Dentistry Flashcards
between mandible and maxilla, which do you repair 1st if both are fractured?
mandible - caudal to rostral (symphysis last) then mid facial
to address tensile stress of mandible, what should be done in repairs with intraosseous wire?
provide 2nd area of fixation (stabilization) to neutralize shear and rotation
what are 2 wire patterns that can be utilizing a pin to augment repair for maxillofacial fracture?
skewer pin - drilled through bone fragments or placed on surface of bone “internal splint”
what are methods to overcome the downsides of ESF with mandible
- place fixation pins through 4 cortices
- bilateral placement of connecting bars (type 2 ESF)
- place fixation of both mandibles in single arched connecting rod that traverses both sides
- use acrylic connecting bar
what are 3 types of small plate systems used for mandibular fracture
martin miniplate (walter lorenz): titanium
synthes maxillofacial system: 1- 4 mm
advanced locking plate system (ALPS)
for mandibular fracture, what are options for large defects?
compression fixation with cortical bone graft or synthetic graft
where can cortical graft be excised from? what is the size limit?
ulna, rib
<40 cm
for ramus fracture, where do you put tension vs stabilization plate?
tension band plate - coronoid crest
stabilization plate - ventral condyloid crest
for sequence of treatment of mandible/maxillary fractures and teeth in fracture line, what is inside-to-outside
bone, then teeth, then soft tissues, then specific dental injury
what stress exhibited at:
oral/alveolar
aboral
ramus
rostral
oral/alveolar - tensile stress
aboral - compression
ramus - shear
rostral - rotational
what are the feline disease associated with dental disease
FeLV/FIV, feline bartonellosis
what are the dentition formulas cats/dogs? young/adults?
Cats:
young - 3/3, 1/1, 3/2
adult - 3/3, 1/1, 3/2, 1/1
Dogs:
young - 3/3, 1/1, 3/3
adult - 3/3, 1/1, 4/4, 2/3
what is the general quadrant system for dentistry?
R maxilla - 1_ _
L maxilla - 2 _ _
R mandi - 4 _ _
L mandi - 3 _ _
what is the rule of 4/9?
canine: _ _ 4
1st molar: _ _ 9
when radiographing teeth, what technique would you use for mandibular molars, mandibular premolars, nasal cavity?
parallel technique (film/pad/plate parallel to tooth)
when radiographing teeth, what technique would you use for other parts? what is the technique?
bisecting angle
what are the 5 dental nerve blocks used?
- maxillary n.
- infraorbital n.
- major palatine n.
- inferior alveolar (mandibular) n.
- middle mental n.
what does each of the 5 dental nerve blocks affect?
- maxillary n.: incisive bone, maxilla, palatine bone, maxillary teeth and soft tissue
- infraorbital n.: incisive bone and maxilla, maxillary incisors, canine, PM and molar
- major palatine n.: palatine shelf, maxillar/adjacent ST
- inferior alveolar (mandibular) n.: rostral mandibular body and teeth, rostaral to injection site
- middle mental n.: incisors and canine tooth of the corresponding side along with the adjacent bone and soft tissues.
what makes up the periodontium?
gingiva, periodontal ligament, alveolar bone, and cementum
closed treatment vs open periodontal therapy, which depth?
if pocket >5 mm -> open treatment
modified widman flap?
internal bevel incision slightly apical to gingival margin and down to alveolar bone (no vertical incision)
when are gingivectomy and gingivoplasty contraindicated?
when <2mm gingiva attached, also when horizontal/ventral bone loss extends beyond mucogingival junction
what cells line pulp cavity? what do they produce?
odontoblasts - predentin (becomes dentin)
what is complicated versus uncomplicated tooth fracture?
uncomplicated - without pulp exposure
complicated - with pulp exposure
what is caries?
demineralization of tooth surface by acids during fermentation of highly refined carbs by cariogenic bacteria
when is vital pulp therapy usually used?
primarily on teeth with complicated crown fracture, occurring up to 2 days prior to presentation of the animal that is greater than 18 months of age
AND
upto 2 weeks prior to presentation in animals less than 18 months of age
what are 2 forms of root canal therapy?
apexification - treatment of closed apex when necrotic pulp in incompletely developed permanent tooth in young adult animals OR teeth in adult animals with open apices from root resorption
minimal shaping - fill root canal with CaOH2 paste with restoration of corcinal acces opening
retrograde root canal - sx treatment
what component or material can a luxated avulsed teeth be placed on for temporary pulp protection before re-implantation
how long does it maintain vitality of periodontal ligament cells?
fresh milk
3-6 hrs
what is placed in root pulp cavity for root canals?
CaOH
what % cats affected by tooth resorption?
25-75%
what are reported treatment options for stomatitis
professional dental cleaning
topical/systemic antibiotic +/- tooth extraction
topical chlorhexidine
corticosteroids
cyclosporine
bovine lactoferrin
low dose doxycycline
intertercon omega**
what are contraindication with crown amputation with intentional root retention
teeth with periodontitis, endodontic disease, periapical pathology and not recommended when closed or open extraction possible
what material is used to do maxillomandibular fixation? (intraoral splinting)? what is the benefit of this material?
bis-acryl fixation (composite)
thermal injury does not occur
describe the 2 interdental wiring techniques mention in Tobias
Stout multiple loop
- place wire subgingivally between teeth
- loops situated buccal side of interdental spaces of maxillary teeth and lingual side of interdental space of mandibular teeth
- static wire end threaded through all loops so both wire ends twisted in pull and twist fashion
Risdon wiring
- wire anchored to one tooth, 2 wire ends twisted along dental arch and anchored again to another tooth
what are 3 primary buttresses of maxillofacial skeleton? what direction and forces do they support?
rostral (medial) nasomaxillary ^
lateral (zygomaticomaxillary) #
caudal (pterygomaxillary) ^
^ - medial/caudal vertical support withstand transverse forces
# - vertical planes; withstand shearing
