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Platelet morphology and mean platelet volume are generally not affected by the volume-reduction process (Answer D) cheap 2.5mg provera. Platelet aggregation is also maintained 10 mg provera fast delivery, and it may be increased after centrifugation (Answer E) because lowering the pH of the platelet product by addition of anticoagulant prior to centrifugation prevents aggregation order provera us. How many milliliters of anticoagulant-preservative solution does one 500 mL whole blood unit contain? Anticoagulants used for blood collections contain citrate that prevents coagulation by binding to calcium ions and blocking the coagulation cascade purchase provera 2.5 mg online. Reduced amount of anticoagulant could lead to clotting of the unit and its wastage. Excessive amount of anticoagulant would potentially cause unnecessary citrate toxicity in a patient. One 500 mL whole blood unit contains 70 mL of anticoagulant-preservative solution. The other choices (Answers A, B, D, and E) represent the incorrect amount of anticoagulant-preservative solution. Citrate is added to prevent blood clotting and it also acts as a membrane stabilizer. Therefore, energy for the frst half of the glycolysis pathway and membrane integrity is maintained. Use of 1 unit, reduces donor exposures and leads to decreased risk of potential transfusion-transmitted infections and decreased risk of alloimmunization. For the same reason, it has lower isohemagglutinin titers and may be benefcial for posttransplant transfusion in minor 5. Also, one should recognize that the transport conditions may differ from the storage conditions. Blood ComPonent PreParation and Storage Answer: D—Standards require red cells to be stored at 1–6°C; however, during shipping the range is 1–10°C. If glycerol is not added, crystal formation in the extracellular space will cause movement of the intracellular fuid out of the cell by osmotic force and result in cell shrinkage. High concentration glycerol method is somewhat simpler compared to a low concentration technique. Low concentration technique requires liquid nitrogen for freezing, storing, and shipping, and also the freezing rate needs to be controlled during freezing. Both methods require trained personnel, and deglycerolization after thawing with extensive washing since glycerol can cause in vivo and in vitro hemolysis. Your blood bank receives an order for 2 units of red blood cells for an outpatient transfusion for a sickle cell patient with anti-U and anti-k antibodies. After an exhaustive search of the Rare Donor Inventory, 2 antigen-negative frozen units are identifed in a donor center across the country. Your blood bank has the capability to thaw/deglycerolize on-site with an open system. Notify the patient’s physician that the blood bank will not be able to obtain the units B. Have the blood center thaw/deglycerolize the units and ship so they are immediately available C. Have the units shipped frozen, confrm appointment with clinician, thaw 2 days prior to the appointment to ensure availability for the appointment E. Have the units shipped frozen, confrm appointment with the clinician, thaw/deglycerolize the units at the morning of the appointment Concept: The use of glycerol, as discussed in Question 17, allows for freezing red cells at −65°C for up to 10 years. This allows for longer term storage of rare units, such as the ones noted in this question. As the method used to thaw/deglycerolize involves an open system, the units will expire 24 h after thaw (there is an approved closed method, both when adding glycerol and removing it, allowing for up to 2 weeks expiration postthaw but that is not specifed here). Answer: E—This option provides the approach most likely to avoid wasting the units. Answer A is not correct, as the hospital’s blood supplier likely would arrange for shipment of the units. The other choices (Answers B, C, and D) are incorrect because the units would expire prior to the appointment based on the use of an open system. Blood ComPonent PreParation and Storage 101 Please answer Questions 18 and 19 using the following process map: 18. Leukoreduction