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522 MT1 > Dental 4 > Flashcards

Dental 4 Flashcards

1
Q

what do you almost always need to discern oral inflammation

A

BIOPSY

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2
Q

this condition is characterized by ulceration, inflammation, and mucosal necrosis
ulcers typically on alveolar and buccal mucosa opposite plaque: on gingiva, larger margins of tongue, pall folds, or lip margins

A

canine ulcerative stomatitis, a plaque induced oral inflammation

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3
Q

Maltese, CCKS, Greyhounds, Labs predisposed to what condition? often history of pain, reluctance to eat, recents oral exam or bite, and systemic dz uncommon but there will be hyperglobulinemia

A

canine ulcerative stomatitis

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4
Q

what is mainstay of CUS therapy

A

daily diligent plaque control!!
- complete PD assessment
- complete PD tx
- extractions as needed
- homecare brushing
- +- medical therapy
- frequent reassessment
and then PD recalls (examine monthly, ones exam 6 mo)
med mgmt

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5
Q

if pt fails canine ulcerative stomatitis medical mgmt, what is next step

A

surgical intervention, once med options are exhausted (extract teeth)

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6
Q

this multifactorial cat condition, more common in muklticat environments, is a manifestation of aberrant immune response to chronic antigenic stimulation and current SOC involves extractions of at least all M and PM teeth, w or w/o med mgmt

A

FCGS feline chronic gingivostomatitis

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7
Q

inflammation that does NOT cross the mucogingival line and that is confined to attached gingiva is _______, but inflammation that crosses the gingival line into alveolar tissue and palatoglossal folds is _______ [name the chronic cat condition]

A

gingivitis
feline chronic gingivostomatitis
(frequently misdiagnosed as gingivitis)

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8
Q

is medical management for FCGS prior to sx therapy often successful?

A

other than pain control, NO
so you should REFER

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9
Q

you should focus on CUS, FGCS, tooth resorption, oral tumors, and prudent Abx use.

A

ok

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10
Q

________ is an idiopathic eosinophilic inflammatory lesion on the hard/soft palate, pharyngeal walls, and/or tonsillar region. pts often present for oral discomfort, dysphagia, repeated swallowing, inappetence, and dx is by histopath of the lesion

A

eosinophilic stomatitis

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11
Q

how is eosinophilic stomatitis treated

A

immunosuppression: prednisone, cyclosporine
may need to be ongoing, depends on pt.

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12
Q

treatment of tooth resorption is determined by stage or by type

A

type

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13
Q

what is type I TR? tx?

A

tooth retains normal density and the PDL space is unchanged
extraction

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14
Q

what is type II TR? tx?

A

narrowing or disappearance of PDL space in at least some areas, and decreased radiopacity of tooth; often the root structure also appears same density as adjacent bone
coronectomy (bc there is no root left to remove)

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15
Q

what is type III TR? tx?

A

resorption occurs in same tooth: there are areas of normal AND narrow or lost PDL space, and focal or multifocal radiolucency in tooth but decreased radiopacity in other areas of tooth. in multirooted teeth only
hybrid extraction - extract root with well defined PDL, coronectomy of other root

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16
Q

this kind of tooth resorption appears as a crescent shaped defect in medial root that appears as though it is being resorbed by bone. does not need to be treated.

A

ERR external root replacement

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17
Q

oral masses can be classified as reactive, odontogenic, or malignant.
what are 2 reactive masses to know?

A

gingival hyperplasia and focal fibrous hyperplasia

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18
Q

oral masses can be classified as reactive, odontogenic, or malignant.
what are 3 odontogenic masses to know?

A
  • canine acanthomatous ameloblastoma - malignant transformation of jxnl epithelium
  • peripheral odontogenic fibroma - cellular fibroblastic connective tissue separate from normal fibrous connective tissue
  • odontoma (less common)
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19
Q

canine acanthomatous ameloblastoma more likely to show up on ______, while peripheral odontogenic fibroma more likely to show up on MN and on _______

A

mandible vs maxilla; rostral maxilla

20
Q

top 3 malignant non-odontogenic oral tumors in dogs

A

melanoma
SCC
fibrosarcoma

21
Q

most common malignant non-odontogenic oral tumor on cats is.

