Which among the following is not a feature of Mediterranean anemia?

 # Which among the following is not a feature of Mediterranean anemia?

A. Rodent like facies

B. Fessa bodies

C. Rib within rib appearance

D. Platybasia

The correct answer is D. Platybasia.

Mediterranean anemia, also known as thalassemia, is a group of inherited blood disorders characterized by reduced or absent production of normal hemoglobin. This leads to various clinical manifestations, including skeletal changes due to bone marrow expansion. However, platybasia (flattening of the skull base) is not typically associated with thalassemia.

Rodent-like facies: This is a characteristic of sickle cell anemia, not thalassemia. It refers to the overgrowth of the maxillary bones and protrusion of the upper incisors.

Fessas bodies: In heterozygotes, the disease is mild and is called thalassemia minor or thalassemia trait. It represents both α-and β-thalassemia. Homozygotes may exhibit a severe form of the disease that is called thalassemia major or homozygous -thalassemia, in which the production of β-chains is markedly decreased or absent, and a consequent decrease in synthesis of total hemoglobin occurs. This results

in severe hypochromic anemia. Furthermore, excess α-chains, which synthesize at the normal rate, precipitate as insoluble inclusion bodies within the erythrocytes and their precursors.

The presence of such intracellular inclusion bodies (Fessas bodies) leads to increased erythrocyte hemolysis and severe ineffective hematopoiesis. Approximately 70–85% of marrow normoblasts are destroyed in severely affected patients. These processes result in profound anemia and an associated increase in marrow activity, which is estimated to increase 5- to 30-fold.

Rib within rib appearance: This is also known as "rib notching" and is caused by bone marrow expansion eroding the undersurface of the ribs.

Reference:

Radiopaedia: https://radiopaedia.org/articles/thalassaemia

All are features of Keratocystic odontogenic tumor EXCEPT:

# All are features of Keratocystic odontogenic tumor EXCEPT:

A. Most common location is the posterior body of the mandible

B. Shows evidence of a cortical border, when not secondarily infected

C. Internal structure is most commonly radiopaque

D. Curved internal septa may be present

The correct answer is C. Internal structure is most commonly radioopaque.

Keratocystic odontogenic tumors (KCOTs) are benign but locally aggressive lesions. Their radiographic appearance is typically:

Radiolucent: KCOTs appear as dark areas on radiographs, indicating that they are less dense than the surrounding bone.

Well-defined borders: They usually have clear and distinct margins.

Unilocular or multilocular: They can be single-chambered (unilocular) or multi-chambered (multilocular).

Scalloped borders: The edges of the lesion may have a wavy or scalloped appearance.

Curved septa: If multilocular, the internal septa may appear curved.

Reference:

Odontogenic keratocyst | Radiology Reference Article | Radiopaedia.org: https://radiopaedia.org/articles/odontogenic-keratocyst

# Soldering and welding is not possible in:

 # Soldering and welding is not possible in:

Stainless steel wire

Elgiloy

Nitinol

TMA

The correct answer is C. Nitinol.

Limitations of NiTi wires

NiTi wires have very low formability in the clinical setting. These wires cannot be welded or soldered due to the passivating nature of titanium dioxide which is strongly adhered to the metal surface. The frictional forces in the nitinol wire are very high due to high Ti content, and therefore these wires are unsuitable for sliding tooth movements such as retraction on the wire.

NiTi wires have highest nickel content among the appliances used in orthodontics which is 55%. Although they are greatly biocompatible, however, high nickel content could be disadvantageous by causing hypersensitive reactions.

Reference: Orthodontics: Diagnosis and management of malocclusion and dentofacial deformities, OP Kharbanda, 2020

STOP USING DABUR LAL DANT MANJAN ! Why you should not use Dabur Lal Dant Manjan?

 Dabur Lal Dant Manjan is not fluoridated. It is an Ayurvedic toothpaste made with traditional herbs and ingredients. While it's popular in many countries, including India, its legal sale in the USA might be limited due to the lack of fluoride, which is a standard ingredient in toothpaste for cavity prevention.

Here's why it's still sold legally in many countries:

Cultural Preference: Ayurvedic practices are deeply ingrained in many cultures, and people trust and prefer traditional remedies like Dabur Lal Dant Manjan.

Alternative Ingredients: While not containing fluoride, Dabur Lal Dant Manjan includes ingredients like clove and other herbs that are believed to have antibacterial and oral health benefits.

Focus on Gum Health: Some users believe that the toothpaste is effective in maintaining gum health and preventing gum diseases.

Lack of Awareness: In some regions, there might be a lack of awareness about the importance of fluoride in preventing tooth decay.

Important Note: The American Dental Association (ADA) recommends using toothpaste with fluoride for effective cavity prevention. If you're concerned about tooth decay, consult your dentist for advice on the most suitable toothpaste for your oral health needs.

A 17 year old male, who has been using Dabur Lal Dant Manjan since his early childhood and has never used fluoridated toothpaste has developed dental caries as depicted in the image below. Though there could be many other contributory factors like poor oral hygiene, low salivary flow, mouth breathing habit, use of drugs causing xerostomia, radiation-induced salivary gland aplasia or some unknown factors, use of fluoridated toothpaste could have reduced the severity of the decay.