:27salt. Okay. And basically for effective
3:19:31carries prevention you add the salt in
3:19:33the ionic form which is mainly sodium
3:19:35chloride and it is dissolved in water.
3:19:38Okay. And there are two methods. What is
3:19:40this? One is batch and the other is
3:19:42continuous. Okay. So in the continuous
3:19:44you spray a dose concentration through a
3:19:47nozzle on a belt. So whenever you put it
3:19:50on a conveyor belt that method would be
3:19:52continuous process it will not be the
3:19:54batch process. Okay. So potassium
3:19:57fluoride is the preferred method when
3:20:00you use it on the conveyor belt. Okay.
3:20:04uh
3:20:06I'm not sure uh what you're talking uh
3:20:09and also was sodium fluoride and
3:20:12potassium fluoride asked as the
3:20:13preferred method then in that case it
3:20:16will be potassium fluoride so you need
3:20:19to recall the exact options in order to
3:20:22know that okay so uh yeah so let's
3:20:26quickly go to the next question
3:20:28meanwhile okay
3:20:31uh all right so which of The following
3:20:34scenarios best represents the concept of
3:20:37value of death in health protection.
3:20:39Okay. Now see this uh word which is used
3:20:42commonly as the valley of death. Okay.
3:20:44This is used in various aspects in case
3:20:47of a uh you know in whenever we talk
3:20:50about uh you know different different
3:20:52scenarios apart from health. Okay. So
3:20:55probably some people must have come
3:20:56across this concept. This is an
3:20:58absolutely miscellaneous question not
3:21:00expected from you all but one or two
3:21:02bons are always there. So this is a con
3:21:06term which is normally used. So when do
3:21:08we use this term in businesses startups
3:21:10is basically that when we speak about
3:21:13finance. Okay this refers to the
3:21:16critical phase where you have like when
3:21:18you speak about the startup. So this is
3:21:20when this is the time when a startup has
3:21:23started it has received its initial
3:21:25funding. Okay. and uh you know till the
3:21:29time it generates a sustainable revenue
3:21:31that is how it is used in business. When
3:21:33we speak about this term in innovation
3:21:36and technology then this is the gap
3:21:38between the innovation that has taken
3:21:40place and when you have actually
3:21:42commercialized this process. Okay. Now
3:21:44when we speak about uh the health
3:21:48protection like how the value of death
3:21:50concept will be applicable in your
3:21:52health. So basically this is the gap
3:21:55between like suppose you've done a
3:21:56research okay there is some new vaccine
3:21:58which has come up for a new product
3:22:00which had not existed suppose HIV
3:22:02vaccine okay until you actually develop
3:22:06it and implement it in the public okay
3:22:09so this is where the promising
3:22:11laboratory discoveries are failing into
3:22:14the application understood that point so
3:22:17basically what will be the answer in
3:22:19that case if you apply this concept the
3:22:22answer would be definitely definitely B.
3:22:24Okay. Now, uh let's go to the next
3:22:28question. Okay. Uh so automatically the
3:22:31answer in that case would be B because
3:22:33where an intervention is not able to
3:22:35progress from the initial research to
3:22:37the practical implementation. Got it?
3:22:40Got this point? Okay. Now coming to the
3:22:43next question uh has reference in which
3:22:46value of death has it is not taught in
3:22:48your standard public health books beta.
3:22:50This is a random concept. This is very
3:22:52uh this is something which is used in
3:22:54health research. This is not in your
3:22:56subenater. This is not in your park and
3:22:58you couldn't have done it. It is just a
3:23:00fluke like if someone just answered. So
3:23:04uh I know I know but answer option B to
3:23:08okay that is the answer that is that uh
3:23:11the gap between the uh research and the
3:23:14implementation. Understood that point.
3:23:17Okay. Now coming to the next point which
3:23:19is sensitivity and specificity. Question
3:23:22number four we go to okay sensitivity
3:23:25and spec first statement is they are the
3:23:28inherent properties of a diagnostic test
3:23:30and they do not change when the test is
3:23:32performed at primary health care or a
3:23:35tertiary healthcare. That is statement
3:23:36number one. Now is this statement
3:23:39correct? Okay obviously this statement
3:23:41is correct. We have read this multiple
3:23:43number of times that for a diagnostic
3:23:46test when we speak about it basically
3:23:48sensitivity and specificity are the are
3:23:51the characteristics which are normally
3:23:53present and they are characteristic of
3:23:55the test. Okay. Now suppose if you do uh
3:24:00HIV testing in India or in America the
3:24:02results are going to be same. So
3:24:04whenever we speak of sensitivity and
3:24:06specificity uh here you can see a
3:24:08screenshot of the nodes right here also
3:24:10uh this ionic thing was taught to you in
3:24:13salt fluoridation. Okay coming to this
3:24:15question also exact statements if you
3:24:17see here that I have written that you
3:24:19know they are the inherent
3:24:21characteristics of a test and but when
3:24:25we speak about a positive predictive
3:24:27value and a negative predictive value.
3:24:29Okay, see this screenshot is there.
3:24:32Okay, so we have written that predictive
3:24:34value depend on the prevalence of the
3:24:35disease. Okay, and what are sensitivity
3:24:38and specificity? They do not rely on the
3:24:40prevalence. Here we have clearly uh you
3:24:42know explained this concept that uh like
3:24:46um for HIV Eliza first test is highly
3:24:48sensitive. So they are they do not rely
3:24:50on the prevalence and they are the
3:24:52inherent characteristics of the test.
3:24:53This is the exact statement brought to
3:24:55you in your notes as well. Okay. Now
3:24:58what happens in this case is uh is the
3:25:01second um positive predictive value
3:25:06decreases and negative predictive value
3:25:09increases. This is what you're saying.
3:25:11Okay. So what we have written in the
3:25:13question is positive predictive value
3:25:15decre increases and negative decreases.
3:25:17Okay. So maybe there is some uh
3:25:19discrepancy in recalling. If this is
3:25:21decreases here then both the statements
3:25:23are correct. If this statement stays
3:25:25increasing here then statement one is
3:25:27correct but statement two is incorrect.
3:25:30Why? Let's look at the concept then
3:25:32automatically we'll be able to
3:25:33understand what this means. Okay. So
3:25:36basically what do we know is that
3:25:37sensitivity and specificity are inherent
3:25:40characteristics of the test. Okay.
3:25:42Another thing is predictive value
3:25:44depends on the prevalence. Okay. We know
3:25:47that. Okay. So basically what uh for a
3:25:50rare disease the prevalence would be low
3:25:52or high the prevalence would be low.
3:25:55Okay. So if the if the disease is rare
3:25:57the positive predictive value will
3:25:59decrease and the negative predictive
3:26:01value will increase. Okay. So the
3:26:04concept that you need to uh uh remember
3:26:08here is that prevalence is directly
3:26:10proportional to the positive predictive
3:26:12value and it is inversely proportional
3:26:15to negative predictive value. If the
3:26:18prevalence uh you know if the uh what
3:26:20you need to mainly remember is for a
3:26:22rare disease low positive predictive
3:26:25value will be there and negative
3:26:26predictive value will be high and for a
3:26:28common disease high predictive value and
3:26:31low negative predictive value. Okay. So
3:26:34basically what you need to remember is
3:26:37this concept.
3:26:39If if the disease is rare that means if
3:26:41the prevalence is low then the positive
3:26:44predictive value will also be low and
3:26:46the negative predictive value will be
3:26:48more. Okay. So prevalence is directly
3:26:51proportional to positive predictive
3:26:52value and inversely proportional to
3:26:54negative predictive value. And for a
3:26:56rare disease low positive predictive
3:26:58high negative predictive. for a common
3:27:00disease high positive predictive and low
3:27:03negative predictive value. This is the
3:27:05concept that you have to apply in a
3:27:08question like this. Okay. Um
3:27:11yeah question statement one says that
3:27:14sensitivity and specificity are inherent
3:27:16characteristics. They are the
3:27:17characteristic of that test. Okay. Uh
3:27:20okay. So I think if it is given at as
3:27:23decreased fleback you you have marked
3:27:26both the things right. Okay.
3:27:29just concept I explained whether it was
3:27:31given decrease or increase if you have
3:27:33applied it nothing like it okay now
3:27:36coming to the next question this is also
3:27:39straight from your notes okay and I had
3:27:41marked this that this is a pq
3:27:43specifically marked that this is
3:27:45important okay coming to this question
3:27:48there is a community- based oral health
3:27:50program okay now uh this uses a locally
3:27:53available uh technology which is from
3:27:56natural resources to clean your for
3:27:58maintaining the oral hygiene. Okay. For
3:28:00example, you are using mango leaves for
3:28:03cleaning the teeth. Okay. Now, such uh
3:28:06such practices are encouraged. Why?
3:28:08First is they are inexpensive,
3:28:10culturally acceptable, sustainable and
3:28:13can be managed independently by the
3:28:15community. So, what is this principle of
3:28:18primary healthcare? Okay. Now what we
3:28:21know that out of the five principles
3:28:22there is one principle called as the uh
3:28:25there is one uh the first option says
3:28:27equitable distribution. What does that
3:28:29mean? That healthcare should be equally
3:28:31accessible by the poor and the rich.
3:28:33Second is appropriate technology that is
3:28:36that even if a technology which is uh
3:28:40you know economical and affordable by
3:28:42everyone culturally acceptable where
3:28:45people don't have toothbrushes if you
3:28:47have mango leaf and neem leaf they can
3:28:49use that for cleaning their teeth okay
3:28:52this is sustainable and they can be
3:28:54maintained by the community so this is
3:28:56an example of appropriate technology
3:28:59understood community participation is
3:29:01where people of the leaders and the all
3:29:03the people are participating. So
3:29:05automatically it will not be community
3:29:06participation. Intersectoral
3:29:08coordination is where suppose the food
3:29:10sector is coordinating with the uh
3:29:12transport sector. Examples like that.
3:29:14Okay. So if you see your notes this is
3:29:17specifically mentioned that use of mean
3:29:19fix or mangle. Okay. These are used when
3:29:23toothbrushes are unavailable. And in the
3:29:25bracket I've written PYQ marked mango
3:29:27here and this is given in your primary
3:29:30healthcare in appropriate technology.
3:29:32Okay. Uh no, you don't have to reward
3:29:36papers. Okay. This is related to health
3:29:39protection. This is part of health
3:29:41protection and they can ask anything
3:29:42related to that. Okay. And I think if
3:29:45you've not attempted, you will not get
3:29:47negative marking. And if no one has uh
3:29:50attempted that question, I don't think
3:29:51you should be wasting your time or
3:29:53precious energy into answering into
3:29:56doing this. Okay.
3:29:58Um
3:30:00yeah. Yeah. uh fleback this is I uh this
3:30:05is exactly what I'm telling you this is
3:30:07given in your notes this is given in
3:30:09your pq this is appropriate technology
3:30:12only I have covered it in your notes and
3:30:14this is the screenshot of the notes that
3:30:16I have attached everywhere okay
3:30:19all right coming to the next question
3:30:21which is with reference to these
3:30:24fluorosis index okay identify the
3:30:27correct statements statement one is mild
3:30:30fluorosis involves is less than 25% of
3:30:32the tooth surface. Statement two says
3:30:35that a community fluorosis index of 04
3:30:38indicates that the community is at risk
3:30:40of dental fluorosis. Statement three is
3:30:43severe fluorosis is characterized by
3:30:46pitting and brown discoloration. Now see
3:30:50all these questions look very simple but
3:30:52who can answer these? A person who knows
3:30:54these concepts through and through.
3:30:56Okay. So basically if you know these
3:30:59fluorosis what they have asked is that
3:31:01what is questionable questionable is
3:31:04where it is you know what is very mild.
3:31:06So they have said that it is less than
3:31:0825%. Okay that is mild fluorosis
3:31:12understood that what do you understand
3:31:14by mild fluorosis here mild is basically
3:31:17when it is less than 25%.
3:31:20Okay and so similarly mild is less than
3:31:2325%. Okay. When we speak about severe
3:31:26fluorosis that is mainly more than uh
3:31:29you know um there are there is brown
3:31:32discoloration. Okay. Uh option was very
3:31:35mild. So then definitely it is more apt.
3:31:38If you speak of very mild, it is
3:31:40actually more apt because then statement
3:31:43one becomes more clear. Okay. So in that
3:31:46case it will be very mild. Okay. And
3:31:49then in this the option would be
3:31:52basically
3:31:54option A is correct. Okay. And when we
3:31:56speak about severe fluorosis then it is
3:31:59then this is more correct. Okay. When we
3:32:01speak of severe fluorosis then the
3:32:03answer which gets corrected is that
3:32:05there is brownish discoloration. Okay.
3:32:07Now let's understand what is community
3:32:09fluorosis index. So basically what is
3:32:11community fuorosis index is? Community
3:32:13fluorosis index is something which is
3:32:15basically it is uh you know evaluating
3:32:18your uh it is a measure which is used in
3:32:21dental public health to assess that what
3:32:24is the overall burden okay like how much
3:32:28uh disease is actually spread about and
3:32:30what is the burden prevalence and
3:32:32severity of dental fluorosis present in
3:32:34the population okay now how it is
3:32:37calculated is that first is you know in
3:32:40a population uh you take the score of
3:32:42modified fluorosis index then for each
3:32:45clinical category you give a number okay
3:32:48so what they have asked is that 04 means
3:32:50that you know the population is very
3:32:52much at risk that statement is false why
3:32:55because 4 simply indicates a borderline
3:32:57case that means that you know mild
3:33:00fluorosis is present on the verge of
3:33:02experiencing a noticeable aesthetic
3:33:05impact okay so this is a early warning
3:33:08sign all right so this is not when it is
3:33:11very much at risk. Understood this
3:33:14question? Okay. Is that clear for all of
3:33:16you? Okay.
3:33:19All right. Um,
3:33:25Anerban, what did Anureran say? There
3:33:28was an option of fluorosis where the two
3:33:30teeth are equally unaffected and
3:33:32lightest is marked. Okay. Uh, Anervan,
3:33:35can you recall this exactly and message
3:33:38me this question please? Okay. Uh so
3:33:41when we come to the next question, let's
3:33:44discuss the next question. This is a
3:33:45very easy question. I'm sure all of you
3:33:47must have answered. Have you all
3:33:48answered this question? Question number
3:33:50seven.
3:34:03Okay.
3:34:16Yeah. So when we speak of uh you know in
3:34:19a case control study okay uh what
3:34:22happens is what is a case control study?
3:34:24Case control study is that you have to
3:34:26ask the questions uh from you know
3:34:29regarding uh the person's like the
3:34:31person has asked taken the history. So
3:34:33cases are the people who have the
3:34:35disease. Okay. Um so basically what you
3:34:38have to do is that you have to ask the
3:34:41patient uh questions about the history
3:34:43okay so uh uh if a person is not having
3:34:48is not able to recall the questions
3:34:49properly okay and is not able to
3:34:52recollect what is that kind of bias
3:34:55where the questions are asked suppose a
3:34:57person has tuberculosis and if you're
3:34:59asking what were the symptoms when did
3:35:01the symptoms first appear and based on
3:35:03that if the person is not able to recall
3:35:05So what is happening is that when you're
3:35:07trying to report uh you're not able to
3:35:09report properly. Okay. So because of
3:35:13that the bias that is resulting is
3:35:15called as a recall bias. Okay. Now there
3:35:18is another type of bias which they have
3:35:20come covered is basically that a person
3:35:23with the disease may be more likely to
3:35:25recall a previous experience. So suppose
3:35:28whenever a history is taken you would be
3:35:30able to recall something which is very
3:35:31recent. You might not be able to recall
3:35:33that okay two years ago how how many
3:35:35cigarettes did I smoke. So this kind of
3:35:38bias is called as telescopic bias. So
3:35:41how a telescopic vision is there right
3:35:43like we remember what is nearer. So that
3:35:45is a telescopic vision understood. So
3:35:48that is telescopic bias that you can
3:35:50recall a previous exposure than a
3:35:52healthy control. So the answer here
3:35:54would be the recall bias and the
3:35:56telescopic bias and this exact thing I
3:36:00had taught you here. Okay, these are
3:36:02types of the information biases. Recall
3:36:04bias is also called as memory bias. So
3:36:07the person is not able to recall the
3:36:09past experiences. Okay, and telescopic
3:36:12bias is that the questions are related
3:36:14to the recent past where events from the
3:36:16distant past may have been forgotten.
3:36:19Okay, Genan, you got it. I explained
3:36:21what is telescopic bias right now.
3:36:23Telescope, how a telescope is shaped,
3:36:26right? You remember you have a near
3:36:28vision. Whatever is near your eye, you
3:36:30can see that. Okay. So that is a
3:36:32telescopic vision. Uh question has
3:36:35invigilator bias also. Invigilator bias
3:36:37would be uh I think invigilator would
3:36:40not be a answer because invigilator uh
3:36:46uh
3:36:48just two more questions Ross. Okay.
3:36:51There are people who are asking me what
3:36:52is telescopic bias. So I have to answer
3:36:54that. Okay.
3:36:58And uh please don't say it in an
3:37:01instructing manner ro. Okay.
3:37:04All right. Coming to the next question
3:37:07which is a schoolgoing child in New
3:37:09Zealand is enrolled in a school dental
3:37:12uh nurse program. Okay. Uh ma'am I guess
3:37:15the question was a little different
3:37:17something about selection from cases or
3:37:20something. Okay. Uh so you can send me
3:37:23uh you can send me the options that you
3:37:26think. Okay. Unless you tell me the
3:37:28exact option then obviously the answer
3:37:31changes right. So uh option A is not uh
3:37:35is not applicable now because exposure
3:37:38bias is something which is related to
3:37:39the exposure of the patient to that. So
3:37:42it is nowhere related to the question.
3:37:44Understood that? Okay.
3:37:48Uh okay send me the right question if
3:37:50you can recall. Okay. Uh coming to the
3:37:54next question. A child is going to the
3:37:56school in New Zealand. Okay. So here we
3:37:58are talking about the New Zealand type
3:38:00of nurses. Okay. And this child is
3:38:03enrolled in a school dental nurse
3:38:05program. Okay. So now here the child
3:38:09requires a class 2 restoration. Okay. So
3:38:12we are talking. So basically what
3:38:14they're and uh in a permanent mer and a
3:38:17simple extraction.
3:38:22uh rash uh please focus on the session
3:38:24okay there are people who want
3:38:26explanations and they are discussing
3:38:28what all other uh options are there so
3:38:31the purpose of this is a healthy
3:38:32discussion okay
3:38:36unless we know all the options we cannot
3:38:38figure out what is the right method okay
3:38:42uh and I have to cater to all other
3:38:44requests not just yours okay so
3:38:48basically here we are talking about the
3:38:50New Zealand and the school dental nurse
3:38:53who are available in the school dental
3:38:55nurse program. Okay. So here we are the
3:38:58child is requiring a class 2 restoration
3:39:00in a permanent mer and a simple
3:39:02extraction of a primary mer. Okay. Now
3:39:05according to the scope of practice of a
3:39:07dental nurse in New Zealand which is the
3:39:09most appropriate course of action. Okay.
3:39:12So again see if you look at the question
3:39:15uh let's all please concentrate on the
3:39:17session flea bag uh uh please don't uh
3:39:20enter into any discussions please just
3:39:22focus here okay yeah so basically uh we
3:39:27are discussing here is that New Zealand
3:39:30we are discussing about New Zealand and
3:39:31the school dental nurse program all
3:39:33right so what we need to do here is that
3:39:36obviously we are discussing about the
3:39:37New Zealand type of nurses all right so
3:39:40what are the functions of the New
3:39:41Zealand type of school dental nurses.
3:39:44These are the following programs. Okay.
3:39:47So, we have uh covered this in your
3:39:49notes, covered this in your PYQ. What
3:39:52are the various functions? Uh a New
3:39:54Zealand type of school nurse can uh do
3:39:57the cavity preparation and fillings in
3:40:00primary as well as permanent teeth.
3:40:02Okay. Whereas as far as extraction is
3:40:05concerned, the school dental nurse can
3:40:08only extract the dist but not the
3:40:10permanent teeth. So here as you can say
3:40:13that you know both the functions are
3:40:15valid okay like uh the restoration in
3:40:19permanent mer the school dental nurse
3:40:20can do and the extraction of a primary
3:40:22mer that also the school dental nurse
3:40:25can do. Okay is that clear with you all?
3:40:30Okay. Uh anyone um don't focus on the
3:40:34scoring too much but okay. Let's just uh
3:40:38focus on preparing for neat and let's
3:40:41hope you get through this. Okay. But uh
3:40:44don't uh don't stress out too much.
3:40:47Okay. Uncomplicated filling.
3:40:49Uncomplicated filling the school dental
3:40:51nurse can do. Okay. Uh okay. Flee bag is
3:40:54saying it is not given. There's nothing
3:40:55like uncomplicated filling honestly.
3:40:57Okay. So um
3:41:01all right understood. Now let uh let's
3:41:04go to the next question. Um of course
3:41:07there is a little confusion in this
3:41:09particular question as to what were the
3:41:11exact answers because it is matched the
3:41:13following but we will still attempt it.
3:41:15Okay. Uh I think that image is not
3:41:19attached
3:41:21that. Okay. Uh so when you look at your
3:41:25soen Peter there is an uh there is an
3:41:28image of uh
3:41:32um
3:41:34there is an image which had to uh which
3:41:37explains that what are the advantages
3:41:39and the dis disadvantages. Okay. So
3:41:42which of these is the correct match the
3:41:44following advantages of a mobile van
3:41:46with their corresponding disadvantages.
3:41:49Okay. Now first one when we talk about
3:41:51it helps reach vulnerable patients.
3:41:54Okay. So obviously this is an advantage.
3:41:56Okay. What is the disadvantage? It
3:41:58requires permission for the site. Yes.
3:42:00Whenever you go to uh the advantage of
3:42:02having a mobile dental van is that the
3:42:05vulnerable patients can be approached.
3:42:07The disadvantage is that you need
3:42:09permission for the site. And the second
3:42:11one is that the patient does not have to
3:42:14travel. Of course that is a advantage.
3:42:17Okay. that a patient does not have to
3:42:19travel. Okay, that is one of the major
3:42:21advantages. Uh so uh obviously this is
3:42:24advantage services can be made available
3:42:26at multiple sites. So when you speak
3:42:29about this particular uh you know uh
3:42:34point which is given in disadvantage.
3:42:35The second one this is basically an
3:42:38advantage. So this will not come in the
3:42:40disadvantage. Okay. And the second one
3:42:43is provide dental services at patients
3:42:45doorstep. not necessarily doorstep but
3:42:48this is usually pro provided in
3:42:50communities or in schools. Okay. Uh it
3:42:52increases missed appointments. You can't
3:42:54say really missed appointments. Uh it
3:42:57there is a problem of followup. Okay. Uh
3:43:00the advantage this says is high
3:43:02maintenance cost. This will not be high
3:43:04maintenance cost. This will be basically
3:43:08uh uh you know the advantage is that for
3:43:11a startup the amount will be less. Okay.
3:43:15And here it requires permission for the
3:43:16site. This is right. So the the match
3:43:19where it is perfectly right is a that
3:43:22you can reach the vulnerable patients
3:43:24and it requires permission for the site.
3:43:26Okay. So uh probably I'll show you if
3:43:30you can see
3:43:33I'm not sure can you see these
3:43:36advantages. I asked the team to add this
3:43:39image in the slide but I guess that's a
3:43:41bug. Okay. So the basic advantages are
3:43:44that they there is moderate startup
3:43:45cost. It addresses the problem of
3:43:47transportation. It decreases missed
3:43:50appointments. Services can be made
3:43:51available at multiple sites. Services
3:43:53are made available to the needy
3:43:55population. These are the advantages.
3:43:56Disadvantages is high maintenance,
3:43:58difficult to access and store patient
3:44:01record. Okay. You can't uh it is
3:44:03difficult to you know store the record
3:44:04of the patients, provide limited
3:44:06services, require permission and
3:44:08difficult to use during mounts. Okay. So
3:44:11basically all these are the advantages
3:44:13and the disadvantages of mobile dental
3:44:16van. So in that case A would be right.
3:44:19Followup was given in C increased
3:44:22misappointments provides dental services
3:44:24at but only one pair has to be marked
3:44:28clearly. Okay. So in C what was the
3:44:31advantage section? Can you tell me thisu
3:44:34if you can tell me the exact uh thing
3:44:37which was asked in the advantage
3:44:38section. Okay.
3:44:43Disadvantage followup can be done. Okay.
3:44:46Uh so what what was the advantage in
3:44:50that case? Can you tell me that option
3:44:52please?
3:44:54Can you all recall that option?
3:44:58Suku I'm waiting for your reply. Suku
3:45:00and 123. Uh otherwise we'll switch to
3:45:03author.
3:45:22Can you tell me this please?
3:45:32It was what you have written but
3:45:34disadvantage then this can't be true.
3:45:36Okay, then this answer can't be true. If
3:45:38you are saying that uh provide dental
3:45:41services at the patient's doorstep uh uh
3:45:45and the other is increased decreased
3:45:47followup then this uh because only one
3:45:50option is correct and it is a okay so
3:45:53maybe something is different here. Okay.
3:45:56All right. So when you when we recall
3:45:58reach out when limited transport. So
3:46:01yeah so probably A is not fully correct
3:46:04and that is why the correct answer is A.
3:46:06Okay.
3:46:08All right. So any other doubts you all
3:46:10have please let me know. Okay. And when
3:46:12you're able to door step is not given
3:46:15now. Okay. Door step is not given. All
3:46:17right. Uh so um let's see doorstep is
3:46:22not given. Okay. Uh and this is
3:46:25something else. No, C is not correct.
3:46:27Beta C, we don't even recall whether
3:46:29doorstep is given or not. How can we say
3:46:31that C is correct? The pair which is A
3:46:34which is both advantage and
3:46:36disadvantage. If both are correct, then
3:46:38we can mark it as correct. Okay. But
3:46:40here we do not know what is doorstep.
3:46:42Then how can we say that is uh correct?
3:46:46It's okay. It's okay. Whenever you
3:46:47recall it, please tell me.
3:46:51So C
3:46:54advantage what is the what what was
3:46:57exactly written in advantage only then
3:46:59we can say now that C was correct we are
3:47:02not able to recall what is given here
3:47:04you are saying door step was not written
3:47:06then what was given here
3:47:13if this is followup you're saying then
3:47:15what was given here you all tell me that
3:47:18okay anyway so whenever we are able to
3:47:21recall it fully. We will we will revise
3:47:23the entire document and we will fill it
3:47:25up and we will share it with you all.
3:47:28Okay. So you will have a better
3:47:29understanding. All right. Okay. So all
3:47:32the best for your results. See you all
3:47:34on the uh other side. Okay. Thank you
3:47:38all so much. Thank you.
3:47:57Thank you so much.
3:48:04[clears throat]
3:48:27>> [clears throat]
3:48:31>> All right guys, good evening everyone.
3:48:34Good evening everyone. This is Dr.
3:48:35Kunalagraal, your subject guru for the
3:48:39subject of orthorontics at DBMC MDS.
3:48:43So guys, how was the exam?
3:48:45[clears throat] I've got mixed reviews
3:48:47yesterday. Some said it was quite okay,
3:48:50some said it was moderate, some said it,
3:48:52some said it was quite lengy and
3:48:55particularly about our subject, about my
3:48:58subject orthorontics. Again, I had mixed
3:49:01reactions. Few question were really,
3:49:03really easy and few question were
3:49:05little, you know, they were little
3:49:06thoughtprovoking like food for thought
3:49:09type questions.
3:49:11Okay. So, how was the exam yesterday
3:49:13guys? How did you attempt the questions?
3:49:16Were you able to attempt all the
3:49:17questions? Ortho was easy. Yeah, I know
3:49:21it. There were many questions from
3:49:22Ortho. Around 23, 24 questions were from
3:49:25Ortho. I know, I know, I know. Ortho had
3:49:28majority questions. I understand. You
3:49:30know, so that makes ortho one of the
3:49:32most important subjects for your
3:49:33preparation. Right. [snorts] Right. So
3:49:37[clears throat] I have done my best to
3:49:39teach you all everything and as I was
3:49:41seeing all the questions which have been
3:49:44asked in the exam yesterday all of them
3:49:46have been taught by me in the in the
3:49:50notes in the recorded lectures in the
3:49:52live lectures in the live sessions doubt
3:49:54clearing session everywhere we have
3:49:56covered everything everywhere some way
3:49:59or the other
3:50:01right it was easy but you know we need
3:50:04common sense in that yes exactly You
3:50:06need common sense in orthodontics. You
3:50:08know there's a there's a landmark
3:50:11article given by Maligan once you said
3:50:14uh who is this Kusu vlog. Okay. So there
3:50:20is a landmark article that's called
3:50:22common sense mechanics given by mullyan.
