Dentistry Flashcards
Name the 4 nerve blocks
Infra-orbital
Caudal maxillary
Middle mental
Caudal mandibular
What needle size do you use for nerve blocks?
25G
How long does lidocaine last as a LA?
60-120mins
What is the onset time of lidocaine for LA?
5minutes
Name the 3 types of mucoperiosteal flaps
Envelope
Triangle
Pedicle
What suture size/type and needle would you use to suture closed the mucoperiosteal flap?
Monosyn 4/0 (5/0 in cats) w/ a reverse cutting needle
When is a crown amputation indicated?
In type 2 tooth resorption in cats (tooth and surrounding bone are same opacity)
How much of the tooth root should you expose in a surgical extraction
1/3-2/3
List 4 complications of nerve blocks
- Nerve damage
- Desensitisation of tongue and lips and self-mutilation on waking
- Paralysis
- Damage to eye
Anatomical structures to beware of when raising flaps
i. Parotid duct above/slight distal to carnassials
ii. Infraorbital neurovascular bundle prox to carnassial
iii. Nasal cavity
What type of bur is used to section a tooth
taper-fissure bur
What size scalpel blade is used to incise the gingival attachment?
15
What is the onset and duration of bupivacaine (0.5%)/ropivacaine (0.75%) as LA
onset 15min, duration 4-8hrs
What is the purpose of polishing?
Smooths the enamel surface as scaling results in surface defects. Removes any remaining plaque and calculus
Rad signs of periodontitis
- Alveolar bone loss, may be vertical or horizontal
- Widening of periodontal ligament space
- Blunting of sharp angle of alveolar marginal bone
- Loss of fuzziness of lamina dura (white line around tooth – is inner surface of alveolus)
Explain the Gingivitis index
1: line of red along gingival margin
2: more extensive redness, gingiva swollen, bleeds on probing
3: bleeding spontaneously
Explain the Calculus index
1 = 1/3 crown covered 2 = 2/3 crown coverd 3 = over 2/3 crown covered in calculus
What is the healthy sulcus depth of a cat/dog?
healthy is <0.5-1mm in cats, <3mm in dogs
What bacterial sp are assoc. w/ development of periodontitis?
- Bacteroides
- Prevotella spp.
- Porphyromonas spp
- Fusobacterium spp.
Why do Maltese and greyhounds tend to have more severe periodontal disease?
Thought to be genetic – possible increased IL1 levels increases inflm. Response (to the bacterial toxins)
Top Ddx for Rough cauliflower-like, ulcerated surface mass at maxillary PM4?
Acanthomatous ameloblastoma (previously called acanthomatous epulis)
Top DDx for Pink, smooth, may be pedunculated, Slow growing oral mass?
Peripheral odontogenic fibroma (previously ossifying epulis and fibromatous epulis).
Explains type 1-3 of Tooth resorption (TR) – prev. feline odontoclastic resorptive lesions (FORLS)
Type 1 – normal root radiodensity and periodontal ligament intact
Type 2 – roots more radiolucent, lack PL space
Type 3 – combination of above ie. One root may have signs of type 1 and other root signs of type 2
What viruses may be associated with Feline chronic gingivostomatitis?
calicivirus, herpes, FIV, FeLV
Top DDx for a cat with Bilateral, erythematous ulcerative and proliferative lesions of gingiva, buccal mucosa, lips, lateral palatoglossal folds and lateral edges of tongue
Feline chronic gingivostomatitis
Define Class IV (MAL4)
mesiodistocclusion (maxillomandibular asymmetry) = special type of wry bite where one jaw class II and one class III
Define Class III (MAL3)
mesiocclusion (mandib mesioccluson) = long mandible and/or short maxilla, or wry mouth.
Define Class II (MAL2)
mandibular distocclusion = when short mandible and/or long maxilla or wry bite
Define Class I (MAL1)
neutrocclusion = both jaws align but individal teeth misaligned
When is permanent eruption finished in cats?
Permanent: eruption complete at 6-7mo (30teeth)
When is permanent eruption finished in dogs?
Permanent dentition: order of eruption – PM1 then incisors (3-4mo), canines, PM2-PM4, then molars (4-6mo), mandibular M3 (6-7mo)
Explain a potential progression of a complicated tooth fracture
Ingress of bacteria into pulp, pulpitis, necrosis, leakage of material periapically –> acute apical periodontitis. Painful, no rad. Signs
When is a vital pulpotomy an option?
If fresh fracture (,48hrs) – vital pulpotomy (involved removal of only small portion of pulp near tip of crown and filling w/ appropriate sealant)
What are some ABs indicated for severe periodontitis?
Choose for bacterial flora – ie gram negative anaerobes. Most commonly used antibiotics are amoxicillin +/- clavulanic acid, metronidazole, clindamycin and doxycycline.
Indications for antimicrobial therapy
- Severe periodontitis
- Acute periodontal or endodontic disease with swelling or bone involvement
- Systemically unwell (pyrexic)
- Oral trauma involving tissue destruction
- Have impaired host defences or who are immuno-compromised
- Surgical extractions and bone removal.
