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Special Histology for Dental Medicine

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A 69-year-old alcoholic

presents to a GP for a range of complaints including dyspepsia (feeling full

after eating, poor digestion), fatigue, weakness, exhaustion, lack of appetite,

weight loss, abdominal distension, swelling, arthralgia, and spinal pain. Even

a physical examination revealing hepatomegaly (enlarged liver), spider angioma,

and ascites (presence of fluid in the abdominal cavity) suggests that the

patient is suffering from cirrhosis. This is confirmed by laboratory, sonography,

and biopsy. Liver cirrhosis is the remodelling of the lobular structure of the

liver into a nodular structure due to the disappearance of hepatocytes,

replacement by connective tissue and nodule formation as a result of chronic

liver disease. Ito cells play an important role in this remodelling process.

Where would we find most of these cells?

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A 12-year-old female patient presents for an

orthodontic check-up after braces placement. In one spot, part of her braces

are slightly pushing and interfering. There is a white spot that cannot be

wiped off. As a result of mechanical irritation, the mucous membrane of the

vestibular surface of the lip has become irritated and keratinised. Such spots

are known as leukoplakia and, in addition to mechanical irritation, a number of

other factors may be involved in their formation. However, the exact cause has

not yet been described. The transformation of which epithelium is involved

here, which normally forms the oral mucosa?

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The researcher was

very interested in an atypical symptom of the disease of COVID-19, namely the

loss of taste. He would like to investigate in more detail the mechanism by

which the taste buds are affected. He obtained tongue samples from patients who

had died of the disease. What kind of papillae of the tongue should he focus on

to most easily find places with an accumulation of taste buds?

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Choose the microphoto, which represents area of the soft palate marked by number 4.

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A 27-year-old female patient presents to her GP

for the second part of a preventive check-up. The patient's blood tests show a

fairly significant anemia. It soon becomes apparent that this is probably due

to a vitamin B12 deficiency, as the patient is a strict vegan and has not

supplemented her diet with this vitamin. During the physical examination, the

doctor notices one more symptom that would confirm this cause. The patient's

tongue has a distinct red colour and is completely smooth. In healthy

individuals, papillae can be observed macroscopically on the surface of the

tongue, which disappear in this condition, known as Hunter's glossitis. The

most common cause is vitamin B12 deficiency. Several types of papillae are

generally found on the tongue. But which of them has keratinized epithelium?

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A 45-year-old patient

comes to the dental emergency at night for an acute toothache. Previously, the

given tooth was more sensitive to cold or warm stimuli. Now the pain is

throbbing and constant, and cold stimuli tend to relieve it. Common analgesics

are ineffective. The patient is diagnosed with acute pulpitis, inflammation of

the dental pulp. The dental pulp is mainly made up of loose connective tissue,

which is also the reason why inflammation spreads easily here. What important

type of cell is also part of the pulp chamber?

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During a preventive dental check-up, 35-year-old

man is found to have tooth decay between his first and second molars. As the

decay has already penetrated the enamel and reached the dentin, new dentin

begins to form in response to this local irritation. What type of dentin is

produced?

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A 38-year-old patient

presents with a painful swelling of the submandibular gland on the left side.

Especially during meals, the gland is painful and produces a large amount of

saliva. During this, small stones are released from the duct. The cause of his

difficulties is the so-called sialolithiasis, i. e. the formation of salivary

stones. The most common cause is a change in the composition of saliva. The

viscosity of saliva increases, and a mucoprotein matrix is ​​formed, into which

inorganic material (calcium, magnesium, phosphorus salts) is subsequently

deposited and a stone is formed. Which parts of the submandibular gland are

involved in the production and composition of saliva?

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A 9-year-old girl comes to the dentist with her

mother. A large swelling, even a cyst, is forming under her tongue. It is a

so-called ranula, which is a retention cyst of the sublingual gland, formed by

obliteration (closure) of the duct, probably as a result of a previous

infection. The outflow of the saliva produced is impossible. The stagnant

saliva dilates the ducts, forming a secretion-filled cyst. The treatment here

is extirpation (surgical removal). Which characteristic describes the closed

main duct of the salivary gland here?

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A 15-year-old girl had her tongue pierced unprofessionally by her

friend. Unfortunately, this unprofessional execution led to an infection of the

tongue, as well as the sublingual salivary gland located nearby. Which of the

following describes the histological description of this gland?

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