from docx import Document
from docx.shared import Pt, Inches, RGBColor
from docx.enum.text import WD_ALIGN_PARAGRAPH
from docx.oxml.ns import qn
from docx.oxml import OxmlElement
import copy

doc = Document()

# ── PAGE MARGINS ──────────────────────────────────────────────────────────────
from docx.shared import Inches
section = doc.sections[0]
section.top_margin    = Inches(0.6)
section.bottom_margin = Inches(0.6)
section.left_margin   = Inches(0.8)
section.right_margin  = Inches(0.8)

# ── DEFAULT FONT ──────────────────────────────────────────────────────────────
normal = doc.styles["Normal"]
normal.font.name = "Calibri"
normal.font.size = Pt(10)

# ── COLOUR PALETTE ────────────────────────────────────────────────────────────
COL = {
    "navy":    RGBColor(0x1A, 0x3A, 0x5C),  # unit headings
    "teal":    RGBColor(0x00, 0x7B, 0x83),  # sub-headings
    "orange":  RGBColor(0xD9, 0x6B, 0x00),  # key terms / labels
    "red":     RGBColor(0xC0, 0x39, 0x2B),  # important / danger
    "green":   RGBColor(0x1E, 0x8B, 0x4C),  # treatment / homeo
    "purple":  RGBColor(0x6A, 0x0D, 0x91),  # classification
    "grey":    RGBColor(0x55, 0x55, 0x55),  # body text
    "black":   RGBColor(0x00, 0x00, 0x00),
    "white":   RGBColor(0xFF, 0xFF, 0xFF),
}

# ── SHADING HELPER ────────────────────────────────────────────────────────────
def shade_cell(cell, hex_color):
    tc   = cell._tc
    tcPr = tc.get_or_add_tcPr()
    shd  = OxmlElement("w:shd")
    shd.set(qn("w:val"),   "clear")
    shd.set(qn("w:color"), "auto")
    shd.set(qn("w:fill"),  hex_color)
    tcPr.append(shd)

def set_cell_border(cell, **kwargs):
    tc   = cell._tc
    tcPr = tc.get_or_add_tcPr()
    tcBorders = OxmlElement("w:tcBorders")
    for edge in ("top","left","bottom","right"):
        elm = OxmlElement(f"w:{edge}")
        elm.set(qn("w:val"),   "single")
        elm.set(qn("w:sz"),    "4")
        elm.set(qn("w:color"), "AAAAAA")
        tcBorders.append(elm)
    tcPr.append(tcBorders)

# ── HELPER: add a coloured heading paragraph ──────────────────────────────────
def unit_heading(text, color=None, bg_hex=None, size=14):
    p = doc.add_paragraph()
    p.paragraph_format.space_before = Pt(10)
    p.paragraph_format.space_after  = Pt(2)
    run = p.add_run(f"  {text}  ")
    run.bold      = True
    run.font.size = Pt(size)
    run.font.color.rgb = COL["white"] if bg_hex else (color or COL["navy"])
    if bg_hex:
        # shade the paragraph background via XML
        pPr  = p._p.get_or_add_pPr()
        shd  = OxmlElement("w:shd")
        shd.set(qn("w:val"),   "clear")
        shd.set(qn("w:color"), "auto")
        shd.set(qn("w:fill"),  bg_hex)
        pPr.append(shd)
    return p

def sub_heading(text, color=None, size=11):
    p = doc.add_paragraph()
    p.paragraph_format.space_before = Pt(6)
    p.paragraph_format.space_after  = Pt(1)
    run = p.add_run(f"▶  {text}")
    run.bold      = True
    run.font.size = Pt(size)
    run.font.color.rgb = color or COL["teal"]
    return p

def bullet(text, indent=0, arrow="➤", color=None, bold_part=None):
    """Add a bullet line. bold_part = string that will be bolded in text."""
    p = doc.add_paragraph()
    p.paragraph_format.left_indent   = Pt(18 + indent*14)
    p.paragraph_format.space_before  = Pt(1)
    p.paragraph_format.space_after   = Pt(1)
    p.paragraph_format.first_line_indent = Pt(-14)
    r0 = p.add_run(f"{arrow}  ")
    r0.font.color.rgb = color or COL["orange"]
    r0.font.size = Pt(10)
    if bold_part and bold_part in text:
        idx = text.index(bold_part)
        before = text[:idx]
        after  = text[idx+len(bold_part):]
        if before:
            rb = p.add_run(before)
            rb.font.size = Pt(10); rb.font.color.rgb = COL["grey"]
        rb2 = p.add_run(bold_part)
        rb2.bold = True; rb2.font.size = Pt(10); rb2.font.color.rgb = COL["black"]
        if after:
            rb3 = p.add_run(after)
            rb3.font.size = Pt(10); rb3.font.color.rgb = COL["grey"]
    else:
        r1 = p.add_run(text)
        r1.font.size = Pt(10)
        r1.font.color.rgb = color or COL["grey"]
    return p

def key_value(key, val, key_color=None, val_color=None):
    p = doc.add_paragraph()
    p.paragraph_format.left_indent  = Pt(18)
    p.paragraph_format.space_before = Pt(1)
    p.paragraph_format.space_after  = Pt(1)
    rk = p.add_run(f"{key}:  ")
    rk.bold = True; rk.font.size = Pt(10)
    rk.font.color.rgb = key_color or COL["orange"]
    rv = p.add_run(val)
    rv.font.size = Pt(10)
    rv.font.color.rgb = val_color or COL["grey"]
    return p

def add_table(headers, rows, hdr_hex="1A3A5C"):
    table = doc.add_table(rows=1+len(rows), cols=len(headers))
    table.style = "Table Grid"
    hdr_row = table.rows[0]
    for i, h in enumerate(headers):
        cell = hdr_row.cells[i]
        cell.text = h
        shade_cell(cell, hdr_hex)
        cell.paragraphs[0].runs[0].bold = True
        cell.paragraphs[0].runs[0].font.color.rgb = COL["white"]
        cell.paragraphs[0].runs[0].font.size = Pt(9)
    for ri, row in enumerate(rows):
        tr = table.rows[ri+1]
        bg = "F0F8FF" if ri % 2 == 0 else "FFFFFF"
        for ci, val in enumerate(row):
            cell = tr.cells[ci]
            cell.text = val
            shade_cell(cell, bg)
            cell.paragraphs[0].runs[0].font.size = Pt(9)
            cell.paragraphs[0].runs[0].font.color.rgb = COL["grey"]
    doc.add_paragraph()

def divider():
    p = doc.add_paragraph("─" * 80)
    p.paragraph_format.space_before = Pt(4)
    p.paragraph_format.space_after  = Pt(4)
    for run in p.runs:
        run.font.color.rgb = RGBColor(0xCC,0xCC,0xCC)
        run.font.size = Pt(7)

