Dental Block 1 Flashcards

1
Q

What is the vermillion border a junction between?

What type of cells is it made of?

A

Skin and Mucous membranes

Stratified squamous

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2
Q

What type of glands are located in the vermillion border?

A

Fordyce Granules- Ectopic sebaceous glands at corners of the mouth and cheeks opposite molar teeth

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3
Q

What are the characteristics of the Masicatory Mucosa

A

25%, Gingiva covering hard palate, primary mucosa in contact w/ food during chewing,
Keratinized

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4
Q

What are the characteristics of the Lining Mucosa

A

60%, floor of mouth, ventral tongue, and tissues of soft palate with no function during mastication,
Non-keratinized

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5
Q

What are the characteristics of Specialized Mucosa?

A

15%, covers dorsal tongue

Non/cornified papillae

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6
Q

How does the Lamina Propria differ between the Lining and Masticatory Mucoasa?

A

Lining- NKSS loose CT w/ collagen, contains glands

Masticatory- P/KSS, variable lamina propria, para/kartinized strat squamous

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7
Q

Gingiva belongs to what category of mucosa?

What are the 3 parts of the gingiva?

A

Masticatory

Attached, Interdental, Free (includes sulcus)

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8
Q

Characteristics of Attached Gingiva

A

Keratinized, stippled, separated from aveolar mucosa by mucogingival groove, attached to tooth by junction of epithelium

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9
Q

Characteristics of Marginal/Free Gingiva

A

Keratinized, not stippled, bound on inner margin by gingival sulcus (separate from tooth), bound to outer margin by oral cavity and apically by free gingival groove

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10
Q

How does gingiva attach to teeth?

A

Attach on neck of tooth by junctional epithelium

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11
Q

What type of muscle makes the tongue?
What divides it into halves?
What are the three parts and two surfaces of the tongue?

A

Striated
Median septum
Parts: oral, pharyngeal, root
Surface: dorsal, ventral

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12
Q

What is the most important articulator for speech production?
What is a second function of the tongue?

A

Tongue

Taste

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13
Q

Where are bitter, sour, salty and sweet tastes located on the anterior 2/3s of the tongue?

A

Bitter- posterior surface
Sour- inner middle
Salty- peripheral except tip
Sweet- tip

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14
Q

What are the four types of papillae on the tongue?

A

Filiform- anterior 2/3, fine hair-like
Fungiform- anterior 2/3, round red spots
Circumvallate- V shaped row near posterior
Foliate- posterior lateral border of the tongue

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15
Q

There are no taste buds on the posterior 1/3 of tongue, but what is located there?

What is the most numerous type of papillae?

A

Nodular surface due to lingual tonsils

Filliform, lack any taste buds

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16
Q

What CN innervates the general/taste sensations of the anterior 2/3 of tongue?

A

Sensation- lingual nerve, CN5 general sensory

Taste- chorda tympani, CN7 special sensory

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17
Q

What CN innervates the general/taste sensations of the posterior 1/3 of tongue?

A

Glossopharyngeal nerve- CN9, general and special

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18
Q

What CN innervates the generals sensation at the base of the tongue?

A

Internal laryngeal nerve- CN10

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19
Q

What types of muscle fibers make up the intrinsic tongue muscles and what is their function?

A

Longitudinal, Transverse, Vertical

Alter shape of tongue

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20
Q

What are the four extrinsic muscles of the tongue?

What is their function?

A

Palatoglossus, Genioglossus, Hypoglossus, Styloglossus

Tongue movement, connect tongue to surrounding structures: soft palate/bones (mandible, hyoid, styloid)

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21
Q

What are the functions of the extrinsic muscles?

A

Tongue movement

Connect tongue to surrounding structures: soft palate and bones (mandible, hyoid, styloid)

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22
Q

What muscle is responsible for tongue protrusion?
What muscle is responsible for tongue retraction?
What muscle is responsible for tongue depression?
What muscle is responsible for tongue elevation?

A

Genioglossus
Styloglossus
Hyoglossus and Genioglossus
Styloglossus and Palatoglossus

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23
Q

What nerve innervates the intrinsic nerves?

What nerve innervates the extrinsic muscles?

A

Hypoglossal

Hypoglossal EXCEPT the palatoglossus muscle- supplied by CN10

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24
Q

What artery and vein supply the tongue/mouth?