Concept: This question highlights the processing of a unit of whole blood into component parts. European countries use a method known as the buffy coat method, which begins with a hard spin (Answer C). Pasteurization (Answer A) is a process used to manufacture albumin, which is pasteurized at 60°C for 10 h to inactivate bacteria and viruses. Leukoreduction (Answer E) is the removal of leukocytes (white blood cells) from the product to a concentration of 6 less than 5 × 10 leukocytes per unit. Given these factors, many hospitals have 100% leukoreduced inventories (known as universal leukoreduction). Thaw at 1–6°C followed by fltration Concept: This question highlights the fnal manufacturing processes in cryoprecipitate production. A summary of the process is as follows: whole blood is “soft spun” into red blood 102 5. The unit is then spun, causing the supernatant plasma to be transferred to another bag (supernatant is now commonly known as “cryo-poor plasma”), and the cryoprecipitate resuspended in residual plasma and frozen. Answers A and C are used in different processes, as explained in the question earlier. Answers D and E are incorrect for either incorrect thawing conditions or process for isolating the cryoprecipitate. Sources of radiation include gamma rays, supplied by cesium-137 and cobalt-60, and X-rays, which may be from either standalone units or linear accelerators used in radiation therapy. These requirements must be verifed annually for cesium-137, semiannually for cobalt-60, and upon installation, major repair, or relocation of any machine. Alternate radiation sources must be checked periodically, as recommended by the manufacturer. The other choices (Answers A, B, C, and E) are all incorrect because they do not represent the correct Gy level or target. For example, if the unit had a shelf-life of 32 days before irradiation, the new expiration date is 28 days. However, if the unit had a shelf-life of 23 days before irradiation, the postirradiation shelf-life is still 23 days. Which test would most likely quickly identify the most common cause of flter failures? Answer: A—Sickle cell trait is responsible for at least a third of leukoreduction flter failures, for which electron microscopy has shown increased adherence to the flter by the sickled cells, which may impact the ability to remove the white cells. Additional parameters thought to impact fltration effcacy include temperature, cell–cell interactions, number of leukocytes prior to fltration, protein content, velocity of the product through the flter, and the storage age of the product. Blood type and presence of antibody (Answer B) are not known to have an impact on fltration. Blood ComPonent PreParation and Storage or extensive bacterial contamination theoretically could increase the protein content; however, on screening, a very high hemoglobin would likely be identifed beforehand with questions of suitability or by hemoglobin measurement prior to donation, and bacteremia identifed via culture may take several hours (Answers C and E). It is thawed at 30–37°C, and maintained at 1–6°C for up to 5 days from date it was thawed. The smaller percentage of these other factors does not appear to be clinically relevant. After it is thawed out and kept in refrigerator for more than 24 h at 1–6°C, it can be relabeled as thawed plasma and can be used for additional 4 days. Practically speaking, most blood banks using thawed plasma, label the product as thawed plasma as soon as it is thawed, so they do not have to relabel the product at 24 h. The other choices (Answers A, B, C, and D) are incorrect based on the earlier description. Prevention of hypocalcemia in the donor Concept: Granulocytes are collected using a leukapheresis procedure. Its use should be avoided in critically ill patients, patients with severe liver disease, patients with kidney disease, and in patients with bleeding disorders. There is nothing in use to prolong granulocyte activity (Answer D), hence the 24 h expiration date. A donor who admits to type 2 diabetes mellitus and is not compliant with his metformin B. A donor who donated platelets 5 days ago with the same blood type as the recipient 5.