3:50:25It's a it's an it's an article which is
3:50:27spread over 16 parts. It's one of the
3:50:30lengthiest articles in any journal I've
3:50:33read in my entire life. 16 parts of a
3:50:36single article, right? So yes, you need
3:50:39common sense in orthodorontics.
3:50:41Absolutely correct. So everything
3:50:43everything everything
3:50:45was from the notes. I have taken out all
3:50:48the screenshots.
3:50:50I have pasted all the relevant
3:50:52screenshots in the slides which are
3:50:54going to follow. So I'm going to tell
3:50:56you which topic, which slide, which
3:50:58question was taken from which part of
3:51:00the chapter, which part of the topic and
3:51:02from where in the notes. I'm going to
3:51:04tell you that. So let's start with the
3:51:08very first question. It's a no-brainer.
3:51:10Which of the following sephometric
3:51:11landmarks is not bilateral?
3:51:15So another way to ask that which of the
3:51:18following landmarks is unilateral,
3:51:21right? That's that's the exact meaning
3:51:23of that
3:51:26students. Okay. Koma is saying
3:51:31when students complain of volume of
3:51:33notes it proved to be worth at the end.
3:51:37Yeah, I know. I got multiple complaints
3:51:39from the student, multiple feedback from
3:51:41the student that oro notes are quite
3:51:43bulky. I know I know. So this time I've
3:51:46done my best to reduce the size of the
3:51:48notes. I know. So everything is well
3:51:52that ends well, right?
3:51:54I think I should have not taken CDs per
3:51:57DBM. Okay. Oh, okay. You are from CDs.
3:52:00Okay. Okay. So now you are watching the
3:52:03YouTube live session from DBMI. Suku
3:52:06logs three. Okay. Okay. Fine. No
3:52:08problem. I'm not here to compare
3:52:10anything. It's your individual choice
3:52:12whether you want to take CDs or you want
3:52:14to be part of DBS DBMS. It's completely
3:52:16your call. I'm here to teach you. I'm
3:52:18here to guide you. I'm here to give you
3:52:20the right answers. Okay. So options are
3:52:23orbital, gon, articular or mentor.
3:52:26What do you think? So this is where I
3:52:29have included this topic in the notes.
3:52:32We [clears throat] have talked about
3:52:33this in the chapter on cphlometrics. You
3:52:35can see and we have done the
3:52:38classification based on location of
3:52:40landmarks based on their type soft
3:52:43tissue hard tissue hard tissue bilateral
3:52:45midital mital also are also known as
3:52:48unilateral right and I have also given
3:52:51you the diagrams directly from the
3:52:54textbooks I have labeled everything I
3:52:57have labeled everything there's one more
3:52:59question on cifometrics later on based
3:53:01on this uh uh the identification of
3:53:04landmarks itself. So I'm going to tell
3:53:06you I'm going to I'm going to tell you
3:53:08exactly what landmarks were asked where
3:53:11and and at which point. Okay. So what
3:53:14should be the correct answer? See
3:53:16orbital is present bilaterally. It's the
3:53:19lowermost point on the bony orbits. So
3:53:21there are two orbits. There will be two
3:53:23orbitals. Gon it's present at the angle
3:53:26of the mandible. So two angles of the
3:53:27mandible. So two points articular here
3:53:30around the TMJ area. So two TMJs, two
3:53:33articuls. Menon there's only single
3:53:35point that's at the lowermost point on
3:53:38the pony chin. So correct answer is
3:53:40mentor. Okay
3:53:44next
3:53:46identify correctly the following sin
3:53:48conrosis from the image below. So this
3:53:50was an image based question directly
3:53:51picked up from the notes. Again I've
3:53:54included this figure in the notes in the
3:53:56in the second chapter of the notes. So
3:53:59this is the sincondrosis that's present
3:54:01at the base of the skull. That is one of
3:54:04the most important primary growth
3:54:06centers of the base of the skull. It's
3:54:08made up of primary cartilage, right?
3:54:10It's made up of primary cartilage. Yes
3:54:11or no? So this is the diagram I'm
3:54:14talking about. You can see here I've
3:54:17already labeled it. We have spinoidal
3:54:20synchondrosis.
3:54:22We have interphenidal synchondrosis. We
3:54:25have spinoxal synchondrosis.
3:54:27Right? And also I have included the H
3:54:32when the synchondoses usually get fused
3:54:34with each other that leads to oification
3:54:37of synchondrosis
3:54:40right. So based on this diagram you can
3:54:43you can see here. So first is the
3:54:47sphenoithmoidal. This is the
3:54:50sphenoithmoidal
3:54:52synchondrosis.
3:54:56Second is interphenoidal.
3:55:00It's present within the sphenoid bone.
3:55:02Right? And the third one is
3:55:05spheno
3:55:07occipital. It's present between the
3:55:09sppheninoid bone and the occipital bone.
3:55:12Between the sppheninoid and the basio
3:55:14occipital. So now you can look at the
3:55:16options. First is spino sphenoithmoidal.
3:55:20Second is interphenoidal and third is
3:55:22phoxipal. So the correct answer will be
3:55:25option A.
3:55:28Okay.
3:55:30All right. Next question. Again a
3:55:33no-brainer.
3:55:34It's based on Scammon's growth curve.
3:55:37Again we have talked about Scammon's
3:55:38growth curve hundreds of time. Which of
3:55:41these developments is indicated by the
3:55:43yellow line? Yellow oblique orange line
3:55:46whichever you want to call it whatever.
3:55:49Okay. So this is the scamman's growth
3:55:52curve. we have talked about in the notes
3:55:53as well and I have highlighted in the
3:55:55notes also that this is a very very
3:55:58frequently asked multiple choice
3:56:00question
3:56:02very very frequently asked multiple
3:56:03choice question application based image
3:56:06based anything anything can be asked
3:56:09right so scam was the person who who
3:56:13categorized who who who represented the
3:56:17growth pattern of four different types
3:56:19of human body tissues in a graphical
3:56:21format And he we he looked into lymphoid
3:56:24system, the neural system, the
3:56:27reproductive system, maxilla and the
3:56:29mandible separately. And based on the
3:56:33growth pattern, based on the trend what
3:56:35these organs observe, he made a graph
3:56:40for the general body growth which is
3:56:41sigmoid shaped. So let's take a look.
3:56:45This is lymphoid.
3:56:49This is neural.
3:56:51This is reproductive.
3:56:55And the yellow one is the general.
3:56:59It follows a Sshaped growth pattern also
3:57:01called as sigmoid growth pattern. Right?
3:57:04So it's a no-brainer. Correct answer is
3:57:06option C, general development.
3:57:09I hope you have got it correct.
3:57:12I hope you have got it correct. In the
3:57:15exam, the graph was very weird like a
3:57:17child who drew it with crayon. Okay,
3:57:19guys, it happens sometimes.
3:57:22Uh,
3:57:27yes, we are solving int 2026 November
3:57:30session which was held yesterday. Sabil
3:57:33Ahmed, this is the answer to your
3:57:35question. Okay.
3:57:38All right. Ch. So this was also taught
3:57:42in the notes that's why I want to that's
3:57:45why I want to emphasize on right. So
3:57:48this is the graph and I have given all
3:57:51the important points of all the
3:57:54description which follows the graph for
3:57:57you to refer to.
3:58:01Next question. So this was the question
3:58:02I was talking about just a while ago.
3:58:04Identify the subflometric landmarks
3:58:06marked in the image given and select the
3:58:08correct combination. So let's take a
3:58:11look.
3:58:13You have to tell me. You have to tell
3:58:15me. Now I have opened up my YouTube chat
3:58:19window and you have to tell me which
3:58:21point is which. Okay. So I want you to
3:58:27pay attention here. So this is again
3:58:29this was taught by me in the chapter on
3:58:32simplatrics.
3:58:34We have worked a lot for you to make it
3:58:37understandable in a very simple
3:58:38language, easy to understand language.
3:58:41So these are the landmarks and
3:58:42measurement points
3:58:44and the same landmarks in a realtime
3:58:47X-ray. This is the X-ray image I was
3:58:49talking about. So this is a realtime
3:58:52X-ray image of a patient. Okay. And
3:58:55these [snorts] are the landmarks which
3:58:56are seen on an X-ray.
3:59:00So
3:59:02now let's take a look.
3:59:06Point one is point B.
3:59:10Clear? Point 2 is pokeon.
3:59:17Point 3 is
3:59:20Nathon and 4 is
3:59:24Menon. Any doubt in this? I don't think
3:59:28so. I don't hope so there is any doubt.
3:59:31So what should be the answer?
3:59:34Point.1
3:59:37is point B 1 second. So.1
3:59:441 second. Yeah.1
3:59:47is point B2 pon 3 nan 4 men. So correct
3:59:51answer is option D.
3:59:54Is it clear?
4:00:00Yes, absolutely. Harika, point one is
4:00:02point B. Pogon, Nathan and Menon.
4:00:04Absolutely correct. I think there is
4:00:07some
4:00:08chat going on between Sabil Ahmed and
4:00:11other people. I was in wrong place. MDS
4:00:14MS
4:00:17Anyways, I I should ignore these things.
4:00:20All right. So, let's move forward.
4:00:24Rapid paddle expansion is classified
4:00:25under which types of orthonoric force
4:00:27application? So this was a multiple
4:00:30correct choice answer. So RM is
4:00:33classified under what type of orthonoric
4:00:36force application? That was the
4:00:38question. So RM first of all it is
4:00:41reciprocal in nature. Every action is
4:00:44equal and opposite reaction. Okay.
4:00:46Number two,
4:00:48I have also talked about the different
4:00:50types of forces.
4:00:54In the chapter on biology of tok moment
4:00:56you can see here I think there was one
4:00:58more question very similar question
4:01:00which uh in which the the the one of the
4:01:03graph was given and and you had to
4:01:04identify which type of aonic force is
4:01:06that I'm going to come to that point
4:01:08also I'm going to I'm going to come to
4:01:10that question as well okay so
4:01:15what do you think should be the answer
4:01:17it is reciprocal in nature and it is
4:01:22interrupted also.
4:01:24So option three and four are correct.
4:01:27Interrupted plus reciprocal. Okay. Okay.
4:01:30Fine. Even if it was single correct
4:01:33answer even if it was a single correct
4:01:36answer what I can see in the chat in the
4:01:38in the in the comments I will choose
4:01:41reciprocal.
4:01:43I will choose reciprocal or
4:01:46actually reciprocal is not a type of
4:01:48force. uh reciprocal is not a type of
4:01:51force. I should correct myself. It is
4:01:53not reciprocal. It should be interrupted
4:01:56once and for all. It is interrupted. If
4:01:58it is a single choice answer, if it is a
4:02:01multiple choice answer, then we have
4:02:03interrupted and we have reciprocal. Is
4:02:06that clear?
4:02:08So I've given I've given related options
4:02:11also. I have given relative related
4:02:14examples also. C
4:02:17continuous forces we have elasttomericic
4:02:19chains and nitric coil springs
4:02:21interrupted forces like fixed athonoric
4:02:24appliances
4:02:25plus RM also you can add it here and
4:02:29intermittent forces which are all
4:02:31removable orthonoric appliances
4:02:32including
4:02:34external oretic appliances aligners
4:02:37elastics everything. So all the options
4:02:40all the types of forces are exemplified
4:02:43by related by related orthonic
4:02:46appliances. Okay.
4:02:54Okay. Fine. Next question. A girl
4:02:57approaching a first growth spurt exhibit
4:03:01various secondary sexual changes. Which
4:03:03of the following changes are associated
4:03:05with this stage? Appearance of breast
4:03:07buds. Growth of pubic hair extending
4:03:09towards the thigh. Onset of menstruation
4:03:12or appearance of underarm hair also
4:03:14called as appearance of axillary hair.
4:03:19This also has been taken up by me in the
4:03:22very first chapter.
4:03:24So this is the this is the table I have
4:03:27included. This is the table I have
4:03:30included. One second. There's some lag.
4:03:32Actually this notepad is not responding
4:03:36according to my movement of my fingers.
4:03:38So this is the heading of the table
4:03:42adolescent growth stat versus secondary
4:03:43sexual characteristics for both girls
4:03:45and boys. So the question is
4:03:47specifically asking about girls. You can
4:03:49see here for girls the total adolescent
4:03:52total duration of adolesccent growth is
4:03:543 years and stage one where we have
4:03:57beginning of adolescent growth it is
4:03:59shown I mean the the the signs which are
4:04:02shown are appearance of breasts and
4:04:04initial pubic hair it's already given in
4:04:07the notes it's already given in the
4:04:09notes right so the correct answer will
4:04:12be appearance of breasts that is the
4:04:15first change to occur it is followed by
4:04:17other
4:04:19like noticeable breast development,
4:04:21axillary hair, darker or more abundant
4:04:23pubic hair and growth spurt ending like
4:04:26deh starting of menes that is minarch
4:04:29broadening of hips with adult fat
4:04:30distribution breast development is
4:04:32completed that is around that is in the
4:04:35stage third that is when the when the
4:04:37girl has completed her pubertal growth
4:04:40stage that's that's when
4:04:43okay so this has also been taken up by
4:04:45me in the very first chapter of the
4:04:48nodes.
4:04:51Next, which of the following is a growth
4:04:54indicator? Again, it's a no-brainer.
4:04:56Very very simple question. Hand
4:04:59radioraph, sketification indicator,
4:05:01chronological age or cervical vertebrae.
4:05:03So, you tell me the answer. I want the
4:05:06answer from you. So, we have had a
4:05:09complete chapter
4:05:11that is skeletal maturity indicator.
4:05:15We have had we have discussed
4:05:18we have we have had a hell lot of
4:05:20discussion on skeleton maturity
4:05:22indicators where we talked about
4:05:24different types of growth patterns. We
4:05:26have talked about different modalities
4:05:28to assess the skeletal growth handra
4:05:30cervical vertebrae frontal sinus
4:05:33biomarkers everything yes or no. So this
4:05:37these screenshots are taken up by that
4:05:39chapter itself where we have talked
4:05:40about handrest radioraph we have also
4:05:43talked about cervical vertebral maturity
4:05:46indicator everything right fisherman's
4:05:50skittle growth index hassan farman
4:05:52lampers skis jog raven brown everything
4:05:55is covered properly extensively in the
4:05:58notes
4:06:00yes or no so this is the screenshot of
4:06:03the notes you can refer
4:06:07So
4:06:09one second. Okay. It was accept.
4:06:13All right. So we can change it.
4:06:18Okay. Okay. Okay. Which is not an
4:06:20indicator. All right. All right. All
4:06:22right. So I'll add it here. Which all of
4:06:24the following are growth indicators
4:06:26except.
4:06:28Okay. If that is the question except I
4:06:31will choose chronological age.
4:06:33Chronological age is the age defined by
4:06:37Krogman
4:06:39is the age defined by Crogman which is
4:06:42calculated from the date of birth of the
4:06:44child. Suppose I am born in April. So
4:06:49from the date of birth of whichever year
4:06:52till today 2nd November whatever my age
4:06:54is that is a chronological age and that
4:06:56is that is that is absolutely no uh that
4:06:59has got absolutely no relation to the
4:07:01extent of skeletal growth present in the
4:07:04in the child. Okay to overcome that
4:07:07problem different authors have found
4:07:10they have different authors have made
4:07:12different ways of assess assessing the
4:07:14skeletal growth indicators. So we have
4:07:16hand restraint lossification indicator
4:07:18we have a cervical vertebrae maturity
4:07:20indicator. But which of the following is
4:07:23not a growth indicator? If this was the
4:07:26question option C is the correct answer
4:07:29that is chronological age.
4:07:32Okay.
4:07:36One second.
4:07:40Okay. It was except I clearly remember.
4:07:42So I have given you the answer. If it
4:07:44is, if the question was asking about
4:07:46which of the following is not a growth
4:07:48indicator, chronological age is the
4:07:50correct answer.
4:07:52Which of the following athonic
4:07:54appliances is used in the mandibular
4:07:55arch exclusively?
4:08:00Again, we have talked about all these
4:08:02appliances multiple times. We have
4:08:03talked about quadellex, pendex, lip
4:08:05bumper, house, everything we have talked
4:08:07about. So, this is the screenshot for
4:08:09your reference.
4:08:12One second. Yeah, this is the screenshot
4:08:14of the of the So this particular
4:08:18question has been taken up from the
4:08:20chapter on space regaining in
4:08:21orthorontics.
4:08:23We have talked about lip bumper. We have
4:08:25talked about franulum appliance. We have
4:08:26talked about any number of other mer
4:08:28distalization appliances in this
4:08:30particular chapter. So one of the
4:08:33appliance which is exclusively
4:08:36used in the mandibular arage is the lip
4:08:40bumper.
4:08:41So lip bumper in one you know I've even
4:08:44described lip bumper in elsewhere in the
4:08:47in the in the notes I think in the
4:08:50management of class 2 division one
4:08:51molecule if I remember correctly we have
4:08:54discussed about that so
4:08:57lip bumper is an appliance which is used
4:08:59for correction of lip trap number one
4:09:02that is one of the primary indicators
4:09:04second it is used to cause mandibular
4:09:09molar distal ization.
4:09:14So the pressure from the oral
4:09:16musculature particularly from the
4:09:18mentalis and the and the orclaris orus
4:09:21around the lower lip that is transmitted
4:09:24backwards
4:09:25that is transmitted backwards and that
4:09:28transmission of forces backward leads to
4:09:30distalization of the mer backwards in
4:09:33the in the mandular arch. And the same
4:09:36appliance, listen to me carefully, the
4:09:38same lip bumper appliance if it is used
4:09:40in the maxillary arch
4:09:43it is called as
4:09:4710 holes appliance it is called as 10
4:09:50hole appliance for the maxiage.
4:09:54Okay,
4:10:00GT ortho questions are better framed and
4:10:02more provoking. Yeah, I know. I have
4:10:05I must not uh thank you for the
4:10:08acknowledgement first of all.
4:10:11So, I have actually worked a lot on
4:10:14creating questions for GT.
4:10:16Just hold on please.
4:10:20Hello.
4:10:24Yeah, speaking.
4:10:32Yes ma'am. I think you had called uh you
4:10:34had called on WhatsApp yesterday evening
4:10:35also. Now ma'am is it okay if I call you
4:10:38within half an hour? I'm just taking a
4:10:39lecture right now. I'll call you within
4:10:41half an hour please. Yeah I'll just call
4:10:43you back. Thank you.
4:10:49So yeah what was I saying?
4:10:52I have actually worked a lot in creating
4:10:54the questions for GT because I have seen
4:10:56the trend more and more questions have
4:10:58been asked based on the clinical
4:11:00scenario what come stress direct pickup
4:11:04questions. So I have followed the same
4:11:07pattern I have included a topic I have
4:11:11created those questions taking into
4:11:14consideration the clinical application
4:11:16of those con those concepts. So I'll
4:11:19take this as a compliment for me. Uh,
4:11:22who is this? Flea Bag E818L.
4:11:26I don't know your real name ma'am. If
4:11:27you can write down your real name, it
4:11:28will be really thankful. I'll be really
4:11:30thankful for you.
4:11:33Your YouTube sessions were helping an
4:11:34exam for me. Thank you so much. I'm
4:11:36going to take your pro revision for
4:11:38sure. Okay. Thank you so much. Thank you
4:11:40so much. Right. So, the correct answer
4:11:43is lip bumper appliance.
4:11:46Okay.
4:11:48Next question.
4:11:50With reference to the concept of couple
4:11:53forces in orthodontics, consider the
4:11:55following statements. We are talking
4:11:57about couple forces in orthodorontics.
4:11:59We have to take into consideration the
4:12:01couple force in orthonorics. We have
4:12:03already discussed about that in the
4:12:05chapter on biomechanics.
4:12:07Statement one. Now this is a
4:12:10thoughtprovoking question. And I told
4:12:11you earlier a couple consists of two
4:12:14forces of equal magnitude acting in
4:12:17opposite direction along the same line
4:12:20of action. So this might be confusing.
4:12:23Two out of three parameters are correct
4:12:26but the same line of action is
4:12:29incorrect.
4:12:32Cuts along different lines of action.
4:12:34They are called non-olinear forces
4:12:39equal and opposite but along different
4:12:42lines of action. So option so statement
4:12:45first is wrong. A couple produces
4:12:47rotational movement. Absolutely correct.
4:12:50A couple combined with a force may
4:12:52completely change the direction of tooth
4:12:54movement. But this is also correct. So
4:12:56we are left with statements two and
4:12:58three which are absolutely correct. So
4:13:02this has already been taken in the
4:13:05chapter on biomechanics of tooth moment.
4:13:08You see here we have talked about the
4:13:09definition of couple. Two equal and
4:13:12opposite non-olinear forces. Non-olinear
4:13:15forces means one force is acting along
4:13:18the top surface. One force is acting
4:13:20along the bottom surface. Even though
4:13:23they are equal in magnitude but they are
4:13:26in opposite direction. Not passing
4:13:28through the same point of reference. We
4:13:31are passing through they are passing
4:13:33through the different planes right?
4:13:41If the forces had been passing through a
4:13:44common point equal and opposite would we
4:13:48have any rotational tendency? Would we
4:13:49have any rotational movement? No. Right?
4:13:52Because both the forces are going to
4:13:53cancel out each other. There will be net
4:13:56there will be zero net force acting on
4:13:58that body. So the net force is zero. The
4:14:01net movement will be zero. It will be
4:14:02useless. Yes or no? So here force one is
4:14:07equal to force two.
4:14:10So the net effect is force net will be
4:14:15force one plus force two and it will be
4:14:19in the clockwise direction.
4:14:23Yes or no? I have also exemplified the
4:14:26same concept in a clinical situation.
4:14:28See here. So this is the most commonly
4:14:31encountered clinical situation. We have
4:14:32a rotated preolar. So what we have done?
4:14:37We have bonded one we have bonded one uh
4:14:40lingual button on the parallel surface.
4:14:42We have bonded one lingual button on the
4:14:44parallel surface of the canine as well.
4:14:47And we have started with a echain which
4:14:50is pulling the tooth one side which is
4:14:52pulling the tooth on the other side. So
4:14:54there are two forces equal and opposite
4:14:57but not passing through the same point.
4:15:00So what is the end result? If you can
4:15:02see the the preolar has been the preolar
4:15:06has been corrected. The actual
4:15:08inclination the rotation of the preolar
4:15:10has been corrected. Okay. So this is the
4:15:13clinical use. I have exemplified the
4:15:15clinical use in this chapter in this
4:15:18topic. So correct answer is option B
4:15:21that is statements two and three are
4:15:23correct but the statement one is
4:15:24incorrect why I've told you the answer
4:15:28it is not along the same line it is
4:15:29along the different lines of action
4:15:37so depth explanation DBMI people give
4:15:40okay thank you I'm a big fan of you and
4:15:43literally I will take orthodontics uh
4:15:46Bangalore dental college god promise me
4:15:49to get the required rank. You are
4:15:50walking walking museum of Orthodontics.
4:15:53I'm going to take a screenshot of this
4:15:55man. This is the best
4:15:58comment I have got. Walking Museum of
4:16:01Orthodontics. Okay. And I have passed
4:16:05out from government dental college in
4:16:06Bangalore. Uh Sai Krishna Reddi. So this
4:16:10is for you because you are saying you
4:16:12want to take orthonontics in Bangalore
4:16:13dental college. So I am an alumni of GDC
4:16:15Bangalore. Just for your information.
4:16:20Now next, which of the following
4:16:22sondroys is an important growth site in
4:16:25the cranial base contributing to
4:16:27anthroposterial growth and influencing
4:16:29the position of the maxilla? Actually
4:16:32I beg to differ here. Thin chondrois is
4:16:36not a growth site. First of all, it is a
4:16:38growth center made up of primary
4:16:41cartilage. It's made up of primary
4:16:43cartilage. And growth sites are made up
4:16:46of secondary cartilage. Growth sites are
4:16:49condalaic cartilage. The sutures. Okay.
4:16:53So sincondosis is a growth center not a
4:16:55growth site. Again we have discussed
4:16:58about this earlier.
4:17:00So what are the different synondroses?
4:17:02This is the same same screenshot I had
4:17:04used earlier uh just a few questions
4:17:07back. [snorts]
4:17:09So
4:17:11sincondoses are basically
4:17:14they are the growth center present in
4:17:15the cranial base. So the so the
4:17:18birectional growth of the synchondrosis
4:17:20that leads to the growth of the cranial
4:17:23base in an antroposterial direction.
4:17:26Right? Okay. I'll explain this here. See
4:17:30this is the skull.
4:17:34This is the maxilla
4:17:37mandible. Okay,
4:17:39clear. So sin condosis, this is a
4:17:43cranial base. You can see here this is
4:17:45the cranial base
4:17:47and the sin condos are present here
4:17:53at the cranial base. So the birectional
4:17:56growth of sin condondrosis
4:17:59it leads to the growth of the cranial
4:18:01base in an upward and forward direction.
4:18:05Okay.
4:18:07Okay. And here we have the maxilla. This
4:18:12is the nasomagillary complex. Just
4:18:14pardon my drawing. I'm just making it uh
4:18:17in a in a schematic manner. Now, because
4:18:20the synchondrosis is pushing the cranial
4:18:22basin upward and forward direction, the
4:18:25nasomary complex is secondarily and
4:18:27passively translated downwards in a
4:18:30downward and forward direction because
4:18:32of secondary displacement. So that's a
4:18:36different concept. altogether that is a
4:18:38different concept altogether what I want
4:18:40to tell you is thin chondrois is the
4:18:42primary pacemaker it is the primary
4:18:45pacemaker of the cranial base which
4:18:48allows which lets the cranial base to
4:18:50grow in an upward and forward direction
4:18:53okay so this has been taught to you in
4:18:56the lectures in the in the in the uh in
4:19:00the notes see it is written it is the
4:19:02pacemaker of the growth of the skull
4:19:05it's written written here that is a
4:19:07spinooxipital synchondrosis is a
4:19:09pacemaker of the growth of the skull.
4:19:11It's already written here. So what
4:19:13should be the answer? It is spheno
4:19:17occipital synchondrosis is the
4:19:19[clears throat] correct answer.
4:19:26Okay. Even if other option was sutures
4:19:28like frontal sagittital frontal suture
4:19:31whatever sutures are not the primary
4:19:34growth centers.
4:19:36Sutures are not the primary growth
4:19:38center. Okay.
4:19:41Next identify the appliance from the
4:19:43image provided below. Again this is a
4:19:45no-brainer.
4:19:47Which appliance is this? We have talked
4:19:49about multiple times in the notes. This
4:19:53has been taken in the chapter on space
4:19:55regaining. So this is a pendulum
4:19:58appliance which is used for
4:20:01distillization of the moler
4:20:04which is used for distalization of the
4:20:05mers.
4:20:08Ive also I've also uh put the different
4:20:13modification of the pendulum appliance.
4:20:15The first modification is pendex. Pendex
4:20:18means pendulum appliance having a
4:20:20provision of transverse maxillary
4:20:22expansion. And there's the incorporation
4:20:23of Jack's screw in the nance battle
4:20:26button. Then we have M pendulum.
4:20:29That's the second B. Then we have
4:20:32Hilar's PhD appliance. And we have
4:20:34hybrid T-Rex appliance. So all these
4:20:36appliances
4:20:38are asked as image based questions in
4:20:40some form or the other. I think this
4:20:43this appliance hybrid T-Rex appliance
4:20:46was asked two years back. It was asked
4:20:49two years back in INIC. I don't
4:20:51remember. either I don't remember
4:20:53whether it was in May session or in
4:20:55November session but it was asked two
4:20:56years back in 2024 for sure. Okay. And
4:21:00we have the frog appliance also. So
4:21:02everything is given in the notes. So
4:21:04this is a pendulum appliance. No doubt
4:21:07about it. Absolutely no doubt about it.
4:21:14Anil is asking why do you still remember
4:21:17more than or sardar?
4:21:20What do you mean by orthosard? I didn't
4:21:22understand your question. Anil, can you
4:21:24please
4:21:26be more specific? What is the meaning of
4:21:28orthosard? I don't I don't get your
4:21:30question. A patient presence with angle
4:21:33of plus two with both SNA and SB angle
4:21:36within the normal range. So the answer
4:21:38is already given in the question. SNA
4:21:41and SNB angles are already in the normal
4:21:42range. What is the skeletal
4:21:43classification? So SNA, SNB, A and B
4:21:47everything has been taught to you. They
4:21:49are part of STEAR cyclometric analysis.