A

Artery: Dorsal lingual artery
Vein: Lingual Vein- drains to internal jugular

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25
What lymph nodes are on the tip of the neck? What lymph nodes are on the anterior 2/3 of the neck? What lymph nodes are the posterior 1/3 of the neck?
Submental bilateral, Deep cervical Submandibular unilateral, Deep cervical Deep cervical
26
Characteristics of the Parotid Gland
Largest Serous saliva w/ ptyalin- starches 30% of saliva
27
Characteristics of Submandibular gland
Bi-lobed, excretes through submandibular duct 10% mucous, 90% serous 60% of saliva produced w/ salivary amylase "Gleeks"
28
What are the characteristics of the sublingual gland?
Smallest Mostly mucous Mulitple ducts of Rivinus (8-20) Only 5% of total saliva produced
29
Where are minor salivary glands located in the mouth?
Between 600-1000 that line oral cavity and oropharynx secreting serous, mucous or mixed saliva directly into oral cavity
30
What are the functions of PNS CNs 3 7 9 and 10
3- narrow pupil, focuses lens 7- tears, nasal, salivary glands 9- parotid gland 10- viscera down to proximal half of colon, cardiac, pulmonary, esophageal plexus
31
What are the two parts of the roof of the oral cavity?
Hard Palate: bony, anterior | Soft Palate: muscular, posterior
32
What structures does the hard palate help make?
Roof of oral/floor of nasal cavities Ant: Maxilla palantine process Post: Palatine plates Bound by alveolar arches
33
What is the under surface of the hard palate covered with? | What structure does it show in the anterior parts of the mouth?
``` Mucoperiosteum Transverse ridges (rugae) ```
34
What is the function of the masseter muscle? | Where does the Masseter muscle span from and to?
Elevate mandible, crush/grind chewing | Zygomatic arch to mandible angle
35
What happens to hypertrophy or bruxism occurs in the masseter muscle?
Bruxism- hypertrophy, which leads to reduced/occluded parotid gland
36
What is the function of the temporalis muscle? | Where does the Temporalis muscle span from and to?
Largest muscle that elevates/retracts mandible Exerts light chewing forces Temporal fossa to body of mandible
37
What is the function of the Medial Pterygoid muscle? | Where does the Medial Pterygoid muscle span from and to?
Elevate, protrusion and lateral shift of the mandible | Sphenoid bone to medial surface of mandibular ramus
38
What is the function of the Lateral Pterygoid muscle? | Where does the Lateral Pterygoid muscle span from and to?
Protrusion/retrusion/depression of mandible | Pterygoid plate/Sphenoid bone to articular disc
39
What event occurs if the lateral pterygoid muscle premature contracts prematurely? What two muscles make up the "mandibular hammock" of the face?
TMJ shifting Masseter Medial Pterygoid
40
Term dentition is used to describe ?
Natural teeth in jaw bones | Primary, mixed, permanent
41
All four muscles of mastication are innervated by what CN?
5-3
42
The first set of 20 primary teeth are AKA what 3 names?
Baby teeth Milk teeth Deciduous teeth
43
Define/when does Mixed Dentition occur? Permanent dentition refers to what?
When both primary and permanent teeth are present between 6-12y/o 32 secondary/adult teeth
44
How are the mouth quadrants broken up by the World Dental Federation?
UR- 1-8 MRQ UL- 2-8 MLQ LL- 3-8 ManLQ LR- 4-8 ManLQ
45
Define Mesial | Define Distal
Towards midline of dental arch | Away from midline of dental arch
46
What are the 3 basic food processing functions of teeth? | What are the four basic types of teeth?
Cut, Hold/grasp, Grind | Incisor, Canine, Premolar, Molar
47
Function of incisors Function of canines Function of premolars (bicuspis) Function of molars
Cut w/out heavy force Cut and tear w/ force Hold and grind food Chew and grind food
48
How do premolar and molars differ in number from baby to adult teeth?
Pre-molar: none in primary, two in permanent Molar: two sets in primary, three sets in permanent
49
Define Eruption | Define Exfoliation
Movement of tooth from developmental position to occlusion plane Process of roots of primary teeth are reabsorbed so primary too falls out
50
Define Occlusion | Occlusal contact is the trigger that stops ?
Mandibular/maxillary relationship at closing | Tooth eruption
51
What are the 3 phases of tooth eruption?
Pre-eruptive phase Eruptive- root formation, penetration, movement, occlusion Post eruptive
52
What is the second layer to begin forming in tooth anatomy?
Enamel | Begins 6-8wks in utero
53
How does in utero tooth formation occur?
Ameloblasts lay collagenous matrix which is mineralized by alkaline phosphatase Enamel proteins are removed leaving mineralized tissue behind
54
Enamel has what type of structure? | What is the make up?
Rod/crystaline 97%- hydroxyapatite 3%- other
55
What is the middle layer of the tooth?
Dentin- equal hardness to bone | First layer to form, grows inward towards pulp
56
How is dentin formed during tooth formation? | Where does the dentin receive nutrients from?
Odontoblastic for growth/repair | Pulp
57