# ════════════════════════════════════════════════════════════════════════════
# COVER / TITLE
# ════════════════════════════════════════════════════════════════════════════
unit_heading("BHMS 3RD YEAR  |  SURGERY NOTES", bg_hex="1A3A5C", size=16)
p = doc.add_paragraph()
p.paragraph_format.space_after = Pt(2)
r = p.add_run("  Oral & Maxillofacial Surgery  ·  Complete Revision Notes")
r.font.color.rgb = COL["teal"]; r.font.size = Pt(11); r.italic = True

divider()

# ════════════════════════════════════════════════════════════════════════════
# UNIT 1 — TOOTH ANATOMY
# ════════════════════════════════════════════════════════════════════════════
unit_heading("UNIT 1 — ANATOMY OF TEETH & GUMS", bg_hex="007B83", size=13)

sub_heading("Tooth Layers", color=COL["navy"])
add_table(
    ["Layer", "Location", "Composition", "Key Point"],
    [
        ["Enamel",   "Crown",         "96% hydroxyapatite",             "Hardest tissue · avascular · no regeneration"],
        ["Dentin",   "Crown + Root",  "70% mineral, 30% collagen",      "Dentinal tubules · slightly elastic"],
        ["Pulp",     "Central canal", "Vessels + nerves (loose CT)",    "Vitality · pain via Aδ & C fibres"],
        ["Cementum", "Root surface",  "Bone-like, 45% mineral",         "Attaches PDL (Sharpey's fibres)"],
    ]
)

sub_heading("Periodontal Structures (Periodontium)", color=COL["navy"])
for item in [
    "Gingiva → keratinized mucosa around tooth",
    "PDL (Periodontal Ligament) → Sharpey's fibres · 0.15–0.38 mm wide",
    "Alveolar bone → tooth-bearing bone of maxilla & mandible",
    "Cementum → root coverage; anchors PDL",
]:
    bullet(item)

sub_heading("Types of Teeth (Adult = 32)", color=COL["navy"])
add_table(
    ["Type", "No.", "Function", "Roots"],
    [
        ["Incisors",  "8",  "Cutting",          "1"],
        ["Canines",   "4",  "Tearing",           "1 (longest)"],
        ["Premolars", "8",  "Crushing/grinding", "1–2"],
        ["Molars",    "12", "Grinding",          "2–3"],
    ]
)

sub_heading("Occlusion & Angle's Classification", color=COL["navy"])
add_table(
    ["Class", "Description"],
    [
        ["I (Normal)",    "Upper 1st molar mesiobuccal cusp → buccal groove of lower 1st molar"],
        ["II (Retrognathic)", "Lower jaw posterior"],
        ["III (Prognathic)",  "Lower jaw anterior"],
    ],
    hdr_hex="007B83"
)

divider()

# ════════════════════════════════════════════════════════════════════════════
# UNIT 2 — CLINICAL EXAMINATION
# ════════════════════════════════════════════════════════════════════════════
unit_heading("UNIT 2 — CLINICAL EXAMINATION OF TEETH & GUMS", bg_hex="007B83", size=13)

sub_heading("Normal Gingiva", color=COL["navy"])
for x in ["Coral pink · stippled (orange-peel texture) · firm",
          "Sulcus depth 1–3 mm · no bleeding · no mobility"]:
    bullet(x, arrow="✔", color=COL["green"])

sub_heading("Common Conditions", color=COL["navy"])
add_table(
    ["Condition", "Limits", "Key Sign", "Bone Loss?"],
    [
        ["Caries",       "Enamel → pulp",         "Cavity · sensitivity · discoloration", "No"],
        ["Gingivitis",   "Gingiva only",           "Bleeding · redness · swelling",        "No"],
        ["Periodontitis","Gingiva + PDL + bone",   "Pockets >3mm · mobility",              "YES"],
    ]
)

sub_heading("Examination Protocol (IPDPA)", color=COL["navy"])
for step in [
    "Inspection → visual teeth & gums",
    "Palpation → swellings, lymph nodes",
    "Percussion → tenderness = periapical pathology",
    "Probing → pocket depth, BOP",
    "Assessment → vitality testing (cold/EPT)",
]:
    bullet(step, arrow="→")

sub_heading("Malocclusion / Jaw Alignment", color=COL["navy"])
for x in ["Check: overjet, overbite, crossbite, open bite, midline shift",
          "3 planes: sagittal (AP) · vertical · transverse",
          "TMJ: clicking, pain, asymmetry"]:
    bullet(x)

divider()

# ════════════════════════════════════════════════════════════════════════════
# UNIT 3 — JAW TUMOURS
# ════════════════════════════════════════════════════════════════════════════
unit_heading("UNIT 3 — JAW TUMOURS", bg_hex="6A0D91", size=13)

sub_heading("Classification", color=COL["purple"])
add_table(
    ["Benign", "Malignant"],
    [
        ["Ameloblastoma (commonest)",        "Squamous Cell Carcinoma (commonest oral Ca)"],
        ["Odontoma (compound/complex)",      "Osteosarcoma"],
        ["Ossifying fibroma",                "Chondrosarcoma"],
        ["Osteoma · Myxoma · Hemangioma",    "Burkitt's lymphoma (EBV · children · Africa)"],
        ["Cementoma",                        "Multiple myeloma (punched-out lesions)"],
    ],
    hdr_hex="6A0D91"
)

sub_heading("Benign vs Malignant — Key X-ray & Clinical Clues", color=COL["purple"])
add_table(
    ["Feature", "Benign", "Malignant"],
    [
        ["Borders",     "Well-defined · corticated",      "Ill-defined · moth-eaten"],
        ["Teeth",       "Displaced",                       "Root resorption · floating teeth"],
        ["Nerve",       "Rarely affected",                 "Paresthesia (IAN)"],
        ["LN",          "Absent",                          "Cervical lymphadenopathy"],
        ["Growth",      "Slow",                            "Rapid"],
    ]
)

sub_heading("Surgical Options", color=COL["purple"])
add_table(
    ["Procedure", "Indication"],
    [
        ["Enucleation",           "Small benign cysts"],
        ["Marginal resection",    "Benign + cortical involvement"],
        ["Segmental resection",   "Large aggressive/malignant"],
        ["Hemimandibulectomy",    "Extensive malignant"],
        ["Marsupialization",      "Large cysts (decompression)"],
        ["Chemo/Radiotherapy",    "Malignant tumours"],
    ],
    hdr_hex="6A0D91"
)

sub_heading("Homeopathic Remedies — Jaw Tumours", color=COL["green"])
for r in [
    "Hecla lava → jaw tumours, osteitis, exostoses (FIRST choice)",
    "Calcarea fluorica → hard bony tumours, cysts",
    "Conium maculatum → hard slowly growing tumours; elderly",
    "Phosphorus → osteosarcoma tendency; sensitive gums",
    "Thuja → soft pedunculated growths",
    "Silicea → suppurative, indurated swellings",
]:
    bullet(r, arrow="◉", color=COL["green"])

divider()