4:21:52Right? They are a part of STEAR
4:21:54cyometric analysis.
4:21:57Yes or no? So we have talked about SNA
4:22:00angle. We have talked about SNB angle.
4:22:03We have also talked about A and B angle
4:22:05and the relationship of each other with
4:22:08the how the maxilla is positioned in
4:22:11respect to the cranial base. How the
4:22:12mandible is positioned in respect to the
4:22:13cranial base and how both jaws are
4:22:16positioned within the face in respect to
4:22:18each other. Right? We have talked about
4:22:21that in detail. Everything is covered in
4:22:23the notes. So what should be the answer?
4:22:27I told you the the answer is already
4:22:30given in the question. The values are
4:22:32within the normal range. So what is the
4:22:33skeletal classification? It is skeletal
4:22:36class one. Simple no-brainer.
4:22:44facial profile was written convex
4:22:46already with prominent upper lip. I have
4:22:48one more question guys that six uh six
4:22:51degree. Now I have one more question.
4:22:53I'm coming to that question. Just wait a
4:22:54bit.
4:22:56A 19year-old female patient presents
4:22:58with a 4 mm midline diastthema. Clinical
4:23:01examination reveals a thick maxillary
4:23:03label phenom extending up to the incess
4:23:05of papula. Radioraphic examination also
4:23:08confirms the presence of a phenom
4:23:10attachment. What is the most appropriate
4:23:12sequence of treatment?
4:23:14So we have got midline diastema. We have
4:23:17got a thick fibrous label phenom as
4:23:19well. Surgical correction of the phenom
4:23:22followed by observation for spontaneous
4:23:23closure of the diastema. Surgical
4:23:26correction followed by placement of a
4:23:27bonded retainer. Composite restoration
4:23:30with retainer and management with
4:23:32Holly's retainer alone. So we have
4:23:35talked about this in the chapter on
4:23:37minor surgical procedures. We have
4:23:39talked about phenecttomine particularly
4:23:41I've also told you I've also told you
4:23:45that there had been two schools of
4:23:47thoughts different author different
4:23:49schools of thoughts but now the most
4:23:52I mean but nowadays globally the
4:23:54consensus which is followed in the world
4:23:58world over is this it is better to close
4:24:01the space orthonorically then resect
4:24:04carefully the fibrous attachment and
4:24:05liate the teeth together immediately
4:24:07afterward scarring ing then assists the
4:24:09closure
4:24:11and the reason they have given is that
4:24:14if the surgery is done before the space
4:24:15closure scar tissue may form and hinder
4:24:18elimination of the diastema.
4:24:21Okay, we have also talked about the
4:24:23clinical significance. What are the
4:24:24agent procedures to minimize the relapse
4:24:27among other things. So the correct
4:24:31answer should be
4:24:33ortho treatment
4:24:36followed by frenicctomy
4:24:40followed by retention
4:24:43that is the correct sequence of events.
4:24:45But since orthonic treatment is not
4:24:47given it is not given as an as an option
4:24:51we can also go for option A that is
4:24:53surgical correction of frenum followed
4:24:55to observation for spontaneous closure
4:24:57of your dacma. Why? Now you some of you
4:25:00might argue how does a diastema close
4:25:03spontaneously? It closes [snorts]
4:25:05spontaneously because of contraure
4:25:11due to the scar tissue.
4:25:16The scar tissue which is formed it it
4:25:19leads to contraure. It leads to it leads
4:25:21to contraction of the tissues towards
4:25:23each other like reciprocal anchorage
4:25:25what we talked about earlier. Right? So
4:25:27that leads to closure of the midline
4:25:30dashimma.
4:25:32Okay.
4:25:36Okay. All right. Rohit Partil is saying
4:25:40if author treatment is given. Okay.
4:25:41Fine. So I have already told you the
4:25:44answer. Even if treatment was given as
4:25:47an option
4:25:49then we have to go with this sequence.
4:25:51Or treatment followed by frenctomy
4:25:53followed by retention.
4:25:58All right,
4:26:01next question. During author tooth
4:26:03movement, different types of tooth
4:26:05movement require different magnitudes of
4:26:06light forces. Which of the following
4:26:08movements requires the least amount of
4:26:10authoric force? Now, I want an answer
4:26:13from you guys. Which of the following
4:26:16tooth movements requires the least
4:26:18amount of authoric force magnitude wise?
4:26:21Is it control tipping, uncontrol
4:26:23tipping, extrusion or intrusion?
4:26:28Okay.
4:26:33So I told you know even if author
4:26:34treatment was given I have already given
4:26:37you the sequence of events right or
4:26:40treatment followed by frenctomy followed
4:26:43by retention. So which of the following
4:26:46toukman requires the least amount of
4:26:48force? Absolutely correct. Hitesh
4:26:50Anerband flee by harika atul absolutely
4:26:55correct it is intrusive. So this has
4:26:58also been taught in the notes. The
4:27:00chapter is biomechanics of tooth
4:27:01movement. I have given you the range of
4:27:04the of the forces which need to be given
4:27:08to the teeth for different types of
4:27:10tooth movement. And here you are
4:27:13intrusion requires the least amount of
4:27:15force that is 10 to 20 g per cm squared.
4:27:19It's 10 to 20 g per cm squared of root
4:27:24surface area of the tooth. Okay,
4:27:28see it's already written here. Bodily
4:27:31movement requires the highest amount of
4:27:33force. Number one, intrusion requires
4:27:36the lowest amount of force. But
4:27:39but but but
4:27:41it is the most difficult tooth movement
4:27:43to achieve clinically. And this has been
4:27:46asked as an MCQ also earlier
4:27:50because it is difficult for the
4:27:51orthodontist to control the force
4:27:52applied on a very small root surface
4:27:54area and to prevent root resorption
4:27:57because I mean as a consequence that is
4:28:01why intrusion is one of the most
4:28:02difficult to move moment to achieve
4:28:04clinically in the orthorontic practice.
4:28:07Clear?
4:28:09During a correction of a midline dimemer
4:28:11using elastics, which type of anchorage
4:28:14is required?
4:28:16Reciprocal rainforce cortical absolute.
4:28:18Again, this is a very very simple
4:28:20question. It's a no-brainer. We have
4:28:22talked about this in the chapter on
4:28:24anchorage in orthodontics.
4:28:26This is the screenshot of the notes. You
4:28:28have it right in front of your screen.
4:28:31So reciprocal anchorage is when the two
4:28:34teeth are moving towards each other
4:28:36taking each other's support and that is
4:28:39a classic example of how reciprocal
4:28:41anchorage works for correction of
4:28:43midline diastema. Number one also we
4:28:47have talked about this just four five
4:28:49questions ago right did we or did we not
4:28:52no I don't think so we have talked about
4:28:54this so whenever we have a buckle non-
4:28:57occlusion or a scissor bite like this
4:29:00situation here the upper mer are more
4:29:02buckly position the lower mers are more
4:29:04lingually positioned so there is no
4:29:06contact between the upper and lower
4:29:08occlusal surface at all
4:29:10right so this condition can also be
4:29:12corrected by bonding and attach
4:29:14attachment on the buckle surface of the
4:29:16upper and on the lingual surface of the
4:29:18lower mer and passing an elastic
4:29:22through the bite. So this is known as
4:29:26through the bite elastics.
4:29:32This is also an example of reciprocal
4:29:34anchorage.
4:29:36Clear?
4:29:39Clear. So correct answer is it's
4:29:43reciprocal anchor. It's a no-brainer.
4:29:48Now this is an image based question.
4:29:50Identify the type of aonic force based
4:29:53on the graph presented below. So this
4:29:55was the graph. Force is is measured uh
4:30:00in respect to time along the x-axis.
4:30:04So we have talked about this earlier. I
4:30:07told you these are the different types
4:30:08of forces. This has been given in detail
4:30:11in the notes also. We have got
4:30:13continuous forces examples elastic chain
4:30:15nit coil springs. We have got
4:30:17interrupted forces like fixed authentic
4:30:19appliances like arch wires. I'll add one
4:30:22more here. We have RE also here there
4:30:25was a question right and we have
4:30:28intermittent forces examples all
4:30:31removable orthonic appliances including
4:30:33orthopedic appliances elastics aligners
4:30:36everything.
4:30:37So these are the graphs for intermittent
4:30:40interrupted and continuous forces which
4:30:42are very well given in the notes very
4:30:44well explained in the in the chapter on
4:30:46biology of tok moment. It has been
4:30:49explained extensively exhaustively. So
4:30:52there should not have been any doubt
4:30:54while attempting this question. So what
4:30:57is the answer? What is the answer? It is
4:31:01interrupted force
4:31:03exemplified by fixed orthorontic
4:31:06appliances.
4:31:13Okay. See medical corner you are again
4:31:15and again saying option option. See this
4:31:19is a recall bas basically this is a
4:31:22recall. You cannot know exactly for sure
4:31:25what was the exact terminology used in
4:31:27the question.
4:31:29Yes or no? I am not given the exam. I am
4:31:32simply dependent on how well the
4:31:35students are going to recall the
4:31:36questions to me. Right. Right. So even
4:31:39if some other question some other
4:31:42terminology is given in the question
4:31:44just be just be here. Right.
4:31:48option heavy force fine heavy force
4:31:51doesn't matter doesn't matter but we are
4:31:54talking about the graph here right let's
4:31:57concentrate on the graph you know the
4:31:58graph you know the answer
4:32:01what does it matter how does it matter
4:32:03option you know the correct answer right
4:32:05so just mark it and assess yourself
4:32:11okay
4:32:13next question a 9-year-old patient
4:32:15present with a convex facial profile
4:32:18A&B angle of 6°. Now few people were
4:32:21saying one question was about 6°. So
4:32:23this is the question. The maxillary and
4:32:25mandibular anterior teeth are in
4:32:26edgetoedge relationship with each other.
4:32:29Which of the following appliances is
4:32:31most appropriate for correcting the
4:32:32anterior dental relationship.
4:32:35Now I think there's some question
4:32:37there's some error in this question or
4:32:39it has not been recalled properly or
4:32:41there has been mixture of two different
4:32:43question into one question. We are
4:32:45seeing here an edge to edge relationship
4:32:48of the incizers. Right? We are seeing H2
4:32:51relationship of the incizers and in
4:32:54angle of 6° means the patient has
4:32:57skeletal class two.
4:33:00Agreed? Okay. Now the skeletal class 2
4:33:04patient needs to be uh I mean the the
4:33:07treatment for skeletal class 2 patient
4:33:09we have to focus either on the magula or
4:33:11on the mandible. If the magula is at
4:33:14fault, the treatment protocol will be
4:33:16different. If the mandible is at fault,
4:33:18the treatment protocol will be
4:33:19different. Okay.
4:33:22Now, reverse pull headare and face mask
4:33:25are one and the same thing. It's not a
4:33:28class three. It is. So, this appliance
4:33:31is used for class 3 correction because
4:33:33of maxillary hypoplasia.
4:33:35Okay.
4:33:37Because of hyperlasia.
4:33:39Now if the question is saying patient
4:33:42has an X2 relationship
4:33:45but the patient has class 2 relationship
4:33:48class 2 sedital skeletal discrepancy
4:33:50there's only one option which can be
4:33:52done
4:33:54we have twin block appliance okay it was
4:33:58even if patient had crossbite
4:34:01once again if the question was like
4:34:03there's a posterior crossbite
4:34:06unilateral when the patient is opening
4:34:08the mouth there was a mild
4:34:09midline deviation. There was midline
4:34:11deviation.
4:34:13All right.
4:34:15Uh one second. There was anti- crossbite
4:34:17H2 in centric.
4:34:20Okay. Fine. Even if Okay. Fine. I'll
4:34:23frame one more question right now.
4:34:25Patient has an anterior crossbite.
4:34:30Okay. Now let's assume the A and B angle
4:34:34is -6°. Let's assume that - 6° means the
4:34:40mandible is forward or the maxul is
4:34:43back, maxul is hypoccastic. It's a 9
4:34:46years old patient. Ideal time to start
4:34:49with a it's an ideal time to start with
4:34:52a face mask therapy.
4:34:55And I told you both options face mask
4:34:57and reverse headare cannot be given
4:34:59simultaneously. So as I said earlier
4:35:02this question recall mistake I don't
4:35:06know exactly what were the options but
4:35:09for this question if you are saying the
4:35:11patient had antic crossbite the correct
4:35:14answer should be face mask
4:35:19is it clear and angle of minus 6° that
4:35:22is important
4:35:30Rohit is saying the question was like
4:35:32there's posterior crossbite and lateral
4:35:34when the patient is opening the mouth
4:35:35there was mild there was midline
4:35:37deviation when the patient is opening
4:35:39the mouth there there is deviation okay
4:35:44okay question may a b angle 2 or
4:35:49question six okay
4:35:52Okay. Okay. Okay. Okay. It was in this
4:35:54angle was 2° is having anti- crossbite
4:35:57appearance improve when he closes edge
4:35:59to edge. So only four ant uh tooth walls
4:36:02in crossbite. Okay fine jo
4:36:06whatever the case is whatever the cases
4:36:09I think this question is not recalled
4:36:11properly. Doesn't matter we have got
4:36:13different versions of the question
4:36:16depending on each student's recall
4:36:18capability.
4:36:20Right? So the point I'm making here so
4:36:22everything is taught in the in the in
4:36:25the in the course in the uh in the notes
4:36:28it's there. So this is the general
4:36:30indication for all my functional
4:36:32appliances contra indications. Then
4:36:35particularly talking about the twin
4:36:36block we have we have a separate section
4:36:38on twin block. We have talked about the
4:36:42physiological mode of action of twin
4:36:43block. Everything the anatomy the the
4:36:46architecture of this of the twin block
4:36:48everything is is given there. Okay,
4:36:52now this is a very interesting question.
4:36:55Weak masticatory muscles are commonly
4:36:57associated with which of the following
4:37:00facial types? Doicosyphalic,
4:37:02brachyphalic, misosipalic or
4:37:04endomorphic?
4:37:06Now I want all of you to answer this
4:37:08question. Please write down in the chat
4:37:10box whatever options you have, whatever
4:37:12answer you have marked in the in the
4:37:13exam you're studying.
4:37:16So this has been taught this has been
4:37:18taken at two places in the notes. One is
4:37:22essential diagnostic aids where we have
4:37:25talked about uh uh methods to assess the
4:37:28clinical Frankfurt mandipular brain
4:37:30angle. Based on that there are three
4:37:32patterns hyper divergent, hyper
4:37:36divergent and norm divergent. Okay. And
4:37:39also we have taken the same topic
4:37:43in the chapter on eeology of mal
4:37:45occlusion. Right? So we have talked
4:37:48about longface syndrome. So
4:37:52so I have also talked about the
4:37:56musculature pattern in long face
4:37:58syndrome in horizontal growth pattern.
4:38:00I've also talked about in vertically
4:38:03growing patients there is more degree of
4:38:05anchor loss because of weak musculature
4:38:07pattern.
4:38:08Now weak musculature
4:38:10happens because
4:38:13I'll draw one diagram here. We talking
4:38:16about the master muscle particularly. So
4:38:19you know the master muscle origin and
4:38:21insertion. You know that already right?
4:38:23So in horizontal growth pattern patients
4:38:26the mass muscle is more vertically
4:38:30oriented.
4:38:34I'm talking about
4:38:36horizontal growth pattern patients.
4:38:38Whereas in vertically growing patients,
4:38:41the master muscle fibers are more
4:38:44obliquely oriented. So the black colored
4:38:47fibers are for
4:38:51the black colored fibers are for
4:38:54vertically growing tissues.
4:38:56So it's basically the direction of
4:39:00muscle fibers which have a important
4:39:03role to play in how much force the
4:39:05muscle is going to generate how much
4:39:07occlusal force the muscle is going to
4:39:09generate. So based on different
4:39:12literature based on different uh
4:39:17evidence
4:39:18it is a doipalic patient the hyper
4:39:21divergent the longface patient which has
4:39:23got a weak musculature. Actually it
4:39:26should not be doipalic patient it should
4:39:29be leptoroo patient. Lepto
4:39:34prrooopic
4:39:35long and narrow face. It is consistent
4:39:37with doyphalic
4:39:39head grow that is a different thing but
4:39:41the correct option should have been
4:39:43leptoloic phase. Okay.
4:39:47A patient present with retroin maxillary
4:39:49central incizers and proclin maxillary
4:39:52lapro incizers. So this patient has got
4:39:55class 2 division 2 ml occlusion
4:39:57resulting in a deep bite. The patient is
4:40:00undergoing twin block therapy. What
4:40:02modification should be made to the plans
4:40:04to help reduce the deep bite?
4:40:06So we have talked about the mechanism of
4:40:09action of twin block. Okay. We have
4:40:12talked about the mechanism of action of
4:40:13twin block. See here there are three
4:40:16phases. Active phase, support phase and
4:40:19retention phase. It's a active phase. It
4:40:22is written here. See just look for
4:40:25yourself.
4:40:26The vertical dimension is controlled by
4:40:29adjusting or trimming the bite blocks
4:40:31once the record response has been
4:40:32attained clinically to allow for
4:40:35preferential lower molar eruption. In
4:40:38fact, this is the main philosophy behind
4:40:41the working of the appliance, right? We
4:40:44want the molers to erupt. We want the
4:40:46lower mers to erupt differentially. We
4:40:49want the lower mers to erupt
4:40:51differentially so that
4:40:55deep bite correct.
4:40:58So we have the occlusal bite blocks.
4:41:03These are the occlusal bite blocks right
4:41:05for the maxeline and the mandibular. So
4:41:07this is the
4:41:09lower mer. So what we do we sequentially
4:41:14trim off the occlusal bite block 1 mm by
4:41:171 mm. And that trimming of the occlusive
4:41:20bite block is going to allow the
4:41:23differential eruption of the lower mer.
4:41:26And that differential eruption of the
4:41:27lower mer is going to open up the deep
4:41:30bite anteriorly. It gets opened up
4:41:33because the mandible will rotate in a
4:41:35clockwise direction. Right? Because of
4:41:37wedging effect. So that's why
4:41:41that's why the correct answer will be
4:41:43option D to reduce the posterior bite
4:41:45block thickness.
4:41:50Doesn't matter if they haven't mentioned
4:41:52the masticator muscle. They have just
4:41:54mentioned the weak musc the mus the weak
4:41:56musculature. That's one and the same
4:41:58thing. They assume that you know that
4:42:00they talking about the masticator
4:42:01musculature.
4:42:02One option was to trim the acrylic on
4:42:04the occlusal surface of upper block
4:42:05opposing the lower mer. So this is
4:42:07exactly what I said. In fact, this is
4:42:10how the twin block actually works. We
4:42:13have to trim the occlusal surface of the
4:42:15upper block opposing the lower mers.
4:42:18That is how the twin block works. Right?
4:42:22Okay. Next, it's a numerical based
4:42:25question NBQ. You have to calculate the
4:42:28magnitude of moment from the clinical
4:42:30scenario. So this was the figure given.
4:42:34Let's assume it was a central incizer. I
4:42:36don't know which tooth that was. So the
4:42:38force acting at the bracket is 50 g. The
4:42:41center of resistance and the point of
4:42:44force application distance is 10 mm. You
4:42:47are supposed to calculate the moment. So
4:42:49moment is what? Force into perpendicular
4:42:53distance, right?
4:42:5550 g into 10 mm that will be 500 g mm.
4:43:02Now moment is a vector quantity. Vector
4:43:04quantity means it cont it consists of
4:43:07magnitude and direction both. Right? So
4:43:10here nothing is given about direction.
4:43:12So this tooth is going to rotate in a
4:43:14clockwise direction. So the correct
4:43:18method of representing the moment it is
4:43:22500 g mm
4:43:26clockwise.
4:43:28Okay. See here we have talked about
4:43:30moment in the chapter on bio in the
4:43:33chapter on biomechanics of tooth moment.
4:43:35Moment is force into perpendicular
4:43:38distance from the point of force
4:43:40application to the center of resistance.
4:43:42See it's written here. So this is the
4:43:45example I've given with a diagram in the
4:43:47notes. This is the this is exactly what
4:43:50is happening right. Force is 50 g
4:43:53distance is 10 mm. So what is the moment
4:43:56force into distance?
4:43:59It is written here. See exactly example
4:44:02example
4:44:04force 50 g distance 10 mm moment will be
4:44:07500 g mm clockwise. This is this was the
4:44:10exact question which was asked in the in
4:44:12the exam.
4:44:16The question asked for treatment of deep
4:44:19bite. Okay. All right. Now a patient
4:44:23presents with maxis entrance in sizes
4:44:25rotated by 90° which is corrected using
4:44:27fixed oric appliances at the time of
4:44:30debonding. Which procedure
4:44:33should be performed to minimize the
4:44:35chances of or of rotational relapse?
4:44:38Again
4:44:39the hint is already given in the
4:44:41question.
4:44:42So that so that the the tooth is
4:44:44rotated. We have corrected the rotation.
4:44:46Now we want to minimize the relapse.
4:44:49What are the options? CSF, Prectomy,
4:44:52gingivvectomy and interroximal reduction
4:44:54and always retainer for 6 months. So we
4:44:57have talked about CSF in the chapter on
4:44:58minor surgical procedure. Right?
4:45:02Right. So
4:45:05I have also written here it is
4:45:06specifically used for retention of the
4:45:09rotated teeth. Once you have corrected
4:45:12the rotated teeth, you're going to
4:45:14you're going to uh circumferentially
4:45:17move the B park barker knife gingally I
4:45:21mean uh through the gingavic reise and
4:45:24section the gingaval fibers. So that is
4:45:27going to minimize the relapse.
4:45:30Okay, that is specifically used the CSF
4:45:33is specifically used for retention of
4:45:36rotated teeth. So, it's a no-brainer.
4:45:39Option A is the correct answer.
4:45:42Clear?
4:45:44Now, this was an application based
4:45:46question on the chapter on serial
4:45:48extractions. A patient aged 8.5 years
4:45:52had her decid primary canine extracted
4:45:5412 months ago. So, desidus primary
4:45:57canine is C. The underlying preolar's
4:45:59root is half completed. So, we are
4:46:03talking about the first preolar. We are
4:46:04assuming about the first preolar and
4:46:07anteriors are in good alignment. What
4:46:09should be the next step? Extract the
4:46:12underlying preolar. Extract the primary
4:46:14second mer. Extract the primary first
4:46:16mer or start fixed orthonoric treatment.
4:46:20So what do you think should be the
4:46:21answer? Let's take a look at the
4:46:23sequence of serial extraction given by
4:46:26dual.
4:46:28So C followed by D followed by four.
4:46:33Right? So the first so the decid canines
4:46:37are removed between ages 8 and 9 years
4:46:40of age that is consistent with what is
4:46:42given in the question the patient ages
4:46:448.5 years and had her ex had her primary
4:46:47canine extracted so she is gone for good
4:46:50right now what do you after that the
4:46:53first decid mers are removed
4:46:55approximately 12 months after the
4:46:57desidus can that is around 9 to 10 years
4:46:59of age followed by extraction of the
4:47:02followed by extraction of the first
4:47:03premoner. So C D and four. So this is an
4:47:07application based question on the
4:47:08sequence of events by dual method. So
4:47:12what should be the correct answer? It is
4:47:15extraction of the primary first mer C
4:47:18followed by D followed by four.
4:47:23Okay.
4:47:28So that's all for the orthonorics part.
4:47:32Do we have any question?
4:47:37So as I said earlier, so this recall is
4:47:39based on memory actually. We cannot know
4:47:42for sure exactly. We cannot know for
4:47:44sure exactly what was the exact language
4:47:47asked in the question asked in the exam.
4:47:50We can simply assume and we can create
4:47:52the questions and the related options
4:47:54according to that.
4:47:57In question number 21, the patient was a
4:47:59child. Will we still go with CSF? Okay,
4:48:02one second. Question number 21. If the
4:48:05patient was a child, will we still go
4:48:07for CSF? Yeah. So, what's wrong in that?
4:48:10CSF is is is is not a very invasive
4:48:14procedure, right? We are doing something
4:48:16for the betterment of the patient. We
4:48:17are reducing the amount of we are
4:48:19reducing the duration of
4:48:22retention to be used later on, right? We
4:48:25are reducing the ret the duration of
4:48:26retention. So that is good in the long
4:48:29run for the child. The age does not
4:48:32matter. In fact, retention.
4:48:37Okay.
4:48:4011th question. Okay. Let me scroll back.
4:48:4311th question.
4:48:4611th question.
4:48:49Yeah. So, what is the doubt here?
4:48:52Dental pearls 29. What is the doubt
4:48:55here? Identify the plants from the
4:48:57image.
4:48:59This is a straightforward question,
4:49:00right? See, why is it not appendex? Why
4:49:04is it not appendex? Because there is no
4:49:06jack screw in the nance battle button.
4:49:08It is simply a pendulum plans. We have
4:49:11got TMS springs that's going to dislice
4:49:13the mers, right? That's going to dislice
4:49:16the mer.
4:49:18Okay, simple. It's a pendulum plans.
4:49:22Intermittent and interrupted, please. So
4:49:25I so I am going little short of time
4:49:28here. Other faculty members are already
4:49:30waiting. So if you want a detailed
4:49:33understanding about intermittent and
4:49:34interrupted forces, we can have that in
4:49:36the in the doubt clearing session
4:49:38somewhere. Okay. Nasol angle an shinoi.
4:49:43What are you saying? Nasol angle is 90
4:49:45to 110.
4:49:47I am confused in appendex. I told you
4:49:49know it is not appendex because appendex
4:49:53you have to have a jack screw here.
4:49:57I showed you the image right? This is
4:49:59the image of the pendex appliance. This
4:50:02is the appendex.
4:50:04You can see here there is a provision of
4:50:06transverse expansion by incorporation of
4:50:09a midline jack screw which is not there
4:50:12in the in the in the image given in the
4:50:14question. So that's why that is that's
4:50:17why that is simply a pendulum appliance.
4:50:22Okay.
4:50:24All right. So do we have any other
4:50:26doubt? Do we have any other question?
4:50:28Can you please tell me that body of
4:50:30ramas which part shows V principle? It
4:50:33is a ramis of the mandible which shows V
4:50:35principle.
4:50:37It's a ramis of the mandible which shows
4:50:38V principle. Ankit Sharma. Akshit
4:50:40Sharma. Sorry. It's a ramis of the
4:50:42mandible. All right. Any other doubts
4:50:45guys? Dr. Himmani and Dr. Ashwaria both
4:50:47are waiting. So I will hand over the
4:50:51control to them and I will wrap up my
4:50:55session. Again if you have any doubt you
4:50:58know where to find me. You can tag me on
4:51:00the telegram group and I will take up
4:51:03all doubts personally but I want proper
4:51:06tags in the telegram group. Thank you so
4:51:09much. All the best and Dr. Himmani over
4:51:13to you.
4:51:13>> Thank you. Thank you Dr. Kunal. Thank
4:51:15you for that wonderful recall and good
4:51:18evening dear friends. Good evening
4:51:19Bacho. Uh welcome to the oral surgery. I
4:51:24will just
4:51:36right. I hope I am visible and audible.
4:51:43Just give me a second. I will just turn
4:51:44on my screen.
4:51:53Can you all see my screen? Yes.
4:51:57Just um you can answer me on YouTube. Is
4:52:00my screen visible to all of you?
4:52:09Is my screen visible to all of you? So
4:52:12only when you say yes, I will be able to
4:52:14proceed.
4:52:18Okay. Amit Bharti is saying yes. All
4:52:20right. Can you see the whole screen
4:52:23properly because I'm taking the session
4:52:25from outside of my studio. Yes. Can you
4:52:29see the first question? All right. Thank
4:52:30you. Thank you for your answer. Amit,
4:52:33Dental Pearls, Nidhin, Arian and
4:52:35Aayushi. Aushi can't see the screen, but
4:52:38everybody else can. So, studio please
4:52:42confirm if my screen is visible
4:52:43properly.
4:52:46Yes.
4:52:58Yes. Some of you are saying no. Some of
4:53:00you are saying yes.
4:53:03So, let me just rearrange my screen for
4:53:07one second.
4:53:14Yes. Is it okay now?
4:53:17Only your video is coming, not my PPT.
4:53:20Okay. My PPT is not coming. So, what we
4:53:23will do is we will
4:53:31Okay, studio. I need help because my PPT
4:53:34is not visible to students.