What is the make up of dentin?
70% hydroxyapatite 20% organic 10% water
58
What is the last tissue to form during tooth development? | Development of cementum results in ?
Cementum | Tooth eruption
59
Where does the cementum receive it's nutrients since it's an avascular structure? What is the composition of cementum?
Periodontal ligament | 50% hydroxyapatite, 50% organic and water
60
What does pulp comprise of?
``` Fibroblasts Odontoblasts Vascular/nerve/lymph components Type 1 and 2 collagen Unmineralized ```
61
Where does pulp exit the tooth? | What joins cementum of tooth to the alveolar bone?
Apex | CT Type 1 Collagen
62
What are the 4 functions of the periodontal ligament?
Supportive, Remodel, Sensory, Nutrition
63
Define BioFilm
Group of microbes that adhere to surfaces | Frequently embedded under self produced matrix of extracellular polymeric substances
64
Define Pellicle
Acellular layer of salivary proteins, mucins and macromolecules on oral surfaces that is 10micrometers thick
65
How does enamel pellicle stick and adhere to tooth surfaces?
Mucus component
66
What are the four functions of the dental pellicle?
Protect Lube Prevent desiccation Substrate for bacterial attachment
67
Enamel pellicle forms how fast?
Less than 30m after brushing
68
What type of bacteria initially attach to sticky surfaces of pellicle?
Planktonic
69
How is a firm anchor established between bacteria and surfaces?
Covalent ionic/H bond mediated by organisms and receptors on surface
70
What is the essential first step in biofilm development? | What is the only non-shedding surface in the body?
Attachment to tooth surface | Enamel
71
Bacteria have what two structures that aid in surface attachment?
Fimbriae | Fibrils
72
What are the four phases of plaque formation?
Pellicle formation Attachement Young Supragingival plaque- gram pos cocci Aged Supragingival plaque- gram neg anaerobic bacteria
73
What are the "early" colonizers of biofilm attachment? | Where do secondary colonizers emerge from?
Non-mutan streptococci and Actinomyces spcs. Gingival crevice Tongue Saliva
74
What microbes are the Secondary Colonizers?
``` P. Intermedia P. Ioescheii Capnocytophaga Fusobacterium nucleatum Prophyromonas gingivalis ```
75
What process is essential for ongoing development of plaque's microenvironment?
Quorom sensing
76
Supragingival plaque is mostly what type of microbes? | Subgingival plaque is mostly what type of microbes?
Gram positive facultative anaerobes Mixed facultative strict anaerobe bacteria that are Asacchorolytic- metabolizes peptides
77
What three processes/excretions result in decreased oxygen as tooth plaque matures?
Strep and Actinomyces are Sacchorolytic and Acidogenic and secrete a Polymeric substance causing decreased O tension
78
What does the Latin word Carie mean?
Rot, decay | Similar to Greek word for death
79
Define Caries
Infectious transmissible disease from oral bacteria that metabolize sugars into acids causing tooth demineralization
80
What two bacteria are the main cariogenic bacteria?
Streptococci | Lactobacillus
81
In order for cavities to form, what three requirements must exist?
Cariogenic bacteria Sugar Tooth surface
82
How do dental caries first appear?
Chalky white spot due to loss of translucency of enamel rods due to demineralization
83
What is the main microbe of the pathogenesis of caries?
Mutans Streptococcus | Actinomyces and Lactobacillus
84
Define Vertical Transmission
S. mutans transmitted from caregiver to infant through saliva
85
Most carious lesions occur where on teeth?
Interproximal surface of primary teeth
86
Four processes that reduce caries on teeth
Often brushing Fresh produce Flossing Parents have good habits
87
How does saliva help prevent caries?
pH 6-8 IgA, lysozyme, lactoferrin, histatins, peroxidase Supersaturated Ca, PO4, and BiCarb (addition of Flouride, not natural occurence)
88
What can cause xerstomia?
Systemic diseases Gland damage Surgery/radiation Medications
89
Intermediate restorative material is made up of ?
Zinc oxide Eugenol Reqs mechanical retention and can remain for one eyar
90
Healthy gingiva are absent of four things and have four characteristics present?
``` Absent of inflammation or deformity of: Marginal Attached Alveolar Periodontium (bone, cementum and PDL) ``` Have: uniform color, knife edge, scalloped, firm and stippled
91
Gingivitis is AKA? | It is indicative of ?
Early gum disease | Precursor to advanced gum disease if inflammation extends into alveolar process, PDL and/or cementum
92
What is the etiology of gingivitis?
Bacterial biofilm- plaque
93
What are the four types of gingivits?
Plaque associated gingivitis NUG Medication induced Allergic
94
Characteristics of plaque-associated gingivitis?
Pathogenic bacteria on salivary pellicle from poor hygiene causing inflammation Gram pos/neg an/aerobes Etiology- plaque and calculus
95
Characteristics of NUG
Stress and smoking leading to blunted/punch out interproximal papillae with a gray pseudomembrane, bad breath and pain Can arise from immunosuppressed or nutrition