A

SCC

22
Q

melanoma: males or females? more predisposed, age is _____, and typically involve gingiva

A

males, 10.5-12 years

23
Q

melanoma: what site has better prognosis (although met rate is 50-80%)

A

melanoma of lip

24
Q

SCC: what is breed and sex and age predilection

A

no breed or sex predisposed
8.4 years dog 10.5 cat

25
Q

what has higher metastatic rate: melanoma or SCC

A

melanoma 50-80%

SCC low except for caudal tumors (tonsil) in dog; aggressive local behaviour but low met rate cats, although typically late dx so poor px

26
Q

this oral tumor: large breed dogs overrepresented, 8 years, locally aggressive tumors, low met rate, and hi lo tumors

A

fibrosarcoma
hi lo means no hits features malignancy, but grow really aggressively

27
Q

what are 2 important things to remember about oral tumor approach, in general

A

clinical photos
periodontal tx to prepare the oral cavity
biopsy
also: min database prior to anes and thorough exam under anes

28
Q

2 types of biopsies, and which is preference of prof

A

incisional biopsy (intralesional)
this one

excisional biopsy (marginal excision)
take photo prior

29
Q

when to refer an oral mass case

A

early: after history dx is achieved or after mass is ID’d in exam and prior to biopsy

30
Q

after history dx and staging is complete, what are 4 possible surgical goals for oral oncologic sx?

A

curative intent surgery
debunking surgery
surgery for local ontrol
or palliative sx

31
Q

what was the procedure

A

subtotal mandibulectomy

32
Q

mandibular fractures are more common in dogs or cats?

A

cats

33
Q

what does initial stabilization for maxillofacial trauma involve

A

if unresponsive, ABCs
vital parameters
primary surgery: MM, CRT, pulse quality, lung sounds, RR pattern, MENTATION, etc.
secondary surgery
CN EXAMINATION
analgesia
conscious +- sedated MF exam

34
Q

name at least 4 signs of maxillofacial trauma

A

epistaxis
malocclusion
facial asymmetry
DAI (?)
ex or enophthalmos
pain on palpation
soft tissue disruption
often hard to tell wo imaging

35
Q

what are at least 3 mechanisms of maxillofacial trauma

A

altercation esp dog: animal bite 50%
motor vehicle accident
fall from height esp cat
hit by object or horse
play
unknown

36
Q

what is imaging modality of choice for evaluation of maxillofacial trauma

A

head CT

37
Q

what are 6 tx goals of MFT

A

reestablish premorbid occlusion
rigid skeletal fixation of fractures
quick return to fxn
address DAI (diffuse axonal injury?)
soft tissue reconstruction
cosmoses

38
Q

what are 3 special considerations in oral medicine pediatric pts

A

as conservative as possible
growth aberrations
malocclusions secondary to trauma to deciduous dentition and permeant tooth germs

39
Q

indications for use of Abx as mono therapy for PDD

A

none

40
Q

indications for use of prep Abx prior to processing with dental sx or PD tx

A

none

41
Q

indication for use of pulse-dose Abx in pts deemed anes risk

A

none

42
Q

5 indications for perioperative Abx prophylaxis for oral surgery

A

immunosuppressed patient: DM, Cushing’s, etc.
prosthetic joints and immunocompromised
historical infective endocarditis
heart valve replacement or pacemaker implant
repaired congenital heart defect with shunts or valvular regurgitation

43
Q

indications for postoperative Abx tx for oral sx

A

clinical judgment
systemic risk factor for infection (immunosuppression)
ONF or major oromaxillofacial sx repair
implant or graft placement
NOT routine extractions

44
Q

what are Abx treating in oral surgery? like the actual target

A

NOT tx or preventing tissue infection
they are aiding in dealing w bacteria creating when manipulating subgingival tissues

45
Q

when Abx are used for oral surgery, when and how to deliver? which one?

A

at induction, IV, one time
ampicillin

522 MT1 (21 decks)

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