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Anaerobic culture-based primary testing performed on a sample of the platelet product D discount provera 5 mg on-line. Primary testing of platelets with a rapid bacterial detection device Concept: This patient has a transfusion reaction associated with fever order provera online now, chills generic 2.5 mg provera with amex, rigors discount 2.5 mg provera, and hypotension, which may indicate a transfusion-transmitted infection (e. Bacterial contamination of platelets is of higher concern when compared to other blood products because the higher storage temperature with agitation facilitates proliferation of bacteria. Different methods are in place in order to prevent the initial contamination during the collection process, as well as detection of bacterial contamination prior to transfusion. Answer: A—The venipuncture site should be properly disinfected with approved antibacterial agents, such as povidone iodine and/or chlorhexidine; however, bacteria residing deeper in the skin are not destroyed by disinfectants. The pouch is intended to capture the skin plug with the frst few millimeters of blood, decreasing the rate of bacterial contamination. Leukoreduction flters have a pore size of about 4 µm and would allow majority of bacteria to pass through (Answer B). Platelets should be tested at least 24 h after collection, and products can be released to transfusion services after at least 24 h from inoculation, or according to instructions from the bacterial detection device used (Answer D). Studies have shown that the rate of transfusion-related septic reactions and fatalities associated with transfusion of platelets increases with duration of storage. Thus, platelets that have not undergone pathogen reduction have an expiration date of 5 days from the initial collection. Blood ComPonent PreParation and Storage 95 Secondary testing of platelet products may be performed by transfusion services by rapid bacterial detection tests performed within 24 h prior to transfusion. Further, these platelets with extended shelf-life can be shipped intrastate but not interstate. Liquid plasma is currently used for the treatment of coagulopathies in patients undergoing massive transfusions. Contains viable lymphocytes that can cause graft versus host disease in patients at risk B. Can be further processed for manufacturing of cryoprecipitate Concept: Liquid plasma is the plasma derived from whole blood but is never frozen. It is used for the treatment of patients with massive hemorrhages and associated coagulopathies. Advantages of liquid plasma are that it does not necessitate thawing and is therefore, immediately available in emergency situations, and it has a longer shelf-life compared to thawed plasma. Answer: A—One disadvantage of liquid plasma is that contains viable lymphocytes, and it puts susceptible patients at risk for transfusion-associated graft versus host disease. Liquid plasma is separated from whole blood within 5 days of expiration of the whole blood (Answer B) and it is stored at temperatures between 1 and 6°C (Answer D). Although coagulation profle is similar to thawed plasma after manufacturing, levels of coagulation factors decline with increased storage time, after 2 weeks coagulation factors being at about 50% of the initial levels (Answer C). Blood ComPonent PreParation and Storage 97 Concept: Volume–reduction of platelets may be indicated for patients at risk for transfusion- associated circulatory overload, for intrauterine transfusions, or for limiting the amount of isoagglutinins in platelet products. Answer: B—Volume-reduced platelets may be stored for a maximum of 4 h when manufactured by an open system. There is no determination of the maximum allowable storage time of a closed manufacturing system (Answer C). Platelet morphology and mean platelet volume are generally not affected by the volume-reduction process (Answer D). Platelet aggregation is also maintained, and it may be increased after centrifugation (Answer E) because lowering the pH of the platelet product by addition of anticoagulant prior to centrifugation prevents aggregation. How many milliliters of anticoagulant-preservative solution does one 500 mL whole blood unit contain? Anticoagulants used for blood collections contain citrate that prevents coagulation by binding to calcium ions and blocking the coagulation cascade. Reduced amount of anticoagulant could lead to clotting of the unit and its wastage. Excessive amount of anticoagulant would potentially cause unnecessary citrate toxicity in a patient. One 500 mL whole blood unit contains 70 mL of anticoagulant-preservative solution. The other choices (Answers A, B, D, and E) represent the incorrect amount of anticoagulant-preservative solution. Citrate is added to prevent blood clotting and it also acts as a membrane stabilizer. Therefore, energy for the frst half of the glycolysis pathway and membrane integrity is maintained. Use of 1 unit, reduces donor exposures and leads to decreased risk of potential transfusion-transmitted infections and decreased risk of alloimmunization. For the same reason, it has lower isohemagglutinin titers and may be benefcial for posttransplant transfusion in minor 5. Also, one should recognize that the transport conditions may differ from the storage conditions. Blood ComPonent PreParation and Storage Answer: D—Standards require red cells to be stored at 1–6°C; however, during shipping the range is 1–10°C. If glycerol is not added, crystal formation in the extracellular space will cause movement