96
How is NUG treated?
Chlorhexidine | ABX- metronidazole
97
How does medication induced gingivitis present?
Gingival hyperplasia and excess collagen, caused by Cyclosporine, Phenytoin or Nifedipine
98
Allergic gingivitis is caused by ? but commonly by ? | How is it treated
Herbs, mouth wash, mints, gum, peppers Cinnamon or lauryl sulfate Topical steroids
99
What are four systemic causes of gingivitis?
Hormones Drugs Stress Vitamin C deficiency
100
What are four local factors that can cause gingivitis?
Crowded teeth Dental caries Frenulum attachments Overhanging restorations
101
What is the name of the tooth brushing technique?
Bass Sulcular Toothbrush Technique at 45* angle twice a day for 2 min each Floss daily Scrape tongue Rinse w/ mouth wash
102
Define Gingivitis, what it includes, it's etiology and if it's reversible
Inflamed soft tissue Epithelial and CTs Poor hygiene, injury or immunocompromised Is reversible
103
Define Periodontitis, what it includes, it's etiology and if it's reversible
Inflamed hard and soft tissue | Including alveolar bone, gingiva, and PDL from anaerobic bacteria
104
Define inflamed PDL, what it includes, it's etiology and if it's reversible
Excessive wear, mobility and widened PDL Non-bacterial causes: poor restoration, ill fitting appliances/trauma Bacterial- near apex due to inflammation in pulp Reversible
105
What is the number cause of tooth loss in adults? | What is this cause always preceded by?
Periodontal disease | Always by gingivitis
106
Periodontal Dz is inflammation of what supporting structures?
Inflammation of peridontium and it's structures: Gingiva PDL attachment Aveolar bone
107
What are the three diseased states of periodontal diseases?
Gingiva- red/receded PDL- loose, wide, deep Alveolar bone- resorbs No Tx
108
How will diseased tissue present with probing?
Apical migration of junctional epithelium from Cementum Enamel Junction Loss of PDL attachment from cementum
109
Untreated gingivitis can advance to periodontitis creating what three issues?
Chronic inflammation Deep pockets Bone loss
110
Periodontal diseases cause deteriorating bone as a result of ?
Calculus and bacterial toxins
111
Classification of Gingival Periodontal Disease
Erythema/edema Attachment at CEJ No bone loss
112
Classification of Slight Periodontitis
Erythema/edema Loss of attachment and mild reduction of bone HEIGHT Restored w/ nonsurgical cleaning by hygienist
113
Classification of moderate periodontal disease
Erythema/edema Moderate bone LOSS Furcation invasion Tooth mobility
114
Classification of Severe Periodontal disease
``` Severe bone loss Furcation invasion Migration of teeth Loss of occlusal vertical dimension Dentures needed ```
115
What are the early warning signs of future periodontal disease?
``` Gingivitis Probing apical to CEJ X-ray evidence of bone loss Tooth mobility Migration of teeth ```
116
What are S/Sx of an active periodontal disease?
``` Mobile teeth Mouth sores/purulence Bone loss Halitosis Blunted interproximal papillae ```
117
Define Red Bacterial Complex
Tannerella forsythia Treponema denticola Porphyromonas gingivalis
118
Define Pophyromonas gingivalis
Non motile gran neg anaerobic rod that releases enzymes/collagenases to initiate inflammation
119
What is the keystone pathogen for periodontal disease process?
Prphyromonas gingivalis | Chiefly responsible for bone loss
120
Characteristics of Tannerella Forsythia
Gram Neg Obl Anaerobe Spindle pleomorph that forms biofilm and surface layer protein adnhesion to epitherlial cells Produces cysteine proteases and subverts host immune system
121
Characteristics of Treponema denticola
Gram Neg anaerobe motile spirochete that travels in viscous environment Produces enzymes to degrade collagen and invade tissue Unable to synthesize fatty acids, found in periocornitis sites and NUG
122
Treponema denticola is one of how m an types of treponems found in the oral cavity?
57
123
What are the non-surgical treatment methods of periodontal disease?
Sub/supra-gingival scaling and root planing every 3mon ABX into sulcus Rest, diet, exercise No smoking/remove occlusion
124
What are the surgical innervations of treating periodontal disease?
For pockets >5mm 2-6mon after non-surgical methods Irreversible
125
What are the three phases of treating periodontal diseases?
Assessment- PA/medic Initial Dx- GenDen Treatment- periodontist/hygienist
126
How does a periapical abcess appear on x-ray and what is the treatment?
Localized preiapical radiolucency with widened PDL | Treated w/ local anesthesia, I&D, refer to dentist for root canal therapy
127
Define Periodontal Abscess
Acute inflammation in sulcus of a periodontal pocket from pre-existing periodontal lesion with a vital tooth. Presents as pain, edema that involves bone/PDL attachment, mobile tooth, pus and foul taste
128
How does a periodontal abscess appear on radiographs and how is it treated?
Bone loss from previous periodontal pocket | Local anesthetic, I&D, saline rinse, refer to dentist for scaling/root planning every 3mon