# ════════════════════════════════════════════════════════════════════════════
# UNIT 4 — EPULIS
# ════════════════════════════════════════════════════════════════════════════
unit_heading("UNIT 4 — EPULIS", bg_hex="D96B00", size=13)

sub_heading("Definition", color=COL["orange"])
bullet("Epulis = any localised gingival tumour-like swelling", arrow="→")

sub_heading("Types at a Glance", color=COL["orange"])
add_table(
    ["Type", "Key Feature", "Histology", "Treatment"],
    [
        ["Fibrous (commonest)",        "Firm · pale pink · sessile/pedunculated",   "Dense fibrous CT",                    "Excision + remove irritant"],
        ["Pyogenic Granuloma",         "Red/purple · bleeds easily · rapid growth", "Granulation tissue · capillary prolif","Excision · treat in pregnancy"],
        ["Giant Cell Epulis",          "Purple-red · anterior molars · F > M",      "Multinucleate giant cells (osteoclast)","Excision + periosteal curettage"],
        ["Congenital Epulis (newborn)","At birth · maxillary ridge",                "—",                                   "Often regresses spontaneously"],
    ],
    hdr_hex="D96B00"
)

sub_heading("Homeopathic Remedies — Epulis", color=COL["green"])
for r in [
    "Thuya → pedunculated, fleshy epulides",
    "Calcarea carbonica → flabby pale growths; plump patients",
    "Hecla lava → bony involvement",
    "Nitric acid → ulcerating, bleeding gums; splinter pain",
    "Merc sol → ulcerated gums + foetid breath",
]:
    bullet(r, arrow="◉", color=COL["green"])

divider()

# ════════════════════════════════════════════════════════════════════════════
# UNIT 5 — AMELOBLASTOMA
# ════════════════════════════════════════════════════════════════════════════
unit_heading("UNIT 5 — AMELOBLASTOMA", bg_hex="C0392B", size=13)

sub_heading("Key Facts", color=COL["red"])
for x in [
    "Most common benign odontogenic tumour · locally aggressive",
    "Origin → odontogenic epithelium",
    "Age → 3rd–4th decade · Site → 80% mandible (post. ramus)",
]:
    bullet(x, arrow="⚑", color=COL["red"])

sub_heading("Subtypes", color=COL["red"])
add_table(
    ["Type", "%", "Notes"],
    [
        ["Multicystic (conventional)", "86%", "Soap-bubble X-ray · HIGH recurrence with enucleation alone"],
        ["Unicystic",                  "13%", "Young patients · mimics dentigerous cyst · better prognosis"],
        ["Peripheral (extraosseous)",  "<1%", "Gingival soft tissue · least aggressive"],
    ],
    hdr_hex="C0392B"
)

sub_heading("Histological Variants (Multicystic)", color=COL["red"])
for v in ["Follicular", "Plexiform", "Acanthomatous", "Granular cell", "Basal cell", "Desmoplastic (anterior jaw)"]:
    bullet(v, arrow="→")

sub_heading("Radiological Findings", color=COL["red"])
for x in [
    "Multicystic → Soap-bubble / honeycomb multilocular radiolucency",
    "Unicystic → Unilocular radiolucency around unerupted lower molar",
    "Root resorption · cortical expansion/thinning · NOT radio-opaque",
]:
    bullet(x, arrow="☞")

sub_heading("Treatment", color=COL["red"])
add_table(
    ["Type", "Treatment", "Note"],
    [
        ["Unicystic",          "Enucleation + curettage OR marsupialization",          "Low recurrence"],
        ["Multicystic (small)","Resection with 1–1.5 cm bone margins",                 "⚠ Enucleation alone → 50–90% recurrence"],
        ["Large/recurrent",    "Hemimandibulectomy + bone reconstruction",              "Free flap / bone graft"],
        ["Peripheral",         "Simple local excision",                                 "Minimal recurrence"],
    ],
    hdr_hex="C0392B"
)

sub_heading("Homeopathic Therapeutics — Ameloblastoma", color=COL["green"])
for r in [
    "Calcarea fluorica → hard cystic jaw swellings",
    "Hecla lava → jaw tumours / exostoses",
    "Silicea → chronic indolent swellings",
    "Baryta carbonica → elderly; gland involvement",
    "⚠ Refer for surgery · homeopathy as adjunct/palliation",
]:
    bullet(r, arrow="◉", color=COL["green"])

divider()

# ════════════════════════════════════════════════════════════════════════════
# UNIT 6 — DENTAL CYSTS
# ════════════════════════════════════════════════════════════════════════════
unit_heading("UNIT 6 — DENTAL CYSTS", bg_hex="1E8B4C", size=13)

sub_heading("Definition", color=COL["green"])
bullet("Cyst = pathological cavity lined by EPITHELIUM · fluid/semi-fluid contents · fibrous wall", arrow="→")

sub_heading("Classification", color=COL["green"])
add_table(
    ["Cyst", "Origin", "X-ray", "Key Feature"],
    [
        ["Radicular (Periapical)", "Infected pulp → Malassez rests",         "Periapical RLcy + sclerotic rim",        "Most common jaw cyst · non-vital tooth"],
        ["Residual",               "Radicular cyst left after extraction",    "RLcy in edentulous area",                "No tooth present"],
        ["Dentigerous (Follicular)","Reduced enamel epithelium of unerupted tooth","RLcy around CROWN at CEJ",      "Lower 3rd molar > upper canine"],
        ["OKC",                    "Dental lamina remnants",                  "Scalloped multi/unilocular",             "Keratinized lining · HIGH recurrence"],
        ["Eruption cyst",          "Follicle of erupting tooth",              "Soft tissue (no bone)",                  "Children · over erupting tooth"],
    ],
    hdr_hex="1E8B4C"
)

sub_heading("Radicular Cyst — Pathogenesis", color=COL["navy"])
for step in [
    "Caries → pulp necrosis",
    "→ Epithelial rests of Malassez stimulated",
    "→ Epithelial proliferation",
    "→ Cyst formation",
]:
    bullet(step, arrow="→")

sub_heading("OKC — Special Points", color=COL["green"])
for x in [
    "Lining → thin, parakeratinised, corrugated; palisaded flat basal cells",
    "Contents → creamy/cheesy keratin",
    "Recurrence → 25–60% (satellite cysts, thin friable wall)",
    "Gorlin-Goltz Syndrome → multiple OKCs + basal cell naevi + PTCH1 gene (AD)",
    "Treatment → Enucleation + Carnoy's solution + peripheral ostectomy · 10-yr follow-up",
]:
    bullet(x, arrow="⚠" if "Recurrence" in x or "Gorlin" in x else "→", color=COL["red"] if "Recurrence" in x or "Gorlin" in x else COL["grey"])

sub_heading("Dentigerous Cyst — Key Points", color=COL["green"])
for x in [
    "Fluid between reduced enamel epithelium & crown of unerupted tooth",
    "X-ray → RLcy attached at CEJ; crown inside cyst",
    "⚠ Risk of ameloblastoma transformation from cyst wall",
    "Treatment → Marsupialization (children, large) OR Enucleation + extraction",
]:
    bullet(x, arrow="⚠" if "⚠" in x else "→", color=COL["red"] if "⚠" in x else COL["grey"])

sub_heading("Surgical Enucleation — Steps", color=COL["navy"])
for i, step in enumerate([
    "LA/GA + perioperative assessment",
    "Mucoperiosteal flap incision",
    "Bone window (bur/chisel)",
    "Cyst wall separated with periosteal elevator",
    "Cyst removed INTACT → histopathology",
    "Curettage of cavity + saline irrigation",
    "Primary closure OR BIPP pack (large cavity)",
], 1):
    bullet(f"Step {i} → {step}", arrow=f"{i}.")