4:53:45Okay, I think I have not shared my
4:53:47screen. All right. Okay.
4:53:51Okay. Can you all see my screen now?
4:53:55Is my screen visible?
4:54:00Yes, I mean my I mean I am visible but
4:54:04is also the PPT visible
4:54:08everybody.
4:54:11Is my PPT visible
4:54:15now?
4:54:21Yes. Okay. Can you all see question
4:54:23number one in standardly 41 osteotomy?
4:54:26It's blank.
4:54:31But it's black. Okay.
4:54:36Why should it be black?
4:54:41Your screen sharing is paused.
4:54:48Okay. Just give me some few seconds.
5:23:22Virtual
5:23:30camera.
5:24:36Okay.
5:24:38All right. Um
5:24:41AB I hope it is visible and audible and
5:24:44clear.
5:24:46This is there is something with doctors
5:24:49that they are very gadget gavar and I'm
5:24:51the biggest example of that. So I'm very
5:24:54sorry to keep you all waiting. Just tell
5:24:56me a yes. There are very few students
5:24:58now. But uh just let me know if you can
5:25:01see my screen.
5:25:07Am I audible and visible?
5:25:11Yes. No audio. Can you all hear me now?
5:25:15Audible. All right. Okay. Okay. So, you
5:25:18can all call in your friends. You can
5:25:20all let them know that we have restarted
5:25:21with the session. And let us begin with
5:25:24the neat MDS oral surgery recall.
5:25:32Yeah.
5:25:34Okay. So is this is this screen visible?
5:25:37I think it is visible now. All right.
5:25:40Okay. All right. Okay. So let us begin
5:25:43with the recall of the first question.
5:25:45The question says that in standard
5:25:50leotford one osteotomy which of these
5:25:53bones is not involved. All right. So the
5:25:56two key words here are the standard. So
5:25:59we all know that if this is the skull,
5:26:03this is the pyroform. This is the oral
5:26:06cavity. This is your conventional
5:26:09leaffort surgery or a standard leapot
5:26:11one surgery. This is a highly photo one
5:26:15surgery and when we say high we go
5:26:17slightly higher. Okay. What is involved?
5:26:20We all know anterior wall of maguline.
5:26:22By the way, this is straightforward from
5:26:24our notes. Okay. What is involved? We
5:26:26cut the anterior wall of magilla. We cut
5:26:29the natural nasal wall and we cut the
5:26:31nasal septum. Then at the end we go to
5:26:34the tergoid region. Right? Now all these
5:26:37three options
5:26:40even if you don't know the answer.
5:26:41Right? All these three options are the
5:26:44same anatomy.
5:26:46What is perpendicular plate of ethmoid
5:26:48bone? It is the superior part of the
5:26:50nasal septum. What is vulmer? It is the
5:26:53inferior part of the nasal septum. And
5:26:55what is nasal septum? Nasal septum is
5:26:57the nasal septum. Right? So what is
5:26:59nasal septum made up of? Superiorly, it
5:27:01is made of the perpendicular plate of
5:27:02itmoid bone. Inferiorly, it is made of
5:27:04the vulmer bone. Right? So when we do a
5:27:07septal osteotomy or the nasal septum
5:27:09osteotomy we are basically separating
5:27:12the nasal septum from the rest of the
5:27:14maxilla. In no case the zygoma body is
5:27:19involved. Right? We cut the base of
5:27:21zygoma but not the body of zygoma. And
5:27:23that is the correct answer. The zygoma
5:27:26body. Okay. Coming to question number
5:27:29two.
5:27:31Which of these is the best time to
5:27:33perform secondary alvular bone grafting?
5:27:35Again, directly from our notes. For some
5:27:38reason, this is blurred and I can't show
5:27:41you the exact lines. But exactly, we
5:27:44have told you how you have to do it
5:27:45after expansion of maxilla and before
5:27:49eruption of kine. We have also taught
5:27:50you that sometimes the orthodontist
5:27:53after we have done the expansion after
5:27:55they have done the arch alignment when
5:27:57the surgeon is doing the alvaro bone
5:27:59grafting at that time when the surgeon
5:28:01is putting the bone graft and he can see
5:28:02the canine the orthonorist comes in and
5:28:05puts his bracket on the canine and takes
5:28:07that wire out into the mouth. So
5:28:09whenever you want to take like whenever
5:28:10the bone is formed then he can just use
5:28:12the wire and pull the canine out. Right?
5:28:15So you can wait for passive eruption of
5:28:17canine or you can do an orthodontic
5:28:19eruption of canine also by fixing a
5:28:22bracket during the secondary alvolar
5:28:23bone grafting. So the correct answer is
5:28:25maxillary expansion after expansion and
5:28:28before the eruption of canine
5:28:30by the way it is a absolute pq. All
5:28:33right this is a pq.
5:28:35Okay. Which of these solutions is used
5:28:38in arthroynthesis because it resembles
5:28:40closely to the chemistry of body fluids.
5:28:42Again direct pick arthroentis done with
5:28:47ringers lactate MCQ ionic right this is
5:28:51blurred for some reason but you can go
5:28:53back to your notes and check where we
5:28:54have exactly taught you that
5:28:56arthroynthesis initially they have tried
5:28:59with multiple things they have tried
5:29:00with ibuprofen solution metronidel
5:29:03solution and lot of things but now
5:29:04finally we know that RL is the best
5:29:07solution how much RL 200 to 300 ml of
5:29:10ringers lacted solution is used I'm I'm
5:29:12sure all of you have marked it correct
5:29:14here. Damun Hershit uh Damun and all of
5:29:17all of you right okay we have also shown
5:29:20you in the class how we do arthroynentis
5:29:23in the holmmon hiling line which is also
5:29:26known as a canthotraal line where we put
5:29:28two needles from one needle we put the
5:29:31fluid from the other needle the fluid
5:29:33comes out the fluid that we use is
5:29:35ringinglected solution um the nerve
5:29:38block that we give here is the oriculo
5:29:41temporal nerve block
5:29:44right uh we always do it under
5:29:47anesthesia I've also shown you cases
5:29:48from the clinic and this is how you do
5:29:50the arthosentthesis
5:29:53okay now this was the only tricky
5:29:56question in oral surgery um a patient is
5:29:59planned for surgery for internal
5:30:01derangement of TM joint due to
5:30:03anteriorly displaced disc not aminable
5:30:07to non-invasive therapy so we know that
5:30:09whenever there's an internal derangement
5:30:11and we are not able able to treat it
5:30:13non-surgically by arthosentesis and all
5:30:16of that.
5:30:18We do an open joint surgery. All right.
5:30:20What do we do? We give a preoricular
5:30:22incision. We clean the joint. We hold
5:30:25the disc which is anteriorly displaced.
5:30:27We pull the disc back and we fix the
5:30:29disc with a wire with a mcch anchor or
5:30:31with something of the screw. Right? Now
5:30:34the question is asking
5:30:37which of these investigations
5:30:39is done before surgery? What is sure is
5:30:43a bilateral TMJ MRI dynamic. What is
5:30:46dynamic? Dynamic is open and closed
5:30:49mouth.
5:30:51Normally we do the closed mouth view
5:30:53first. Okay? And then we ask the patient
5:30:55to open the mouth as much as the patient
5:30:57is able to open and we see whether the
5:31:00disc which is stuck in the closed mouth
5:31:02view is it reducing or not in the open
5:31:06mouth view. Right? We have discussed
5:31:07this in our class also that we always do
5:31:10a bilateral MRI even if the problem is
5:31:13on one side we always do it bilaterally
5:31:15to correlate the normal or the with the
5:31:17abnormal side right that is the dynamic
5:31:19what is dynamic open and closed both so
5:31:22definitely we do a MRI the next closest
5:31:25option that we feel and also after
5:31:28discussion with a lot of seniors is CBCT
5:31:32of TMJ all right so be happy and
5:31:35everybody those who have marked
5:31:37one and two. The most probable correct
5:31:39answer is 1 and two that is definitely
5:31:43MRI and CBCT. Okay. The other options of
5:31:47ultrasound and none scan. So ultrasound
5:31:50sometimes people do ultrasound when they
5:31:52are doing a guided guided arthroynthesis
5:31:57or even a guided arthroscopy. So
5:31:59sometimes unlike Indians you know
5:32:01usually Indian surgeons what they do
5:32:03they do a blind arthroysis all of us
5:32:05even I do a blind arthroenteris that
5:32:07means I put a local anesthesia on the
5:32:09joint I put two needles I wash the joint
5:32:12by palpating the landmarks in other
5:32:15countries they put up ultrasound probe
5:32:16and then they see where the needle is
5:32:18growing so they're going so they do a
5:32:20guided arthosynthesis that is the
5:32:22purpose of ultrasound is ultrasound
5:32:24useful when you've already done an MRI
5:32:26and when you're going to surgery No,
5:32:28ultrasound is not useful there. It'll
5:32:30only give you a glimpse of the
5:32:31superficial things over the joint.
5:32:34Right? So, ultrasound is definitely
5:32:35wrong. The confusing option here is bone
5:32:38scan. Okay. Why do we do a technium 99
5:32:40MTP scan? This is a nuclear medicine
5:32:42scan. Right? We do this nuclear medicine
5:32:45scan whenever we want to see growth or
5:32:49metabolic activity.
5:32:52Whenever we have to see growth or
5:32:54metabolic activity, we do the technician
5:32:5799 MDP scan. Okay, this is usually done
5:33:00in cases of condiler hypertrophy or
5:33:04idiopathic condiler resorption. Whenever
5:33:06there's an abnonormal
5:33:08uh metabolic activity going on in the
5:33:10condile of mandible, we do a technium 99
5:33:14mdp scan. Right? So usually we don't do
5:33:17this before simple disc displacement
5:33:19surgeries. So the best option that comes
5:33:21out is one and two MRI and CBCT. All
5:33:24right, I am still uh I haven't still
5:33:27found a textbook source. Let me read it.
5:33:30Let me give me some more time. I will
5:33:31read it. Find a textbook source and then
5:33:33when we put these questions into our
5:33:35app, we will give it with reference from
5:33:37a textbook source. This is the answer
5:33:39that we feel is the best. And after
5:33:40discussion with the the faculties, lot
5:33:44of senior faculties, we have gotten into
5:33:46this answer. All right. So the best
5:33:47answer should be one and two. Okay, how
5:33:50many have got it correct? Okay, Prem
5:33:52Shanka has chosen the option A and Prem
5:33:54Shankar looks like you are correct.
5:33:56Okay,
5:33:58this is straightforward. A patient is
5:34:00clicking during opening and closing. So
5:34:02opening and closing click nowhere there
5:34:04is mention of pain. Okay, pain is not
5:34:07mentioned. Right? With intermittent
5:34:10catching of disk which releases upon
5:34:13maximum mouth opening that means pain is
5:34:15not there. mouth opening is not affected
5:34:19and uh the catching is there
5:34:21intermittent catching is there but it is
5:34:23relieved. So definitely it is Wilky's
5:34:27stage two internal derangement and we
5:34:29all know stage one and stage two are a
5:34:31part of disk displacement with
5:34:34reduction. That is the correct answer.
5:34:35Again straightforward from our notes we
5:34:38have also taught it in the live class. I
5:34:39don't know why somehow this this is hazy
5:34:41but we have taught you that stage one
5:34:43and two are with reduction. Stage three,
5:34:46four and five are without reduction.
5:34:50Right? So this is ID with and without
5:34:51reduction. And very clearly we can see
5:34:53in two there is occasional painful
5:34:56clicking, intermittent locking and
5:34:59headaches along with painless clicking.
5:35:01So it is somewhere between clicking and
5:35:05intermittent locking. So it has reached
5:35:07somewhere between stage one and two. It
5:35:09is not that the patient is unable to
5:35:11open the mouth. The primary thing which
5:35:13differentiates between with reduction
5:35:15and without reduction is decreased mouth
5:35:18opening. Decreased mouth opening is what
5:35:21you will see in cases with reduction. If
5:35:23the patient is not able to open the
5:35:26mouth fully then it is with reduction.
5:35:28But here the question very clearly
5:35:30mentions that the catching releases upon
5:35:33maximum mouth opening. Right? So there
5:35:35is no restriction mouth opening. This is
5:35:37definitely ID with reduction. And all of
5:35:40you are correct here. Sorab damana
5:35:45you're all correct. Okay. Again a direct
5:35:49pick from the notes. A 14-year-old child
5:35:51was operated with a right
5:35:54side TMJ ankylosis with arthrectomy.
5:35:57What is arthrectomy? Arthtomy is nothing
5:35:58but gap arthroplasty and costtochondal
5:36:01grafting. Now we all know that the only
5:36:04problem only long-term side effect of
5:36:07costal chronal graft is overgrowth. Can
5:36:10this overgrowth happen in one
5:36:13week? No. Can it happen in one month?
5:36:16No. Can it happen in one year?
5:36:18Definitely when the costal graft adapts
5:36:20to the site and when it starts growing
5:36:22just like the normal site the growth is
5:36:25unpredictable.
5:36:26The problem with CCG is unpredictable
5:36:29growth. It may grow equal to the normal
5:36:32side. It may grow less than the normal
5:36:34side or it may grow more than the normal
5:36:37side which is the case in this question.
5:36:402 years later good amount of time he
5:36:42presents with facial asymmetry with
5:36:44progressive deviation to the left side.
5:36:47Now the deviation instead of anky losses
5:36:50if it is on the right side deviation
5:36:51should be on the right side but after
5:36:53surgery deviation is on the left side.
5:36:55Why? Because that costtoondal graft is
5:36:57overgrowing as compared to the normal
5:36:59side. Right? So what does he need? The
5:37:02diagnosis. What is the diagnosis?
5:37:03Diagnosis is CCG overgrowth. Right? And
5:37:08at this point of time what is the age of
5:37:10the child? From 14 years the age of the
5:37:12child is 16 years.
5:37:15So at 16 years when the growth is not
5:37:17yet completed the pubertal spurt is
5:37:19still going on will you do a surgery for
5:37:22facial asymmetry? No. Will you do an
5:37:24asymmetric BSSO surgery? No. Will you do
5:37:27orthogonatic surgery? So again you can
5:37:29rule this out because all the options A,
5:37:32B and D. They are all orthogonatic
5:37:34surgeries. This is orthogonatic surgery.
5:37:36This is orthogonatic surgery and this is
5:37:38orthogonatic surgery. Will you do
5:37:39orthonatic surgery at this point when
5:37:41the child is still growing and there is
5:37:43a progressive
5:37:45deviation means still the deviation is
5:37:47continuing and worsening. So no the
5:37:50answer is high condiler shave or also
5:37:53known as high condilectomy.
5:37:56What you will do is the costtochondal
5:37:58graft which has now become a new condile
5:38:00you will remove the top head of the
5:38:02costtoondal graft and
5:38:05[snorts] remove the growth site on that
5:38:07side. So assuming or hoping that now the
5:38:10growth should be equal automatically it
5:38:13will remodel and the asymmetry will
5:38:15correct itself. Right? So we have done
5:38:17this. This is again from our notes. I've
5:38:19also shown you a case. This is a picture
5:38:21of the nodes and this is a picture of
5:38:23the case and I've shown you how to
5:38:24harvest the CCG. Which rib is taken for
5:38:27CCG. Okay. How do you insert a CCG with
5:38:30the submandibular incision? How it looks
5:38:32on the X-ray. And this is the overgrowth
5:38:35of CCG which is resected. This was one
5:38:38of the cases from MAC which I had shown
5:38:39you that how in a child we had a CCG
5:38:41overgrowth and we removed that extra
5:38:43condile. So here we have done a absolute
5:38:45condilectomy. We could also do a high
5:38:47condor shape that means remove only this
5:38:49much part of the condile but maybe this
5:38:51child has already achieved growth. So we
5:38:53have removed the a part of the condile
5:38:55which is excessively enlarged. So you
5:38:57can do a high condilectomy or you can do
5:38:59a full condilectomy depending on what
5:39:02you want to remove. Right? So this is
5:39:03the treatment. Again from our notes I'm
5:39:05very happy most of you have marked it
5:39:07correctly and you will get full marks
5:39:10for this. Okay again this was a tricky
5:39:13question but if you have used your
5:39:14little bit of uh presence of mind or
5:39:17logic maybe you will be able to answer
5:39:19this. The two key words in this question
5:39:21are an elderly patient. Okay. Whenever
5:39:25you hear the word elderly or old or
5:39:28atrophic or geriatric, you know the
5:39:31thing that should come to your mind is
5:39:33avoid surgery. [snorts] Whenever you
5:39:35heard the word elderly. Okay. Now what
5:39:37does he have? He presents with recurrent
5:39:41selfreducing
5:39:43dislocations of TMJ. Now these are the
5:39:45two key words that you had to pick up in
5:39:47the exam. Elderly and self-reducing.
5:39:50That means yes he has a problem but he's
5:39:53able to solve that problem on his own
5:39:55also right which of these should be the
5:39:58strategy for management here. Will you
5:40:01go for dory procedure which is a surgery
5:40:03where you fracture the zygomatic arch
5:40:06and put it in front of the condile? No.
5:40:08Will you do an amintomy which is again a
5:40:11surgery where you remove the eminence
5:40:12and allow the condile to become
5:40:14self-reducing? No. It is already
5:40:16self-reducing.
5:40:18Will you do a capsule which is again a
5:40:20surgery to tighten the capsule around
5:40:23the joint but it'll need an incision?
5:40:26No, you will avoid surgery. And the only
5:40:28procedure which avoids surgery is
5:40:32prolo therapy.
5:40:35We have learned about prolotherapy in
5:40:37our notes. This is a screenshot of our
5:40:39notes and I have told you prolotherapy
5:40:41is also proliferative therapy which is
5:40:45where we inject an irritating solution
5:40:48like 25% or 50% dextrose or autologus
5:40:54blood. It is injected around the joint
5:40:57in the peradicular area pericular area
5:41:01so that fibrosis occurs. So what it will
5:41:04h it will do when you inject that
5:41:07autologus blood autologus same just as
5:41:09you take the patient's blood sample
5:41:11similarly the surgeon will take some
5:41:12blood from the vein and inject it around
5:41:15the joint what it will do it will
5:41:17probably induce fibrosis in that region
5:41:20and that fibrosis will cause the
5:41:23recurrent dislocations to probably get
5:41:25better with time right so that is the
5:41:28treatment prolotherapy and we do it with
5:41:30either dextrose or autologus blood and
5:41:34that is the answer. Prem shanker, you
5:41:36are absolutely correct. Your answer is
5:41:38correct. So, we will use autologus blood
5:41:39injection here.
5:41:42Okay, which of these is correct? Now,
5:41:43this is not a straightforward question.
5:41:45It's a combination of multiple clinical
5:41:47features of condila fractures. And
5:41:50again, it is like I have taught you how
5:41:53to decide which side the chin will go.
5:41:55There's a very nice video which is there
5:41:57on our YouTube channel where I have
5:41:58taught you that you know how to decide
5:42:00chin deviation will happen to which
5:42:01side. Okay. Now imagine this is the
5:42:04mandible. Okay. This side condile is
5:42:07fractured. So when the patient is trying
5:42:09to open the mouth, this condile will
5:42:12work. This condile will not work because
5:42:14of the fracture. Right? So when this
5:42:16condile will work, it will push the chin
5:42:19to the affected side. Right? So
5:42:22unilateral condile fracture will cause
5:42:24deviation of chin to the ipsilateral
5:42:28side or the affected side not the
5:42:31unaffected side. Right? So this option
5:42:34is wrong. Whenever there's a unilateral
5:42:36condile fracture the other condile will
5:42:39move normally and it'll push to the
5:42:41opposite side. So deviation will happen
5:42:43to the same side as fracture. So
5:42:45affected side also known as the
5:42:47ipsilateral side. So option one becomes
5:42:49wrong. Bilateral condile fracture will
5:42:51cause anterior open bite. Absolutely
5:42:53correct. What happens is when there is a
5:42:55bilateral condile fracture, this is also
5:42:57not moving. This is also not moving. And
5:43:00the molers in this region will gag.
5:43:04There will be a gagging of posterior
5:43:06occlusion. Gagging of posterior
5:43:09occlusion. That means normally our teeth
5:43:12will meet like these. Posterior teeth
5:43:15and anterior teeth will meet together.
5:43:18Okay. But in condala fracture what
5:43:20happens is posterior teeth meet before
5:43:22the anterior teeth. So what happens
5:43:25anterior open bite right? This is
5:43:28exactly what happens in bilateral
5:43:29condala fracture. There is posterior
5:43:31teeth contact which happens before the
5:43:33anterior teeth contact and that causes a
5:43:36gagging of occlusion and anterior open
5:43:38bite. Right? So this is just a clinical
5:43:41feature which is asked and this is
5:43:43absolutely correct. The third option is
5:43:45inferior alvular nerve damage may happen
5:43:48if the fracture line passes through the
5:43:50inferior alvular canal. Obviously this
5:43:52is correct because here is the inferior
5:43:55alvar the mandibular foramin and from
5:43:58here the inferior alvular nerve enters
5:44:00the mandible. Okay it runs throughout
5:44:02the body of mandible till it comes out
5:44:03from the mental forin bilaterally. So if
5:44:06there is a fracture which happens say
5:44:08like this in the body or in the angle
5:44:11region and it involves the inferior alo
5:44:14canal it can cause a paristhesia of the
5:44:17inferior alvola nerve. So option two is
5:44:20absolutely correct right sorry option
5:44:22three is absolutely correct. The last
5:44:24option is any tooth in the line of
5:44:28fracture needs extraction. This is
5:44:31wrong. We always avoid extractions.
5:44:36We always avoid extractions. Rather in
5:44:39the notes we have given you very clearly
5:44:41what are the indications of extraction
5:44:44of a tooth in the line of fire. What is
5:44:46line of fire? Line of fracture. Will you
5:44:49remove every tooth that is involved in
5:44:50the fracture? Obviously not. Rather that
5:44:53tooth is helping me to reduce the
5:44:55fracture. I will never remove that
5:44:57tooth. Only if the tooth has gross
5:44:59abscess. it is nonfunctional like a
5:45:02third mer or it is inhibiting a proper
5:45:05reduction of the fractures only then I
5:45:07will remove the tooth otherwise I will
5:45:09not remove the tooth right so the
5:45:11correct answer to this question becomes
5:45:13option C which is two and three option
5:45:16one and option four are wrong okay I
5:45:18don't know how many of you have done it
5:45:19correctly but yes a lot of you bra shank
5:45:21and dam you are saying um
5:45:26key um you have marked C which is
5:45:29absolutely correct
5:45:31is telling us that she has seen a lot of
5:45:34videos of free revision and old paper
5:45:39analysis and free mock test 100
5:45:42questions say all right thank you for
5:45:44that uh feedback we're very happy to
5:45:47help everybody and it's glad I'm glad
5:45:50that it has helped you okay quickly
5:45:52coming to the next question which of
5:45:53these is a reliable marker of CSF rhoria
5:45:56again absolute direct lines from our
5:45:59notes the Answer is TOAO protein also
5:46:02known as beta2 transfer. Now this is one
5:46:05PQ which has been asked hundreds of
5:46:07times before and not literally but it
5:46:09has been asked so many times. Sometimes
5:46:11they will ask you beta 1 transferin,
5:46:13beta 2 transferin. Sometimes they will
5:46:15ask you glucose protein, beta 2
5:46:16transferin. Sometimes they will ask you
5:46:18to protein like last neat they ask to
5:46:21protein. Tao protein is another name of
5:46:23beta2 transferin. Same question just the
5:46:26names are twisted options are twisted in
5:46:28same question they are asking in
5:46:29different different format so again
5:46:31direct pick from our notes and I don't
5:46:34know why it is getting blurred but you
5:46:35can go to page number 134 and read that
5:46:40we have told you exactly CSF rhoria
5:46:42happens when there is an anterior
5:46:44cranial fossa fracture CSF autoia
5:46:46happens when there's a middle cranial
5:46:48fosa or tegman tempanany fracture
5:46:51and this is the MCQ where we taught you
5:46:54that it will cause beta2 transferin is
5:46:57the biochemistry test which will exactly
5:47:00tell you that whether it is nasal
5:47:02secretion which is also clear versus CSF
5:47:07which is also clear but CSF has more
5:47:09protein as compared to nasal secretion
5:47:11but is that the best criteria to check
5:47:13no the best criteria to check is check
5:47:15with beta 2 transfer right so it's a PQ
5:47:18and I'm sure all of you have done it
5:47:20correctly
5:47:24Okay, classify the type of noi fracture.
5:47:26Again, a direct pick from the notes and
5:47:28I'm sure most of you have done it
5:47:30correctly. It's a type two fracture.
5:47:32Okay, we have seen that when there is a
5:47:34single segment fracture, one segment
5:47:37fracture, we call it class one. Okay.
5:47:40When the commulated fracture,
5:47:43we call it class 2 or class 3. What is
5:47:45the difference between class 2 and class
5:47:473? In class two, the medial canthal
5:47:50tendon is still attached to a large
5:47:52segment of bone. In class three, the
5:47:55medial canthal tendon is detached. Okay.
5:47:59So this is the difference between class
5:48:001, class 2 and class 3. There is no
5:48:02class 4 in noi fracture. And this very
5:48:04clearly you can see that it is not a
5:48:07simple fracture. It is definitely a
5:48:09communated fracture. You can see
5:48:10multiple segments of bone that are
5:48:12fractured. But the MCT this is the MCT
5:48:15this white part this MCT is still
5:48:17attached to a large segment of bone. So
5:48:20clearly it becomes a noi type two
5:48:22fracture. Okay I hope there is no doubt
5:48:26here again I am telling you if it's a
5:48:28single segment fracture type one
5:48:30communed fracture but MCT attached type
5:48:34two multiple segment or a communed
5:48:36fracture with MCT detached very clearly
5:48:39you can see here that the MCT is
5:48:40detached. What is MCT? MCT is medial
5:48:44canal tendon. Right? So where I our
5:48:49palpibbra is connected to the bony orbit
5:48:52by the medial canal tendon and the
5:48:54lateral canal tendon. Right? Behind that
5:48:57you have the globe and everything else.
5:48:59So MCT detachment will cause a lot of
5:49:01problems. It'll cause rounding of the
5:49:03inner corner. It'll cause traumatic
5:49:04teleanthus. Bow string test will be
5:49:06positive. And we have learned about all
5:49:08this in our videos. Right? So uh this is
5:49:11the uh learning and I'm sure most of you
5:49:14have marked it correctly. Next question
5:49:17again direct pick from notes direct P
5:49:19byq post trauma situation crack pot
5:49:22sound on percussion of the first mer is
5:49:25a typical finding of fetch fracture we
5:49:27all know it is leaf for one fracture
5:49:29open page I don't know the page but uh
5:49:34cracked pot sound mal occlusion open
5:49:37bite cracked port sound typical of leaf
5:49:40for one or guarin fracture all right so
5:49:43this is direct from our notes there's
5:49:45Nothing to explain here. It's a typical
5:49:47clinical fret feature. Apart from that,
5:49:49we also have the guarin sign which is u
5:49:52echimosis in the greater palatine
5:49:55foramin region. Right? So that is
5:49:57another sign you have in leafoot one
5:50:00fractures and crackpot sound is another
5:50:02typical feature of a leaffort one
5:50:04fracture. Very good. Yes. Uh Astana,
5:50:08you're correct. Okay. Now this was a
5:50:10slightly tricky question just because of
5:50:12the fact that they have mixed two
5:50:14things. Geometric plates. What are
5:50:17geometric plates? Geometric plates are
5:50:19nothing but 3D plates. Okay, we have
5:50:21taught you that how many plates have
5:50:24been combined by Dr. Mustafa into
5:50:26geometric or 3D plates. Okay, we have
5:50:28not used the word geometric plates. But
5:50:30that is not the question. Okay, we have
5:50:31taught you about geometric plates. We
5:50:33have taught you how uh you know lambda
5:50:35and delta and strut design and y design.
5:50:39These are the different designs of the
5:50:403D plate, 3D mini plates. These are also
5:50:43known as geometric plates. Why? Because
5:50:46um in two planes they will take care of
5:50:50the tensional and the torsional forces
5:50:52on the mandible. Right? So in both
5:50:54planes they will act. That is why they
5:50:55are called geometric plates. Basically
5:50:57they are nothing but a combination of
5:50:59different different mini plates. Okay?
5:51:01So geometric plates but that's not the
5:51:03question. The question is they are
5:51:04developed for management of mandible
5:51:06condala fracture. For which of these
5:51:08reasons? Actually the question is asking
5:51:10you where is the tension line?