of the intracellular fuid out of the cell by osmotic force and result in cell shrinkage. High concentration glycerol method is somewhat simpler compared to a low concentration technique. Low concentration technique requires liquid nitrogen for freezing, storing, and shipping, and also the freezing rate needs to be controlled during freezing. Both methods require trained personnel, and deglycerolization after thawing with extensive washing since glycerol can cause in vivo and in vitro hemolysis. Your blood bank receives an order for 2 units of red blood cells for an outpatient transfusion for a sickle cell patient with anti-U and anti-k antibodies. After an exhaustive search of the Rare Donor Inventory, 2 antigen-negative frozen units are identifed in a donor center across the country. Your blood bank has the capability to thaw/deglycerolize on-site with an open system. Notify the patient’s physician that the blood bank will not be able to obtain the units B. Have the blood center thaw/deglycerolize the units and ship so they are immediately available C. Have the units shipped frozen, confrm appointment with clinician, thaw 2 days prior to the appointment to ensure availability for the appointment E. Have the units shipped frozen, confrm appointment with the clinician, thaw/deglycerolize the units at the morning of the appointment Concept: The use of glycerol, as discussed in Question 17, allows for freezing red cells at −65°C for up to 10 years. This allows for longer term storage of rare units, such as the ones noted in this question. As the method used to thaw/deglycerolize involves an open system, the units will expire 24 h after thaw (there is an approved closed method, both when adding glycerol and removing it, allowing for up to 2 weeks expiration postthaw but that is not specifed here). Answer: E—This option provides the approach most likely to avoid wasting the units. Answer A is not correct, as the hospital’s blood supplier likely would arrange for shipment of the units. The other choices (Answers B, C, and D) are incorrect because the units would expire prior to the appointment based on the use of an open system. Blood ComPonent PreParation and Storage 101 Please answer Questions 18 and 19 using the following process map: 18. Leukoreduction Concept: This question highlights the processing of a unit of whole blood into component parts. European countries use a method known as the buffy coat method, which begins with a hard spin (Answer C). Pasteurization (Answer A) is a process used to manufacture albumin, which is pasteurized at 60°C for 10 h to inactivate bacteria and viruses. Leukoreduction (Answer E) is the removal of leukocytes (white blood cells) from the product to a concentration of 6 less than 5 × 10 leukocytes per unit.

I keep six honest serving men They taught me all I know Their names are what buy provera master card, why provera 5mg online, when How purchase provera 2.5 mg free shipping, where and who provera 2.5mg discount. Thus while writing a dissertation the questions what, why, when, how, where and who should be answered. Dissertation/Thesis proposals are designed to: • Justify and plan (or contract for) a research project. Tips to Start Thesis/Dissertation Writing General Advice • Establish a writing schedule, preferably writing at the same time and place each day. Proposal-Specifc Advice • Understand that the proposal will be a negotiated document, so be prepared to draft, redraft, and resubmit it. Annexure Title The title should describe the content in the fewest possible words. The title needs to be accurate, specific, retrievable short yet sufficiently descriptive and as informative as possible. Do not produce long incomprehensible strings and adjectives as seen in this example: “Cytological changes in the conjunctiva in the patients with vitamin A deficiency with or without protein calorie malnutrition”. At the same time the title should not be made meaningless for the sake of brevity as seen in this example “Cell block study”. Thus it is worth analyzing the title and to make sure that it contains elements of the dissertation that it is intended to convey. For example: “Conjunctival Cytology in Xerophthalmia”, “Cell Block Study of Body Fluids”. Introduction The introduction should answer the question “why you want to do the study”? It should introduce the state of knowledge before the work was started, define the gaps in knowledge which the work will fill and state what works set out to do? A good introduction should: • Establish the general territory (real world or research) in which the research is placed. In other words, the introduction needs to provide sufficient background for readers to understand where from your study is coming. Aims and Objectives The objectives of the research project should summarize what is to be achieved by the study. Aim or the General Objective of a study states what is expected to be achieved by the study in general terms. It is possible (and advisable) to break down a general objective into smaller, logically connected parts. It is not necessary to review the entire story of the subject from Pythagoras to the present day but only relevant articles should be reviewed. We know a subject ourselves or we know where we can find the information about it”, said Dr Samuel Johnson. The literature review is a critical look at the existing research that is significant to the work that you are carrying out. Obviously, at this point you are not likely to have read everything related to your research questions, but you should still be able to identify the