sub_heading("Follow-Up Protocol", color=COL["navy"])
add_table(
    ["Time", "Action"],
    [
        ["1 week",     "Wound check"],
        ["1 month",    "Healing assessment"],
        ["3 months",   "Clinical review"],
        ["6 months",   "X-ray"],
        ["1 year",     "X-ray"],
        ["Annual",     "X-ray for 5–10 yrs (OKC)"],
    ],
    hdr_hex="1A3A5C"
)

sub_heading("Marsupialization (Partsch I)", color=COL["navy"])
for x in [
    "Creates surgical window → cyst opens to oral cavity",
    "Reduces intracystic pressure → bone fills gradually",
    "Used → large cysts in children; dentigerous cysts (allows tooth eruption)",
    "⚠ Disadvantage → no complete histopathology; slow resolution",
]:
    bullet(x, arrow="→")

divider()

# ════════════════════════════════════════════════════════════════════════════
# UNIT 7 — ALVEOLAR ABSCESS
# ════════════════════════════════════════════════════════════════════════════
unit_heading("UNIT 7 — ALVEOLAR ABSCESS", bg_hex="C0392B", size=13)

sub_heading("Definition & Types", color=COL["red"])
for x in [
    "Acute dentoalveolar abscess → rapid onset · severe pain",
    "Chronic dentoalveolar abscess → sinus tract (parulis) present",
    "Phoenix abscess → acute exacerbation of chronic periapical lesion",
]:
    bullet(x, arrow="→")

sub_heading("Causes", color=COL["red"])
add_table(
    ["Cause", "Mechanism"],
    [
        ["Dental caries (commonest)", "Pulp necrosis → periapical spread"],
        ["Periodontal disease",       "Pocket → bone → abscess"],
        ["Trauma",                    "Pulp necrosis"],
        ["Failed RCT",                "Residual infection"],
        ["Pericoronitis",             "Partially erupted wisdom tooth"],
    ],
    hdr_hex="C0392B"
)

sub_heading("Clinical Features", color=COL["red"])
for x in [
    "LOCAL → throbbing pain · percussion tenderness · non-vital tooth · swelling · mobility",
    "CHRONIC → sinus tract (parulis) · minimal pain",
    "SYSTEMIC (spreading) → fever · lymphadenopathy · trismus · dysphagia",
]:
    bullet(x, arrow="☞")

sub_heading("Spread of Infection → Spaces", color=COL["red"])
for sp in [
    "Buccal space (commonest) → cheek swelling",
    "Palatal space → maxillary palatal roots",
    "Submandibular space → lower 2nd/3rd molar",
    "Ludwig's angina → bilateral submandibular + sublingual + submental → ⚠ AIRWAY EMERGENCY",
    "Cavernous sinus thrombosis (rare) → upper tooth via angular vein → life-threatening",
]:
    color = COL["red"] if "EMERGENCY" in sp or "thrombosis" in sp else COL["grey"]
    bullet(sp, arrow="→", color=color)

sub_heading("Radiological Findings", color=COL["red"])
for x in [
    "Early → widened PDL space",
    "Acute → ill-defined periapical bone destruction",
    "Chronic → well-defined sclerotic periapical lesion",
]:
    bullet(x, arrow="→")

sub_heading("Drainage Techniques", color=COL["navy"])
add_table(
    ["Route", "Indication", "Technique"],
    [
        ["Via root canal", "Early · accessible tooth", "Open access cavity → pus drains through tooth"],
        ["Intraoral I&D", "Fluctuant swelling pointing intraorally", "Horizontal incision at fluctuant point → blunt dissection → drain inserted → suture"],
        ["Extraoral I&D", "Extraoral extension / deep space / Ludwig's", "Incision below mandibular border (skin crease) → Hilton's method → drain inserted"],
        ["Tracheostomy", "Ludwig's angina → airway compromise", "Emergency airway securing"],
    ],
    hdr_hex="1A3A5C"
)

sub_heading("Medical Treatment", color=COL["navy"])
for x in [
    "Amoxicillin 500 mg TDS × 5 days (first line)",
    "Metronidazole 400 mg TDS (anaerobes)",
    "Clindamycin (if penicillin allergy)",
    "NSAIDs + Paracetamol (analgesia)",
    "Definitive → Extraction OR RCT once acute phase settled",
]:
    bullet(x, arrow="→")

sub_heading("Homeopathic Management — Dental Abscess", color=COL["green"])
add_table(
    ["Remedy", "Indication"],
    [
        ["Belladonna",           "Early acute · throbbing · hot · red · fever"],
        ["Hepar sulphur (low)",  "Promotes suppuration · extreme touch sensitivity"],
        ["Hepar sulphur (high)", "Aborts suppuration"],
        ["Myristica sebifera",   "'Homeopathic knife' → promotes rapid drainage"],
        ["Silicea",              "Chronic abscess · sinus tract · slow healing"],
        ["Merc sol",             "Salivation · foetid breath · gum ulceration · worse at night"],
        ["Pyrogenium",           "Septic state · offensive discharge · high fever"],
    ],
    hdr_hex="1E8B4C"
)

divider()

# ════════════════════════════════════════════════════════════════════════════
# QUICK REFERENCE — MASTER COMPARISON TABLE
# ════════════════════════════════════════════════════════════════════════════
unit_heading("QUICK REFERENCE — MASTER TABLE", bg_hex="1A3A5C", size=13)
add_table(
    ["Condition", "X-ray", "Key Clinical Sign", "Treatment"],
    [
        ["Radicular cyst",    "Periapical RLcy + sclerotic rim",          "Non-vital tooth",                  "RCT or enucleation"],
        ["Residual cyst",     "RLcy in edentulous area",                  "Previous extraction site",         "Enucleation"],
        ["Dentigerous cyst",  "RLcy around crown at CEJ",                 "Unerupted tooth",                  "Enucleation/marsupialization"],
        ["OKC",               "Scalloped multilocular; grows along bone", "Keratin contents; high recurrence","Enucleation + Carnoy's · long F/U"],
        ["Ameloblastoma",     "Soap-bubble multilocular",                 "Painless jaw swelling",            "Resection with margins"],
        ["Alveolar abscess",  "Periapical RLcy ± bone destruction",       "Tender; non-vital; swelling",      "Drain + Abx + Extraction/RCT"],
        ["Fibrous epulis",    "Normal / slight resorption",               "Firm pink gingival mass",          "Excision"],
        ["Giant cell epulis", "Cup-shaped bone resorption",               "Purple-red gingival mass",         "Excision + periosteal curettage"],
    ]
)

