com OXFORD MEDICAL PUBLICATIONS Oxford Handbook of Integrated Dental Biosciences www.com Published and forthcoming Oxford Handbooks Oxford Handbook for the Foundation Oxford Handbook of Genetics Programme 4e Oxford Handbook of Genitourinary Oxford Handbook of Acute Medicine 3e Medicine, HIV, and Sexual Health 2e Oxford Handbook of Anaesthesia 4e Oxford Handbook of Geriatric Oxford Handbook of Applied Dental Medicine 2e Sciences Oxford Handbook of Infectious Oxford Handbook of Cardiology 2e Diseases and Microbiology 2e Oxford Handbook of Clinical and Oxford Handbook of Key Clinical Healthcare Research Evidence 2e Oxford Handbook of Clinical and Oxford Handbook of Medical Laboratory Investigation 3e Dermatology 2e Oxford Handbook of Clinical Oxford Handbook of Medical Imaging Dentistry 6e Oxford Handbook of Medical Oxford Handbook of Clinical Sciences 2e Diagnosis 3e Oxford Handbook of Medical Statistics Oxford Handbook of Clinical Oxford Handbook of Neonatology 2e Examination and Practical Skills 2e Oxford Handbook of Nephrology and Oxford Handbook of Clinical Hypertension 2e Haematology 4e Oxford Handbook of Neurology 2e Oxford Handbook of Clinical Oxford Handbook of Nutrition and Immunology and Allergy 3e Dietetics 2e Oxford Handbook of Clinical Oxford Handbook of Obstetrics and Medicine—Mini Edition 9e Gynaecology 3e Oxford Handbook of Clinical Oxford Handbook of Occupational Medicine 10e Health 2e Oxford Handbook of Clinical Pathology Oxford Handbook of Oncology 3e Oxford Handbook of Clinical Oxford Handbook of Operative Pharmacy 3e Surgery 3e Oxford Handbook of Clinical Oxford Handbook of Ophthalmology 3e Rehabilitation 2e Oxford Handbook of Oral and Oxford Handbook of Clinical Maxillofacial Surgery Specialties 10e Oxford Handbook of Orthopaedics Oxford Handbook of Clinical and Trauma Surgery 4e Oxford Handbook of Paediatrics 2e Oxford Handbook of Complementary Oxford Handbook of Pain Management Medicine Oxford Handbook of Palliative Care 2e Oxford Handbook of Critical Care 3e Oxford Handbook of Practical Drug Oxford Handbook of Dental Patient Therapy 2e Care Oxford Handbook of Pre-Hospital Oxford Handbook of Dialysis 4e Care Oxford Handbook of Emergency Oxford Handbook of Psychiatry 3e Medicine 4e Oxford Handbook of Public Health Oxford Handbook of Endocrinology Practice 3e and Diabetes 3e Oxford Handbook of Reproductive Oxford Handbook of ENT and Head Medicine & Family Planning 2e and Neck Surgery 2e Oxford Handbook of Respiratory Oxford Handbook of Epidemiology for Medicine 3e Clinicians Oxford Handbook of Rheumatology 3e Oxford Handbook of Expedition and Oxford Handbook of Sport and Wilderness Medicine 2e Exercise Medicine 2e Oxford Handbook of Forensic Medicine Handbook of Surgical Consent Oxford Handbook of Gastroenterology Oxford Handbook of Tropical & Hepatology 2e Medicine 4e Oxford Handbook of General Oxford Handbook of Urology 3e Practice 4e www.com Oxford Handbook of Integrated Dental Biosciences Second Edition Professor Hugh Devlin Professor in Restorative Dentistry, University of Manchester, UK Dr Rebecca Craven Senior Lecturer in Dental Health, University of Manchester, UK www.com 1 Great Clarendon Street, Oxford, OX2 6DP, United Kingdom Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries © Oxford University Press 2018 The moral rights of the authors have been asserted First Edition published in 2002 Impression: 1 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by licence or under terms agreed with the appropriate reprographics rights organization.
Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this work in any other form and you must impose this same condition on any acquirer Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016, United States of America British Library Cataloguing in Publication Data Data available Library of Congress Control Number: 2017955323 ISBN 978–0–19–875978–2 Printed and bound in China by C&C Offset Printing Co. Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.
Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breast-feeding Links to third party websites are provided by Oxford in good faith and for information only. Oxford disclaims any responsibility for the materials contained in any third party website referenced in this work.com v Foreword Contemporary clinical teaching and learning in dentistry and other health professions now integrates the biosciences with clinical scenarios. This Oxford Handbook of Applied Dental Sciences is, however, the first that pro- vides a format to support this style of learning. Hugh Devlin and Rebecca Craven have a vast experience of teaching and learning in dentistry and have been at the forefront of advances in this inte- gration.
Understanding the relevance of the non-clinical science to the clinical practice that it underpins is now known to provide much more effective learn- ing. This integration enables deep learning. It stimulates interest in the bio- sciences for the clinical learner and its application becomes more meaningful. Hugh Devlin is a successful teaching and research enthusiast.
He has taught undergraduates and postgraduates at the University of Manchester for over 35 years and his depth and breadth of experience could not be more appropriate for the development of this book. He is a respected clini- cal academic with over one hundred scientific publications many of which explore the link between basic dental science and their clinical application. Hugh received the IADR Distinguished Scientist Award (2011) for Research in Prosthodontics and Implants. Rebecca Craven worked in general dental practice and community and hospital dentistry before spending over 25 years in successful university research and teaching.