5:51:15That is the question. The question is
5:51:16where is the tension line in mandibular
5:51:20condile fracture. We all know that
5:51:22whenever there is a mandible fracture
5:51:24there is tension and compression. Okay.
5:51:28In the symphysis and condile there is a
5:51:31third force also which is known as
5:51:33torsion.
5:51:34Right?
5:51:36Tension in the mandibular condile is
5:51:38always in the anterior border.
5:51:45We have seen that how the lateral
5:51:47tergoid pulls the condile anterior
5:51:50medially. When it is attached to the
5:51:52anterior side, it will pull it anterior
5:51:55medially and the anterior border of the
5:51:57condile will be the first part to open
5:51:59up. And that is why we say that there is
5:52:01a tension in the anterior border.
5:52:04Posterior border has compression and the
5:52:08facial surface of the condile the
5:52:10frontal surface of the condile has this
5:52:11torsional force and instead of putting
5:52:14two parallel two nonp parallel mini
5:52:16plates you can put geometric plates and
5:52:18that is the fun. The correct answer here
5:52:20is C. Let me explain it to you with our
5:52:23concepts which we have explained in the
5:52:24notes. Look at this. Okay. Now we all
5:52:27know that this is the tergoid plate of
5:52:29the sppheninoid bone. The there are two
5:52:32bellies of the lateral terragoid muscle.
5:52:34This is the joint. This is the articular
5:52:36disc.
5:52:37The superior belly of the lateral
5:52:39terragoid muscle attaches to the
5:52:41articular disc. The inferior belly of
5:52:43the tergoid lateral tergoid muscle
5:52:45attaches to the neck of condi. Right?
5:52:48Now whenever there is a fracture
5:52:50whenever there is a fracture the muscle
5:52:53will pull the condile towards itself.
5:52:55Right? Because the origin always pulls
5:52:58the insertion towards itself. Insertion
5:53:00is mobile. Origin is fixed. Skull base
5:53:03is fixed. Right? So lateral tragoid
5:53:05muscle which comes from the sppheninoid
5:53:08and inserts into the condile will pull
5:53:11the condile toward itself. It will
5:53:14create a tension on the anterior border
5:53:18and [snorts] the sigmoid notch region.
5:53:20That is the first reason. Second reason
5:53:23the shape of the mandible the grains of
5:53:25the mandible are also such that there is
5:53:29always a tension created in the anterior
5:53:31part of the condile and compression in
5:53:34the posterior part of the condile. So
5:53:36whenever we are doing an orif of the
5:53:37condile the rule is either put a thick
5:53:40recon plate that takes care of all the
5:53:41forces or put too many plates which are
5:53:44nonp parallel.
5:53:46Why nonp parallel? So that you can
5:53:49control the torsional forces also or you
5:53:51put a 3D plate like this a trapezoidal
5:53:54plate or lambda plate right this is what
5:53:58is taught in the class also right so the
5:54:03first displacement the first
5:54:04interfragmentaryary displacement will
5:54:06happen in the anterior border of cordile
5:54:10because of the pull of the lateral
5:54:11tergoid muscle right so tension in the
5:54:14anterior border this is not even a a
5:54:17surgical question. This is more of a
5:54:19anatomy of mandible and forces of
5:54:21mandible kind of a question. Right? So
5:54:23the correct answer here is tension on
5:54:25the anterior border. I don't know how
5:54:27many of you have done it correctly but
5:54:29that is the correct answer. Okay.
5:54:33Which of these is an advantage of using
5:54:35locking plate over the non-locking
5:54:38plate? Now we have done this again. It
5:54:40is from the notes. The only difference
5:54:41is instead of recon plate the examiner
5:54:44has asked you mini plate. I've always
5:54:46taught you that locking plates and
5:54:47non-locking plates or locking plate
5:54:49mechanism is for reconstruction plate.
5:54:52Recently they have also introduced it in
5:54:56many plates. Okay. However, its primary
5:54:59fund its primary uh function is instill
5:55:03in the recon plates and function is
5:55:05still the same. Our answer remains the
5:55:07same. It prevents the
5:55:12sorry
5:55:14yeah it prevents the primary loss of
5:55:17reduction. Again straightforward from
5:55:19our notes we have taken the non-locking
5:55:22screws and locking screws. Non-locking
5:55:24screws the primary problem is loss of
5:55:27reduction. Whereas in locking there is
5:55:29no loss of reduction. All right, it's
5:55:32there on page number 116 of our latest
5:55:34notes and you can see it from there
5:55:36because there is some blurring here.
5:55:38Okay, what is slightly confusing here is
5:55:41primary and secondary loss of reduction.
5:55:43Let me tell you that also. So loss of
5:55:45reduction. What is reduction? Reduction
5:55:48means see
5:55:51this is a fracture. After the fracture
5:55:54what has happened? One segment has
5:55:57stayed in its place. Another segment has
5:56:00gone away. Okay. Now what the surgeon
5:56:03will do? Will he put the plate directly?
5:56:05No. The first step is he will reduce the
5:56:08fracture. Okay. What [snorts] he will
5:56:10do? He will put this segment back up and
5:56:14put it back into articulation. He will
5:56:16put it back in its correct position.
5:56:18That step is called as reduction of
5:56:20fracture. Okay. After the surgeon has
5:56:23done that, he will use some forceps. He
5:56:25will use some bone reducing forceps and
5:56:27he will hold the segments in place.
5:56:29Okay. After he has put the segments in
5:56:33correct position after he has reduced
5:56:35the plates, now he's going to use a
5:56:38plate
5:56:39and fix the plate with screws. Either
5:56:42recon plate or mini plate or whatever
5:56:44plate. Okay. Sometimes when we are
5:56:48tightening the screws,
5:56:50when we are tightening the screws,
5:56:54what happens is the fracture segments
5:56:56which was brought together, they go
5:56:58apart. Okay? There is some positional
5:57:01change because of the screw tightening
5:57:04that causes loss of reduction.
5:57:08The loss of reduction which happens
5:57:10during the surgery is known as primary
5:57:14loss of reduction happens during the
5:57:16surgery or immediately in the
5:57:18perioperative period. Right? During the
5:57:20surgery but if in case everything was
5:57:24correct, the surgeon has put the plates
5:57:25correctly. Everything was perfectly
5:57:27done. But 10 days after the surgery,
5:57:30there was some infection in the
5:57:31mandible. There was some infection over
5:57:33the plate. because of the infection. Now
5:57:36the screws have become loose. Now the
5:57:38segments have lost its correct contact.
5:57:40Now again the segments have gone back to
5:57:43the incorrect position. Why? Because the
5:57:46plate fractured or some of the screws
5:57:49came out.
5:57:51That loss of reduction which happens
5:57:53days after surgery is known as secondary
5:57:57loss of reduction. Okay? It happens days
5:57:59or weeks after surgery.
5:58:03Just like infection, primary infection
5:58:05which happens during the surgery.
5:58:06Secondary sepsis or secondary infection
5:58:08which happens a long time after or
5:58:10hemorrhage. Primary hemorrhage that
5:58:12happens during the surgery. Secondary
5:58:14hemorrhage which happens late. Okay,
5:58:16delayed hemorrhages. Just like that,
5:58:18primary and secondary loss of reduction.
5:58:21In this case, the locking plate will
5:58:23avoid the primary loss of reduction and
5:58:26that is the correct answer. All right. I
5:58:28hope it is clear with all of you. Uh I
5:58:30know a lot of you must be confused
5:58:32between primary and secondary. So Prem
5:58:34Shanka you've marked C which is okay.
5:58:37You can't know all the answers. Even
5:58:38rank one will have a lot of answers that
5:58:40are wrong. So don't worry about the
5:58:42wrong answers. Uh I'm sure you've done a
5:58:44lot correct also. All right. So let us
5:58:46focus on the correct answers here.
5:58:49Okay. So locking non-locking we have
5:58:51explained in detail. Okay. Which of
5:58:53these is the correct treatment for
5:58:55multi-cystic amblastoma? I don't think
5:58:57anybody has done it wrong. The correct
5:58:59answer is D because all of these are not
5:59:02treatment of tumor. We never treat a
5:59:05tumor with cryotherapy or inucleation or
5:59:08curitage. Tumor is always treated with
5:59:10resection. And we all know that
5:59:11amobolastoma is a tumor. Right? Again a
5:59:14straight pick from our notes. It's
5:59:17written removal of tumor with 1 to 1.5
5:59:20cm of adjacent bone along with the next
5:59:24soft tissue barrier straight lines from
5:59:26nodes. Straightforward answer we've also
5:59:30told you about marginal and segmental
5:59:32resection. We've also shown you the
5:59:34cases how there was a big multi-cystic
5:59:36amblast. Another case from MAC and how
5:59:39we have done a resection. This is the
5:59:41resection segment and how you don't just
5:59:43remove the tumor but you also remove
5:59:46normal looking bone because tumors are
5:59:48infiltrating property. They infiltrate
5:59:51microscopically. So you don't know
5:59:53whether that normal looking part has
5:59:55tumor or not. So you always take that
5:59:57margin and remove 1 to 1.5 cm of bone
6:00:01around the tumor. And the next layer of
6:00:04soft tissue also say if bone is involved
6:00:06you remove bone and perryostium. If bone
6:00:08and perryostium are involved, you remove
6:00:10bone perryostium and the upper muscle or
6:00:13connective tissue whatever is there over
6:00:15that structure. So 1 to 1.5 cm of bone
6:00:19plus the next anatomical barrier
6:00:23or the next soft tissue layer.
6:00:27All right. Identify the technique of
6:00:29mandibular anesthesia shown in the
6:00:31image. Now this was not the exact image.
6:00:34The image was a Chinese kind of a person
6:00:37lying down in a chair and uh this was
6:00:40the mouth was closed. Clearly the mouth
6:00:43was closed and this image was also there
6:00:46where the target area of the needle was
6:00:50shown which was somewhere here on the
6:00:52medial side of the uh on the posterior
6:00:55side of the mandible in the sigmoid
6:00:56notch region and very clearly this is
6:00:58the vaserani ainosi technique. Yes. SSJ,
6:01:02Ekta, Prem Shanka, you're all correct
6:01:04there. Okay. There is no doubt again a
6:01:06straight pick from our notes where we
6:01:08have taught you the vaseranosi
6:01:10technique. A patient develops sudden
6:01:12facial paralysis with inability to close
6:01:14the eye after an inferior alva nerve
6:01:16block. Clearly you have gone too
6:01:18posteriorly entered into the perotid
6:01:21gland and caused a facial nerve
6:01:23paralysis. Straight pick from the notes.
6:01:26I am shy now by saying this again and
6:01:28again. This is a straightforward
6:01:29diagram. This is the massitor. This is
6:01:32the medial tergoid. We inject and this
6:01:34is the ramos of mandible. We inject in
6:01:36the teriggo mandibular region. If we go
6:01:39to posteriorly, we will enter the
6:01:41peroted gland. The peroted gland has the
6:01:43facial nerve and we are going to do a
6:01:45facial nerve paly. Straight forward
6:01:47line. If the bone does not hit the
6:01:51posterior pathway, reach the perot
6:01:54gland, the facial nerve is blocked.
6:01:57Right? So straight lines from our notes
6:02:00that it will cause a facial nerve paly.
6:02:02So please read notes very nicely for the
6:02:04upcoming neat exam also.
6:02:07Okay. In winter's war lines extraction
6:02:09is indicated under general anesthesia or
6:02:12sedation. This is not an absolute
6:02:14criteria when the length of the red line
6:02:16is more than 5 mm. Again we have taught
6:02:19you now this particular line may not be
6:02:21there but we have taught you that as the
6:02:23length of the red line increases with
6:02:25every 1 mm increase in length of red
6:02:27line the difficulty increases three
6:02:29times. So they say that generally if the
6:02:32red line is less than 5 mm you can do it
6:02:35under LA. If the red line is more than 5
6:02:38mm you should consider sedation or
6:02:41general anesthesia. If it is more than 9
6:02:43mm it's a very risky surgery. It may
6:02:45cause a mandibular fracture. So you have
6:02:47to be very um clear in choosing that
6:02:50case whether you really need to remove
6:02:52that third mer or not. Okay. So the
6:02:55correct answer is 5 mm.
6:02:58All right. So with each increasing
6:03:00length of red line by 1 mm the impacted
6:03:02tooth becomes three times more difficult
6:03:04to remove. This is by Ho and Jeffrey Ho
6:03:07which is our standard book or exodonia.
6:03:09If the red line is less than 5 mm can be
6:03:12removed under just LA. Anything above a
6:03:14GA or LA sedation would be more
6:03:17appropriate. This is again directly from
6:03:19Jeffrey Ho and the correct answer is 5
6:03:21mm. Okay. A patient receiving warerin
6:03:24therapy needs tooth extraction for
6:03:26urgent dental indication. It is urgent.
6:03:30So you can't discontinue warin for 7
6:03:33days. It is urgent. Even if it is not
6:03:35urgent, this discontinuation of warin is
6:03:38not required for minor surgical
6:03:39procedures. INR is within the
6:03:42recommended therapeutic range and no
6:03:44history of uncontrolled bleeding in the
6:03:46past. What is the most appropriate
6:03:48management? The correct answer is B.
6:03:50Check the INR. Okay, we have taught you
6:03:53it is again there in the notes that in
6:03:56case of
6:03:58okay so this is antiplatelet drugs and
6:04:00anti-coagulants like warin
6:04:04patient who need minor surgery check
6:04:08PTNR. Okay, BT, CT all not required only
6:04:12PTNR. If the INR is less than 3.5 to 4,
6:04:19okay, you can proceed with the minor
6:04:22surgery. What minor surgery? Tooth
6:04:24extraction. Very clearly written our
6:04:26notes. If INR is more than 3.5 or if you
6:04:30have to undergo a major surgery, then
6:04:32only you will stop warferin and you will
6:04:34cause you will do a bridging therapy. B
6:04:38R I D G I N G bridging therapy with
6:04:40aspirin. No, bridging therapy is done
6:04:42with heperin which has a very short
6:04:45half-life.
6:04:46Right? So we have taught you about
6:04:48bridging therapy. We've taught you about
6:04:49INR. What is the correct INR? This
6:04:51question says again and again that it is
6:04:53within the therapeutic range. Okay? So
6:04:55you assess the INR proceed with minor
6:04:58surgery in most cases with INR within
6:05:00the range. What is the range? 3.5 to 4
6:05:02is the range and use local heatic
6:05:05measures. You can use a pack, you can
6:05:06use a pressure pack, you can use
6:05:08suturing, you can use some local
6:05:10stipics,
6:05:11stop the bleed, right? So the correct
6:05:13answer is B and uh you can mark it
6:05:17correctly. Okay. What is the most common
6:05:20cause of dry socket? Now there's nothing
6:05:21to teach here. Again, it is from burns
6:05:24hypothesis which is there in your notes.
6:05:26Dislodgement of blood clot formation of
6:05:28bone. Why will it cause dry socket?
6:05:30Infection will cause infected socket and
6:05:32not dry socket. I'm not sure what was
6:05:34the option D. If you guys know what was
6:05:36the option D, you can u let us know
6:05:39about the option D and u
6:05:44tell us the correct answer. So
6:05:45dislodgement of blood clot is the
6:05:46correct answer. We've taught you about
6:05:49dry socket in detail in the lecture.
6:05:50This is the lecture pictures and we've
6:05:52told you that it's an empty socket. Dry
6:05:54socket is not an infected socket. So
6:05:57there is no role of antibiotic. It's
6:05:59just a socket which has lost its blood
6:06:01clot. The most probable hypothesis is
6:06:04the plasmminolyis theory by burns burns
6:06:07hypothesis. Okay. And the last question
6:06:09of oral surgery in case of an impacted
6:06:12mandibular third mer which is an which
6:06:16is an approximation with the inferior
6:06:18canal. Which of these is an indication
6:06:19of their contact? Now this is the
6:06:21straightforward
6:06:23uh ho and poin criteria which is again
6:06:26there in your notes. Ho and poet
6:06:31criteria and even if you don't know the
6:06:34ho and poetin criteria you know the
6:06:35options are so simple that you can
6:06:37easily rule out the options and come to
6:06:39the answer. Okay enlarged follicle why
6:06:42is an enlarged follicle a problem. It is
6:06:44rather helpful in removing the tooth. It
6:06:46is not causing a entry into the canal.
6:06:48So this is wrong. Clear demarcation of
6:06:51cortical outline of the canal. That
6:06:53means the canal is free of the tooth. So
6:06:55again this cannot be a problem thing 1
6:06:58mm distance between the root
6:07:021 mm distance between the root and the
6:07:04canal why should this be a problem why
6:07:06should this be a contact so even if you
6:07:08don't know the whole point and criteria
6:07:10you know that if it is blurring if the
6:07:13tooth is involving the canal it will
6:07:16cause some changes so if this part of
6:07:20the canal is very very clear on x-ray
6:07:23this part will not be that clear it will
6:07:25be hazy it will be some some some hazy
6:07:28outline blurring of the canal because of
6:07:30the overlap of the roots right so it's a
6:07:32straightforward answer option D is the
6:07:35correct answer okay
6:07:41okay so this brings us to the end of
6:07:44oral surgery recall I will take your
6:07:45doubts also let us first finish with
6:07:47this three anatomy questions which of
6:07:50these muscles of larynx is responsible
6:07:52for abduction we all know it as the
6:07:54Posterior cricoquaritenoid
6:07:58also known as the safety muscle of
6:08:00larynx
6:08:02which is marked as number one. It is the
6:08:04only muscle which can open the larynel
6:08:07inlet which can cause abduction of the
6:08:10vocal cords the glauus and the correct
6:08:12answer becomes one. All right it's an
6:08:14image based question so nothing to
6:08:16explain there. Again straightforward
6:08:17from our notes. Okay this is adduction.
6:08:20This is abduction and the only muscle
6:08:22causing abduction is posterior
6:08:25requireenoid. Right? Straight from our
6:08:27anatomy notes.
6:08:29Okay. Next question was taught both in
6:08:32anatomy and oral surgery. Identify the
6:08:34correct image from the options below.
6:08:36Now whenever you see this bulblike
6:08:38protuberance, okay, this bulb like
6:08:41vulmerine segment, it's always a
6:08:43bilateral cleft lift. So there's a cleft
6:08:45on the left side, there's a cleft on the
6:08:46right side. Whatever tag is remaining
6:08:48hangs in between the cleft, right? So
6:08:50this is a bilateral cleft clip.
6:08:54This is clearly a cleft pallet. There is
6:08:56nothing to explain here. It's clearly
6:08:58cleft of pallet. The lip looks fine.
6:09:01This is an oblique facial cleft. The
6:09:03image was not the same. The image was a
6:09:05clinical image, but I could not find a
6:09:06clinical image. This is an oblique
6:09:08facial cleft. You can always see here
6:09:10that the lateral nasal process and the
6:09:12maxillary process have also not fused.
6:09:15And this is a partial cleft. This is an
6:09:17incomplete cleft of the midline. Midline
6:09:21incomplete
6:09:23cleft lip. Very very rare. Very very
6:09:25rare. Both C and D are very very rare.
6:09:28What is very common is A and B cleft of
6:09:30lip and pallet and different
6:09:31combinations. C and D are extremely
6:09:34rare. Okay. Even I have seen only one or
6:09:35two cases. I mean I've not seen much but
6:09:37they are rare according to textbook
6:09:39also. Right. So what is the correct
6:09:41answer? Option A has to be bilateral. So
6:09:44m
6:09:47okay so instead of bilateral my team has
6:09:49written unilateral.
6:09:52So okay anyways let us not look at the
6:09:54options. The options correct options
6:09:55were there in the exam. Option A was
6:09:58bilateral cleft lip. B was cleft of
6:10:01pallet. C was oblique facial cleft and D
6:10:06was incomplete midline cleft lip. I'm
6:10:09sure most of you have marked this
6:10:10correctly. uh and you've uh learned it
6:10:14properly. All right, we've taught you in
6:10:16embryology also how different processes
6:10:19fuse and they cause development of
6:10:21different parts. You can go back and
6:10:23read from both anatomy notes and oral
6:10:25surgery notes. Okay. And the last
6:10:27question from anatomy and for the day
6:10:30from me is which of the statements are
6:10:32correct? Okay. Now this question came in
6:10:34the oral surgery part but it was more of
6:10:36an anatomy question. The inferior alvea
6:10:39nerve is a branch of the V3 mandular
6:10:41division of the triminal nerve.
6:10:42Absolutely correct. We all know that the
6:10:45V3 divides into an anterior branch, a
6:10:47posterior branch from the posterior
6:10:48branch. The last nerve is the inferior
6:10:51alva nerve. Inferior alva nerve enters
6:10:54the mandible through the mandibular
6:10:55foram and into the mandibular canal.
6:10:57Absolutely correct. We all know that the
6:11:00mandible has a mandibular foram and
6:11:02covered by the lingula. The mandibular
6:11:04nerve enters and runs and comes out of
6:11:06the mental nerve mental foram. So this
6:11:08is also correct. The lingual nerve
6:11:11supplies general sensations to the
6:11:13anterior two/3s of the tongue. Again it
6:11:15is absolutely correct. We all know
6:11:17lingual nerve supplies sensations. The
6:11:19facial nerve supplies sensory innovation
6:11:21to the mandibular teeth. This is wrong.
6:11:24We all know it is the inferior alvular
6:11:27nerve only which supplies the pulp of
6:11:30the mandibular teeth. So option four
6:11:32becomes wrong. So what is correct?
6:11:33Option one, two and three are correct.
6:11:35I'm sure most of you have done it
6:11:36correctly. It is from the notes. It is
6:11:38not from the notes. You know this
6:11:40answer. All right. So with this we
6:11:42complete the recall of oral surgery and
6:11:45anatomy. Let me look at your
6:11:48doubts if there is any. So the question
6:11:51on bisphosphonates
6:11:53is taken in medicine. So don't worry
6:11:56about that question or oral pathology.
6:11:59Okay. Um
6:12:01the answer is osteorra necrosis. If you
6:12:04want the answer I will tell you. SSJ 68
6:12:08female taking IV bisphosate for breast
6:12:10carcinoma. That was the question and she
6:12:12has exposed bone after extraction and
6:12:14the bone is uh nonvital and uh there is
6:12:20a reactive epithelium formation that
6:12:22kind of a question was there. We've
6:12:23taken it an oral path. You will see it
6:12:24with Dr. Shishi at the end. The correct
6:12:26answer is osteorion necrosis. very
6:12:28clear-cut question. Okay.
6:12:32What major risk or complication must
6:12:34dentist discuss with the patient before
6:12:36extraction? Now this is more of a
6:12:37conceptual question. We will discuss it
6:12:39in the class uh whenever we are taking
6:12:42the oral surgery class. This is not the
6:12:44right platform to discuss a whole
6:12:45concept. I'll take you your doubts uh
6:12:48from the exam.
6:12:52Yeah. So SSJ I've already told you the
6:12:53answer.
6:12:56Increased risk of alvol or ostitis.
6:12:58Okay, that is the option D. Thank you so
6:12:59much for completing that option for me.
6:13:02Okay. All right. So, that completes our
6:13:06uh answers. Somia, please don't worry if
6:13:08a lot of questions are not correct. Uh
6:13:11doesn't matter much.
6:13:14Lot of people have answers that are
6:13:16wrong and uh it doesn't matter. Even the
6:13:20topper will have a lot of questions that
6:13:22are not right. Okay? So, don't worry
6:13:25about the wrong questions.
6:13:27Be happy about the things you have done
6:13:29right and ensure that whatever things
6:13:31you have done wrong you will make it
6:13:33correct in the neat exam. All right,
6:13:35that is the learning we have to take
6:13:37from here. And with this I will end this
6:13:40session. Who do we have next? Uh studio
6:13:43team,
6:13:44which faculty do we have next?
6:13:52Okay, I think uh there is still time for
6:13:55the next faculty to join in.
6:14:19All right. Till the time uh we have Dr.
6:14:21Anaya next after me and um
6:14:26you guys want to uh share your feelings.
6:14:29You can discuss it here. Tell me how you
6:14:33feel. I know a lot of you are thinking
6:14:35that why so many answers are wrong and
6:14:37all of that but uh
6:14:40session
6:14:41we will do the session it's a it's a
6:14:44history of DBMC MDS that we always do
6:14:46the recall first probably the only
6:14:49people doing all subject recall with the
6:14:51experts I'm very proud of this one thing
6:14:53which we are doing so we will finish it
6:14:55today and um Dr. Anaya is joining all of
6:14:59you shortly. So don't worry if you are
6:15:02tired we can u you can watch it
6:15:04tomorrow. It's it's not it'll be there
6:15:06on YouTube forever. It'll we are not
6:15:08going to take it out. It's there on
6:15:10YouTube. And u
6:15:13please tell the cutff. How can I tell
6:15:15the cutff? Beta. It is the authorities
6:15:17that will have the key and that will
6:15:19tell the cutff. And like I said,
6:15:23okay, you have done your hard work. You
6:15:26have done your best in your exam. Okay.
6:15:29Now what will be the result is not your
6:15:32tension. Leave it for God. Uh again
6:15:35medical corner is asking me the expected
6:15:36cut off. Don't think about all these
6:15:38things. Think about what next you can do
6:15:39in neat. How can you make that exam
6:15:41better? Okay. This is a rule.
6:15:48Right? So all of you don't worry about
6:15:50the result. Just take a rest today. I
6:15:54know it's been a lot of you must be
6:15:56overwhelmed by the fact that so many
6:15:58questions are right, so many questions
6:15:59are wrong. Just take a good break and u
6:16:03continue with your studies in a better
6:16:05way, in a more energetic way from
6:16:08tomorrow or day after. It's okay if you
6:16:09take a two-day break also. Okay.
6:16:13Yes. So Prem Shankar is saying he was
6:16:15not prepared for the exam but felt like
6:16:17paper was more conceptual and basic.
6:16:19This is exactly how it will be in neat
6:16:21also. Neat will be more factual. I mean
6:16:23even if it's a clinical question, the
6:16:25clinical question will be less of gross
6:16:28concepts and more of your basic
6:16:30knowledge. Okay? So basic knowledge is
6:16:33what you need to revise like this
6:16:35session also I've told you we have shown
6:16:37you that you know hardcore difficult
6:16:39questions are not that many simple basic
6:16:42questions are many right so focus on the
6:16:45simple questions West.
6:17:04All right. And uh I'm very happy to have
6:17:08Dr. Anaya with us now. Dr. Anaya will
6:17:11takeodontics.
6:17:13Welcome to the session Dr. Anaya.
6:17:18Uh you're on mute ma'am. Yeah, just on
6:17:21mute.
6:17:21>> All right. Okay.
6:17:23So, over to you and uh all the best
6:17:26children. Uh do better, do best, study
6:17:30hard, and don't worry about the result.
6:19:15Okay, I was muted. I'm so sorry. Um,
6:19:25yes. So, a very good evening all of you
6:19:27are a very very good evening. Uh I hope
6:19:30the exam went well. It was a wonderful
6:19:33question paper. It has many it had many
6:19:37new types of questions. Questions like
6:19:40match the following. Loads of match the
6:19:42following were there and then we had
6:19:45assertion reasoning type of questions.
6:19:48Uh good image based questions we had and
6:19:51yes all of that. So um it was it must
6:19:55have been easy though it must have been
6:19:57difficult to you know uh complete it on
6:20:00time. It must have been lengthy must
6:20:02have felt more exhausted
6:20:05but yes it was a very good
6:20:06[clears throat] exposure to a beautiful
6:20:08question paper. We had around 13 12 to
6:20:1213 questions from
6:20:15and let me take it one by one the
6:20:17questions that were asked in your under
6:20:19my ICT. All right. Yes, I'm now break.
6:20:28So,
6:20:31okay. Is this some sort of um All right.
6:20:46Um,
6:20:49is my volume not very
6:20:52metallic audio?
6:20:55Just give me a minute. We are doing some
6:20:58settings.
6:21:23Is the audio any better now?
6:21:27Um,
6:21:39clear now. All right. So, am I clear to
6:21:42everybody?
6:21:44Shall I begin with the first question?
6:21:46All right. So, I think it's clear the
6:21:49sound. Um, can we please open the PPT
6:21:52now? Okay. Now better.
6:22:00Yeah. Yeah, it's it's all right now.
6:22:03Okay, let's open the PPT.
6:22:24Okay.
6:22:28Yes. Right. So, so, so the first
6:22:31question that we have here is it was a
6:22:35statement A statement B kind of
6:22:37question. Which statement is correct?
