ORAL SURGERY PART I II NEET MDS 2022 INICET MDS 2022 Quick Revision WE ARE WITH YOU

happiness this is dr shree khan from team mds conquer now i am here to give a quick glance of subject oral surgery so before going into the discussion there are few important aspects that i need to focus on okay so oral surgery is more of an uh logical based or a concept based subject when compared to many other uh subjects like your general anatomy biochemistry physiology general medicine or your community your dental materials and few other areas like has to be revised because they have more of a memory based stuff so oral surgery is more often a concert based and i hope most of you are very strong and familiar with oral surgery i hope like most of you can handle the things well in the examination hall so that's the first thing that i want to stress on so you can just have a glance over the video that's going to help you to focus more on the memory based stuff for the important aspects the second important thing is i mean like most of you are tensed most of you were tensed or depressed or like all sorts of feelings are running in your mind and of course this is a time where the things will be like this you hardly have like five to six days from now and please stick on to your basic fund or basic protocols that what we have been doing from past few months okay so we have planned in such a way that how we are going to be in the last seven days what you are going to do in the last seven days so that's what our plan is on the day one uh in the orientation session i hope like most of you i remember that orientation day like last 15 days plan should be started from day one and i hope most of you were well organized and please just go with the basic requirement so the basic fund of the last 15 days or the seven days or one week plan okay don't change any plan don't don't go or don't take suggestions from any side regarding the change of plan okay so whatever you're doing you're on the right track you're on the right way and just stick on to that so we are very happy for the toppers of andhra and telangana most of the students were right now in the good places in well gdc's in good departments let's start the classification of local anesthesia so local anesthesia is basically divided into esters and amides basically so your esters are again divided into two types they are the benzoic acid derivatives and the para benzenoic acid derivatives so in the benzenolic acid derivatives these are the things which will be and in parabenic acid derivatives you will have a word like pro you can easily identify them with the word pro so the regularly your amides amites will have two eyes in the numbering okay so you can just identify the amide with two eggs the only stir with two eyes is this okay this is this is an exception just remember that exception part then you can see there might most of the image you can have two eyes two eyes two eyes two eyes two eyes two eyes two eyes two s so i might say two s so please do add a note of this this is again regularly and most commonly asked question so time to reach the peak value is very less in the case of iv iv you have the bioavailability of 100 percentage so before this okay iv before the iv okay there is one more method which with the peak values reach in a very very less duration of time when compared to the iv that is endotracheal incubation okay so that is the first one followed by the iv second one topical third one okay and intramuscular and subcutaneous and do make a note about the half-lives half-lives is least for half-life is maximum fun okay so that's the reason why these are more toxic because most cardiotoxic is a drug of choice for hot tick of course if they ask which is the most toxic or which of the following has most half-life if you have diabetes you can go for that then followed by now it is the used drug which has most half-life is will be working your toxic levels and everything will be more for you okay and make a note about these absolute contraindications rest all are relative these are absolute contraindications and please do learn about this if you are not if if you are not clear with this please do learn this table this table is very very important what is amola so definition most of you are familiar with this it's a mix of lidocaine and trilocat and one more is biological side classification so basically upon which a b c d classes are divided it is a receptor present on the membrane and this is receptor present on the internal internal receptor this is independent this is receptor dependent and independent most of your clinical ls will comes under the class four that is class d okay your benzene will comes under the class c and uh and your i mean like your scorpion comes under the class b your biotoxins will comes under the class a this is one more classification basing upon the duration short acting is 30 minutes intermediate acting is 60 minutes long acting is 90 minutes so bupiva kind is a long acting one the next comes the pka values of most of the things pka value is least for benzoic and maximum for this okay so they're gonna ask you the pk values of this area because these are the most commonly used lidocaine trilocan arctic and they have a range of 7.7 do make a note about benji can that is 8.1 and of course this this these things are very very basic they can ask you a diagram based question over this area by giving a b c d and i ask you to identify what you say what is b please do go through go through this these are all are important very basic questions but they are important so what is pka value how does it is going to affect its going to affect the onset okay and coming next to this lipid solubility it is going to cause the anesthetic potency will be determined protein binding capacity is going to cause the duration so please go through this this table is very