Dental Pathology

Question 1

Obj: Be able to describe attrition and abrasion

Question 2

Obj: Be able to describe tooth fractures

Question 3

Obj: Understand treatment options for tooth fractures

Question 4

Obj: Define tooth resorptive lesion stages and types

Question 5

Obj: Understand treatment options for tooth resorptive lesions

Question 6

Define Attrition

Answer 6

• wearing of dental hard tissues from the opposing teeth due to contact
• “Occlusal wear”

Question 7

What affect does the spread of attrition have? (Fast vs slow)

Answer 7

• Slow:
  
  • tertiary dentin will be laid down to protect the pulp
    
    • often has a dark brown appearance
• Fast:
  
  • tertiary dentin is damaged
  • may have pulp inflammation or exposure

Question 8

Define abrasion

Answer 8

• Wearing of dental hard tissues by something other than opposing teeth
  
  • I.e. tennis balls, wire cages, etc

Question 9

What affect does the speed of abrasion have? (Fast vs slow)

Answer 9

• Slow:
  
  • tertiary dentin will be laid down to protect the pulp
• Fast:
  
  • Tertiary dentin is damaged
  • may have pulp exposure

Question 10

What is a common sequela of dental abrasions?

Answer 10

crown fractures

Question 11

How can Attrition be treated/prevented?

Answer 11

• Radiographs to evaluate for endodontic disease
• Treat malocclusion
• Extraction, root canal therapy
• Orthodontic movement
• Combination of therapy
• Some cases may not require treatment

Question 12

How can dental Abrasion be treated/prevented?

Answer 12

• Radiographs are needed to evaluate for endodontic disease
• Treat underlying disease - (i.e. Allergies)
• Behavioral counseling (i.e. cage chewers)
• Extraction, root canal therapy
• Protective crowns
• Combination therapy
• Some cases may not require treatment

Question 13

What teeth are most commonly fractured in dogs

Answer 13

• 104
• 204
• 304
• 404
• 108
• 208

Question 14

What are the most commonly fractured teeth in cats

Answer 14

• 104
• 204
• 304
• 404

Question 15

What are the clinical signs of a tooth fracture

Answer 15

• Asymptomatic
  
  • often w/ dead tooth, non-exposed pulp
• Decreased appetite
• Changes in chewing
• Increased salivation
• Behavior changes

Question 16

Uncomplicated vs complicated tooth fractures

Answer 16

• Uncomplicated:
  
  • No direct pulp exposure
  • Enamel fracture
  • Involving enamel and dentin of the crown
• Complicated:
  
  • Direct pulp exposure
  • Crown fractures

Question 17

What are the common types of uncomplicated dental fractures

Answer 17

• Enamel infraction (EI)
• Enamel fracture (EF)
• Uncomplicated Crown fracture (UF)
• Uncomplicated crown-root fracture (UCRF)

Question 18

Enamel infraction (EI) vs Enamel fracture (EF)

Answer 18

• Enamel Infraction:
  
  • incomplete fracture or crack in the enamel w/out loss of tooth substance
• Enamel Fracture:
  
  • fracture with loss of enamel only

Question 19

Uncomplicated crown Fracture (UCF) vs Uncomplicated Crown-Root Fracture (UCRF)

Answer 19

• UCF:
  
  • fracture of the crown that does not expose the pulp
• UCRF:
  
  • Fracture and root that does not expose the pulp

Question 20

What is the treatment for Uncomplicated Dental Fractures?

Answer 20

• Depends on presence of Endodontic disease (Need Rads)
  
  • Evidence of endodontic disease?
    
    • extraction or root canal therapy
  • No evidence of endodontic disease?
    
    • Exposed dentin tubules can cause sensitivity
    • Over time tertiary dentin may seal the dentin tubules and protect the pulp (‘wait and see’)
    • Recent fractures and/or sharp edges
      
      • Odontoplasty w/ bonded sealant
    • Recheck Rads in 6-12months for endodontic disease

Question 21

What is the benefits of Odontoplasty w/ bonded sealant for recent tooth fractures?

Answer 21

• Decreases plaque accumulation
• decreases sensitivity and risk of infection by blocking exposed dental tubules
• Improves comfort of the patient

Question 22

Complicated crown fracture (CCF) vs Complicated crown-root fracture (CCRF)

Answer 22

• CCF:
  
  • Fracture of the crown that exposes the pulp
• CCRF:
  
  • Fracture of the crown and root that exposes the pulp