129
Define Pericornitis
Acute inflammation in tissues surrounding crown of partially erupted tooth from trapped food/bacteria beneath flap
130
How will a periconitis PT present?
Throbbing pain to ear/throat/floor of mouth Foul taste Trismus- facial edema NUG like necrosis
131
How does a pericornitis appear on x-ray and how is it treated?
Impacted/erupted mandibular 3rd molar | Antiseptic lavage to remove debris, ABX, refer to dentist for removal of flap or extraction
132
Define Alveolar Osteitis
Dry Socket- post extraction inflammation of exposed alveolar process due to loss of initial blood clot due to negative pressure, suction, smoking, trauma or bacteria
133
How does Dry Socket present
3-4 days post extraction | Exposed unprotected bone w/ severe pain and foul odor
134
How are dry sockets treated?
Remove sutures and irrigate with warm saline, place Peridex antimicrobial rinse for PT home irrigation, analgesics x 1wk. If paste is used, replace x 24hrs
135
What type of facial trauma causes more visible scars? | How are they sutured?
Perpendicular lacerations or normal lines of expression Two layer closure- absorbable on inner muscle first, close skin second Suture at vermillion border first
136
What type of tissue injury is treated first in facial trauma?
Hard tissues
137
What vascular structure needs to be noted and avoided in facial trauma?
Labial artery
138
What are the three classes of sutures?
Collagen Synthetic absorbable Non-absorbable
139
How are suture sizes referenced? | What size is usually used?
Diameter of suture strand denoted by zeroes. More zeroes= smaller the strand diameter 4.0 absorbable for mouth use
140
What size suture material is used for different closures?
``` Lips- start at vermillion border Muscle- 3 or 4 Subcutaneous- 4 or 5 Epithelium- 6 nylon non-absorbable Avoid silk to skin, causes acute inflammation and scarring ```
141
Define Un/Complicated Crown Fracture
Uncomplicated- partial fracture of tip of tooth, still intact Complicated- separation of crown from tooth body
142
How are teeth that are traumatically removed from the mouth stored?
Saliva, under tongue Lowfat milk Coconut water Pedialyte No water/gatorade Don't wrap in tiddue Don't leave exposed to air
143
Traumatically removed teeth need to be replaced within what time frame or what ?
Within 1 hr to reduce ankylosis or root resorption
144
Why do you not scrub root surface of a tooth avulsion?
Injures PDL cells and cementum will not attach to alveolar bone
145
Define Lefort Fractures 1-3
1: Transverse maxillary, above level of teeth 2: Pyramidal, level of nasal bones 3: craniofacial dysfunction, orbital level
146
What is the most common midfacial fracture? | What is the most common facial fracture?
Zygomatic complex from lateral blow to cheek, can depress the cheek bone (dimple) Nasal bone
147
What kind of optical s/sx can be seen in an orbital fracture?
Bleeding into cornea of Fx side | Restricted movement
148
Fx to orbital rim risk interfering with which CN?
CN2
149
Define Blow Out Fx
Orbital rim remains intact but crack forms in thin bone in floor of socket (double vision, lowered globe, restricted movement, enophthalmos)
150
Unilateral condylar fractures lead to deviation to what side?
Affected side when mouth is open
151
Define Angle Class 1 Define Angle Class 2 Define Angle Class 3
Masiobuccal cusp of maxillary 1st molar aligns w/ buccal groove of Mandibular 1st molar Masiobuccal cusp of maxillary 1st molar is anterior to buccal groove of Mandibular 1st molar Masiobuccal cusp of maxillary 1st molar is posterior to buccal groove of Mandibular 1st molar
152
What are S/Sx of a severe oral/perioral infection?
``` Dyspnia Dysphagia Severe trismus Fever and swelling ABX resistant ```
153
What is a life threatening sequel to a severe oral/perioral infection?
Septicemia Airway obstruction Cavernous sinus thrombosis Ludwigs angina
154
What are the four primary maxillary space infections?
Canine- infected maxillary canines Buccal- infected maxillary and mandibular pre/molars Vestibular abscess Palatal abscess
155
Primary mandibular spaces and the infections that reside there
``` Submental- madibular incisors Buccal- infected maxillary/mandibular pre/molars Submandibular- mandibular pre/molars Sublingual- mandibular pre/molars Vestibular abscess ```
156
Define Ludwig's Angina
Bilateral involvement of sublingua, submental and submandibular spaces
157
What is the purpose of I&D?
Remove pus/debris/bacteria in abscesses/cellulitis Reduce tissue tension Changes oxygen tension
158
What are the steps of an I&D procedure?
Nerve block Incise area of max flactulance Blunt dissection and copious irrigation Insert/stabilize a drain
159
When/why would you follow up an I&D with ABX?
Swelling w/ systemic problem Pericornitis w/ systemic problems Facial space infections Compromised host defenses
160
What are the risks of ABX use?
Allergy Toxicity C Diff Resistant strains
161
Oral infection considerations for ABX therapy?
Polymicrobic Broad spectrum Culture Systemic protection