# KEY HOMEOPATHIC REMEDIES CHEAT SHEET
unit_heading("HOMEOPATHY CHEAT SHEET", bg_hex="6A0D91", size=13)
add_table(
    ["Remedy", "Key Indication"],
    [
        ["Hecla lava",           "Jaw tumours · exostoses · alveolar swellings — FIRST CHOICE"],
        ["Calcarea fluorica",    "Hard tumours · cysts · bone hypertrophy"],
        ["Silicea",              "Chronic suppuration · sinuses · slow healing · OKC/abscess"],
        ["Myristica sebifera",   "Dental abscess — rapid drainage ('homeopathic knife')"],
        ["Hepar sulphur",        "Abscess — low pot. → suppurate; high pot. → abort"],
        ["Merc sol",             "Gum ulcers · salivation · foetid breath"],
        ["Thuya",                "Soft pedunculated growths · epulis · polyps"],
        ["Belladonna",           "Acute abscess — throbbing · heat · redness · fever"],
        ["Pyrogenium",           "Septic states · high fever · offensive discharge"],
        ["Conium maculatum",     "Hard slow-growing tumours · elderly"],
    ],
    hdr_hex="6A0D91"
)

# save
out = "/tmp/workspace/bhms-surgery/BHMS_Surgery_Notes.docx"
doc.save(out)
print(f"Saved: {out}")

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<h1 class="cover">🦷 BHMS 3RD YEAR — SURGERY NOTES
  <span>Oral &amp; Maxillofacial Surgery · Complete Revision Notes</span>
</h1>

<!-- ═══════════════════════════ UNIT 1 ═══════════════════════════ -->
<div class="unit u1">UNIT 1 — ANATOMY OF TEETH &amp; GUMS</div>

<div class="sub">Tooth Layers</div>
<table class="th-teal">
  <tr><th>Layer</th><th>Location</th><th>Composition</th><th>Key Point</th></tr>
  <tr><td><b class="kw">Enamel</b></td><td>Crown</td><td>96% hydroxyapatite</td><td>Hardest tissue · avascular · no regeneration</td></tr>
  <tr><td><b class="kw">Dentin</b></td><td>Crown + Root</td><td>70% mineral, 30% collagen</td><td>Dentinal tubules · slightly elastic</td></tr>
  <tr><td><b class="kw">Pulp</b></td><td>Central canal</td><td>Vessels + nerves</td><td>Vitality · pain via Aδ &amp; C fibres</td></tr>
  <tr><td><b class="kw">Cementum</b></td><td>Root surface</td><td>Bone-like · 45% mineral</td><td>Anchors Sharpey's fibres (PDL)</td></tr>
</table>

<div class="sub">Periodontal Structures</div>
<ul class="arrow">
  <li>Gingiva → keratinized mucosa around tooth</li>
  <li>PDL → Sharpey's fibres · width 0.15–0.38 mm</li>
  <li>Alveolar bone → tooth-bearing bone of maxilla &amp; mandible</li>
  <li>Cementum → root coverage; anchors PDL</li>
</ul>

<div class="sub">Types of Teeth (Adult = 32)</div>
<table class="th-teal">
  <tr><th>Type</th><th>No.</th><th>Function</th><th>Roots</th></tr>
  <tr><td>Incisors</td><td>8</td><td>Cutting</td><td>1</td></tr>
  <tr><td>Canines</td><td>4</td><td>Tearing</td><td>1 (longest)</td></tr>
  <tr><td>Premolars</td><td>8</td><td>Crushing</td><td>1–2</td></tr>
  <tr><td>Molars</td><td>12</td><td>Grinding</td><td>2–3</td></tr>
</table>

<div class="sub">Angle's Classification of Occlusion</div>
<table class="th-navy">
  <tr><th>Class</th><th>Description</th></tr>
  <tr><td><b class="badge badge-g">I – Normal</b></td><td>U/1st molar MB cusp → buccal groove of L/1st molar</td></tr>
  <tr><td><b class="badge badge-o">II – Retro</b></td><td>Lower jaw posterior</td></tr>
  <tr><td><b class="badge badge-r">III – Progn</b></td><td>Lower jaw anterior</td></tr>
</table>

<hr class="divider">

<!-- ═══════════════════════════ UNIT 2 ═══════════════════════════ -->
<div class="unit u2">UNIT 2 — CLINICAL EXAMINATION OF TEETH &amp; GUMS</div>

<div class="sub">Normal Gingiva</div>
<ul class="check">
  <li>Coral pink · stippled (orange-peel texture) · firm · non-bleeding</li>
  <li>Sulcus depth 1–3 mm · no mobility</li>
</ul>

<div class="sub">Common Conditions</div>
<table class="th-teal">
  <tr><th>Condition</th><th>Limits</th><th>Key Sign</th><th>Bone Loss?</th></tr>
  <tr><td><b class="kw">Caries</b></td><td>Enamel → pulp</td><td>Cavity · sensitivity · discoloration</td><td><span class="badge badge-g">No</span></td></tr>
  <tr><td><b class="kw">Gingivitis</b></td><td>Gingiva only</td><td>Bleeding · redness · swelling</td><td><span class="badge badge-g">No</span></td></tr>
  <tr><td><b class="kw">Periodontitis</b></td><td>Gingiva + PDL + bone</td><td>Pockets &gt;3 mm · mobility</td><td><span class="badge badge-r">YES</span></td></tr>
</table>

<div class="sub">Examination Protocol (IPDPA)</div>
<ul class="arrow">
  <li><b class="orange">I</b>nspection → visual teeth &amp; gums</li>
  <li><b class="orange">P</b>alpation → swellings, lymph nodes</li>
  <li><b class="orange">P</b>ercussion → tenderness = periapical pathology</li>
  <li><b class="orange">P</b>robing → pocket depth, BOP</li>
  <li><b class="orange">A</b>ssessment → vitality testing (cold/EPT)</li>
</ul>

<div class="sub">Malocclusion Assessment</div>
<ul class="arrow">
  <li>Check → overjet · overbite · crossbite · open bite · midline shift</li>
  <li>3 planes → sagittal (AP) · vertical · transverse</li>
  <li>TMJ → clicking · pain · asymmetry</li>
</ul>