Rebecca, like Hugh, has vast experience in and a passion for teaching and learning and could not be better placed to produce this book. Her studying for the award of ‘Fellowship in Dental Surgery’ required returning to bioscience study after several years of clinical practice and this sparked a lifelong passion to integrate the two disciplines. Rebecca now leads postgraduate Masters programmes in both research and Dental Public Health, a discipline in which she is an NHS Consultant. She also leads the first year of the undergraduate dental programme.
Integrating bioscience with clinical care and seeking to apply, appropriately, the best evidence, is at the heart of the University of Manchester Dentistry pro- grammes and of this book. This book is truly ‘applied’ and presents the bioscience as clinically rele- vant as possible, with a separate sections detailing the relevant clinical appli- cation and putting the science into context. This book therefore supports contemporary methods of teaching where students study a subject based on a clinical scenario. Hugh Devlin and Rebecca Craven have presented a ‘systems’ approach by describing how the different major organs work, what happens with disease, and how this affects the patient’s dental treat- ment.
Rather than discuss sections on pharmacology, histology, epidemiol- ogy, and public health, these subjects are woven throughout the text and referred to where their use is most relevant. The first edition of this book was edited by the late Professor Crispian Scully and had separate sections on physiology, pathology, anatomy, and the www.com vi vi FOREWORD rest. This second edition integrates the topics and focuses more closely on their clinical relevance so that readers will want to supplement their reading of this handbook from other texts, especially for detailed anatomy and cell biology. This book will be an invaluable resource for dental students and dentists studying for higher qualifications after graduation.
Paul Coulthard BDS MFGDP(UK) MDS FDSRCS FDSRCS(OS) PhD Dean of the School of Dentistry at the University of Manchester and Professor of Oral and Maxillofacial Surgery www.com vii Preface Our aim is to provide a pocket book of bioscience which is tailored to the needs of dental students. Our approach has been to provide knowledge that is relevant to clinical dental practice and is up-to-date. We want clini- cians to reflect on the biological principles and mechanisms, which we hope will encourage deep learning. Science is essential to understand the signs and symptoms of any patient’s disease and the clinician-scientist will be able to offer clear explanations when proposing treatment options to a patient.
Most undergraduate programmes now include some early introduction to dentistry alongside biosciences, but until now that change has not been reflected in textbooks. We aim is to bridge this gap and show directly the relevance of the biology to the clinician. The previous handbook on this subject, the Oxford Handbook of Applied Dental Sciences, edited by the late Professor Crispian Scully, had separate sections on physiology, pathology, anatomy, and the rest. This new hand- book seeks to integrate the topics and focus more closely on their clinical relevance so readers will want to supplement their reading of this hand- book from other texts, especially for detailed anatomy and cell biology.
The thirteen chapters lead the reader through the major body systems. In most cases, a one page opening is a succinct summary of a topic, enriched by diagrams and illustrations. The authors have many decades of experience in clinical dentistry and learning and teaching where we have aspired to an integrated and evidence- based approach. The Oxford Handbook format is ideally suited to the den- tal undergraduate and has proved very popular and practical for students.
It is also hoped that clinicians who are seeking to revise their understanding of biosciences or are preparing for higher clinical examinations may find this a useful starting point. Hugh Devlin Rebecca Craven 2017 www.com viii Acknowledgements The authors would like to acknowledge the help of Mr Daniel Wand at the University of Manchester who gave much assistance with many of the diagrams.com ix Contents Symbols and abbreviations xi 1 Oral cavity and gut 1 2 Temporomandibular joint and surrounding musculature 39 3 Oral mucosa, saliva, and speech 65 4 Bone 85 5 Liver 111 6 Kidneys and chronic renal disease 133 7 Diabetes 149 8 The respiratory system 169 9 Heart and blood supply 187 10 Blood 207 11 Immune system 231 12 Central nervous system 257 13 Endocrine system 287 Index 305 www.com xi Symbols and abbreviations & and = equal to × multiply α alpha β beta γ gamma κ kappa i increased ® registered trademark ACE angiotensin converting enzyme ACH acetaldehyde ACS acute coronary syndrome ACTH adrenocorticotrophic hormone APTT activated partial thromboplastin time ADCC antibody dependent cellular cytotoxicity ADJ amelodentinal junction ADP adenosine diphosphate ADS anatomic dead space AGE advanced glycation end product ALL acute lymphoblastic leukaemia ALP alkaline phosphatase ALT alanine aminotransferase AML acute myeloid leukaemia ACE angiotensin converting enzyme ANP atrial natriuretic hormone APC antigen presenting cell ARB angiotensin receptor blockers ASA American Society of Anaesthesiologists AST aspartate aminotransferase ATP adenosine triphosphate ATP adenosine triphosphate AV atrioventricular BMI body mass index BP blood pressure BSE bovine spongiform encephalitis CCK cholecystokinin www.com xi xii SYMBOLS AND ABBREVIATIONS CPG central pattern generator CHD coronary heart disease CIED cardiovascular implantable electronic device CKD chronic kidney disease CKD-MBD CKD-mineral and bone disorder CLL chronic lymphocytic leukaemia CML chronic myeloid leukaemia CNS central nervous system COMT catechol-O-methyltransferase COPD chronic obstructive pulmonary disease CPAP continuous positive airway pressure CRF chronic renal failure CSF colony stimulating factor CT computed tomography CVA cerebrovascular accident DCCT Diabetes Control and Complications Trial DPG diphosphoglycerate ECG electrocardiogram e.