162
What are five scenarios ABX are not used?
``` Chronic/localized abscess Dental sinus tract (fistula) Alveolar osteitis Pericornitis w/out systemic involvement Vestibular abscess w/out systemic Routine root canal ```
163
What is the ABX of choice for odontogenic infections?
Amoxicillin- broad spectrum, bacericidal against Gram-Pos/Neg that's more absorbed in GI than PenVK Low protein binding to inc bioavailability
164
How much Amoxicillin is used?
1000mg loading dose | Maintain- 500mg PO x 8hrs x 7 days
165
When is Augmentin used?
Amoxicillin and Clavulanic Acid combo When Sx don't improve s/ amoxicillin Inc spectrum in persistent infections but is $$ Risk of GI/hepatic toxicity from severe anaphylactic allergic reactions
166
How much Augmentin is used?
Clavulanic Acid- 125mg PO x 8hrs x 5-7 days
167
When is Clindamycin used?
PT allergic to penicillin Only a bacteriostatic for anaerobic bacteria but can penetrate bone PT must stop at first sign of diarrhea or risk 8x inc of C Diff
168
How much Clindamycin is used?
Loading- 600mg | Maintain- 300mg PO x 6hrs x 7days
169
Define Tori
Variation of normal that is composed for normal bone and covered by normal mucosa on hart palate of maxilla/lingual side of teeth in mandible
170
Define Exosstosis
Variation of normal composed of normal bone and covered by normal mucosa on buccal side of maxillary/mandibular teeth
171
Define Benign Migratory Glossitis
Geographic tongue
172
What type of PT population is fissured tongue found in?
Melkersson-Rosenthal Syndrome Down Syndrome Xerostomia PTs
173
How to distinguish lingual varicosities from pathological issue?
Asymptomatic that blanches
174
Define Linea Alba
White raised ridge of tissue that's horizontally or bilaterally from benign hyperkeratosis of buccal mucosa
175
Define Lichen Planus
Benign developmental variation of normal buccal mucosa | White/yellow thin lines forming lace-like pattern bilateral pattern
176
Define the pathognomonic sign Wickham's Striae? | What causes this?
Lichen Planus | Auto immune response to damage on basal cells of oral epithelium, only topical steroids to treat if erosive/painful
177
Define Hairy Leukoplakia and it's cause
Parallel hair-like white lesions on lateral tongue surface made of Candida Albicans from the Epstein Barr virus or HIV exposure Treat HIV and Acyclovir and anti-fungals
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Define Leukoplakia
White patch that does not rub off due to thickened surface keratin layer Only clinical name, doesn't imply histopathologic tissue alteration Considered pre-malignancy
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Define Candidiasis
Curdy white layer that leaves inflammed base when wiped off from Candida Albicans that presents as burning, dysgeeusia and can be co-infected with Staph Acute- atrophic red patches or white/curd colonies Chronic- denture related form confined to area
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What are the local and systemic risks of a Candidiasis infection?
Local: Topical steroids, Broad spectrum antibiotics , Xerostomia, Heavy smoking Systemic- poorly controlled DM, immunosuppressed, leukemia PTs, infants
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How are Cadidiasis infections treated?
Nystatin suspension Clotrimazole Ketoconazole tabs Fluconazole tabs
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Define Angular Cheilitis
Dry cracks on commissures from candida albicans infections from excessive sun exposure, anemia or denture wearers treated w/ antifungals
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Define Black Hairy Tongue
Elongation of filiform papillae, papillae grow longer and don't shed due to bad oral hygiene, ABX use, tobacco or coffee/tea
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How is Black Hairy Tongue treated?
Improve oral hygiene Superoxide mouth rinse Topical antifungal
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Smokeless tobacco can cause what visible changes to mucosa?
Keratosis- white wrinkled mucosa in mandibular vestibule at the site of placement OR from osmotic water loss Reversible within two weeks of cessation
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Define Nicotinic Stomatitis
Benign variation of normal buccal mucosa that looks like white inflamed opening to minor salivary glands from heat generated from pipes or prolonged tobacco exposure Reversed with cessation
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How does mucosal allergy present?
Circumscribed erythematous patches at site of contact that's treated with corticosteroids and antihistamines
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Define Glossitis and how's it treated
Enlarged tongue causing inability to close lips | Samyloidosis, Downs, Beckwith-Wiedemann Syndrome and hypothyroidism
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Define Ankyloglossia
Tongue tied
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How does a traumatic ulcer present?