<hr class="divider">

<!-- ═══════════════════════════ UNIT 3 ═══════════════════════════ -->
<div class="unit u3">UNIT 3 — JAW TUMOURS</div>

<div class="sub">Classification</div>
<table class="th-purple">
  <tr><th>Benign</th><th>Malignant</th></tr>
  <tr><td>Ameloblastoma (commonest)</td><td>Squamous Cell Carcinoma (commonest oral Ca)</td></tr>
  <tr><td>Odontoma (compound/complex)</td><td>Osteosarcoma</td></tr>
  <tr><td>Ossifying fibroma · Osteoma</td><td>Chondrosarcoma</td></tr>
  <tr><td>Myxoma · Hemangioma · Cementoma</td><td>Burkitt's lymphoma (EBV · children · Africa)</td></tr>
  <tr><td></td><td>Multiple myeloma (punched-out lesions)</td></tr>
</table>

<div class="sub">Benign vs Malignant</div>
<table class="th-navy">
  <tr><th>Feature</th><th>Benign</th><th>Malignant</th></tr>
  <tr><td>Borders</td><td>Well-defined · corticated</td><td>Moth-eaten · ill-defined</td></tr>
  <tr><td>Teeth</td><td>Displaced</td><td>Resorbed / floating</td></tr>
  <tr><td>Nerve</td><td>Spared</td><td>Paresthesia (IAN)</td></tr>
  <tr><td>Lymph nodes</td><td>—</td><td>Cervical lymphadenopathy</td></tr>
  <tr><td>Growth</td><td>Slow</td><td>Rapid</td></tr>
</table>

<div class="sub">Surgical Options</div>
<table class="th-purple">
  <tr><th>Procedure</th><th>Indication</th></tr>
  <tr><td>Enucleation</td><td>Small benign cysts</td></tr>
  <tr><td>Marginal resection</td><td>Benign + cortical involvement</td></tr>
  <tr><td>Segmental resection</td><td>Large aggressive / malignant</td></tr>
  <tr><td>Hemimandibulectomy</td><td>Extensive malignant</td></tr>
  <tr><td>Marsupialization</td><td>Large cysts (decompression)</td></tr>
  <tr><td>Chemo / Radiotherapy</td><td>Malignancies</td></tr>
</table>

<div class="sub">Homeopathic Remedies</div>
<div class="green-box">
<ul class="dot">
  <li><b class="rx">Hecla lava</b> → jaw tumours, osteitis, exostoses <span class="badge badge-g">FIRST CHOICE</span></li>
  <li><b class="rx">Calcarea fluorica</b> → hard bony tumours, cysts</li>
  <li><b class="rx">Conium maculatum</b> → hard slow-growing tumours; elderly</li>
  <li><b class="rx">Phosphorus</b> → osteosarcoma tendency</li>
  <li><b class="rx">Thuja</b> → soft pedunculated growths</li>
  <li><b class="rx">Silicea</b> → suppurative indurated swellings</li>
</ul>
</div>

<hr class="divider">

<!-- ═══════════════════════════ UNIT 4 ═══════════════════════════ -->
<div class="unit u4">UNIT 4 — EPULIS</div>

<div class="note-box">Epulis = any localised tumour-like swelling arising from the <b>gingiva</b></div>

<div class="sub">Types</div>
<table class="th-orange">
  <tr><th>Type</th><th>Key Feature</th><th>Histology</th><th>Treatment</th></tr>
  <tr><td><b class="kw">Fibrous</b> <span class="badge badge-o">Commonest</span></td><td>Firm · pale pink · sessile/pedunculated</td><td>Dense fibrous CT</td><td>Excision + remove irritant</td></tr>
  <tr><td><b class="kw">Pyogenic Granuloma</b></td><td>Red/purple · bleeds easily · rapid growth · pregnancy</td><td>Granulation tissue · capillary proliferation</td><td>Excision · treat pregnancy-related</td></tr>
  <tr><td><b class="kw">Giant Cell Epulis</b></td><td>Purple-red · anterior molars · F &gt; M</td><td>Multinucleate giant cells (osteoclast-like)</td><td>Excision + periosteal curettage</td></tr>
  <tr><td><b class="kw">Congenital</b></td><td>At birth · maxillary ridge</td><td>—</td><td>Often regresses spontaneously</td></tr>
</table>

<div class="sub">Homeopathic Remedies</div>
<div class="green-box">
<ul class="dot">
  <li><b class="rx">Thuya</b> → pedunculated fleshy epulides</li>
  <li><b class="rx">Calcarea carbonica</b> → flabby pale growths; plump patients</li>
  <li><b class="rx">Hecla lava</b> → bony involvement</li>
  <li><b class="rx">Nitric acid</b> → ulcerating bleeding gums; splinter pain</li>
  <li><b class="rx">Merc sol</b> → ulcerated gums + foetid breath</li>
</ul>
</div>

<hr class="divider">

<!-- ═══════════════════════════ UNIT 5 ═══════════════════════════ -->
<div class="unit u5">UNIT 5 — AMELOBLASTOMA</div>

<ul class="flag">
  <li>Most common benign odontogenic tumour · <b class="warn">locally aggressive</b></li>
  <li>Origin → odontogenic epithelium · Age → 3rd–4th decade</li>
  <li>Site → <b class="warn">80% mandible</b> (posterior ramus) · 20% maxilla</li>
</ul>

<div class="sub">Subtypes</div>
<table class="th-red">
  <tr><th>Type</th><th>%</th><th>Notes</th></tr>
  <tr><td><b class="kw">Multicystic (conventional)</b></td><td>86%</td><td>Soap-bubble X-ray · ⚠ <b class="warn">50–90% recurrence</b> with enucleation alone</td></tr>
  <tr><td><b class="kw">Unicystic</b></td><td>13%</td><td>Young patients · mimics dentigerous cyst · better prognosis</td></tr>
  <tr><td><b class="kw">Peripheral</b></td><td>&lt;1%</td><td>Gingival soft tissue · least aggressive</td></tr>
</table>

<div class="sub">Histological Variants</div>
<ul class="arrow">
  <li>Follicular · Plexiform · Acanthomatous · Granular cell · Basal cell · Desmoplastic (anterior jaw)</li>
</ul>

<div class="sub">Radiological Findings</div>
<ul class="arrow">
  <li>Multicystic → <b class="kw">Soap-bubble / honeycomb</b> multilocular radiolucency</li>
  <li>Unicystic → Unilocular radiolucency around unerupted lower molar crown</li>
  <li>Root resorption · cortical expansion/thinning · <b>NOT</b> radio-opaque</li>
</ul>

