Dental surgery - the basics Flashcards
Latin for
Dental crown
dental cervix
dental root
corona,
collum,
radix
Latin for
Pulp cavity
root canal +2 further details
cavum dentis,
canalis radicis,
apex radicis
delta apicis
Latin for
enamel
dentin
cementum
pulp
enamelum, (cannot be penetrated)
dentinum, (can be penetrated (microscopic tubules present))
cementum,
pulpa dentis
Development of a tooth - steps. (2-4-1)
dental lamina
ectoderm-mesenchyma grow
bud
cap
bell
late bell
crown eruption
Topographical-directional terminology used in dentistry. (9)
Distal (back surface)
Mesial refers to the surface of the tooth that is toward the front of the mouth. )
Interproximal (surface between two teeth)
Occlusal
Palatal
Lingual
Buccal
Labial
Vestibular (toward the pouch the cheeks form between dental arcade and cheek)
wide vs narrow pulp chamber in 2 consecutive teeth - what does it mean
the wide chamber mean thats its not laying down anymore dentin, the pulp is dead.
what tooth material does the periodontal ligament attach to?
cementum and the alveolar bone
columnar epithelial cells that produce and deposit enamel on the surface of a developing vertebrate tooth are called
ameloblasts
a cell of neural crest origin that is part of the outer surface of the dental pulp, and whose biological function is dentinogenesis
odontoblast
(cementoblasts make cementum)
what viral disease affects canine ameloblasts causing them to be poorly developed and pinkish in color?
canine distemper virus
How can deciduous puppy teeth be shed if the root is 5x longer than the crown?
deciduous tooth root undergoes resorption process which contributes to it falling out
retained and unerupted deciduous teeth may develop…
deciduous cysts (especially boxers!)
thus, always radiograph the jaw where there is a missing tooth
enamel thickness in dogs and cats
only 1-2 mm! very easy to chip away
very thin compared to e.g. people who have 5-6 mm
describe small animal enamel
Small animal enamel is a thin, highly mineralized outer layer of the tooth, comprising about 96% hydroxyapatite.
Its relative thinness compared to human enamel makes it more susceptible to wear and damage.
describe small animal dentin
Small animal dentin lies beneath the enamel and constitutes the bulk of the tooth structure.
It is less mineralized (about 70% hydroxyapatite) and more porous, containing microscopic tubules that communicate with the pulp, making it more sensitive to external stimuli and more prone to infection or damage once exposed.
dentin continues to grow throughout life
describe small animal cementum
Small animal cementum is a calcified tissue that covers the tooth root, providing attachment for the periodontal ligament to anchor the tooth to the alveolar bone.
Unlike enamel, cementum continues to form throughout life, playing a critical role in tooth stability and periodontal health.
Dog Deciduous teeth.
2 x (I3/3 : C1/1 : P3/3) = 28
Dog deciduous teeth Eruption when?
4th-6th (3rd-12th) week of age
Dog permanent teeth
2 x {I3/3 : C1/1 : P4/4 : M2/3} = 42
dog molars do not have
deciduous predecessors
(nor does premolar 1)
Dog permanent teeth Eruption when?
3rd-7th month of age
what tooth type do cats and dogs have?
Brachyodont teeth
are radicular, meaning rooted (as opposed to e.g. rabbit teeth which are aradicular (meaning non-rooted)
closure (very fragile, thin at first) of the apex of the root by appr.7-11th
month of age; the earliest in lower M1, the latest in upper canine.
Normocclusion is called
scissors bite (in some breeds, a malocclusion is considered desirable or ‘normal’ by breed standards)
4 types of teeth and their purposes
incisors for grasping
canines for grabbing, killing, holding
premolars for sectioning
molars for chewing, shearing
carnassial teeth are numbered what?
P4 of maxilla & M1 of mandible
so 108 & 208?
and 309 and 409?
Review bones of the skull.
Cat deciduous teeth.
2 x {I3/3 : C1/1 : P3/2} = 26
Cat deciduous teeth eruption.
Eruption at 3rd-6th (3rd-12th) week of age
Cat permanent teeth.
2 x {I3/3 : C1/1 : P3/2 : M1/1} = 30
Cat permanent teeth eruption.
Eruption at 3rd-5th month of age
Types of skull – head shape
Mesaticephalic
Dolicocephalic
Brachycephalic
Pre-dental Clinical examination – non-sedated
Head – symmetry, shape, ability to
open/close jaws etc.
Occlusion
Lymph nodes
Teeth, tongue, mucosa & gingiva
Additional if possible/necessary + history
Don’t forget preanesthetic investigations
as necessary and general clinical exam!
Dental Clinical examination –
sedated/anesthetized. (6)
Occlusion (Normocclusion vs. malocclusion)
Mucosa, palate (palpate it!), pharynx, larynx, tonsils (push them out of their crypts even), sublingual check, periodontium, teeth
Diagnostic instrumentation necessary –
periodontal probe, explorer, dental mirror.
Imaging – X-ray, CT/CBCT, MRI, U/S
Additional investigations: cyto/histo (biopsy), impression etc.
DENTAL CHART!
COHAT =
comprehensive oral health assessment and treatment
Examination - sequence. (7)
History: info from the owner
Communicate with owner! What and why.
Awake exam
First diff. ddx, communicate w owner!
Pre-anesthetic evaluation
Anesthetized/sedated exam (dental chart)
Dx and treatment options, communicate
with owner and don’t forget price estimate!
Treatment - sequence. (5)
Treatment options and pricing info –
communicate with owner!
Decision making
Perform procedure(s)
Homecare instructions – communicate with owner clearly and given written instructions.
Follow-up checks – short and long term.