Rolled white border of hyperkeratosis at area of trauma (chemical, thermal or mechanical cheek biter) Treated w/ topical peroxide and avoid biting
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Aphthous ulcer only grow on what type of tissue?
Non-keratinized
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Define primary herpetic gingivostomatitis
Vesicle that progresses to ulcers with red halos that can spread during asymptomatic saliva from HSV-1 Possible fever malaise and lymphadenopathy
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What meds can be used for Primary Herpetic Gingivostomatitis
Acetaminophen | Severe cases- Acyclovir
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Primary Herpetic Gingivostomatitis activates but then goes dormant in which CN?
CN5 sensory ganglia of oral and perioral regions
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Define Herpangina/Herpetic Whitlow
Herpes in the finger
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How does primary syphilis present? | What type of microbe transmits it?
Painless lesion w/ central depression at site of inoculation Treponema pallidum bacteria
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How does secondary syphilis present?
Gray/white plaques covering ulcerated mucosa appearing 6wks after primary chancre appeared Will have rash on hands, feet and body MOST infectious stage of syphilis
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Define Amalgam tattoo
Blue/purple dot on alveolar soft tissue from accidental implantation during amalgam restoration proximal to tattoo
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Define hemangioma
Vascular anomaly from rapid growth phase of endothelial cell proliferation Blanches to touch
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Define Hematoma
Red/brown/blue lesion that does NOT blanch to pressure | Doesn't resolve in 2wks, consider Dyscrasia
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What are the different sizes of petechiae, purpura, and ecchymosis?
Petichiae: 1-2mm Purpura: 2mm-2cm Ecchmosis: >2cm
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What can cause petechiae, purpura, and ecchymosis?
Trauma Systemic Dz Clotting disorder Mono
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Define melanotic macule
Painless tan/brown macule less than 0.5cm from genetics/solar radiation
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Define Melanocytic Nevus
Intraoral mole/freckle less than 0.5cm in diamter that's usually raised and has a smooth surface Benign proliferation of melanocytes
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What types of cells make up the majority of neoplasms in the oral cavity?
SCC- 90%, flat squamous arranged like scales | Verrucous- 5%, squamous, rarely spreads
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Where does minor salivary gland carcinoma occur?
Lining oropharynx and hard palate
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What are the neoplasm lymphomas of the oral cavity?
Non/Hodgkin
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What are the benign tumors of the oral cavity?
``` Leukoplakia Erythroplakia Pyogenic Grauloma Fibroma ```
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When are Kaposi Sarcoma seen?
Painless blue/purple macule that's a tumor of vascular proliferation from cytomegalovirus usually seen in HIV Pts treated with retro-viral therapy
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Characteristics of Squamous Cell Carcinoma
Deep ulcerated mass w/ possible local pain, referred pain to ear or parasthesia of lip Caused by tobacco, alcohol, solar radiation or genetics
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How are Squamous Cell Carcinoas biopsied?
Brush biopsy
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Define Squamous Papilloma
Painless solitary white lesion with narrow base caused by local trauma or HPV
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Define Cerruca Vulgaris
Common Wart | Painless solitary lesion with pedunculated/broad base usually occurring on labial mucosa and tongue from HPV-2/4/40
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Define Condyloma Acuminatum
Painless multiple nodules on broad base in clusters usually on lip, tongue or soft palate caused by HPV-6/11/16/18
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Define Inflammatory Papillary Hyperplasia
Painless erythematous nodules from ill fitting dentures and poor hygiene (possible candidiasis infection)
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Define Pyoenic Granuloma
Pregnancy tumor | Red elevated lesion in between interproximal papillae from local factors/hormonal changes
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Define Irritation Fibroma
Firm solitary nodule on buccal mucosa on labial mucosa, tongue and gingiva from reactive hyperplasia of CT in response to trauma/mechanical erosion