very important in the conceptual questions related to local anesthesia of course anti-convolution blood levels of lidocaine is a regular last question and this is most common tonal clonic scissors are seen above 7.5 mu gram per ml next comes comes with this particular classification what are direct acting what are indirect acting what are mixed acting so please go through this and what are the signs that are seen in the case of a mild to moderate overdoses okay so what are the signs and symptoms i hope most of you are very familiar with this if not just have a glance because they can give a case-based question by telling you these are the signs and features are seen upon upon giving a local anesthetic and they can interrelate with the case-based thing burning sensation upon injection is basically due to the ph of the drug or maybe the cataracts may be contaminated with alcohol or may be overheated or maybe containing the vasopress and coming to the food and drug okay lactation categories what is s what is s question mark what is s dot what is ms and i mean like what are the most of your local anesthetics used comes under b and c okay b is leader and comes under b okay and your prilogan comes under b okay so please do make a note about this lactation categories related to the local anesthesia and i hope you're well aware of this full mouth extraction the first teeth to be extracted is the maxillary posterior teeth and the last teeth to be extracted is the mandibular cannon so please do make a note about the sequence i hope you are good at this because this was discussed so many times on the group next comes this is again a very important try as categories by color giving okay what is red color what is yellow color what is green color and what is black color most of i mean like this two to three questions given on this in 2017 session of neet examination of course questions are given in 2020 question is given in 2018 you should not miss this malapactic classification do make a note of this okay what is this class 1 what is class 2 what is class 3 what is class 4 and how it is the next goes is there is something called as uh mental higher distance and something called as an thyro thyromental distance okay so this is they can give you a labeling they can ask you what is a what is b so please do make a note of these values and when you're talking about this particular test that is the measuring the distance between the thyromental distance if the distance is 6.5 millimeters no problem for laryngoscopy if it is 6 to 6.5 there is a difficulty but you can try if it is less than 6 it is very difficult so this stress indirectly is going to give you an idea that uh the accessibility of laryngoscopic so please do make a note about the laryngoscopy diagrams because they are regular last your emergency general surgery and oral surgery emergency equipments and the devices which are used in the emergency are regularly asked questions from 2017 neet examination and most of them are discussed well on the group so please do finish that coming to the pregnancy okay so pregnancy generally in the first and the third time instance you are going to avoid any uh procedures which are going to create the stress so most of the procedures will be done in the second trimester and the i mean like what's going to happen there is something called as a supine hypotension syndrome of pregnancy that really occurs in the case of your late third trimester when the woman is in the supine position for more than three to seven minutes there will be signs or symptoms of cinco this is basically due to the compression of gravity uterus gravity prograde is compression which decreases the returns to the inferior vena cava thereby decreasing the venous returns so what you have to do you have to keep the woman under lateral position of the standing position [Music] as standing position is not possible on the dental chair so we will ask the woman to turn to the lateral side so left lateral side you have more questions on pregnancy the left lateral side position of pregnant women is left lateral side okay it can be a standing side but not possible on the dental chair ah then comes is with hemoglobin what is the treatment option that is the administration of 100 days of oxygen sometimes may not improve the situation so in such conditions you are going to give a slow iv please do make a note iv it is iv administration of one percentage of with methyl blue that is 1.5 milligrams per kg or 0.7 milligrams per lpa repeated every four hours if the cyanosis persists or returns the other thing that you can use in this particular situation is giving vitamin c okay you can give the patient vitamin c that is administration of you can see this uh you can you can this is im that is iv this is im administration of ascor because it does nothing but vitamin c that is hundred to two hundred milligrams per day this accelerates the metabolic pathway through which the ferrous is going to produce so federic to ferrous transformation is the main issue that occurs in the case of hemoglobin so you are going to reverse it back by using either methyl blue or by using the vitamin c ascorbic acid so relatively contraindicated is preload and flilokin is mainly concerned with this particular abnormality so please do make a note of this okay diagram based question okay what is this little people what is this big people and uh okay they can ask your diagram based question by giving this ammonium okay that is called as an aromatic ammonia ah which is a respiratory stimulant okay we have many controversies whether it's a respiratory retenter stimulant it is a respiratory stimulant if you don't have respiratory stimulant then you have to go for a respiratory irritant as an option okay they're gonna ask you there's 11 number blade which is useful for the stab incision or abscess you can see a pointed tip