<div class="sub">Treatment</div>
<table class="th-red">
  <tr><th>Type</th><th>Treatment</th><th>Note</th></tr>
  <tr><td>Unicystic</td><td>Enucleation + curettage OR marsupialization</td><td><span class="badge badge-g">Low recurrence</span></td></tr>
  <tr><td>Multicystic</td><td>Resection with 1–1.5 cm bone margins</td><td><span class="badge badge-r">⚠ No enucleation alone</span></td></tr>
  <tr><td>Large / recurrent</td><td>Hemimandibulectomy + bone reconstruction</td><td>Free flap / bone graft</td></tr>
  <tr><td>Peripheral</td><td>Simple local excision</td><td>Minimal recurrence</td></tr>
</table>

<div class="sub">Homeopathic Therapeutics</div>
<div class="green-box">
<ul class="dot">
  <li><b class="rx">Calcarea fluorica</b> → hard cystic jaw swellings</li>
  <li><b class="rx">Hecla lava</b> → jaw tumours / exostoses</li>
  <li><b class="rx">Silicea</b> → chronic indolent swellings</li>
  <li><b class="rx">Baryta carbonica</b> → elderly; gland involvement</li>
  <li>⚠ Refer for surgery · homeopathy as adjunct/palliation</li>
</ul>
</div>

<hr class="divider">

<!-- ═══════════════════════════ UNIT 6 ═══════════════════════════ -->
<div class="unit u6">UNIT 6 — DENTAL CYSTS</div>

<div class="note-box">Cyst = pathological cavity lined by <b>epithelium</b> · fluid contents · fibrous wall</div>

<div class="sub">Classification</div>
<table class="th-green">
  <tr><th>Cyst</th><th>Origin</th><th>X-ray</th><th>Key Feature</th></tr>
  <tr><td><b class="kw">Radicular (Periapical)</b></td><td>Malassez rests (infected pulp)</td><td>Periapical RLcy + sclerotic rim</td><td><span class="badge badge-b">Most common jaw cyst</span> · non-vital tooth</td></tr>
  <tr><td><b class="kw">Residual</b></td><td>Radicular cyst left post-extraction</td><td>RLcy in edentulous area</td><td>No tooth present</td></tr>
  <tr><td><b class="kw">Dentigerous (Follicular)</b></td><td>Reduced enamel epithelium</td><td>RLcy around crown at CEJ</td><td>Lower 3rd molar &gt; upper canine</td></tr>
  <tr><td><b class="kw">OKC</b></td><td>Dental lamina remnants</td><td>Scalloped multi/unilocular</td><td><span class="badge badge-r">HIGH recurrence</span> · keratin contents</td></tr>
  <tr><td><b class="kw">Eruption cyst</b></td><td>Follicle of erupting tooth</td><td>Soft tissue (no bone)</td><td>Children · self-resolves</td></tr>
</table>

<div class="sub">Radicular Cyst → Pathogenesis</div>
<ul class="arrow">
  <li>Caries → pulp necrosis → stimulates epithelial rests of Malassez → proliferation → cyst</li>
</ul>

<div class="sub">OKC — Special Points</div>
<div class="danger-box">
<ul class="warn">
  <li>Lining → thin, <b>parakeratinised</b>, corrugated; palisaded flat basal cells</li>
  <li>Recurrence → 25–60% (satellite cysts, thin friable wall)</li>
  <li>Gorlin-Goltz Syndrome → multiple OKCs + basal cell naevi + <b>PTCH1 gene</b> (autosomal dominant)</li>
  <li>Treatment → Enucleation + <b>Carnoy's solution</b> + peripheral ostectomy · 10-yr follow-up</li>
</ul>
</div>

<div class="sub">Dentigerous Cyst — Key Points</div>
<ul class="arrow">
  <li>Fluid between reduced enamel epithelium &amp; crown of unerupted tooth</li>
  <li>X-ray → RLcy attached at CEJ; crown inside cyst</li>
  <li class="warn">⚠ Risk of ameloblastoma transformation from cyst wall</li>
  <li>Treatment → Marsupialization (large; children) OR Enucleation + extraction</li>
</ul>

<div class="sub">Surgical Enucleation — Steps</div>
<ul class="num">
  <li data-n="1.">LA/GA · perioperative assessment</li>
  <li data-n="2.">Mucoperiosteal flap incision</li>
  <li data-n="3.">Bone window (bur / chisel)</li>
  <li data-n="4.">Cyst wall separated with periosteal elevator</li>
  <li data-n="5.">Cyst removed <b>INTACT</b> → send for histopathology</li>
  <li data-n="6.">Curettage of cavity + saline irrigation</li>
  <li data-n="7.">Primary closure OR BIPP pack (large cavity)</li>
</ul>

<div class="sub">Follow-Up Protocol</div>
<table class="th-navy">
  <tr><th>Time</th><th>Action</th></tr>
  <tr><td>1 week</td><td>Wound check</td></tr>
  <tr><td>1 month</td><td>Healing assessment</td></tr>
  <tr><td>3 months</td><td>Clinical review</td></tr>
  <tr><td>6 months + 1 year</td><td>X-ray</td></tr>
  <tr><td>Annual × 10 yrs</td><td>X-ray (OKC)</td></tr>
</table>

<div class="sub">Marsupialization (Partsch I)</div>
<ul class="arrow">
  <li>Creates window → cyst opens to oral cavity → reduces intracystic pressure → bone fills</li>
  <li>Used → large cysts in children; dentigerous cysts (allows tooth eruption)</li>
  <li>⚠ Disadvantage → incomplete histopathology; slow resolution (months)</li>
</ul>

<hr class="divider">

<!-- ═══════════════════════════ UNIT 7 ═══════════════════════════ -->
<div class="unit u7">UNIT 7 — ALVEOLAR ABSCESS</div>

<div class="sub">Types</div>
<ul class="arrow">
  <li><b class="kw">Acute</b> → rapid onset · severe throbbing pain</li>
  <li><b class="kw">Chronic</b> → sinus tract (parulis) · dull ache</li>
  <li><b class="kw">Phoenix</b> → acute exacerbation of chronic periapical lesion</li>
</ul>

<div class="sub">Causes</div>
<table class="th-red">
  <tr><th>Cause</th><th>Mechanism</th></tr>
  <tr><td>Dental caries <span class="badge badge-r">Commonest</span></td><td>Pulp necrosis → periapical spread</td></tr>
  <tr><td>Periodontal disease</td><td>Deep pocket → bone → abscess</td></tr>
  <tr><td>Trauma</td><td>Pulp necrosis</td></tr>
  <tr><td>Failed RCT</td><td>Residual infection</td></tr>
  <tr><td>Pericoronitis</td><td>Partially erupted wisdom tooth</td></tr>
</table>

<div class="sub">Clinical Features</div>
<ul class="arrow">
  <li><b class="orange">LOCAL</b> → throbbing pain · percussion tender · non-vital tooth · swelling · mobility</li>
  <li><b class="orange">CHRONIC</b> → sinus tract (parulis) · minimal pain</li>
  <li><b class="warn">SYSTEMIC</b> → fever · lymphadenopathy · trismus · dysphagia</li>
</ul>