6:22:39Which statement is not correct? Whether
6:22:41both of them are correct or not. So the
6:22:43first statement we have here is a tell
6:22:46show do technique is a technique where
6:22:48you verbally explain a procedure
6:22:51visually demonstrate it and then we
6:22:54perform it. Okay fair enough. Tell that
6:22:57means verbally explain uh show that
6:23:00means visually demonstrate and then do
6:23:02so perform it. So seems like statement A
6:23:05is correct. Statement B was yes answer
6:23:09is C. C easy C. Great. See was voice
6:23:11control is contraindicated. No, it is
6:23:13not contraindicated. The only thing is
6:23:16there are a few behavior management
6:23:18techniques that come under aversive
6:23:20conditioning and these are voice control
6:23:22and physical restraints. So for only for
6:23:26the only thing about these aversive
6:23:28conditioning methods is that you need to
6:23:30take the parents consent for it and then
6:23:33do it without consent. you don't do
6:23:35things like voice control and uh
6:23:38physical [clears throat] distress
6:23:39otherwise it is not contraindicated in
6:23:41pediatric dentistry uh um so the uh so
6:23:45the answer is only A is correct
6:23:48statement B is wrong so the answer is C
6:23:50there right
6:23:53okay so this is like our notes direct
6:23:57pick we had talked about what is touhu
6:24:00technique so direct pick from the notes
6:24:04that we have read in our classes. Right?
6:24:07The next question we have is an
6:24:10assertion reason type of question. Uh so
6:24:15uh it was the assertion that was given
6:24:17was formocresol is not used in pulp
6:24:21therapy now and the reason for it was
6:24:24formaldihide is proved to be
6:24:26carcinogenic.
6:24:27Okay. So formocr basically is used when
6:24:32you need to fix the pulp. Okay. So I
6:24:34need you to fix the pulp you need you
6:24:36use formol in cases of pulpotomy
6:24:38procedures mostly but they say it's not
6:24:41used now because formaldihide is
6:24:43carcinogenic the answer is again C that
6:24:47is reason is correct and it explains the
6:24:50assertion that means both the A and R
6:24:54statements are correct okay formol has
6:24:57many alternatives now better
6:24:59alternatives that do not have
6:25:01carcinogenic effects and these are
6:25:03things like feric sulfate, lasers, MPA.
6:25:08Okay. So in the text even in clinical
6:25:11practice we do not use formicrosol
6:25:13anymore because formalihide has been
6:25:16proved to be carcinogenic.
6:25:18Clear?
6:25:20Uh option B is form is class one B
6:25:23carcinogenic
6:25:26option B. Okay. So uh the thing is u
6:25:31when you read theoretically it says that
6:25:33when you do a number of pulp pulpotoies
6:25:37or pulpectctomies in a particular uh
6:25:39patient where you use pomerol when it
6:25:42exceeds a huge huge huge number only
6:25:44then it'll start having its carcinogenic
6:25:47effect. But since it is proven to be
6:25:50carcinogenic
6:25:52uh they say that when it has better
6:25:54alternatives now why use something that
6:25:58might have a negative effect. So
6:26:01generally now even in clinical practice
6:26:03we avoid or we have generally stopped
6:26:06using formol for the sole reason that
6:26:08somewhere it it acts as a carcinogenic.
6:26:12So you do not want to put the patient at
6:26:14risk. Okay. It it is not that you do one
6:26:17or two pulpecttoies pulpotoies and the
6:26:20formandihide will have such an effect.
6:26:22No, you try to avoid it because it has
6:26:25such properties and you have better
6:26:27alternatives. Now so you avoid formol
6:26:30and that is why the reason explains the
6:26:33assertion well okay anal are we clear
6:26:36there?
6:26:38Um yes that's why we avoid it. So
6:26:41because when you know that a particular
6:26:43thing you know the plastic can be
6:26:46carcinogenic so you stop using the
6:26:48plastic bottles now you don't waste when
6:26:50I use 3,000 plastic bottles only then I
6:26:53will get cancer so no you want to uh
6:26:57stop something's trend so you stop it
6:26:59right away because it has a negative
6:27:01property in it right so because of the
6:27:03property that it is carcinogenic you do
6:27:06not use formicrosol or you try to use
6:27:09the alternatives to it in pul therapy
6:27:11techniques, right? So, the answer to the
6:27:13second question is C. Right?
6:27:18Okay. The next question, the next
6:27:22question is
6:27:24um all right. So, then
6:27:28the [clears throat] next question is who
6:27:30has given the ankyoglossia
6:27:33classification? So, Ankyoglossia means
6:27:36tongue tie. So who gave the ankylo
6:27:39glossia classification? The
6:27:41classification was given by B cotlllo.
6:27:45So it's called as the cotllo
6:27:46classification
6:27:48and cotllo's classification is very
6:27:50easy. You'll get it in hundreds of uh
6:27:53you know [clears throat] you'll get it
6:27:54in a lot of from a lot of sources. So
6:27:56basically cautus classification says
6:27:59that uh there are four classes to the
6:28:02tongue tie starting from normal that
6:28:06means a completely free tongue then we
6:28:08have a class one where 12 to 16 mm of
6:28:11the tongue is free. Okay. So the cotllo
6:28:15classified the tongue tie based on the
6:28:18free on how much uh length of the tongue
6:28:21has a free movement. So uh first is
6:28:24normal that is free tongue right. Uh the
6:28:27second one is uh class one that means it
6:28:31is also called as mild ankyoglossia 12
6:28:33to 16 mm of the tongue is free. Class 2
6:28:36is moderate ankyoglossia that means 8 to
6:28:4011 mm of the uh tongue is free. Class 3
6:28:44is severe ankyoglossia that is around 3
6:28:46to 7 mm only of the tongue is free. And
6:28:50the picture that is given here is class
6:28:524 ankyoglossia. That's complete
6:28:54ankyoglossia. That means less than 3 mm
6:28:57of the tongue is free for movement.
6:29:01Right? So um yes
6:29:07all the questions are seen somewhere but
6:29:09could not remember happens so many times
6:29:12but that's just the pressure of the exam
6:29:15the pressure of completing it on time.
6:29:17So you know that's the anxiety and it's
6:29:19basically not exactly you know by
6:29:22hearting everything but the real thing
6:29:25the real thing is to hide that anxiety
6:29:27to keep that anxiety backstage and be
6:29:30able to remember what you have seen.
6:29:32That's the anxiety management of the
6:29:34exam. So you know that's what you're
6:29:36supposed to do. Nobody can remember 100%
6:29:38of what they've learned. But if you keep
6:29:41yourself calm and relaxed you'll be able
6:29:44to at least recall whatever you've read.
6:29:46that happens with everybody. Okay.
6:29:50So yes, that's the classification of
6:29:53tongue type. All right. The next
6:29:56question was 2 year 2 year 10 month old
6:30:00child. All right. 2 year and 10 month
6:30:02old child presents with white opaque
6:30:04lesions on the labial surface of the
6:30:07maxillary incizers.
6:30:10What is the most likely diagnosis? So
6:30:12what is the most likely diagnosis? The
6:30:14most likely diagnosis is early childhood
6:30:18carries. Okay, let's go with early
6:30:20childhood carries because the nursing
6:30:22model carries will also is a type of
6:30:25early childhood carries and since they
6:30:27are talking just about the white opaque
6:30:30lesions that means it is an initial
6:30:33lesion. So when we see white opaque
6:30:36leion to severe early childhood carries
6:30:37and rampant carries
6:30:40it is out of the question and because
6:30:43they're just talking about initial
6:30:44carries instead of going for nursing
6:30:47bottle because they've not even
6:30:48mentioned he's on bottle feed or he
6:30:50feeds through the night. So the safest
6:30:52answer is early childhood carries. The
6:30:55answer is B. Early childhood carries.
6:30:57Why confuse between B and C? Cto severe
6:31:00severe white opaque lesions you don't
6:31:02have. Now maxillary anteriors are the
6:31:06first teeth to get carious. Always
6:31:08remember the most common teeth to get
6:31:12carries in primary in primary you know
6:31:16dentition are the maxillary anterior
6:31:18teeth. Maxillary anterior you have white
6:31:21opaque lesions rest of the teeth to
6:31:23still must be carries free. So that's
6:31:25just an early lesion to severe ECC and
6:31:28rampant car is out of question to the
6:31:31safest answer here is ECC. Hope that's
6:31:34clear
6:31:37to okay answer is B ECC.
6:31:42Next we come on to this question that is
6:31:47all right. Which of the following
6:31:49correctly arranges the fluoride products
6:31:52in order of increasing the fluoride ppm
6:31:56concentration? So basically to arrange
6:31:58the products in order you need to find
6:32:00out the ppm of fluoride. I hope you all
6:32:03know how to calculate the ppm of
6:32:05fluoride. For example, so answer here is
6:32:09basically a that is 0.05%
6:32:12NAF mouthwash then 1.23% 2 3% of ATF gel
6:32:17and then 5% of NAF varnish. That's the
6:32:21uh that's the sequence of increasing
6:32:23fluoride ppm. All right. Now 0.05%
6:32:28of NAF means uh so this is weight by
6:32:31volume. 0.05 means weight by volume
6:32:34which means 0.05 05 g
6:32:39of sodium fluoride present in 100 ml of
6:32:43present in 100 ml which means 500 ppm.
6:32:47So 0.05%
6:32:48of NAF means 500 ppm of fluoride. Now
6:32:53when you see 1.23% of APF gel that means
6:32:5912,300
6:33:00ppm of fluoride ions. So that's 500.
6:33:04This is 12,300.
6:33:06And then 5% NAF means what? So 5%
6:33:11solution contains 5 g of NAF per 100 ml,
6:33:17which translates to 50,000 ppm of
6:33:21compound. And even when you're
6:33:23calculating the weight percentage of
6:33:25pure fluoride present in it, it comes to
6:33:28around 22,600
6:33:30ppm. So 5% NAF means 22,600
6:33:35ppm of fluoride that means um 500 ppm
6:33:4112,300 ppm and then uh 22,600 ppm. So
6:33:47the correct answer becomes a that is
6:33:50given to you. Okay.
6:33:58All right. So uh just let me know if it
6:34:02is clear now the voice the answer there
6:34:04is a
6:34:07all right coming on to the question
6:34:09number six very easy it's a match the uh
6:34:14match the following kind of um
6:34:18all right it's a match the following
6:34:20kind of question so band and loop is
6:34:22basically what band and loop is
6:34:25unilateral single primary molar loss
6:34:28okay so a match is two transpal arch is
6:34:32stabilizes the maxillary mers in
6:34:35bilateral loss. Nans palatal is added
6:34:39anchorage to prevent the maxillary drift
6:34:42measial drift sorry and then d is um
6:34:46okay and then d is distal shoe distal
6:34:48shoe is uh guides the eruption of the
6:34:51first permanent mers. So for according
6:34:54to this the answer becomes a. All right.
6:35:01Okay. Okay. But it's pretty easy. I
6:35:04think uh what I have recollected is
6:35:07there was just one option that said a
6:35:10matches to two. So you know the rest
6:35:13fell in place automatically.
6:35:15So the answer is a there. Now regarding
6:35:19root canal opturating materials used in
6:35:22primary teeth, which of the following
6:35:24statements are correct? Okay. So the
6:35:27opturating materials used in primary
6:35:29teeth. All right. First is idopform
6:35:32based opturating materials resorb early.
6:35:36Yes, they do resolve early. The IDOform
6:35:39based materials resolve early. Right?
6:35:44uh uh hence the metapex that contains
6:35:47idophform resorbs very very soon. All
6:35:51right. Then zinc oxide eugenol resorbs
6:35:53late as compared to physiological root
6:35:55resorption of the primary teeth. Yes,
6:35:58the zinc oxide eugenol forms into a
6:36:00solid mass and it resolves very very
6:36:03late as compared to physiological root
6:36:05resorption rate. So sometimes the uh
6:36:09tooth will resolve faster as compared to
6:36:11zinc oxide eugenol.
6:36:14All right. So uh the answer is so one
6:36:18and two are correct. Okay. Uh then guta
6:36:22is used for obturation of primary teeth
6:36:25pulpctomy. No that's not correct. So
6:36:28third is wrong. Whereas the fourth one
6:36:31that is endoflast consists of zinc oxide
6:36:34iodform and calcium hydroxide. So yes
6:36:38that is again correct. So the answer is
6:36:42the answer is a. A means 1 2 and four.
6:36:46The correct answer is a. That is uh
6:36:49option number 1 2 and four are correct.
6:36:53All right. The answer is a. Can you all
6:36:56see?
6:37:00Okay. Now, question number eight is
6:37:02which of the following tapes is commonly
6:37:04used in naso alvular molding for
6:37:07securing the nasal stent and maintaining
6:37:11approximation of the alvolar segments.
6:37:15The answer is a micro pore tape. The
6:37:18answer is a microore tape. So basically
6:37:21in pre-surgical naso molding therapy
6:37:24micropole tape that is a hypoallergenic
6:37:27paper tape is extensively utilized by
6:37:30clinicians and parents. It is used to
6:37:33apply active extraoral forces across the
6:37:36cheeks and the lips to approximate the
6:37:39alvular segments. It also attaches to
6:37:42orthodontic elastic bands that anchor
6:37:45the extraoral retention arms of the
6:37:47appliance stabilizing both the custom
6:37:51plate and its nasal stand. So the answer
6:37:53is a micro pore tail. Okay.
6:37:58Uh eighth microour tail.
6:38:04All right.
6:38:07Next is um
6:38:12right question number ninth is uh so we
6:38:15have okay again uh 2 years so there must
6:38:18have been some confusion but as a child
6:38:20who's brought to the casualty department
6:38:22following accidental ingestion of 60 mg
6:38:27of fluoride what is the most appropriate
6:38:31immediate management so what is the most
6:38:33appropriate immediate management
6:38:36immediately you administer milk along
6:38:39with calcium salts. So you all know uh
6:38:43um fluoride tends to chilate with
6:38:45calcium. So administering milk and
6:38:48calcium salts will uh you know bind all
6:38:51the fluoride that is running loose in
6:38:53the body and causing all the erosion. So
6:38:55it will bind all the fluoride uh and
6:38:58hence it will stop the fluoride from
6:39:00eroding the gut the esophagus and the
6:39:03rest of the gut. Okay. So that will be
6:39:06the immediate management that is you
6:39:09administer milk and calcium salts for
6:39:11the fluorides to bind to it. Okay. Yes.
6:39:16The option is C. C. Administration of
6:39:19milk along with calcium salts.
6:39:23Coming on to question number 10. Now
6:39:25regarding the hall technique used in
6:39:28pediatric dentistry, which of the
6:39:30following statements are correct? All
6:39:32right. So the first was given was it is
6:39:34indicated in primary teeth with
6:39:36irreversible pulpitis in uncooperative
6:39:39patients. First is correct. May be used
6:39:42in permanent mers with hypommineralized
6:39:45enamel. Yes, it can be used there. It is
6:39:49indicated so second one is also correct.
6:39:52It is indicated for managing carious
6:39:54lesions involving multiple surfaces of
6:39:57the primary mers. Yes, that's correct
6:40:00too.
6:40:02But the stainless steel crown margin
6:40:04should extend approximately 3 to 4 mm
6:40:06subjingly. That is wrong. That can
6:40:09actually hamper the tooth. So the
6:40:12correct answer is 1 2 and three only.
6:40:15Option number A that is statement 1 2
6:40:18and three are correct there.
6:40:22All right. Option A is correct.
6:40:27Yes. So we've read about Hall's
6:40:28technique.
6:40:31Okay. Question number 11 is the image
6:40:34was given and there is repeated
6:40:36scratching of her gingiva in this
6:40:38region. Which of the following is most
6:40:41uh explanatory? The patient gives a
6:40:43history of repeated scratching
6:40:45repeatedly scratching her gingiva. So
6:40:47gingal scratching or gingal picking or
6:40:50gingal p or gingal uh you know it's
6:40:54called as picking or scratching. Uh so
6:40:57this is a classic example of
6:40:59massocchistic habits. Answer is a
6:41:02massochistic habits.
6:41:06Okay. Yes, we've read about masochistic
6:41:10habits.
6:41:12Question number 12 was so they had given
6:41:15an image of the distal shoe space
6:41:17maintainer and they had asked the
6:41:19indication very very easy direct pick
6:41:22from the notes premature loss of the
6:41:24second primary mer before the eruption
6:41:27of the permanent first mer. So the
6:41:29second primary mer that is the e has
6:41:31been lost and uh the uh uh the the first
6:41:36permanent mer is still to erupt. So the
6:41:38correct answer is a
6:41:42right.
6:41:46So we have read about the uh space
6:41:48maintainers about indications
6:41:50fabrications contraindications
6:41:53everything we've read about space
6:41:55maintainers in our notes.
6:41:58So the last question here that we had in
6:42:01Pedo was identify the orthodontic
6:42:05appliance shown in the image. Okay. So
6:42:09the answer is a palatal crib. So always
6:42:12remember two things. There's a palatal
6:42:14crib and there's a palatal ray. When you
6:42:17say rake that means it's something very
6:42:20sharp jutting out like thorns. That's
6:42:23called as a rake. And crib means
6:42:26something like a uh you know like a
6:42:29shelf or something like this like how
6:42:31you can see here. So something that
6:42:33looks like a shelf is called as a crib
6:42:36and something that's like thorns jutting
6:42:38out like that you know sharp uh endings
6:42:41that's called as a uh rake. So this is a
6:42:44crib. The answer is a cemented palatal
6:42:48crib. Answer A. All right. So yes, we've
6:42:52read about rake and we've read about
6:42:55cribs. So yes. Oh, there's one more
6:42:59question. All right. Okay. So, arrange
6:43:02the following motor development
6:43:04milestones in the correct sequence of
6:43:07normal child development. So the answer
6:43:09here is a. Okay. So that means head
6:43:13control that occurs in 4 months. Sitting
6:43:16without support that occurs in six to
6:43:18eight months and walking alone that is
6:43:2012 to 15 months. My god this must be the
6:43:22easiest question. If you would have seen
6:43:24any child in this whole wild wide world
6:43:27you would have answered this. Head
6:43:28control sitting without support and then
6:43:30walking alone. So that's the answer.
6:43:33We've read about various developmental
6:43:36milestones in children in so it's given
6:43:39straight in our notes.
6:43:42All right. The next question is uh again
6:43:45a 9-year-old child who reports 2hour
6:43:48after trauma to maxillary central
6:43:51incizer clinical examination reveals a
6:43:54vertical complicated crown fracture
6:43:57involving enamel dentine and pulp
6:44:00exposure. Okay. The tooth responds
6:44:03positively to vitality test and there
6:44:05are no signs of periapical pathology.
6:44:08What is the treatment of choice? Okay.
6:44:11So the treatment of choice there is C
6:44:15that is partial pulpotomy. Okay. So here
6:44:18it's written wrong. The answer is C that
6:44:21is partial pulpotomy. That is the civex
6:44:23pulpotomy. Whatever part of the pulp is
6:44:27uh inflamed. You just remove that part
6:44:29that part and then you seal it off
6:44:32because 9year-old child maxillary
6:44:34central incizer there are high chances
6:44:36that it is going to be a uh that it is
6:44:39uh going to be a
6:44:41all right so that it's going to be a
6:44:44what do you call as um a open aex case.
6:44:47So in such a case you go for uh uh you
6:44:51go for a partial pulpotomy so that there
6:44:54is continued root growth in that
6:44:56particular case. So the answer is C
6:44:59partial pulpotomy. So with this with
6:45:01this with this we finish off the
6:45:04questions from the pedo segment and next
6:45:08I think we have our uh D AH faculty Dr.
6:45:13Diti Modi I guess. So yes um
6:45:27>> all right so yes we have Dr. Diti Modi.
6:45:31>> Hello dear students. Uh myself Dr. Duti
6:45:34Modi and I'm here to take your DDH
6:45:37questions. All right. I hope all of you
6:45:39are doing well. I know you guys are very
6:45:41tired because the exam was very taxing 3
6:45:44hours plus 1 hour before that 1 hour
6:45:47after that the exact biometrics all of
6:45:49that I know was very very taxing and now
6:45:52this long session but I'll be quick so
6:45:54you'll not have to worry about it okay
6:45:57so as dh it was always simple like it's
6:46:00usually how it is okay so we had almost
6:46:03around five questions I'll just wait a
6:46:06minute so that I can connect with you
6:46:07guys
6:46:09okay can I have a good evening from all
6:46:11the you guys.
6:46:16Yeah. So, the lag uh is still there
6:46:19but uh meanwhile I get the response from
6:46:22everybody. I'll just wait a moment.
6:46:31Yes, Prem having the session since 11:00
6:46:33a.m. I know it is taxing but uh yeah you
6:46:37must be getting that few of you might be
6:46:39getting the dopamine of getting the
6:46:40answers correct thinking that yes you
6:46:41were right in the exam few of you might
6:46:43be getting a little bit sad but it's all
6:46:45right as you we have been telling you
6:46:47you just need to perform rest result is
6:46:50in God's hand good evening everybody
6:46:53good evening Prem good evening prana
6:46:56good evening bindas bio okay I don't
6:46:59know who this person is but yes all
6:47:01right
6:47:03good evening everybody Everybody fine
6:47:04let's be quick and get the answers right
6:47:07away. So now one tricky question was
6:47:09there in this exam. All right and the
6:47:12first one it was on MMPs. Okay. So in
6:47:15this they had asked you that which among
6:47:17these MMP enzymes get trapped in the
6:47:19mineralized dentine during the
6:47:21dentinogenesis.
6:47:23All right. Yes. Yes. I know guys
6:47:26seriously I know you guys haven't slept.
6:47:28I know the exam was very taxing. I can
6:47:30get your messages right now. So there is
6:47:32that lag. Yes, I know. I was also there
6:47:35in the exam. I also gave it and while
6:47:37giving the exam, I had the same thought.
6:47:39I don't know how the students are doing.
6:47:41I was inside from 8:00 till 1:10. We
6:47:44were not allowed to go. So, yes, it was
6:47:47extremely taxing and you guys had to be
6:47:49very quick. I know the sessions were
6:47:51whatever the divisions were there, they
6:47:53were a little tedious because there were
6:47:54heavy loads of each kind of question
6:47:56sections in those. But yes, you all did
6:47:59your best. Now, the main thing is yet to
6:48:01come. Okay. Yes. Yeah. Yeah. Let's
6:48:04begin. Which among this following MMP
6:48:06enzymes get trapped in the mineralized
6:48:07zendine during dentinogenesis? All
6:48:09right. You know in this uh this was a
6:48:12tricky one because we have not been
6:48:14usually studying about the enzymes. We
6:48:16know that they play a role into breaking
6:48:18the collagen and into the
6:48:19mineralization. All right. See the first
6:48:22one the gelatinise one. All right. This
6:48:24one is secreted heavily by your
6:48:26odontolast. All right.
6:48:31And these are the ones these are h
6:48:33helping you in the tissue layout. Okay.
6:48:37So this is the one that is playing a
6:48:38direct role in this. Most of them are
6:48:40playing a direct role but this one is
6:48:42the one that is basically laying down
6:48:43that matrix. All right. So jelly form.
6:48:46So this one is the one that gets
6:48:48entrapped into this. Collagenous is the
6:48:50one that does not get entrapped because
6:48:51it is in the early stage and after that
6:48:53it is doing the breakdown and then the
6:48:54mineralization is occurring. Okay. The
6:48:57stromalyine. This one is the one that is
6:49:00present in the unmineralized predentine
6:49:02only. All right.
6:49:05During the pre-entine time. So this one
6:49:07is also not present there.
6:49:10Enamelize. I know many of you will be
6:49:12thinking that ma'am how this can be the
6:49:14one because it is associated with enamel
6:49:16but yes it is associated. It does play a
6:49:18role into that non-olaginous matrix
6:49:20formation okay onto the protein
6:49:22framework. So the ultimately after doing
6:49:24a lot of research okay I came to this
6:49:26conclusion that your answer is C that is
6:49:29your one and four. Okay I want to know
6:49:31if any of you got this right. I know
6:49:33many of you might have marked 1 2 and
6:49:35three thinking that that could be
6:49:37answer. Many of you might have gone to
6:49:40the option thinking that it could be 2 3
6:49:424 but no it was 1 and four. Okay it is
6:49:44your gelatinous and anamealies. So if
6:49:46any of you by luck has got this answer
6:49:49correct, you will be definitely getting
6:49:51ahead of in few ranks. Okay. But if you
6:49:54have not got it right also it doesn't
6:49:56matter because many of them might not be
6:49:58getting this answer. Okay. It was
6:49:59completely out of the books. So a
6:50:02difficult one. So you only had to do the
6:50:03guesswork. All right.
6:50:07Fine. So as in enamel I had taught you
6:50:09that these are this matrix metal
6:50:10proteins. They're going to play this
6:50:11role. So enzymes. Some of you might have
6:50:13been able to guess it but it was not an
6:50:15easy one. Rest all are easy. So now
6:50:17let's get to that. During the
6:50:19hisystological examination of parit
6:50:20gland biopsy what kind of cells would be
6:50:22seen? See they had already given it very
6:50:25easily that the serious scenis are going
6:50:27to be there. Okay you just had to
6:50:29remember the shape of that you know that
6:50:31the serrus cells how their seenis are.
6:50:33All right this was a very very easy
6:50:35questions and you had to remember I have
6:50:37taught you how on the apical side those
6:50:39granules are there. Okay. So many of you
6:50:42might have thought see gobble if anyone
6:50:43has got wrong that is completely wrong.
6:50:45You know that this one is the one which
6:50:46is associated with your magular sinus.
6:50:49Okay, that's true membrane central
6:50:52cells. No, not these ones also. Now you
6:50:55have to think apical and basil
6:50:56eunophilia means they are trying to talk
6:50:59about the staining. Okay, the zyogen
6:51:01granules when they get stained okay
6:51:03where is it present? So I have taught
6:51:05you that it is the apical part. So it
6:51:07was a very very easy question and I am
6:51:10pretty sure most of you would have got
6:51:11it right. Yes, the questions prana were
6:51:14very technical. Yes, I know they were
6:51:16too lengthy to read. Okay, there were
6:51:17columns the multiple of them remembering
6:51:19the matching even I was tired of
6:51:21remembering those questions that how
6:51:23difficult they are. So I'm pretty sure
6:51:25how like you know you all must be tired.
6:51:31Okay, now let's get to the third
6:51:33question.
6:51:36Okay, see in this you remember I had
6:51:38taught you this. Okay, in your notes
6:51:40also it is very well present and I'm
6:51:42pretty sure all of our students have got
6:51:44it right. Okay, which of the following
6:51:46is the function of enamel not? The
6:51:48classic question I've been taught
6:51:49teaching you like forever right you know
6:51:52that that it does not produce dentine
6:51:54that's your dental papula cells that is
6:51:56one they're going to produce forms into
6:51:58PDL you know it is not that it is your
6:52:00hs that is the one breaking into it does
6:52:03it get converted into pulp no it is not
6:52:05that it has a very very important role
6:52:07that is a cell signaling and
6:52:08dentinogenesis okay I want a thumbs up
6:52:12that all of you got this question right
6:52:14okay I want 100% of you should be
6:52:16getting this right if you're going wrong
6:52:17in this you need to be more focused in
6:52:20your preparation after this. Okay, you
6:52:22cannot get these questions wrong. It
6:52:24will put you off with your rank a lot
6:52:26behind.
6:52:28Okay, as I've always highlighted it,
6:52:30this is very very important in your need
6:52:31in your INI. Okay, just tell me how many
6:52:35of you have got the question number
6:52:36three correct. Okay, I hope there is
6:52:38nobody who has got it wrong. Fine, tell
6:52:40that time. I'll be moving to the fourth
6:52:42one. Which is the correct eruption
6:52:44sequence of the following primary teeth?
6:52:46Okay. Now in this see I have always
6:52:49focused on the permanent one. Primary
6:52:51also we have taught you. I have told you
6:52:52that you need to know the sequence of
6:52:54it. Okay. So you always know that these
6:52:56are your centrals. You know that then
6:52:58the upper one. Fine. Then is your molar.
6:53:01Your primary moler is the one that
6:53:02erupts and after that is your canine.