Requirements for dental procedures. (6)
Separate room – ‘dirty procedures’
Light, assistant, anesthesia support
Intubation for most procedures
Good instruments + (heat) sterilization
Regular maintenance of equipment and
instruments.
X RAY! (intraoral/dental, and should be inside dental workroom)
Dental explorer and periodontal probe
Hand scaler and periodontal curette
Describe Malocclusions
One vs. several teeth
Symmetrical vs. unsymmetrical
Dental vs. skeletal
Hereditary vs. acquired
Classification - classes 1, 2, 3, (4)
www.avdc.org (american veterinary dental college)
Classification of malocclusions.
Neutrocclusions
Mandibular Distoclusions
Mandibular mesioclusions
Maxillomandibular Asymmetry occlusions
Classes 1-4
Very lengthy see avdc webpage for more info.
normal occlusion
Evaluate and record pathological findings on a dental chart. Like what? (4)
Gingivitis, dental plaque, calculus
Missing (or supernumerary) teeth
Dental hard tissue defects
Periodontal attachment level – measure
the depth of gingival sulcus (4 places
around the tooth min), record attachment
loss – pathological pockets +/- gingival
recession.
Normal gingival sulcus depth in dogs and cats.
Dog 1-3 mm
Cat 0,5 – 1mm
normal incisive papilla
AL
attachment loss (in percentages and mm depending on parameter)
is how many mm has the level of tooth attachment migrated apically – towards the root – compared to normal
(periodontal tissues, gingiva, alveolar bone, periodontal ligament which normally have their upper or coronal attachment margin at the level of cementoenamel junction)
PD
probing depth is the measurement in mm from the bottom of the gingival sulcus or
periodontal pocket (pathological) to the gingival margin
(normal in a dog less than 2-3 mm, in a cat less than 0.5-1 mm)
GR
gingival recession is the extent of exposure of root surface in mm, how much has the normal attachment level migrated apically, while probing depth is still normal
GH
gingival hyperplasia/overgrowth – when probing depth is over normal measurement (in mm), while the normal attachment level of periodontal tissues to
cementoenamel junction has been preserved (pseudopockets)
AL is not the same as
PD! (attachment loss is not the same as probing depth)
AL is calculated, taking into account whether
a) a pathological PD exists (probing depth)
b) there is GR (gingival recession)
c) there is GH (gingival hyperplasia)
probing depth 4 mm
gingival recession 2mm
= how much attachment loss?
6 mm
AL is the summation of what (3)
a) a pathological PD exists (probing depth)
b) there is GR (gingival recession)
c) there is GH (gingival hyperplasia)
probing depth 1mm
gingival recession 2 mm
= how much attachment loss?
3 mm
probing depth 4 mm
gingival recession 2 mm
= how much attachment loss?
6 mm
where should the gingiva attach to the tooth (after the sulcus)?
cementoenamel junction
place where teeth roots converge
furcation
defects in this area graded 1-3
identify pathology
grade 3 furcation defect
defects in this area graded 1-3
who has cavites?
dogs and ppl
not cats, cause they’re superior (and don’t eat sugars)
What is the modified triadan?
A dental charting system in veterinary dentistry.
Modified Triadan uses the numbering 101, 102 etc. Starting from the patient’s
upper right, move clockwise from the POV of viewer (face to face with patient).
1xx-4xx permanent dentition,
5xx-8xx deciduous,
xx4 always canine,
xx8 always 4th premolar,
xx9 always 1st molar
Deciduous teeth using the modified triaden charting system.
5xx-8xx deciduous
4th premolars using the modified triaden charting system are numbered..?
xx8 always 4th premolar
1st molar using the modified triaden charting system is numbered…?
xx9 always 1st molar
Dental charting systems in veterinary dentistry: Anatomical system
uses I, C, P, M permanent + no.,
i, c, p deciduous + no.
no. written in the corresponding
quadrant beside the letter,
patient’s right side = letter’s right side.
species?
dog
species?
cat
What should you record on your dental chart? (5)
Only pathological findings
Gingival pocket (pathological) = depth mm
O – missing teeth - circle around tooth
X – extracted (during this Tx episode)
tooth, cross out the tooth
DT, DTP - deciduous tooth, persistent
deciduous tooth
(Supernumerary permanent teeth)
Unerupted permanent teeth
(impacted/embedded)
Dentigerous cyst
TR
tooth resorption
(type, stage see avdc.org)
NB this staging image is old and needs updating.
ED, EH
enamel defect, enamel hypoplasia
RTR
retained root
CA
caries
Caries is tooth decay, commonly called cavities.
AB/AT
or W
abrasion/attrition
or wear
Characterizing fractures. (4)
UCF uncomplicated crown fracture:
closed fracture, pulp not exposed
UCRF uncomplicated crown and root
fracture
CCF complicated crown fracture: open
fracture, pulp exposed
CCRF complicated crown and root fracture
Staging/grading gingivitis.
(modified Löe&Silness, GI –gingival index)
GI 0 – no gingivitis
GI 1 – mild gingivitis, redness, no bleeding
GI 2 – moderate gingivitis, redness,
swelling, bleeding on probing
GI 3 – severe gingivitis, redness, swelling,
spontaneous bleeding and/or ulceration
Staging Furcation involvement.
Stage 0 – normal, cannot access furcation
Stage 1 – furcation can be probed, but
probe enters < 1/3 horizontally
Stage 2 – probe enters > 1/3 horizontally,
but not through-and-through
Stage 3 – through-and-through
horizontally with probe
Staging tooth Mobility.
Stage 0 – normal, no mobility
Stage 1 – horizontal mobility </= 1 mm
Stage 2 - horizontal mobility > 1 mm
Stage 3 – horizontal and vertical mobility
NB! Multirooted teeth – even horizontal
mobility > 1 mm generally classified as
stage 3