<div class="sub">Spread of Infection</div>
<ul class="arrow">
  <li>Buccal space <span class="badge badge-b">Commonest</span> → cheek swelling</li>
  <li>Palatal space → maxillary palatal roots</li>
  <li>Submandibular space → lower 2nd/3rd molar</li>
  <li><b class="warn">Ludwig's angina</b> → bilateral submandibular + sublingual + submental → <span class="badge badge-r">⚠ AIRWAY EMERGENCY</span></li>
  <li>Cavernous sinus thrombosis (rare) → upper tooth → angular vein → life-threatening</li>
</ul>

<div class="sub">Radiological Findings</div>
<ul class="arrow">
  <li>Early → widened PDL space</li>
  <li>Acute → ill-defined periapical bone destruction</li>
  <li>Chronic → well-defined sclerotic periapical lesion</li>
</ul>

<div class="sub">Drainage Techniques</div>
<table class="th-navy">
  <tr><th>Route</th><th>Indication</th><th>Technique</th></tr>
  <tr><td>Via root canal</td><td>Early · accessible tooth</td><td>Open access → pus drains through tooth</td></tr>
  <tr><td>Intraoral I&amp;D</td><td>Fluctuant intraoral swelling</td><td>Horizontal incision at fluctuant point → blunt dissection → corrugated drain → suture</td></tr>
  <tr><td>Extraoral I&amp;D</td><td>Extraoral extension / deep spaces</td><td>Incision below mandibular border (skin crease) → Hilton's method → drain</td></tr>
  <tr><td>Tracheostomy</td><td>Ludwig's angina · airway compromise</td><td>Emergency airway securing</td></tr>
</table>

<div class="sub">Medical Treatment</div>
<ul class="arrow">
  <li>Amoxicillin 500 mg TDS × 5 days <span class="badge badge-b">First line</span></li>
  <li>Metronidazole 400 mg TDS → anaerobes</li>
  <li>Clindamycin → if penicillin allergy</li>
  <li>NSAIDs + Paracetamol → analgesia</li>
  <li>Definitive → Extraction OR RCT once acute phase settled</li>
</ul>

<div class="sub">Homeopathic Management</div>
<div class="green-box">
<table class="th-green">
  <tr><th>Remedy</th><th>Indication</th></tr>
  <tr><td><b class="rx">Belladonna</b></td><td>Early acute · throbbing · hot · red · fever</td></tr>
  <tr><td><b class="rx">Hepar sulphur (low)</b></td><td>Promotes suppuration · extreme touch sensitivity</td></tr>
  <tr><td><b class="rx">Hepar sulphur (high)</b></td><td>Aborts suppuration</td></tr>
  <tr><td><b class="rx">Myristica sebifera</b></td><td>'Homeopathic knife' → promotes rapid drainage</td></tr>
  <tr><td><b class="rx">Silicea</b></td><td>Chronic abscess · sinus tract · slow healing</td></tr>
  <tr><td><b class="rx">Merc sol</b></td><td>Salivation · foetid breath · gum ulceration · worse at night</td></tr>
  <tr><td><b class="rx">Pyrogenium</b></td><td>Septic state · high fever · offensive discharge</td></tr>
</table>
</div>

<hr class="divider">

<!-- ═══════════════════════════ MASTER TABLE ═══════════════════════════ -->
<div class="unit uq">QUICK REFERENCE — MASTER COMPARISON TABLE</div>
<table class="th-navy">
  <tr><th>Condition</th><th>X-ray</th><th>Key Clinical Sign</th><th>Treatment</th></tr>
  <tr><td><b>Radicular cyst</b></td><td>Periapical RLcy + sclerotic rim</td><td>Non-vital tooth</td><td>RCT or enucleation</td></tr>
  <tr><td><b>Residual cyst</b></td><td>RLcy in edentulous area</td><td>Previous extraction site</td><td>Enucleation</td></tr>
  <tr><td><b>Dentigerous cyst</b></td><td>RLcy around crown at CEJ</td><td>Unerupted tooth</td><td>Enucleation / marsupialization</td></tr>
  <tr><td><b>OKC</b></td><td>Scalloped multilocular; grows along bone</td><td>Keratin contents; HIGH recurrence</td><td>Enucleation + Carnoy's · 10-yr F/U</td></tr>
  <tr><td><b>Ameloblastoma</b></td><td>Soap-bubble multilocular</td><td>Painless jaw swelling</td><td>Resection with margins</td></tr>
  <tr><td><b>Alveolar abscess</b></td><td>Periapical RLcy ± bone destruction</td><td>Tender; non-vital; swelling</td><td>Drain + Abx + Extraction/RCT</td></tr>
  <tr><td><b>Fibrous epulis</b></td><td>Normal</td><td>Firm pink gingival mass</td><td>Excision</td></tr>
  <tr><td><b>Giant cell epulis</b></td><td>Cup-shaped bone resorption</td><td>Purple-red gingival mass</td><td>Excision + periosteal curettage</td></tr>
</table>

<!-- ═══════════════════════════ HOMEO CHEAT SHEET ═══════════════════════════ -->
<div class="unit uh">🌿 HOMEOPATHY CHEAT SHEET</div>
<table class="th-purple">
  <tr><th>Remedy</th><th>Key Indication</th></tr>
  <tr><td><b class="rx">Hecla lava</b></td><td>Jaw tumours · exostoses · alveolar swellings <span class="badge badge-g">FIRST CHOICE</span></td></tr>
  <tr><td><b class="rx">Calcarea fluorica</b></td><td>Hard tumours · cysts · bone hypertrophy</td></tr>
  <tr><td><b class="rx">Silicea</b></td><td>Chronic suppuration · sinuses · slow healing</td></tr>
  <tr><td><b class="rx">Myristica sebifera</b></td><td>Dental abscess → rapid drainage ('homeopathic knife')</td></tr>
  <tr><td><b class="rx">Hepar sulphur</b></td><td>Low pot → suppurate · High pot → abort</td></tr>
  <tr><td><b class="rx">Merc sol</b></td><td>Gum ulcers · salivation · foetid breath</td></tr>
  <tr><td><b class="rx">Thuya</b></td><td>Soft pedunculated growths · epulis · polyps</td></tr>
  <tr><td><b class="rx">Belladonna</b></td><td>Acute abscess → throbbing · heat · redness · fever</td></tr>
  <tr><td><b class="rx">Pyrogenium</b></td><td>Septic states · high fever · offensive discharge</td></tr>
  <tr><td><b class="rx">Conium maculatum</b></td><td>Hard slow-growing tumours · elderly</td></tr>
</table>

<p style="text-align:center;color:#aaa;font-size:11px;margin-top:20px">BHMS 3rd Year · Oral &amp; Maxillofacial Surgery · Revision Notes</p>
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