6:53:04Okay. But to confuse you they had put it
6:53:07like that. That maxillary first mer and
6:53:09your mandibular second mer. They had put
6:53:11it like that. So any of you if you are
6:53:14not reading the question properly you
6:53:15might have got it wrong right so you
6:53:17know that the first one is your
6:53:20mandibular central incizer all right
6:53:22after that is your first moler okay
6:53:27reading of molar molar some of you might
6:53:29have got wrong into this fine and after
6:53:31that you know is your canine
6:53:34and then is your moler right so it is
6:53:38your this this one is your correct
6:53:41answer. See, there was a thin line into
6:53:43this. If any of you might have not read
6:53:45the question properly, you might have
6:53:47marked C, but that is wrong. Okay, it is
6:53:49your A. And I've got feedback for the
6:53:51question number three. All of you have
6:53:53got it correct. Very good.
6:53:55Fine. The fourth one was also very easy.
6:53:57It was just the chronology which I have
6:53:59been always teaching you. Those who all
6:54:01know the notes, they know this. Okay. In
6:54:02this notes also, I have given you the
6:54:04questions that which are important for
6:54:06you. The sequence also I have told you.
6:54:09Fine. The last question during the
6:54:11examination of TMG of the patient
6:54:13clicking sound is heard. I don't know
6:54:14why did they give this line in the first
6:54:16because they were trying to actually ask
6:54:17you the anatomy. So that is what they
6:54:19do. They try to drain your brain into
6:54:21reading it. So you have to always make a
6:54:23habit from today onwards and every
6:54:25question you have to read it. Okay. All
6:54:26the faculties they try to give you that
6:54:28big question so that you have a habit of
6:54:30reading them. You don't get lost in it.
6:54:31Your brain does not get tired. Fine.
6:54:34Because the main focus was the second
6:54:35part only. So according to the
6:54:37anatomical consideration of the patient,
6:54:39which structure holds the articular disc
6:54:41posterior during the opening and does
6:54:43not let it slide anterior? Okay, very
6:54:46very simple question, nothing much. See,
6:54:48clicking sound might let get you
6:54:49distracted, but you have to read the
6:54:51entire question and it was very easy.
6:54:53You know temporal mandibular ligament,
6:54:54it is the one that is not going to play
6:54:56any role into it. It is just supporting
6:54:57your mandible. Okay? So that you don't
6:54:59overopen it. You cannot it doesn't go
6:55:01beyond the limit. All right? joint
6:55:03capsule is the one that is holding the
6:55:05fluid and it is holding the joint in its
6:55:07place. It is not the one that is holding
6:55:08your articular disc. Fine. It is not
6:55:11associated with it. Your lateral tergoid
6:55:14muscle, you know that this is the one
6:55:15that is associated to your bone to your
6:55:17mandible. Okay? It is playing a role
6:55:19into the depression of it. So a clear
6:55:21answer was your retroiscal tissue. All
6:55:25right. All of you understood. So I only
6:55:28one question was the one which was
6:55:29tricky. Rest all four you were supposed
6:55:31to get it right. And if something is
6:55:33going wrong, work on it. If there was
6:55:36anxiety, if you were not able to read,
6:55:38if there was fatigue, evaluate it. Okay?
6:55:40Go back to it and think. If you have got
6:55:42this easiest question also wrong, need
6:55:45not to worry. You have still more time.
6:55:47Okay? And you will be able to do it
6:55:49further in your need also. Just
6:55:51re-evaluate. All right? Fine. See in
6:55:54this also I have taught you. We have
6:55:56this in our notes. Fine. So go back and
6:55:59read them properly. Fine. I hope all of
6:56:02you understood it and all the questions
6:56:03are cleared.
6:56:07Okay. So now further I would like to
6:56:10hand over this session to Dr. AJ and
6:56:12he'll be taking over time for the next
6:56:14part. Thank you guys.
6:58:49Okay.
6:58:50So, let's start.
6:59:19Okay, let's start.
6:59:31Yeah friends
6:59:33I am Dr. Ajay Adav. So let's start
6:59:36anesthesia questions
6:59:39straight away. Question number one.
6:59:42Which IV anesthetic agent maintain
6:59:43cardiovascular stability but decreases
6:59:45adrenal
6:59:47steroid synthesis?
6:59:49Ketamine theopentone propolate. Very
6:59:52straightforward answer. It is
6:59:53autotodate. So the advantage of
6:59:56automidate is its cardic stability and
6:59:58that's what is a screenshot from uh our
7:00:01notes also that automidate is the most
7:00:05cardiovascular stable.
7:00:08However despite being the most
7:00:10cardiovascular stable we're not able to
7:00:12use it routinely because it causes
7:00:14adrenal suppression. Although this
7:00:17adrenal suppression is not [snorts] very
7:00:19common but when it happens it can be
7:00:21really disastrous because adrenal
7:00:23suppression is not an acceptable
7:00:25complication. Therefore we restrict the
7:00:28use of autotodate only for
7:00:30cardiovascular stable patients otherwise
7:00:33you know that the most commonly used
7:00:36agent is propall. So the most commonly
7:00:38used induction agent is propall
7:00:42but for cardiac patients we are
7:00:44preferring autoomidate.
7:00:48Then question number two, what the
7:00:50mechanism of action of non-deolarizing
7:00:52is sketal muscle relaxant inhibit
7:00:54binding of calcium to trop troponin C
7:00:57direct competitive antagonist of
7:00:59estoline at nicotinic receptors.
7:01:01Non-competitive antagonist of estoline
7:01:03and nicotinic receptors act by
7:01:05depolarizing the nicotinic receptors or
7:01:08maybe this choice uh may be little
7:01:11different we will see in queries if
7:01:13means other option. Anyway, let's we
7:01:16should focus more on the right option
7:01:19rather than the wrong options. So see
7:01:21this non- deolarizer and that again is a
7:01:23screenshot that non-deolarizers
7:01:26they are used for maintenance of the
7:01:28surgical relaxation
7:01:31depolarizers that is saxamethonium is
7:01:34used for intubation. So as far as
7:01:37mechanism of action is concerned.
7:01:40So muscle relaxent you know are the
7:01:42depolarizers
7:01:45and when we say deolarizers means it is
7:01:47suenylcoline
7:01:50or saxamethonium.
7:01:52So suenylcoline or saxamethonium why it
7:01:54is called depolarizer because it
7:01:56produces relaxation by causing
7:01:58depolarization means it exactly behaves
7:02:01like estylcoline. It bind to the same
7:02:03receptor site asyline binds. Then uh
7:02:07that will produce continuous muscle
7:02:09contraction in all body muscles that we
7:02:11can see as faciculations. But this
7:02:14constant or persistent deolarization
7:02:16will make the membrane to become
7:02:18refractory for a transient period and
7:02:20that period is a period of relaxation.
7:02:22So it produces relaxation by producing
7:02:24persistent deolarization. So that is why
7:02:27it is called as deolarizers. On the
7:02:29other hand, non- deolarizers,
7:02:32non- deolarizers, their mechanism of
7:02:34action is competitive antagonism.
7:02:40Competitive antagonism. You know the
7:02:42meaning of competitive antagonism from
7:02:43your very basic knowledge of
7:02:45pharmacology. That competitive
7:02:47antagonism means the non-deolarizer
7:02:51molecule is going to bind at the same
7:02:53receptor site at which estoline bind
7:02:56preventing estyloline to bind to the
7:02:58receptor. So that is competitive
7:02:59antonism and competitive antagonism you
7:03:02know is a pure number game. If there are
7:03:04more molecules of nondepolizer they will
7:03:06be able to replace estoline from their
7:03:08place. If there are more molecules of
7:03:10esteline they will be able to replace
7:03:12nondepolizers. And that is how we
7:03:14reverse the effect of nondepolizers by
7:03:17giving neo stigman. So neostigment you
7:03:20know prevent that degradation of
7:03:23estelcoline by inhibiting choline
7:03:26estrays. So more estyloline is available
7:03:28at neuromuscular junction to have
7:03:30competitive antagonism with
7:03:32non-epolarizes. So simply the mechanism
7:03:35of action of non-deolarizing skeletal
7:03:37muscle accent is the direct competitive
7:03:40antagonism of estyloline receptor act
7:03:44nicotinic receptors. So B
7:03:51question number three a 19year-old boy
7:03:53is admitted with severe burns and is
7:03:55planned for surgical devment of the
7:03:57wounds which skeletal muscle is
7:03:59contraindicated because of the risk of
7:04:01hypercalemia vicoronium atraurum
7:04:03saxeline pancoronium
7:04:06sueneline so this again is screenshot
7:04:09from our notes depolarizers the
7:04:12saxamethonium I told you it is
7:04:14considered as ideal muscle action for
7:04:16intubation. However, it biggest
7:04:19disadvantage is hypercalemia
7:04:22hypercalemia and why actually it causes
7:04:25hypercalemia
7:04:26because of the deolarization. We have
7:04:28seen the mechanism of action of
7:04:30saxameonium. It causes persistent
7:04:32deolarization. So persistent
7:04:34deolarization means persistent muscle
7:04:36contraction. So that is going to release
7:04:38lot of potassium into circulation
7:04:40producing hypercalemia. So this is one
7:04:43of the most major or you can say
7:04:45limiting side effect of saxamethonium
7:04:48hypercalemia and most of the
7:04:50pharmacology of saxamethonium revolves
7:04:52because it causes hypercalemia and
7:04:54that's what they [clears throat] have
7:04:55asked in this question that patient is
7:04:58admitted with severe burns.
7:05:00Burns you know there's already muscle
7:05:03injury. So already muscle injury means
7:05:05there is already hypercalemia and on top
7:05:09of that if you give saxamethonium that
7:05:12will further add to this hypercalemia
7:05:15and can produce a lifethreatening
7:05:18arhythmia. So therefore saxamethonium or
7:05:21saxa alkaline will be absolutely
7:05:24contraindicated in presence of existing
7:05:27hypercademia and that's why the common
7:05:30contraindication you can say is the
7:05:32recent ones
7:05:34as we have seen in this case or recent
7:05:40uh injury
7:05:42where particularly crush injury or
7:05:45recent stroke
7:05:47where there is also hypercalemia or for
7:05:50that matter I will say hyperc calalemia
7:05:53due to any region is an absolute
7:05:55contraindication for saxame
7:05:59similarly all muscular distrophies
7:06:02muscular distrophies also you know
7:06:04patients are hyper sensitive to the
7:06:06effect of saxameonium
7:06:09so they there can occur severe
7:06:11hypercalemia
7:06:15question number four a patient receives
7:06:18Ramifantaian infusion for 5 hours. After
7:06:20the infusion is stopped, respiratory
7:06:23function recover immediately even in the
7:06:24presence of deranged hypatic and renal
7:06:26function. What the cause? Hydrarolysis
7:06:28by plasma stray. CY
7:06:31P3A [clears throat]
7:06:32metabolism, excretion of drug via
7:06:34respiratory root exhalation, asselated
7:06:36accelerated renal clearance. So
7:06:38ramifentil
7:06:40so that's we have discussed about
7:06:41ramifentil in class that ramifentil
7:06:45that ramifentil is
7:06:50the agent of choice for daycare surgery.
7:06:53So that we even discussed in the agents
7:06:56or anesthesia for daycare surgery that
7:06:59opioid of choice for daycare surgery is
7:07:01dryant.
7:07:04Why? Because it is rapidly metabolized.
7:07:08So it is rapidly metabolized by RBC
7:07:11estraases.
7:07:15RBC as well as plasma straases mainly
7:07:18RBCS estraases. So it is not dependent
7:07:21on hpatic or renal functions. It is
7:07:23metabolized by RBC or plasma stresses.
7:07:27That is why duration of action is around
7:07:2910 minutes making it as an opioid of
7:07:32choice for daycare surgery. So just for
7:07:36your additional knowledge other agents
7:07:38for daycare surgery IV agent of choice
7:07:40is propall inhalation agent of choice is
7:07:43seoflur
7:07:46muscle extent choice of macurium because
7:07:48macurium is also metabolized by plasma
7:07:51pseudocinase
7:07:52and benzodizopin of choice is medazzylam
7:07:55because that is also short acting. So
7:07:57these are the four questions. Now let me
7:07:59just join the link to see if you have
7:08:02any queries or anything you want to
7:08:05correct in these questions. Let me join.
7:08:16>> So anything or any specific question you
7:08:19want to know? Okay, let me go it from
7:08:22the beginning.
7:08:48just connecting
7:08:51YouTube.
7:09:20Okay.
7:09:29I think these still are the former
7:09:31questions
7:09:32or dental questions.
7:09:50So flea bag one option was something
7:09:52about voltage gated sodium channels.
7:09:55Which question you means uh regarding
7:09:58this question number four or what
7:10:05uh
7:10:08you mean in this
7:10:12suctional choline I mean non-epoliz of
7:10:15action it is something related to
7:10:16voltage gated channels. So if it is even
7:10:18related to voltage gated channels it is
7:10:20invalid option they doesn't act through
7:10:24voltage gated channels
7:10:32depolarizing one or nondolarizing one
7:10:34depolarizing what is related to hyperc
7:10:37calmia suction alcholine so I think
7:10:39maybe non-epolarizing related so
7:10:42non-epolizing they don't act through
7:10:44sodium channels so anyway whatever was
7:10:46the option That's invalid option.
7:10:54Anything else?
7:11:15I think uh okay I'll just wait for one
7:11:18more minute. If you want to ask anything
7:11:19you can ask else I'll
7:11:22close the session.
7:11:28Last question answer is okay A. I told
7:11:33you raifentineil is metabolized by RBC
7:11:36or plasma estasis. So answer is a
7:11:40hydrarolysis by plasma stress or in
7:11:43plasma specifically if they give you
7:11:45even RBC so it is RBCS phases.
7:12:07Okay then I think nobody is putting any
7:12:09query.
7:12:12So this time the all questions are
7:12:14exclusive related to anesthesia
7:12:17pharmacology otherwise normally they're
7:12:19asking related to questions to endotraal
7:12:22tube and everything but sometimes they
7:12:23give surprise.
7:12:26So anyway okay then if you have any
7:12:29other doubt later on your telegram you
7:12:31can tag me.
7:12:34Okay then thanks for attending and my
7:12:36best wishes. I hope you all will come
7:12:38with flying colors in your exams.
7:12:42Okay, then my best wishes.
7:13:07Hello everyone.
7:13:11So this is Dr. Abrami your physiology
7:13:14faculty. Uh there were around uh I think
7:13:17five to six questions from physiology.
7:13:21So the questions were like uh from basic
7:13:24discussions only basic physiology only
7:13:26uh and few of the medicine questions
7:13:28also had a physiological basis. So as
7:13:31far as the information obtained from our
7:13:34students uh we've tried to recollect the
7:13:37questions. So the first question uh was
7:13:40from muscle [clears throat] physiology.
7:13:43During the initial 1 minute of moderate
7:13:46intensity exercise, the primary source
7:13:49of energy is derived from. So with this
7:13:52question uh few students said that it
7:13:55was the initial 1 minute of moderate
7:13:58intensity exercise and few of them said
7:14:00which is the uh just immediate source of
7:14:03energy. So we don't know which was the
7:14:05exact word but uh still let's discuss
7:14:08the uh complete sources of energy. So
7:14:11just imagine if you are going to get up
7:14:14and uh run into a race. So you just
7:14:16start running and you just slowly pick
7:14:19up your speed and then you just keep
7:14:22running. That's the sustained running.
7:14:24So the initial 1 to 2 second only your
7:14:28stored ATP will be depleted. It will be
7:14:30used up. Then after that this ATP has to
7:14:34be regenerated. And what are the
7:14:37resources of that? So first 1 to 2
7:14:40second ATP stored ATP will be used up.
7:14:43After that 5 to 10 seconds creatin
7:14:46phosphate will be the major source of
7:14:48energy. Then the next 30 to 90 seconds
7:14:52that that means around 1 minute 60
7:14:56seconds or around 1 minute. Next 1
7:14:58minute would be anorobic glycolysis.
7:15:01That would be the major source of
7:15:03energy. And after that from 1 minute
7:15:06onwards to maybe hours also sustained
7:15:10exercise you just keep on running just
7:15:12think of a marathon race where you just
7:15:13keep on running for distances aerobic
7:15:16oxidative metabolism comes into play. So
7:15:19if the question was like just the
7:15:21immediate energy definitely it is
7:15:23breakdown of ATP but specifically 1
7:15:27minute of uh energy response. So the
7:15:30first one minute around the first minute
7:15:32anorobic glycolysis would be the major
7:15:35source of energy. So if the question was
7:15:38just immediate breakdown of ATP but
7:15:40initial 1 minute means the better option
7:15:42would be anorobic glycolysis of energy.
7:15:48The next question was about match the
7:15:51following centers with the response. So
7:15:54this is mainly about I think the thirst
7:15:56control mechanism and the osmo
7:15:58receptors. So first let me tell you
7:16:00about the thirst control mechanism in
7:16:03hypothalamus. In your hypothalamus
7:16:09especially anterior hypothalamus
7:16:16this is responsible for cooling of the
7:16:19body. How does you remember in our class
7:16:22we learned this with example of a car.
7:16:25When uh you compare hypothalamus with a
7:16:27car, anteriorly in a car you have AC
7:16:30which gives you cooling. Similarly,
7:16:32anterior hypothalamus has cooling effect
7:16:34on the body. So anterior hypothalamus
7:16:37gives you this cooling effect. How does
7:16:39it give you this cooling effect? Because
7:16:41you have thirst centers present in the
7:16:44anterior hypothalamus. Thirst when you
7:16:47drink more water, you can cool down your
7:16:50body. So how will you stimulate this
7:16:53thirst? When will you know how to drink
7:16:56water? When will you know how when I
7:16:58should drink water? How will you know
7:16:59when to drink water? When when not to
7:17:01drink water. It all depends on
7:17:04osmolarity of your blood.
7:17:08If the osmarity of your blood increases,
7:17:10this is sensed by osmo receptors
7:17:15and these osmo receptors are also
7:17:16present in your anterior hypothalammus.
7:17:19uh when we say osmarity increases it
7:17:22means your blood is getting more and
7:17:24more concentrated. So there is a need to
7:17:27take in more water and dilute your
7:17:29blood. So that is sensed by osmo
7:17:32receptors and this will trigger thirst
7:17:34mechanism. It will make you to drink
7:17:36more water. When you drink more water
7:17:39automatically blood osmarity returns to
7:17:42normal. So this is the mechanism of how
7:17:45anterior hypoglamus has cooling effect
7:17:47on the body. And now I think uh these
7:17:51were the options which were given. We've
7:17:53tried to match it. So first we have the
7:17:56stimulus. The stimulus uh would be
7:18:00sensed by your uh
7:18:05actually this uh should have been uh
7:18:09stimulus should have been osmolarity
7:18:12but students said the option was like
7:18:14osmo receptor. So if the stimulus was
7:18:18blood osmolarity
7:18:23that is sensed by the sensors. sensors
7:18:28are present in your hypothalamus
7:18:31and uh the control uh center for this
7:18:35would be again your hypothalamus
7:18:39and
7:18:42the response would be water reabsorption
7:18:45in the kidneys. So as far as we have
7:18:48collected the options from students
7:18:50these were the options but let me give
7:18:52you the correct one
7:18:55the stimulus
7:18:56for this would be increase in blood
7:19:00osmolarity
7:19:03and that is sensed by the sensors which
7:19:08is your osmo receptor
7:19:13and u the center for controlling this
7:19:16would
7:19:17Hypothalamus
7:19:22and
7:19:26the response would be
7:19:29water reabsorption by your kidneys.
7:19:33Either it will make you to drink more
7:19:35water or it will stimulate the kidneys
7:19:39to reabsorb more water. And which is
7:19:42that hormone which is responsible for
7:19:43reabsorbing more water? ADH hypothalamus
7:19:47produces ADH or antidiuretic hormone and
7:19:51this antidiuretic hormone the function
7:19:54is reabsorption of water and when it
7:19:56reabsorbs water osmolarity will return
7:19:59back to normal. So the options were a
7:20:02little confusing in the recol maybe
7:20:05there's a recollection error or what I
7:20:07don't know but the correct one is this
7:20:10should be the correct sequence. So
7:20:13that's about the role of hypothalamus in
7:20:15maintaining your blood osmolarity and
7:20:18thirst mechanism.
7:20:21Third question was on thyroid hormones
7:20:24in circulation bind to which of these
7:20:28proteins? Thyroid hormones? 70% of
7:20:32thyroid hormones or majority of thyroid
7:20:35hormones they bind to TBG thyroid
7:20:39binding globulin which is the major
7:20:43thyroid binding protein.
7:20:46The remaining
7:20:4920 to 25%
7:20:51binds to
7:20:54trans
7:20:55thyin
7:20:57or pre albamin
7:21:01and maybe the remaining 5% binds to
7:21:06albamin. So here the error could be uh
7:21:10or where you will go wrong. Most of the
7:21:12substances in the body bind to albamin
7:21:15only. But thyroid hormones only 5% binds
7:21:18to albamin. Majority of thyroid hormone
7:21:21will bind to thyroid binding globulin.
7:21:24Or the other name of this thyroid
7:21:26binding globulin is thyopexin.
7:21:30Thyropexin.
7:21:32So the best option here would be thyroid
7:21:34binding globulin.
7:21:38Question number four. Which of these
7:21:40would increase insulin glucagon molar
7:21:43ratio? It means simply the ratio of
7:21:46insulin to glucagon. How much of insulin
7:21:48you have to how much of glucagon is
7:21:50present. Normally
7:21:53in wellfed state
7:21:57wellfed state means either you eat a
7:21:59carbohydrate rich meal or I inject you
7:22:02with directly carbohydrates. Glucose. I
7:22:04give you a glucose infusion. Anyways,
7:22:07you're fed with glucose. Either it could
7:22:09be oral or IV glucose. Glucose in the
7:22:13sense uh when you eat carbohydrates,
7:22:16they are going to be converted into
7:22:17glucose or directly if you're given IV
7:22:19bolis infusion of glucose. You have
7:22:22excessive levels of glucose. In order to
7:22:24decrease this blood glucose, insulin
7:22:26levels will rise
7:22:29and glucagon decreases
7:22:33because the function of glucagon the
7:22:36name itself is glucose agonist. It's a
7:22:38glucagon. It its role is to increase
7:22:41your blood glucose level. But already if
7:22:44I directly give you either oral glucose
7:22:47or IV glucose already your blood has
7:22:49glucose. So there's no need for
7:22:51glucagon. Glucagon will decrease.
7:22:52Glucagon increases blood glucose.
7:22:54Already you have more blood glucose. So
7:22:55glucagon levels will decrease. So in
7:22:58wellfed [clears throat]
7:22:58state insulin is more and glucagon is
7:23:01less. If numerator is more and
7:23:04denominator is less obviously your ratio
7:23:07will be more. So insulin to glucagon
7:23:09molar ratio increases. This is in
7:23:13well-fed state. But what happens in
7:23:16fasting state?
7:23:20Exactly the opposite. In fasting state,
7:23:24insulin levels are low
7:23:27and glucagon levels are high and
7:23:30therefore the ratio decreases. So in
7:23:34well-fed state either it could be high
7:23:36carbohydrate meal or IV glucose. But
7:23:39which one do you think will rapidly
7:23:41increase your blood glucose level? You
7:23:43eat glucose or I inject you with
7:23:44glucose. Definitely IV glucose only. So
7:23:47of this the best option would be IV
7:23:49glucose. If you give an IV bolus of
7:23:51dextrose or glucose, insulin levels will
7:23:55increase, glucagon decreases, therefore
7:23:57insulin to glucagon molar ratio
7:23:59increases.
7:24:02[clears throat]
7:24:03Question number five, which of the
7:24:05following is correct? Uh I think
7:24:08sequence was not there about cardiac
7:24:10impulse generation or uh we're not sure
7:24:14about exact framing of the question. So
7:24:16if the question is which of the
7:24:18following is the correct uh sequence
7:24:21then it would be definitely from SA node
7:24:24SA node to AV node AV node to bundle
7:24:29office. Bundle office divides into left
7:24:32bundle branch
7:24:35and right bundle branch.
7:24:40So they in turn divide into
7:24:44perkingi fibers and perki fibers are the
7:24:48fastest conducting system of the heart.
7:24:51So uh if the question is which of the
7:24:54following is responsible for impulse
7:24:56generation then it would be SA node from
7:24:59SA node into AV node. So that would be
7:25:02the uh SA node would be the site of
7:25:05generation of cardiac impulse. Or if the
7:25:08question was which of the following
7:25:09statements are correct something like
7:25:11that then highest conduction with
7:25:13perkengi fibers highest conduction means
7:25:16fastest conduction with perkenji fibers
7:25:18that is correct. Uh there's a slow
7:25:21conduction from epicardium to
7:25:23pericardium sorry endocardium to
7:25:24pericardium. Uh actually the electrical
7:25:28activity goes from endocardium to
7:25:31epicardium. Okay endocardium to
7:25:33epicardium. Um so I'm not sure what uh
7:25:36how the question was framed but anyways
7:25:39Senode is the site of impulse
7:25:41generation. Fastest conduction is seen
7:25:43in the perki fibers and from SA node
7:25:46they pass through the atria to come into
7:25:47the ventricles and uh the electrical
7:25:50activity will be from endocardium to
7:25:52epicardium not from endocardium to
7:25:54paricardium it's from endocardium to
7:25:56epicardium.
7:25:57So that's was about this uh fifth
7:26:01question. If you are able to recollect
7:26:02the correct framing of the question, you
7:26:05can just help us.
7:26:08Question number six, estrogen deficiency
7:26:11in menopause will cause which of these?
7:26:14This we actually discussed in the class.
7:26:15This is a screenshot from what we have
7:26:17discussed in the class. So we studied
7:26:19about the functions of estrogen and then
7:26:22we correlated this with the
7:26:23postmenopausal women. uh until menopause
7:26:26you have estrogen in your body. So these
7:26:29are all the functions of estrogen but
7:26:31after menopause estrogen is not there.
7:26:33So in the absence of estrogen the women
7:26:35will start showing all these
7:26:37postmenopausal features. For example uh
7:26:40estrogen responsible for female
7:26:43secondary sexual characteristics. So
7:26:45after menopause what happens? Female
7:26:48secondary sexual characteristics will
7:26:49decrease. That is why there is breast
7:26:52atrophy.
7:26:54Estrogen increases growth of ovarian
7:26:57follicle. That is why after menopause
7:26:59there is follicular atrophy. Ovelation
7:27:02cannot happen. Anovvelation aminora.
7:27:05Estrogen increases uterine motility,
7:27:07blood flow and contractile proteins.
7:27:10That is why after menopause the tone of
7:27:12the uterus completely decreases
7:27:15and estrogen
7:27:18increases ductal growth in the breast.
7:27:20So after menopause there is loss of
7:27:22breast firmness. Estrogen increases
7:27:24libido after menopause. There is loss of
7:27:26libido.
7:27:28Estrogen inhibits osteoclast. This was
7:27:31the exact statement that we discussed in
7:27:33the class. Estrogen inhibits osteoclast.
7:27:36That is why osteoclasts are cells which
7:27:39do bone destruction. Estrogen is
7:27:42inhibiting osteoclast. It is actually
7:27:44protecting your bones thereby preventing
7:27:46osteoporosis. So before menopause
7:27:49osteoporosis
7:27:50um occurrence is less only but after
7:27:53menopause sudden estrogen withdrawal
7:27:55estrogen is not there and therefore
7:27:59there is osteoporosis in post-menopausal
7:28:02women. So estrogen inhibits osteoclast.
7:28:05So estrogen deficiency will increase
7:28:08osteoclast. Estrogen will inhibit. If
7:28:10estrogen is not there there's no
7:28:11inhibition. So osteoclast activity will
7:28:14increase. So that would be the best
7:28:16option. option B and other functions of
7:28:18estrogen. Estrogen increases
7:28:21proliferation of dendrites in the
7:28:23neurons. Neurons are multiplying and u
7:28:27that is why in a post-menopausal women
7:28:30because the neural activity becomes
7:28:32sluggish cognition decreases. She has
7:28:34mood mood swings and estrogen decreases
7:28:38FSH. That is why after menopause there
7:28:41is a sudden increase in FSH. This is
7:28:43actually a test for postmenopausal. If
7:28:45you want to check if a woman has
7:28:46attained the menopause, confirmity test
7:28:48for menopause, you can check FSH levels.
7:28:51Until menopause, FSH levels will be low.
7:28:53But suddenly after menopause, there's a
7:28:55rapid increase in FSH levels. Estrogen
7:28:57decreases plasma cholesterol. It'll
7:29:00increase nitric oxide. And that is why
7:29:02after menopause plasma cholesterol
7:29:04levels are increasing, isotilation
7:29:06effect is not there. So the women has
7:29:08increased cardiovascular risk.