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Define Epulis Fissuratum
Painless excessive nodular tissue with crease where dentur sits from hyperplasia caused by fibrous CT changes from ill-fitting dentures
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Define Mucocele
Traumatic rupture of minor salivary gland and accumulation of saliva
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Define Ranula
Block of major salivary duct causing accumulation of saliva, usually caused by sialolith or local trauma
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What is the acronym for primary teeth eruption times?
CI LI M C M | 6 9 13 16 23
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What's the acronym for permanent teeth eruption times?
M IC IL C M | 6 6 7 9/11 11/12
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What is the plaque formation timeline?
``` Mins- pellicle and adhesion 2hrs- aerobic gram pos 6hrs- plaque established 2days- doubled mass 5-7 days- gram neg and filamentous bacteria dominate 21- plaque accumulation stabilizes ```
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Caries process involves demineralization of what three things?
Enamel Dentin Cementum
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During the caries process dental plaque metabolize fermentable carbs into ?
Organic acids | Once below critical pH, enzymes break down organic component
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Saliva's pH | Enamal begins to demineralize at what pH?
6-8 | 5.5
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What are the hallmark signs and symptoms of unhealthy gingiva?
``` Dolor Calor Rubor Tumor Functio laesa ```
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What can cause Xerostomia?
Systemic Diseases Gland damage fro surgery/radiation Medication s/e
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What microbe is present in NUG and pericornitis?
Treponema denticola
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What does each microbe of the Red Bacterial Comples do?
T.F.: forms biofilm, produces cysteine proteases T.D: pericornitis and NUG, produces proteolytic enzymes to degrade collagen P.G: keystone pathogen for periodontal disease process, chiefly responsible for bone loss
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Define Dental Anesthesiology
Science of managing pain/anxiety for overall PT health during procedures
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Define Endodontics
Morphology, physiology, and pathology of pulp | Biology of normal pulp, etiology/prevention of diseases and injuries to pulp
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Define Oral/Maxillofacial Pathology
Diseases of oralmaxillofacial regions
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Define OMFS
Surgical/adjunct treatment of disease/injury to hard and soft tissue of oral and maxillofacial region
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Define Orthodontics and Dentofacial Orthopedics
Malocclusions, neuromuscular and skeletal abnormalities
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Define Periodontics
Supporting/surrounding tissues
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Define Prosthodontics
Missing teeth or tissues
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Dental Class 1-3 questions?
Restoration Any -dontic Surgery Oral pathology
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How does a periapical abscess present?
Edema Sensitive to percussion/palpation No response to cold
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How does a periodontal abscess present?
``` Throbbing pain Edema Mobile tooth Foul taste Gingival enlargement lateral to tooth ```
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How is inflammatory papillary hyperplasia treated?
Remake dentures Treat Candidiasis Surgical removal of lesions
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What drugs are given for geographic tongue?
Topical anti-inflammatory agents: * Triamcinolone (Kenalog in Orabase) * Fluocinonide (Lidex)
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What drug is used for mucosal allergy?
*Triamcinolone (Kenalog in Orabase)
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What drug is given for apthous ulcer?
*Triamcinolone (Kenalog in Orabase) | Decadron elixir rinse QID
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Of the oral pathology, what three have bases and which one is uniquely pendunculated?
Squamous papilloma- pedunc. Verruca- broad Condyloma- broad
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What are the S/Sx of gingivitis inflammation?
``` BP HELPERS Bleeding Pain Heat Edema Loss of stipling Purulence Erythema Receding margin Shiny ```
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Acronyms for remembering microbe data?
PG- GRAN Tanner- NG SOAP Treponema- MANGS
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Non-surgical care for periodontal disease should be conducted how often?
3mon