the next one is it's the most commonly used blade that is the 15 number plate in the oral surgery department so angulations of injections 90 degrees is intramuscular to 45 is subcutaneous 25 is iv and 10 to 15 is intra abdominal parts of metallic syringe please do make a note of this okay the parts of metallic fringe they can ask you in the sequence 2017 neat examination question what is helen's tissue forceps what is backhaug tissue forceps okay you can see like this the next one what is endotracheal tubes this is cuffed right so cupped endotracheal tube the next comes is the contraindications make a note about absolute contraindications so these are absolute contraindications of extraction and these are relatable contraindications where you can go with the procedures by taking some precautions and of course this question was given in 2020 neet examination when you have a notch like this what is mainly it's mainly due to the no bundle that is passing through so what you have to do how you have to do you have to go for a split technique for these things so you have to split the teeth or break the teeth into multiple pieces then you have to extract so this is again a familiar question that is asked which what is this the only landmark uh that is mental foramen which can be diagnosed by radiography you can take two different angles of radiograph and you can diagnose this mental foramen and i hope most of you are familiar with these classifications that is a b okay c and followed by the rammus relationship that is class 1 class 2 class 3 and these are the different winter's classification positions of molars the next comes are the difficulty index for the removal of the impacted lower third molars okay so so easiest is going to be difficulty is going to be distributed easiest is going to be a difficult is going to be c easiest is going to be 1 difficulty is going to be 3 so basic upon the calculation of these three you're going to come to a difficult index if it ranges from 7 to 10 that is very difficult 5 to 7 that is moderately difficult three to four that is minimal difficult and i hope most of you are familiar with this war lines or winter lines and i don't want to discuss much but i'm going to keep this literature to be please do make a note so white line is an occlusion reference okay and the amber line represents the level of the bone and when a perpendicular is dropped from the amber line to the imaginary place where the elevator is applied that is called as a red line so red line is going to give an idea that the amount of the bone that should be removed before you take the procedure so please do make a note of all these last lines which are very very important to convert into question what is this intra ligamentary injection so coming to intra alignment injection is a solar type of injection for a single teeth anesthesia and how it is given where it is given so please do make a note of these values this is one more classification of cartridges basing up on the color code so what is gold that is arctic so please do make a note of all these things okay the next comes is the composition of local anesthesia most of you are familiar with so please do go with the components and their functions when you're talking about plane la so all these are absent in the plane area so they can ask you a question which of the following are absent in the case of plain ld so please do make another methyl paraben is a bacteriostatic agent and sodium metabisulfite is an antioxidant the next comes are the needles needle sizes that are used very peculiar thing is something called a static so this is a this is a block where a 30 gauge needle is used rest all you can go for 27's and here you go for either 25 or 27's okay so when to go for like whenever you're using 25s 27s the blocks you're going for a long uh long needle long lengthy needle and rest all you are going for a short needle to make a note this is this is the needle breakers okay so uh the suggestion is like in any any of the blocks like except in the particle anesthesia in any blocks you should not bend the needle for your convenience because whenever you bend the needle and whenever it is penetrating more than five millimeters in the soft tissue there are high chances that the needle breakers can occur so now the advantages of a larger needle or the shorter needle so please do make a note of this and i hope most of you are familiar with this that is a band or a sta that is a single teeth anesthesia which is a complete uh which is a computer controlled anesthesia so please do please do add a note of this literature what is a dynamic pressure sensing technology so all these are very very important new things uh questions can be asked the next comes is this is a needle free injector what is yet okay so please do make a note of this okay they can ask you questions this is pressure syringe designed for the periodontal ligament okay so they can ask you a question over this particular area where nowadays they're trying to find some typical typical typical diagrams to ask you questions so these are the different types of needles so please do add a node second generation needle for the periodontal ligament injection and all these just just have a glance coming to the cleft flute and cleft palate so first thing that you have to make a note is about the rule of ten which is also called as millard's rule of ten what is that 10 pounds 10 grams 10 000 count and less than 10 weeks so the few other things that you have to make about when i'm talking about the clef the first important lots of controversy regarding most of these questions but i request all of you to stick on to this cleft lift is basically due to the non-fusion of medial nasal process plus lateral maxillary process and coming to the next one that is pallet pallet is basically due to the non-fusion between the two lateral