Dental Disease 2 Flashcards
T/F: pulpitis is reversible
True it can be but is often NOT
The older the patient, the less likelihood the pulp will survive
Treatment for pulpitis?
Monitor
Root canal
Extraction
What do you see in radiographs with endodontic disease?
Decreased wall thickness
Lucency around apex
Apical resorption
Classify this tooth fracture
Crack in enamel but no loss of structure
Enamel infraction
Classify this tooth fracture
Loss of enamel only
Enamel fracture
Uncommon
Classify this tooth fracture
Loss of enamel and dentin but no exposure of pulp chamber
Uncomplicated crown fracture
Classify this tooth fracture
Loss of enamel and dentin with exposure of pulp chamber
Complicated
What is a uncomplicated crown/root fracture?
Pulp is not exposed
Break in root
What is the most commonly fractured tooth?
Maxillary 4th premolar
What is the treatment for Ann enamel fracture/uncomplicated fracture ?
+/- indirect pulp capping
Crown restoration
What is the treatment for complicated tooth fractures?
Vital pulpotomy or root canal AND crown restoration
OR
Extraction
What are the indications for endodontics?
Fractured teeth Pulpitis Tooth luxation/avulsion Crown reduction -disarming -base narrow canines -soft tissue trauma after resections
Certain types of dental caries
Advantages to endodontics over extractions?
Less invasive
Preserve tooth function and integrity of jaw
What is a vital pulpotomy?? And when is it done?
Done to maintain a viable tooth that is still able to mature
- immature tooth
- very wide pulp cavity
- apex not completely closed
Coronal portion of pulp is removed with round bur, then flushed with cold sterile saline and then paper points to control bleeding
ProRoot MTA or Ca hydroxide powder placed on exposed pulp —> stimulate odontoblasts to lay down a bridge of dentin to seal the pulp canal
Canal sealed first with a thin layer of hardening calcium hydroxide paste or other cement
Crown restored with acrylic composite material +/- crown application
In what animals is a vital pulpotomy appropriate in?
Young (<18-24months)
Recent pulp exposure
- sooner the better
- > 80% success if done under 48hrs
In what patients would a compete root canal be indicated?
Complicated fracture of the tooth — involves pulp exposure
In patients that are older >24months (mature tooth)
T/F: in a root canal you completely remove all of the pulp contents
True
What are the basic steps to a root canal?
Assess pulp cavity
Remove pulp through access site — tooth in now dead
Clean, disinfect and shape canal
Obturate (fill) canal —> must fill both apical delta and lateral canals
Restore the surface of the crown and acccess site
Why is it important that the root canal is completely filled when doing root canal obturation??
Prevents contamination in dentinal tubules from escaping from the tooth and causing inflammation/destruction of the tooth supporting structures
What do you call a tooth that is partly dislocated from the alveolus but retains some attachment?
Luxation
A tooth that is completely displaced from alveolus
Avulsion
What should you advise the owner to do with a luxated or avulsed tooth prior to arrival at the clinic?
Luxated— push back into alveolus if possible
Avulsed — keep tooth moist (saliva > milk > saline)
What do you do to try and save a luxated/avulsed tooth?
Flush the tooth with saline if dirty but do NOT use antiseptics or scrape surface
Re-seat in alveolus and the splint in place (4wks)
Root canal when splint is removed if tooth has reattached
Follow- up rads to assess periodontal ligament — anykylosis/resorption
What are the two major functions of the peridontal ligament?
Attach tooth to jaw
Separate tooth from alveolar bone to prevent root reabsorption
What is a dental carie?
Cavity
What cell is predominant in tooth resorption?
Osteoclastic
What is the EDX of tooth restoration?
Unknown. May be multifactorial
Most common dz of tooth structure in domestic felines
What is a type 1 resorptive lesion?
Periodontitis with horizontal bone loss
Lymphocytic plasmacytic gingivostomatitis has what EDx and is common in what breeds?
EDx: calicivirus, bacterial, or immunological- ‘allergic to plaque’
Siamese, Abyssinian, Persians, Himalayan’s, Burmese
Signs of lymphocytic plasmacytic gingivostomatitis ?
Ptyalism, halitosis, dysphagia, anorexia, weight loss
What teeth are most commonly affected by gingivostomatitis ?
Maxillary teeth caudal to canines
What would your ddx be for gingivostomatitis? How would you confirm your diagnosis?
Neoplasia
Autoimmune dz
Eosinophilic granuloma syndrome
Histopath
Clinical appearance
Typical history
What is the treatment for gingivostomatitis?
Tooth extraction —sooner the better
Antibiotic - temporary rx
Prophylactic home care
Cyclosporine
Antiviral (if postive for FeLV, FIV, or calicivirus)
Food allergy trial
Breeds associated with juvenile-onset periodontitis?
Cat
Siamese, Maine coon, DSH
Signs of juvenile-onset periodontitis?
Severe gingivitis, periodontal dz
Treatment for juvenile-onset periodontitis?
Prophylactic home care
Some will “outgrow”
Extractions
What are lesions associated with eosinophilic granuloma?
Skin
- ulcers
- linear granuloma
Oral
- Lip ulceration - rodent ulcer
- Hard plate erosion
DDX - SCC
What is the canine equivalent of feline gingivostomatitis -allergy to plaque?
Canine ulcerative paradental stomatitis
Treatment for canine ulcerative paradental stomatitis?
Home care 1-2x daily brushing
May require tooth extractions to control