key texts with which 258 Research Methodology for Health Professionals you will be in conversation as you write your dissertation/thesis. Literature reviews often include both the theoretical approaches to your topic and research (empirical or analytical) on your topic. Writing the Literature Review Allows Understanding • How other researchers/scholars have written about the topic? The literature review has four major functions that you should keep in mind as you write: • It situates the current study within a wider disciplinary conversation. Effective Literature Reviews Should– • Take out the Introduction’s brief description of the background of your study. Tips on Drafting Your Literature Review • Categorize the literature into recognizable topic clusters and begin each with a sub-heading. Demonstrate the places where the literature is lacking, whether due to a methodology you think is incomplete or to assumptions you think are flawed. You should be tying the literature you review to specific facets of your problem, not to review for the sake of reviewing. As tempting as it might be to throw in everything you know, the literature review is not the place for such demonstration. Stick to those pieces of the literature directly relevant to your narrowed subject (question or statement of a problem). You should fight the temptation to strongly express your opinions about the previous literature. Your task is to justify your project given the known scholarship, so polemics, praise, and blame are unnecessary and possibly distracting. Key Points: After assessing the literature in your field, you should be able to answer the following questions: • Why should we study (further) this research topic/problem? Materials and Methods This section is essential and important to most good research proposals. This section includes a description of the general means through which the goals of the study will be achieved: Methods, materials, procedures, tasks, etc. An effective methodology section should: • Introduce the overall methodological approach for each problem or question. Are you going to take a special approach, such as action research, or use case studies? Your methods should have a clear connection with your research questions and/or hypotheses. In other words, make sure that your methods will actually answer your questions or stated objectives, i. One should also include inclusion, exclusion, eligibility and diagnostic criteria especially in medical and health research. Will you use specific theoretical perspectives to help you analyze a text or explain observed behaviors? For instance, if you propose to conduct interviews and use questionnaires, how do you intend to select the sample population? The description of the results of your work is the heart of your thesis/dissertation. In this section you might like to include illustrations, like photograph, sector graphs histograms, pie charts, tables and so on. Remember that illustrations should not be used as ornaments but should support the text and aid in clear description and concise explanations, use them to help convey the information accurately and succinctly. All photographs should have a figure number written in Arabic numerals a short caption or legend and in case of photomicrographs the stain used and magnification should be written, e. Punctuators particularly commas, full stops and quotation marks should be used carefully as wrong usage can alter the meaning totally for example– Go, slow work in progress. It is in the discussion that the author incorporates his contribution into existing knowledge. At its fullest, the discussion will want to do lots of things; it should recapitulate the main findings, discuss the methods you used if there is something interesting or unusual about them, discuss the results of other people those that conflict with yours and those that confirm them and argue the case of your results against those that conflict saying why yours are more convincing. Do not simply say that they disagree and other agree; there has to be some argument. And finally say what the implications of your study are or that more research is needed. When discussing the conclusions of other workers, one should clearly state their origins and quote them correctly bearing in mind that unfavorable comparisons with previous work do not increase the merit of one’s own work. It is better to show how one’s results correct a false impression or lend themselves to a different interpretation. The principal conclusion(s) In the summary, avoid experimental details and references to previous work. Citing of References Harvard style: When there are three or less authors : Write all with their surnames and the year of publication, e. The occurrence of prostatic 262 Research Methodology for Health Professionals tissue in a retroperitoneal teratoma has been observed by earlier workers (Kini, Raghuveer and Pai 1991). When there are more than three authors, write the surname of only the first author, et al and year, e. Vancouver style: Irrespective of the number of authors, write only the reference number as shown in this example: Earlier workers have observed that endometrial hyperplasia is a pre- cancerous condition. Vancouver Style References are numbered according to their appearances in the text and listed accordingly. As per International Committee of Medical Journal Editors, uniform requirements for manuscripts submitted to biomedical journal are available in the following articles: • Br. Immunology: An introduction to molecular and cellular principles of immune response.