pallet process okay so nowadays questions on is of the repair are regularly asked so please do add a note of this lip clef lip is six months cleft palate you can have hard and hard and soft okay hard hard palate and soft palate soft palate you can go for six months hard palate you have to go for double that is six 12 to 18 months okay and when they give a combination that is combination of both that is lip and palette combination so lip and palette combination can be done in stage one stage one that is a uh can be done at six months or can be done at stage two that is when you have a hard palate then you have to go for 12 to 8 months so it's mostly it moves around like either six or 12 to eight months okay so they can ask rhinoplasty also rhinoplasty is once the inter growth is done so rhinoplasty is done after 16 to 18 years after the growth of the segment of the organ is complete i hope you're done with this right you're clear with this good so the next important things i just want to add few more important stuff related to your preparation one such important aspect that i want to focus on is guys you just go back and see all the instruments that are used in your oral surgery departments which are posted as pdfs on your groups please do go through go through all the instruments because those are the regularly asked questions uh in the examination point of view the next comes is the other important aspect that i want to stress on uh the first important aspect is okay uh your fractures coming to the factors that is you have your leaf hoods so please go with the leafford fracture uh diagrams which were shared on the group like how the uh how the transfers of the fracture line in the leaf would one leaf or two are leaf or three leaf one is also called as in a low level fracture or urine fracture or a horizontal fracture or a telescopic fracture whereas coming to the left to the left is a pyramidal fracture okay you can see a pyramidal like structure in the diagram okay that is also called as an infra zygomatic fracture coming to the leaf wood three fracture the leaf or three fracture is a high level fracture and it is also called as a supra supra zygomatic fracture so so please do look about this uh bloat fracture and blowing fracture of the orbit okay regularly asked questions you can and i hope you can manage this by seeing the diagrams and what are the tests that are used you know you can they can use the hess test okay the one is the s test and the second one is the forced induction test they can be used and they can ask you the questions related to the maxillary sinus sinus when it is formed 10 weeks split is formed in 12 weeks what is the lining of the maxillary sinuses by and what is the surgery card will look where you are going to give the insertion and everything so please do make your diagram based off and everything when to go for an incision when to go for just a uh just a suture and a follow-up and what to be done what are the tests to be done because that's the question given in 2020 need what are the signs for acute or inter fistula and chronic horizontal fistula okay so i hope your acute is is by uh five years whereas your chronic is by five piece and i hope you are well familiar with that please do go back your pp books and just have a glance over the factors and the recent recent like lag screws how they are your battle sign okay there are many signs like your battle sign most common uh fracture most common fracture of the mandible is condyle fracture and the least common factor is coronite fracture condyle please do this is a controversy again so go with condyle is the most common fracture of the mandible and the least common fracture is fracture okay do do make a note of this and the most common fracture in the head and neck area is the nasal bone the second most common fracture is the mandible okay if they are asking second most common mid facial fracture that is zygoma mid facial is first is nasal second is diagonal oral head neck first is nice and second is mandela so do make a note okay the next one is the stages of anaesthesia okay stages of anesthesia again what is stage one what is stage two what is stage three what is what is uh what is the stage four okay and you have a different planes in the case of your stage three that is plane one plane two plane three plane four what occurs in each stays and all these things are very very important in examination point of view then you i want you to make a note about the levels of lymph nodes every year they're asking questions levels of lymph nodes i want you to go with the diagram also because they can shade the particular level or grade of lymph nodes and they can ask you which level it is so levels of lymph nodes are again important what is i 1a what is 1b 1a is submental 1b is submandibular 2 is a particular three is middle jiggler okay so all these are there in your pp books this is a 20 20 neet question third one middle jiggler what is fourth lower jupiter so jugular are they starts from two to three and four the next one is 45 level five level five is posterior triangle what is level six level six is anterior compartmental or central compartment what is level seven that is superior mediastinal okay so do do make a note about all these terms like what is radical negation okay what is extended radical neck decision what is bilateral radical negation what is modified radical negative session and in that what is modified radical neck dissection so in this so body fat radical negation is something like you have type 1 type 2 and type 3 in it so type 1 where you are going to pressure only spinal accessory now type you are going to preserve both spinal accessory now and internal jugular vein and type three are going to preserve spinal accessory now internal jugular vein and sternocleidomastoid muscle okay so what is selective neck decisions okay so