7:29:10[clears throat]
7:29:19That was about uh the discussion on
7:29:23physiology questions. So most of them
7:29:25were basic questions but since we were
7:29:27not able to get the exact framing few
7:29:30words if you change few words in the
7:29:32question the answer itself would change.
7:29:34So if you uh are able to recollect the
7:29:36correct phrases which were given you can
7:29:38just uh send it to us. Um otherwise the
7:29:41concepts remain same in physiology. We
7:29:43have discussed the concepts in the right
7:29:45way. Thank you so much for joining with
7:29:47me in this session. See you soon in
7:29:49another session. Thank you.
7:30:13So good evening everyone. I know you
7:30:16guys have been sitting since morning for
7:30:18the recall. Okay. So I will try to
7:30:21finish the recall. Now with respect to
7:30:23oral pathology. Okay. We had around 16
7:30:27we had around 18 to 20 questions from
7:30:31oral pathology. Now I always say that
7:30:34recall is the most important session for
7:30:37the students who are going to appear in
7:30:39the exam or either in the next INI exam
7:30:42or for the upcoming NEAT exam. Okay. So
7:30:45let's have a look on the recall. Now
7:30:48with respect to oral pathology out of
7:30:50all the important topics out of all the
7:30:53important topics uh just give me a
7:30:55second let me just have a look.
7:31:03Okay. Yes. So the next is oral
7:31:07pathology. Okay. Now out of all the
7:31:09important topics I think we had
7:31:11discussed that odontogenic cyst and
7:31:14odontogenic tumor it is the most
7:31:16important topic out of all. So I can say
7:31:19that yes good evening prren. So I can
7:31:21totally say that uh from odontogenics
7:31:24there were seven to eight questions and
7:31:27these seven to eight questions were so
7:31:29easy were so easy and I also know that
7:31:33the questions which had come in this
7:31:35year I ini these were pretty long
7:31:38questions but the questions were very
7:31:40easy only one questions which I found
7:31:43that it was slightly on the difficult
7:31:45side otherwise it was a moderate paper
7:31:48okay but no doubt the paper was slight
7:31:50slightly lengthy so you had to read a
7:31:53lot. Am am I correct? Yes. Good evening
7:31:55everyone. Now which of the following
7:31:57statements are correct regarding a
7:31:59nasopalatine duct cyst? Okay. So we had
7:32:03read nasopalatine duct cyst. Okay. What
7:32:06kind of cyst is the nasopalatine duct
7:32:08cyst? Yes. Now I would also like to say
7:32:11now these questions which I have got
7:32:13option these all these all questions are
7:32:16recalled questions by the students. So
7:32:18if you guys feel that this option was
7:32:21not there, yeah, apart from this option,
7:32:23the option was something else. Just uh
7:32:25mention me on the YouTube chat. Okay,
7:32:27I'm also seeing your uh chat.
7:32:32Address them. Yes. Yes. Do not worry Ro,
7:32:35I will obviously I will address your
7:32:37comments. Okay. And you guys all have my
7:32:39number. So you can also give me a
7:32:41personal message. Okay. If you guys
7:32:43want. I am sure. Okay. One second.
7:32:46Yellow is discoloration of the interior
7:32:48teeth. Now see the same flea bag. Okay.
7:32:51Same thing I have put up on the slide.
7:32:54Okay. So let's come back. Okay. It may
7:32:57appear as a bluish swelling. Now when
7:32:59the cyst expand, when the cyst expand,
7:33:02it shows a bluish discoloration. Okay.
7:33:05Now yellowish discoloration of the cyst,
7:33:08it is very normal yellowish
7:33:09discoloration. It appears as a
7:33:11blanching. So this is not a very
7:33:13correct. I would say that. Now it also
7:33:16depends upon the option what are the
7:33:18sequence of the option. Third [snorts]
7:33:20salty like discharge. Now salty like
7:33:22discharge we had already discussed. Okay
7:33:24that we see nasopalatine dues salty
7:33:27discharge. So one three and it is
7:33:31present in the region of incessive
7:33:33papula. Yes. So let's have a look on the
7:33:36options. So all the options were most of
7:33:38the time were the multiple choice
7:33:40options. Okay. So one bluish swelling
7:33:43four. Now easier way to rule out the
7:33:47option. Rule out the option. Okay. This
7:33:50is what I have got. Okay. Now one option
7:33:54may correct. Four option to this is for
7:33:57sure it is correct. Salty discharge is
7:33:59also there. So option D. Okay. Yellowish
7:34:04discoloration of the teeth was there.
7:34:06Okay. Now it depends option whether it
7:34:09was there. Now whenever we mark an MCQ
7:34:11question we mark based on the most
7:34:15appropriate right answer. Okay, am I
7:34:19clear? So if yellowish discoloration of
7:34:22the tooth was there and if in the option
7:34:251 2 3 4 both are there then we can go
7:34:28with 1 2 3 and four. Okay. But as of now
7:34:32what I have got option D that is 1 3 and
7:34:35four should be the right answer. Okay.
7:34:38Similarly, I have also put the
7:34:41screenshot of the notes which we had
7:34:43discussed. Okay.
7:34:47Now coming to the second question again
7:34:49a question on the cyst. Okay. A 35 year
7:34:52old patient presented with the
7:34:54radolucent lesion associated with the
7:34:58okay it was there as 1 2 3. Okay fine a
7:35:0435 year. Now the main thing what you
7:35:06have to what you have to understand is
7:35:08the concept here. Okay. A 35 year old
7:35:11patient presented with a radolucent
7:35:13lesion associated with a nonvital
7:35:16maxillary anterior teeth. I think the
7:35:18easiest question on the earth. Okay.
7:35:21What is the most likely diagnosis? So
7:35:24the answer here is radicular cyst. So
7:35:26which is the most common most common
7:35:29odontogenic cyst? Radicular cyst. and
7:35:32they have also mentioned that it is
7:35:33present in the maxillary anterior teeth
7:35:36and hence the answer is radicular cyst.
7:35:38Okay, I'm also looking at your uh
7:35:40YouTube chat. Okay, so not to worry.
7:35:42Hence this was pretty well discussed in
7:35:45the class. I have put up the screenshot.
7:35:46I do not need to discuss with you all
7:35:49because you guys know this. Now again a
7:35:51question third question again a question
7:35:53on the cis. What is the characteristic
7:35:56hisystopathological feature of
7:35:57odontogenic keratossis? We know that
7:36:00odontogenic keratossis it is a
7:36:04paracaratinized
7:36:06stratified. So parakarotin
7:36:11then we do not have to read the full
7:36:13question. We know that as in general the
7:36:16OKC is parakarotanized. Hence the answer
7:36:19is a. Coming to the next question. See
7:36:23this we had done this in the class. This
7:36:25is the screenshot of the notes which we
7:36:27had discussed in the live class or the
7:36:29recorded session or even we had
7:36:31discussed this multiple time in your
7:36:34this is basically a PQ. Okay. So we had
7:36:36discussed this in the grand test also.
7:36:38Okay. So the epithelium it is the
7:36:41paracaratenized.
7:36:43Okay. Now this is a question of
7:36:44odontogenic tumor. Now this is a
7:36:46slightly a tricky question. Okay. Which
7:36:49of the following is a characteristic
7:36:50clinical? Now radiographic I have not
7:36:54got what was the radio graphic. Now if
7:36:56you guys can help me out okay with the
7:36:59options uh then it would be much easier
7:37:01for me but as of now this is what I have
7:37:03got from the recall. Which of the
7:37:05following is a characteristic clinical
7:37:07and radiographic feature of the
7:37:09magillary odontogenic tumor. Okay
7:37:14options rule out for any tricky question
7:37:17just try to rule out the option. Okay.
7:37:21Confused between option 1 2 and three.
7:37:23If okay if there is a yellowish
7:37:26discoloration I do not know. Yellowish
7:37:28discoloration can be present. Okay.
7:37:30Yellowish discoloration of the tooth can
7:37:32be present. It is not necessary that it
7:37:35cannot be present. It can be present.
7:37:37Okay. So it can be 1 2 3 and four. Okay.
7:37:41Fleeback.
7:37:43Now question number four. Which of the
7:37:45following is a characteristic clinical
7:37:47and radiographic feature of the
7:37:48magillary odontogenic tumor? So they
7:37:51have not particularly mentioned which
7:37:53odontogenic tumor. So it is a
7:37:54generalized question.
7:37:57Tumor what we will see there will be
7:38:00swelling will be present. This was
7:38:02present I think it was present as a
7:38:03multiplechoice answer. So swelling now
7:38:08paresthesia of the infraorbital nerve.
7:38:12Okay. Now when the any kind of
7:38:14odontogenic tumor tumor when it grows
7:38:18expands excessively okay longstanding
7:38:22then the it can involve the infraorbital
7:38:26nerve and uh you know it can lead to the
7:38:30paristhesia of the just give me a second
7:38:39paristhesia of the infraorbital I got a
7:38:42nose.
7:38:58Okay. Okay. Yes, I can see. Huh.
7:39:01I was not able to check the YouTube
7:39:03chat. One second.
7:39:15Okay ma'am it was benign tumor. So yes
7:39:17if it is was benign tumor then I'm
7:39:20pretty sure that uh infra or vital nerve
7:39:24will not get involved. Okay. So as of
7:39:27now it is the swelling in the maxillary
7:39:30anterior region.
7:39:33Okay. Yes.
7:39:36So now coming to the next question match
7:39:38the following. So we know this
7:39:40pleomorphic edenoma
7:39:43duct like cells in the cornro mixoid
7:39:46stroma. Okay. So one B one B. So
7:39:52uh B option. Now two amoblastoma
7:39:56island of odontogenic epithelium. Now
7:39:59this there is a presence of tall
7:40:01columnar cells and above these tall
7:40:03columnar cells there is a presence of
7:40:05central stilate reticulum like cells. So
7:40:072 a okay. So as of now we are mostly
7:40:11going with B. Okay. OKC may we had just
7:40:15read what is OKC paracaratinized
7:40:18stratified squamus epithelium with
7:40:20corugation. Okay.
7:40:25and parakarotinized stratified squamos
7:40:27epithelium piogenic granuloma. What we
7:40:29are left with lobulated proliferation of
7:40:31capillaries. No dear tumor until unless
7:40:35it expands so much it cannot cause the
7:40:38paristhesia. It cannot cause
7:40:40paristhesia. Okay. Anything paristhesia
7:40:44it it requires a longstanding tumor.
7:40:47Longstanding tumor. Okay. So here the
7:40:50answer is B.
7:40:53So we had read this in the class about
7:40:55the amobol blastoma. I I had just put up
7:40:58the screenshot. Now syndromes match the
7:41:01following. Okay. So very easy way. Okay.
7:41:05Wherever you know that this is the
7:41:07matching option. Try to see the option
7:41:09with that. Okay. So ectoermal dysplacia.
7:41:13Ectodermal dysplacia. Hypodonia with the
7:41:16hypodonia with the conical root. Okay.
7:41:21Cleoranial dysplacia multiple impacted
7:41:24super numery teeth. So 3 A 3 A 3A. Now
7:41:29ectomal dysplacia 2D.
7:41:32Okay. 2D ma'am.
7:41:36Tingling sensation
7:41:39invasion. Yes. Tingling sensation can
7:41:42happen. Okay. Because uh it if if it is
7:41:46near around the infraorbital nerve. Now
7:41:48they have also not mentioned the
7:41:50location. They have also not mentioned
7:41:53the location.
7:41:55Okay. So um cletorranial displacia 3 a
7:42:00then ectoermal displacia 2 D then one we
7:42:04can match with the premature loss
7:42:06hyposphet
7:42:08phosphatamia.
7:42:11Yes. Aos hypophosphetamia delayed
7:42:14eruption with severe periodontitis.
7:42:17Okay. So we can go with option A.
7:42:20Okay. So cleanial disysplasia we had
7:42:23read that there is a presence of
7:42:25multiple impacted supernumeary teeth.
7:42:27Again very very important question. So
7:42:30this is a this is from a past year
7:42:32question. We are discussing the same
7:42:34question from past I think four years
7:42:37regarding the same topic. Okay. So
7:42:40penigus vulgaris what kind of split do
7:42:42we see in penigus vulgaris? Supra
7:42:45basilar split. Okay. PFigus vulgaris
7:42:49supra basillar split. Bulis pmpigoid we
7:42:52see subbasillar split or we can say that
7:42:54subep epithelial cliff. Now cisatrical
7:42:57pmpigoid it is also called as benign
7:43:00mucus membrane pmpigoid. So again but
7:43:03the split which is seen again it is
7:43:05subepithelial split aryma multififor
7:43:08inflammatory cell infiltrate. Okay. So
7:43:12sub epithelial edema in one option
7:43:19beta sub
7:43:21which matches for arythma multififor
7:43:26sub epithelial clefting what will happen
7:43:29there the fluid will come okay and hence
7:43:32it will be seen as vycles and the bulla
7:43:35okay
7:43:37apart from this if there is anything
7:43:39okay if you have any doubt you can just
7:43:42message me on my number 8095. We will
7:43:46have a look in detail.
7:43:48Okay. So this is my WhatsApp number you
7:43:50can message me. Okay. So some students
7:43:53are saying there was a presence of edma
7:43:55some are saying there is no presence of
7:43:56edema. Okay. We will go according to the
7:43:59concept and if your concept is right you
7:44:02will be able to mark the right answer.
7:44:04Okay. So 1 A, 2 B, 3 C and 4 D. Whatever
7:44:08the multiple choice options were there,
7:44:10you can match with that. Okay. See this
7:44:14is a penigus vulgaris hystopathology.
7:44:17Now what is this? This is a basement
7:44:19membrane. And above this basement
7:44:21membrane, what can we see? This is a
7:44:24this is a suprabasellar
7:44:27split. Okay. And hence because of this
7:44:29split the fluid enters inside and we see
7:44:32as vycles and pula.
7:44:36Now again this question was very well
7:44:38discussed in the class regarding mucco
7:44:40epidermmoid. Now uh now just by the name
7:44:46mucco epidermmoid mucus cells
7:44:49epidermmoid cells are okay but there is
7:44:51one more cell that is the intermediate
7:44:54cells are also present. Okay. So
7:44:56intermediate cells, epidermmoid cells
7:44:58and the mucus cells all these three are
7:45:00present. Okay. So 1 2 and three 1 2 and
7:45:04three plasma cells it is not a very
7:45:06clear uh proper clinical or the
7:45:10hystopathological feature of
7:45:12mucoepidermoid carcinoma. Okay.
7:45:16Now question number nine. A patient
7:45:18presented with a scalloped radolucency
7:45:20in the posterior mandible extending
7:45:22between the roots of the adjacent tooth.
7:45:24On aspiration again a question on the
7:45:27cyst. Now this question is on a
7:45:29pseudosis. On aspiration the needle is
7:45:31found to be empty. What is the most
7:45:33likely diagnosis? Okay. So says cyst
7:45:38when we aspirate especially it is
7:45:40present in the posterior mandible. When
7:45:42we aspirate we get there was a one
7:45:44terminology which we had read in the
7:45:46class that is the that is a dry tap that
7:45:50is a dry tap okay so it is not the okay
7:45:54anorismal bones there if we aspirate in
7:45:58the aneurismal bones we will get now
7:46:01these are blood fil cystic cavity so on
7:46:04aspiration we will get blood central
7:46:07giant cell granuloma
7:46:09again we might get blood but especially
7:46:13it is not a empty cavity. Hence here the
7:46:16answer is simple bones which we had very
7:46:19well discussed in the class. Okay, I can
7:46:21tell this. Okay. So when inucleation is
7:46:24done clot debris are seen and on
7:46:26aspiration we get dry taps indicates no
7:46:30cystic fluid. So by this you can figure
7:46:33it out that why I had always stressed on
7:46:36the topic like odontogenic cyst and
7:46:38odontogenic tumor. I think uh when I
7:46:41teach you all the first topic which I
7:46:44teach is the odontogenicsis and out of
7:46:46you know 15 to 20 question you had eight
7:46:50questions from the odontogenicsis. So it
7:46:53is a huge number. Okay. Again very easy
7:46:57question. Same image was discussed in
7:47:00the class. This was the image which was
7:47:02discussed in the class. Am I right? Am I
7:47:06right?
7:47:08So a six-year-old child presented with a
7:47:10bluish fluctuant swelling over the
7:47:12region of a erupting permanent mer. What
7:47:14is the diagnosis? It is eruption.
7:47:18Eruption cyst.
7:47:20Okay. Now which of the following lesion
7:47:22can be associated with the unerrupted
7:47:24mandibular tooth? So this is again a
7:47:26slightly tricky question. Okay. And have
7:47:28a follicular space. Now based on the
7:47:31question what they have mentioned okay
7:47:34they are basically they are telling that
7:47:36it is a we know that in denturesis the
7:47:40important hallmark as we had discussed
7:47:42this in the class gross finding the
7:47:44cystic lining it is always attached at
7:47:47the CJ which is the hallmark of the
7:47:50dentures
7:47:51but they are telling in the question
7:47:54according to the recall what the
7:47:56students had me told me that they were
7:47:58asking about the differential diagnosis.
7:48:02Okay, differential diagnosis. So apart
7:48:06from radicular cyst everything can be
7:48:09present. Everything can be present until
7:48:11unless we are doing the hisystopath we
7:48:13cannot particularly tell that this is a
7:48:15denturous cyst. Okay. So based even in
7:48:18the options it is not just given as a
7:48:21denturous cyst. So they had given
7:48:22dentigerous unicystic amboplastoma and
7:48:25OKC. So 1 3 and four. Yes, differential
7:48:30diagnosis. So based on this whatever the
7:48:32information which I have got this should
7:48:34be the most appropriate answer.
7:48:39Okay. Now coming to the next question.
7:48:41Cement blastoma can be differentiated
7:48:44from the osteoblastto by which of the
7:48:46following features? Now you have to just
7:48:49remember what is cement blastto. Now
7:48:52when there is a cementtoblasttoma
7:48:53cementtoblastoma comes under the third
7:48:56category of the benign odontogenic
7:48:58tumor. what it does excessive cementum
7:49:01formation. Now it gets attached to the
7:49:04apex of the root and now what happens
7:49:07there is a resorption of the root. So
7:49:09the most important feature you can
7:49:12differentiate from the osteoblastto it
7:49:15is association with and the fusion to
7:49:18the root apex of the tooth. Presence of
7:49:20osteoplastic rim lesion size it is not
7:49:23very important. Presence of osteoplastic
7:49:25resorption
7:49:28but the major differentiating feature is
7:49:29the association with and the fusion to
7:49:31the root apex of the tooth. Again
7:49:34cementto blastoma say it is a pyq again
7:49:37this is a question I can say that it is
7:49:38from the odontogenic tumor to 78
7:49:40questions from the cyst odontogenic cyst
7:49:422 three two three questions from the
7:49:44odontogenic tumor. Okay, this we had
7:49:47discussed this in the class. Okay,
7:49:50regarding the cementto plastoma,
7:49:52excessive cement change in the root
7:49:54morphology, root resorption of the
7:49:55involved root. Okay,
7:49:58now hisystopathological examination of a
7:50:01jaw lesion. Now this is slightly a
7:50:03tricky question. Okay. So yes here the
7:50:06answer is a. Yes, the answer is prem
7:50:09shanka. The answer is a. Now all this
7:50:11recall session it is very important for
7:50:13the students who are going to appear in
7:50:15the need. Okay. So, hisystopathological
7:50:17examination of a jaw lesion reveals the
7:50:20following features. Presence of both
7:50:22woven in the lameular bone curvy linear
7:50:25ginger root like bony tbaculate. So,
7:50:27whenever you get a tricky question, try
7:50:30to rule out the options. Try to rule out
7:50:32the options. Okay. Empty lacun arranged
7:50:35along the reversal line presence of the
7:50:37spindle-shaped cells. Okay.
7:50:41We will try to rule out the options.
7:50:43We are sure that this is not the option.
7:50:46Adinometoid odontogenic tumor. Am I
7:50:49clear? Okay. Cmentotolasto.
7:50:54Cementtoblastoma. Now we are confused
7:50:56between fibrous dysplacia and the
7:50:58cementtosious disysplacia. Now now
7:51:00hystopathological may the second option
7:51:03which is given. Okay. Have we read in
7:51:06the live class recorded session what
7:51:09characteristic hisystopathological
7:51:10feature we had read?
7:51:12Chinese transcript pattern. Chinese
7:51:16transcript pattern. So that is the
7:51:19hisystopathological feature. Curvy
7:51:20linear ginger root like bony tbacul. We
7:51:24can say that it is a feature of
7:51:25cementtoious
7:51:28dysplacia. Cementtoious displacia. Now
7:51:31presence of both woven and lamar bone.
7:51:33It is seen in cementtoous displacia.
7:51:35With due course of the time what
7:51:37happens? there is a necrosis and hence
7:51:41these neck crosses they turn into the
7:51:43empty lacun and these are arranged in
7:51:46the reversal line and the presence of
7:51:48spindle-shaped cells is also there okay
7:51:52so according to me based on the options
7:51:54which I have got cementtoshious
7:51:56displacia suit should be the right
7:51:58answer okay now a [snorts] pathologist
7:52:00examines a gross specimen within the
7:52:03following features the tumor appear as a
7:52:05single solid mass the lesion can be
7:52:08separated ated. Now we have to rule out
7:52:10in a manner which lession gets attached
7:52:13to the bone or very highly infiltrative
7:52:17type of lesion. So if it is attached to
7:52:19the bone, we will not be able to
7:52:22separate it. Correct? And if it is a
7:52:24high infiltrative lesion again we not be
7:52:27able to separate it. So they are saying
7:52:28a pathologist examines a gross feature
7:52:31gross specimen with the following
7:52:33features. Okay. What is the most likely
7:52:34diagnosis? The tumor appear as a single
7:52:37solid mass. The lesion can be separated
7:52:40easily from the surrounding bone and
7:52:43mineralized structure are present within
7:52:45the lesion to mineralized structure be
7:52:47the lesion should be easily separated be
7:52:50and it is appearing as a single solid
7:52:52mass. Cementtolastoma. Can we separate
7:52:54cement blastoma? Now it gets attached to
7:52:57the root. There is a high osteoplastic
7:53:00resorption is there. So we cannot
7:53:01separate it. Okay. Osteocaroma.
7:53:04Saroma it is a cancer. Okay. So we
7:53:07cannot separate it since it is a very
7:53:09highly infiltrative lesion. Fibrous
7:53:12dysplasia firstly fibrous displacia it
7:53:15is expensile lesion and it gets attached
7:53:17to the bone. That's what we have read in
7:53:18the class. So the remaining option is
7:53:21oifying fibram. Now answer here is C.
7:53:24Okay. Now oifying fibram. Okay.
7:53:27Separation from the bone. A defined
7:53:29clinical and surgical feature of an
7:53:31acifying fibram. The cementto oscifying
7:53:33fibroma is that it is a well demarcated.
7:53:36So it is a well demarcated by fibrous
7:53:38capsule which which helps in the easier
7:53:41separation from the surrounding normal
7:53:43bone via enucleation of the curach.
7:53:46Okay. Am I clear? Is this clear to you
7:53:49all?
7:53:51Okay.
7:53:53Now again a very easy question.
7:53:55Pleomorphic edenoma we know what do we
7:53:57see in pleomorphic cystic space we can
7:54:00see lined by billayer encoetic
7:54:03epithelium mucco epidermmoid very easy
7:54:06intermediate cells mucus cells
7:54:07epidermmoid cells whatins tumor m
7:54:12whatins tumor cystic space lined by
7:54:16cystic space lined by billayer onetic
7:54:20tumor
7:54:21papillary cyenoma lymphoma Okay. Uh
7:54:25pleomorphic edinoma D mucco epidermoid
7:54:29mucus cells epidermmoid cells adinoic
7:54:31cystic carcinoma. We see there is a crib
7:54:33form pattern. So based on this 1 D 1 D
7:54:38okay with the first option only we can
7:54:41get the right option 2 C 3 B and 4 A. So
7:54:46this is the right answer.
7:54:50Okay. So answer D. Now match the
7:54:52odontogenic cyst with the following
7:54:55characteristic. Okay. So nasopalatine
7:54:58duct cyst nasopalatine duct cyst.
7:55:03Okay.
7:55:05Okay. See okay
7:55:08radicular cyst it is associated with yes
7:55:12necrotic which is the hallmark feature.
7:55:15Okay. for the radicularis denturesis it
7:55:18is associated with an unerupted tooth
7:55:20and hence nasopalatine duct is
7:55:22associated with a vital tooth. Okay. So
7:55:251 a 2 b 3 c. Now this is not important.
7:55:30This is not important. The concept here
7:55:32it is impos important. So if you know
7:55:35the concept you will be able to match.
7:55:37But the options these the options which
7:55:40they had put up these were very easy
7:55:42options because this op these options we
7:55:44had clearly well discussed in the class.
7:55:47Okay. Now which of the following tumor
7:55:49metastasizes in the tongue. Okay. Now
7:55:52the most common most common gets which
7:55:55gets metastasized it is the breast and
7:55:58lung. Breast and the lung. So option one
7:56:01and two. This we had discussed in the
7:56:04benign and the malignant. Okay. Now the
7:56:07last question this was I can say that it
7:56:11was a little bit of question and this
7:56:14was the question which which I was
7:56:16talking in the which I was talking in
7:56:18the starting okay that this was slightly
7:56:20a tricky question a 35 year old patient
7:56:23presented with a soft swelling on the
7:56:25dorsome surface of the tongue
7:56:27histopathological examination reveals an
7:56:29unencapsulated growth okay
7:56:33unencapsulated
7:56:34growth that is positive for GFAB and
7:56:37negative for EMA and P-53. So negative
7:56:41P-53
7:56:44breast carcinoma was not given lung
7:56:47carcinoma were not together in the
7:56:49option. See there this was the uh recall
7:56:52which I have got. Okay. Majority of the
7:56:54students they had told me in the
7:56:55yesterday's recall. Okay. So P53
7:56:59negative it suggests that this is a
7:57:01benign. So condro saroma to ruled out
7:57:05negative EMA. Okay. It is generally for
7:57:09the mixoid condro
7:57:12one second mixoid kind of lesion. So
7:57:15this is ruled out. Okay. myoepithelial
7:57:18tumor and the pleomorphic adenoma
7:57:22that is associated with PLA G1.
7:57:25PLA G1. Okay. So, now they have said
7:57:29that positive GFAP. Now, positive GFAP
7:57:33is
7:57:34that is gile. I hope you can see this
7:57:38gile fibrillary acidic protein. Now,
7:57:42this is the characteristic
7:57:44iminohistochemical
7:57:45finding for the option ecto misenymal
7:57:52condondromixoid
7:57:53tumor. Okay. Hence the answer was B for
7:57:56this. Okay.
7:58:01Okay. Lung was there. If lung is there
7:58:04both lung both breast and lung was not
7:58:09given together. Okay. So if lung is
7:58:12there then lung can be the uh option and
7:58:16apart from this what was given?
7:58:23See kidney. See actually anything can
7:58:27get metastasized to anywhere. Okay. But
7:58:30when we when when they have particularly
7:58:32mentioned that which tumor gets most
7:58:34commonly metastasized to the tongue then
7:58:36we have to look for the options which is
7:58:39which is very much relevant. Okay.
7:58:42Otherwise any tumor can get
7:58:44metastasized. Okay. Any carcinoma can
7:58:47get metastasized. Okay. Are you getting
7:58:50my point? If if the breast was not there
7:58:53apart from the breast kidney was there
7:58:55then I think the answer should go with
7:58:57the lung and kidney. Lung and kidney.
7:59:00Okay. So this finishes your recall for
7:59:03the oral pathology. Apart from this now
7:59:06what you have to focus on that based on
7:59:10this recall what you have to do analyze
7:59:12that which are the questions which are
7:59:15getting repeated most commonly and based
7:59:18on that please do your neat preparation
7:59:21rather than solving the questions which
7:59:23were which was asked 10 or 20 years
7:59:26back. It is just a waste of time. Okay.
7:59:28So focus on the concept. If the concept
7:59:32is good then you will be able to mark
7:59:34the answer right and most importantly
7:59:37focus on the notes which has been given
7:59:40live class or the recorded session
7:59:42please do the grand test which is really
7:59:44very important based on now all these
7:59:47questions are from PQ either from the
7:59:49grand test postclass test okay so this
7:59:52you have to take the key message is that
7:59:55focus on the notes and solve the PQS
7:59:59okay so I wish you Best of luck.

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