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The root is very narrow mesiodistally with mesial and distal root depressions a b c d 4 discount provera online amex. The distal proximal height of contour is more cervical than the mesial height of contour buy 5 mg provera amex. Think of things you have learned about incisors cheap 5mg provera overnight delivery, and try to recall facts you may already know about landmarks in the mouth generic provera 10mg fast delivery. Using a good light source (like a small flashlight), a large mirror (magnifying if possible), and a small, clean disposable dental mirror, carefully compare the maxillary and mandibular incisors in your own mouth while referring to the traits in Table 2-2 from the labial view and lingual view that can be used to differentiate maxillary from mandibular incisors. Write down each trait that can be useful to differentiate the maxillary from the mandibular incisors in your own mouth, and also make note of any of the traits in the text book that do not apply in your mouth. Wheeler’s dental anatomy, physiology of the deciduous and the permanent dentitions. The maxillary central incisor root at the cervix on teeth have been used to draw conclusions through- averages about 6. Data from his have roots that are thicker faciolingually than original research is presented in Tables 2-5A and 2-5B. The crown of the maxillary central incisor averages casts of 715 dental hygiene students and found 11. The crown of the maxillary lateral incisor averages prominent marginal ridges or deep fossae. Woelfel revealed 64% with no lingual depressions on 48% of 793 mandibular central accessory lingual ridges, 32% with one small incisors, and on 51% of 787 mandibular lateral accessory ridge, and only 4% with two ridges. Both types of mandibular incisor crowns average or 62% as wide as the maxillary central incisor. Woelfel’s study anchor teeth (abutments) to attach replacements for lost found that the maxillary incisor crown is longest. As such, they often continue to function as a (faciolingually) that help to anchor them securely in solid support for the replacement teeth for many years. Subsequently, example for all canines, refer to Appendix page 2 while canine crowns from the facial view resemble a five- studying the traits of all canines. Canine teeth do not and the maxillary canine is the longest tooth in the ordinarily have mamelons but may have a notch on mouth even though the mandibular canine crown is either cusp ridge, as seen clearly in Figure 3-2. Chapter 3 | Morphology of the Permanent Canines 69 lingual outline is S shaped, as on all other anterior teeth (Appendix 3q). Further similarities with incisors include the follow- ing: crowns taper, narrowing from the contact areas toward the cervix (Appendix 3e); cervical lines curve more on the mesial than on the distal surface (com- pare mesial and distal views in Appendix 3n); and mar- ginal ridges (as well as crowns) taper lingually from the contact areas toward the cingulum (Appendix 3l), so the crown is narrower on the lingual half than on the facial half. From the incisal view, facial outlines are less convex than lingual outlines (Appendix 3s), and the incisal edges extend from mesial to distal contact areas (Appendix 3r). Further, roots taper narrower from the facial toward the lingual and taper narrower from the cervix toward the apex (Appendix 3h). The location of incisal edge tooth wear on canines Labial view of a maxillary right canine with a is similar to wear on incisors. Facets on the mandibu- prominent labial ridge and notches on mesial and distal cusp ridges lar canine cusp tip and cusp ridge normally form more on the labial border, not the lingual border of the cusp 3. If you find wear The labial surface of a canine is prominently convex with facets on the lingual surface of a mandibular canine or a vertical labial ridge (Appendix 3c and Figure 3-2). If needed, refer back to Figure 2-4 for an illustration of this concept on incisors. Recall that this proportion (greater labi- olingually than mesiodistally) also applied to both types of mandibular incisors. From the proximal views, canine crowns are wedge, or triangular, shaped (Appendix 3o). The height of contour on the facial surface is in the cervical third and on the lingual surface is also in the cervical third on the cingulum (Appendix 3p). Combined, the entire characteristic pattern of incisal wear that is diamond shaped. Labial views of canines with traits to distinguish maxillary from mandibular canines, and traits to distinguish rights from lefts. Unlike incisors where there are two types (a central and ridge (Appendix 3c), which can be quite prominent on a lateral), there is only one type of canine. The