all these are discussed for you what is supra higher neck decision what is extended supra iron next decision what is posterior lateral neck decision what is central compartmental neck decision all these are important and please do make a note simultaneously what are the surgical procedures which are done for the uh cleft lip repair and the cleft palate what are the surgical names okay please do make a note about the surgical names and the next important areas to be focused on when you're talking about this is your uh diagram based stuff okay so i want you to go back have a look over the diagram by stuff uh related to this okay and and i was talking like what is this acute acute uh oro and fistula is identified by five e's right i was talking about what is this five is one is the escape of fluid second one is ap status that is bleeding from nose escape of air and enhanced column of air and you will have exaggerating pain and coming to the chronic the difference between acute and chronic is 14 days okay so when it is called as chronic you'll have the 14 days so you'll have five p's here what are they one is pain second one is persistence pleural discharge that is foul smell or unilateral nasal discharge is there the next piece post national drip will be there the next phase possible sequel of general systemic illness or systemic symptoms will be there and the most common route that goes into this maxillary sinus is parallel root and the most common teeth which is very close is maxillary first molar and the distance between the floor and the roots of the maxillary posterior teeth is somewhere around like one to one point five centimeters and maxillary sinus grows to its maximum size by 18 years okay so these are the things that you have to make and what i'm talking about the maxillary sinus okay so i mean like i just want to add a few words about this like ankylosis so in gap arthroplasty the minimum gap required to prevent re-ankylosis is one sentiment one centimeter is a gap that is required in the treatment of acute dislocation of mandible the mandible should be more downward and backward direction this is how you're going to solve that immobilization should be carried for a duration of one to two weeks not more than that because more than that leads to ankylosis during the procedure of reduction of acute tempo mandibular joint ankylosis dislocation few drops of la local anesthesia are deposited in the case of your glenoid fossa and during your treatment procedures that is uh when you're planning to go for the treatment procedures so where do you where you're going to inject the inject the solutions or inject this steroids or anything because steroids acts as an anti-inflammatory okay so these steroids are regularly given the case of an osteoarthritis or in the case of any any sort of inflammatory diseases related to the temperamental joint they should be given in the superior superior space of the joint you have both superior as well as inferior so you want to given the superior space of the joint the next comes go go with all the diagrams which are there in your oral surgery part uh in your pp book volume four it's very very very very important which cannot be missed at any cost your suturing techniques your fracture lines your fractures your incisions and your instrumentations all these are very very important which cannot be neglected at any cost okay so i again the same goes your maximum doses of local anesthesia given the maximum doses of epinephrine that is given in a normal individual and in the case of your cardiac patient all these are important which cannot be negative the first local anesthesia is cocaine colloquia which has a vasoconstrictor activity is again the cocaine okay so all these like bio uh where does the biological transformation of each and every things takes place and thanks next question is uh structures which are encountered during the lumbar puncture where lumbar puncture is given okay so spinal anesthesia can be performed safely uh between l2 to l3 that is interpretable space in the adults this is a this is a place and where a case of children it is l4 to l5 okay so these are the areas where you are going to do this the next comes the next comes out the structures which are which are involved in the lumbar puncture are again this is a question that is given in the aims examination that is skin followed by subcutaneous tissue followed by supraspinous ligament followed by intra spinous ligament followed by ligamentous flavium followed by dura mater followed by arachnoid space so finally you're going to reach that uh arcanoid space okay so these are the important things that you have to make you know just go with your pp books final anesthesia notes notes of three or four four pages what is uh what is beats block okay what is beats block and uh i mean like few questions like what is ring block uh all these are uh well well organized and well given so please do go with that content which is very very important examination point of view okay so done for uh done from my point of view related to the oral surgery and uh please do well study well okay so try to be confident that's really required so if you're getting panic it is something like you're losing your own score okay so like if you feel like depressed if you feel like panic if you if you're not able to finish the things off so all these negative signs will definitely decrease your score like whatever you can do in these five days just go do go under the examination hall with all the confidence levels and just give your best shot this is what maximum a an aspirant can do in the last five to six days very smart like don't get depressive if you get depressed it's simple logic that you are spoiling your scores so what best we can do just give it that's what you i everyone here are to do okay signing off dr srikanth from team mds conference