SA Sx - Dental 2

pbhati17's version from 2017-09-20 20:28

Sx & Dz cont....

Question Answer
Which tissue forceps are used most often?Adson-brown
Which forceps are least traumatic?DeBakey
Scissors to use?LaGrange
Curve iris
What do periosteal elevators do?Detach gingiva
Mucosa from bone and create gingival or mucogingival flaps
What are mucogingival flapsThe detaching of periosteum, mucosa, and gingiva from alveolar bone of a tooth that is to be extracted
Mucogingival flaps are akaFull thickness flaps
What is used to sever the periodontal ligament?Luxators - luxate root from socket
What is used to tear the periodontal ligament?Elevators - "elevate" the tooth from socket - also come as "winged"
What do winged elevators do?Cut and luxate
What is used to debride bone?Rongeur’s
What is used to remove debris from alveolus?Bone curette tips
What are used to section teeth with multiple rootsFissure and crosscut burs
What is used to remove alveolar boneRound bur
What removes bone spurs?Diamond bur
Which burs smooth boneDiamond "football" burs
Which burs are useful for extracting roots, root tipsSurgical length burs (long shank)
What are the goals of extraction?Complete root extraction
Smooth bone to prevent post-op pain
What is the #1 cause of Oral-Nasal Fistula (ONF)Periodontal dz common in small breeds
What can happen during probing palatal root in the presence of ONF?Nasal hemorrhage
ONF treatment?Extraction! (only tx!)
What is the gold standard for home health care?Brushing
What else may help with home health care with teeth?Diets (Hills t/d)
Oral disinfectants
Barrier gels
Water additives
Oravet chews (Delmopinol)
Oral and topical Omega 3s
What should you always check before recommending home care products?VOHC - Veterinary Oral Health Council
What is CUPS?Chronic Ulcerative Paradental Stomatitis (aka Mucositis)
Mucositis Tx?Daily brushing
What is TR?Tooth Resorption (formerly known as FORL)
What animal is most prone to TR?Cats - 30-50% will develop at some point in their life
Tx TR?Extraction
Crown (coronal) amputation
List the disease conditions of the oral cavity (besides PD)TR (Tooth Resorption)
Cups (Chronic Ulcerative Paradental Stomatitis)
T/F there are 3 classifications of TRTrue
Describe Type I TRInflammation (gingivitis/PD) at junction of crown and root = destroyed
Some/all of root and periodontal ligament is in tact
Describe Type II TRResorption w/in the root
Crown dissolves later
No periodontal ligament seen
Describe Type III TRCombination of Type I & II
Inflammation at jnxn of crown/root
Resorption w/in the root
Crown dissolves later
No periodontal ligament seen
Tx Type III TR?Amputate crown
Extract mesial root
T/F TR hurtsTrue - when crown begins to resorb
What is (gingivo)stomatitis (GS)?Faucitis
Lymphocytic-plasmacytic gingivitis


Question Answer
Severe bilateral inflammation of gingiva, caudal stomaStomatitis
Etiology stomatitis?Unknown
Suspect is hyperimmune response to plaque or tooth itself
Also associated (not czd by) Calici virus
T/F Abx & steroids only provide temporary relief of stomatitisTrue
What happens with stomatitis?Lymphs & plasmocytes infiltrate the gingiva/mucosa
What are the only known "curre" for stomatitis?Extraction - but does not help with all cases
When are partial mouth extractions indicated for stomatitis?If inflammation is confined to caudal areas of mouth
60-80% permanent resolution
When are full mouth extractions indicated for stomatitis?If inflammation extends to canines & incisors or If partial mouth extractions do not resolve inflammation (90% cure)
Gingivitis only =Periodontal Dz
Gingivitis & caudal mucositis =Stomatitis requiring extractions
What may happen in refractory cases of GS?"Terminal" stomatitis - euthanasia
List known therapies for refractory GSCyclosporine
Laser debridement of inflamed tissue
Omega interferon (UK only)
Some potential Stomatitis TxStem cell therapy
Eosinophilic Granulomatis Complex (EGC) vs Stomatitis?Similar signs, but often unilateral
Eosinophils infiltrate the gingiva
Underlying etiology: EGC?Allergies
How can EGC be distinguished from stomatitis?Histo only
Cz of gingival hyperplasiaBreeds - English bulldog
How can we Tx gingival hyperplasia?Gingivectomy - but likely to redevelop
What can we use to removed gingival tissue?Scalpel
Radio Sx
Fluted bur
Tx trauma to mouth?Depends on nature of injury
How can we stabilize a mandibular symphyseal fracture?Cerclage wire

Malocclusions & Oral Tumors

Question Answer
What is included in congenital defects?Supernumary/missing teeth
Root abnorms
Cleft palates
Improper development of oral tissuesCongenital defects
How many classes of malocclusions?1-3
Individual teeth misplacedMal 1
Mandible caudal to maxillaMal 2 - mandibular distoclusion
Mandible rostral to maxillaMal 3 - mandibular meisocclusion
Newest terms for Class 1 malocclusionLance tooth
Canine misdirected syndrome
Tx for traumatic occlusionExtraction (if deciduous teeth)
Which malocclusion is “normal" in bulldogsMal 3
T/F Mal 2/3 should not occur in other breeds (besides bulldogs)True
T/F Mal 2/3 are skeletal hereditary defects and these dogs should not be bredTrue
Term for abnormally shaped crown or rootLaceration aka root convergence
Tx DilacerationExtraction asap to avoid PD Dz
Others: Observation if no PD seen
What is the cz of enamel hypoplasia is 1-2 teeth involved?Trauma to enerupted tooth during enamel deposition
Generalized hypomineralization/dysplasia can occur due to?Pre-existing illness eg, distemper (febrile state before permanent teeth erupt)
Word for cavityCaries
Where do caries most often occur?Maxillary first molars - rare in dogs (almost non-existent in cats)
Pulp hemorrhage is calledPulpitis or intrinsic staining
T/F Teeth with pulp hemorrhage are non vitalTrue
How do root canals appear on dead teeth?Enlarged
When is extraction indicated for focal hemorrhage in a tooth?If the radiographs are abnormal
What is condensing osteitis?Now called focal sclerosing osteomyelitis
From chronic inflammation produces formation of excess periapical bone
Common oral tumorsSCC
Malignant melanoma

Papillomas (young)
Lymphoma (cats)
Granular cell tumor
Epulides, Dontoma = benign
Epulis are now called?Peripheral Odontogenic Fibroma or Focal Fibrous Hyperplasia
Tx for focal fibrous hyperplasiaExtensive debridement (laser best)
Most common oral cancer in catsSCC
Most common oral cancer in dogsMalignant Melanoma
Term for cats when tooth is "out of socket"Extrusion
What is extrusion?A form of chronic osteomyelitis
Radiographs show alveolar osteitis (bone swelling)
Another common weird cystDentigerous cyst