labial ridge runs cervicoin- type traits do not apply to canines, but arch traits cisally near the center of the crown in the middle and are useful to distinguish maxillary from mandibular incisal thirds. A labial ridge is often present but Examine several extracted canines and/or models as not as pronounced as on the maxillary canines. As you examine them, hold incisal third, the labial crown surface is convex but maxillary canines with crowns down and mandibular slightly flattened mesial to the labial ridge and even a canines with crowns up. The outline of larities and the range of differences of canines from the the distal portion of this crown forms a shallow S shape, labial view. The mesial outline of the mandibular The distal contact area of the maxillary canine, like crown is almost flat to slightly convex, nearly in line all anterior teeth, is in a more cervical location on the with the mesial side of the root, and may not bulge distal side than on the mesial side. It is located in the or project beyond the mesial root outline (Appendix middle third, just cervical to the junction of the incisal 4b). This conspicuous feature is quite evident in most and middle thirds (recall Appendix 3g). This is the only mandibular canines in Figure 3-4 but is not seen on canine proximal contact area (mesial or distal) located maxillary canines. The distal side of the crown may in the middle third, and it is the most cervical contact be slightly concave in the cervical third; it is convex of all anterior teeth. There is noticeably more of The mesial contact area of the mandibular canine is the crown distal to the root axis line than mesial to it. It is in tilted or bent distally when the root is held in a vertical the incisal third just cervical to the mesioincisal angle. The cusp and cusp ridges of the maxillary canine make up nearly The maxillary canine crown is nearly as long as the one third of the cervicoincisal length of the crown, maxillary central incisor crown, but the root of the because the angle formed by the cusp ridges is relatively canine is much longerE making the maxillary canine, on sharp, slightly more than a right angle (105degrees) average, the longest tooth in the mouth (Appendix 3k). Compare this to the cusp tip of the man- The mandibular canine is considerably larger than dibular canine, where cusp ridges form a less sharp, either of the mandibular incisors, particularly in length more obtuse (blunt) angle (120degrees) (Appendix 4c). F It is, on average, the longest The mesial cusp ridge of the mandibular canine is also mandibular tooth. The apical third is narrow mesiodistally, and the cusp, resulting in an appearance from the facial that is apex may be pointed or sharp. The apical end of the root The mesial contact area of the maxillary canine is is more often straight rather than curving toward the located at the junction of the incisal and middle thirds. Mandibular canine roots are cusp are usually centered mesiodistally (seen best shorter than the roots of maxillary canines. This is most apparent from the incisal view in Refer to Figure 3-5 while studying similarities and Appendix 4e. Mesial and distal lingual fossae lie on maxillary canines are usually of moderate size. The mesial the lingual ridge and the two fossae on either side of it marginal ridge (extending from the proximal contact are not easily discernible. Its incisal and straighter than the shorter, more elevated, and border is sometimes pointed in the center, resembling curved distal marginal ridge. The indistinct lingual a small cusp or tubercle (seen in the far left maxillary ridge is seldom the most prominent ridge. Lingual views of canines with traits to distinguish maxillary from mandibular canines, and traits to distinguish rights from lefts. The labial surface is much more Maxillary and mandibular canine roots are usually con- convex than on the incisors. Therefore, it The height of contour of the facial surface of the is often possible to see both mesial and distal sides of mandibular canine crown is closer to the cervical line the root and one or both of the proximal longitudinal than on a maxillary canine. Observe this difference in cusp thickness in most views usually curve incisally quite a bit (over 2 mm on canines in Figure 3-6. As on incisors, the curvature for all canines is greater on the mesial surface than on the 2. The that the mandibular canine crowns are narrower facio- incisal ridge and cusp tip of the mandibular canine are lingually than maxillary canines, and have a greater most often located slightly lingual to the root axis line, mesial cervical line curve, accentuates the apparent but it may be centered over it (Appendix 4h).

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