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Small animal surgery I > Dentistry > Flashcards

Dentistry Flashcards

1
Q

What % of dogs and cats over 3 years of age have some kind of oral pathology?

A

80-85%

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2
Q

Discuss the following terms:

Mesial, Distal, Proximal, Interproximal, Diastema, Rostral/caudal, Lingual/Palatal, Vestibular, Occlusal

A

Okay!

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3
Q

What is the difference between the two terms: Apical and Coronal?

A

Apical always means towards the root away from the crown, Coronal means toward the crown away from the root

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4
Q

What is on the outermost surface of a tooth, and what is under it?

A

Enamel, dentin is under

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5
Q

What is outer layer of the tooth connects to the gum?

A

Cementum

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6
Q

How can you tell how young an animal is by looking at the canine tooth?

A

The apex of the canine tooth is open, with a large exposed root canal

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7
Q

What are the two canals in the tooth called? Which ones are buried within the gums?

A

Apical delta, lateral canal. Both are within the gums

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8
Q

What is the only visible part of the peridontium in a normal mouth called?

A

Gingiva

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9
Q

What are the functions of the periodontal ligament?

A

Attaches the tooth to the alveolus, absorbs shock from occlusal forces, supplies nutrients, provides nerve information (proprioception, coordination for mastication)

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10
Q

What happens to the periodontal ligament when there is trauma, or excess Vitamin D?

A

It ossifies, which leads to the osteoclast invasion, turning the tooth brittle and the roots to disappear

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11
Q

What is the cingulum?

A

The part of the maxillary incisors that form a groove for the mandibular incisors to rest behind

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12
Q

What organ is connected to the incisive papilla?

A

Vomeronasal organ

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13
Q

What tooth does the parotid salivary gland papilla come out above?

A

The fourth upper premolar

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14
Q

What cells form dentin? Enamel? Cementum?

A

Dentin - Odontoblasts
Enamel - ameloblasts
Cementum - cementoblasts

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15
Q

T/F: Enamel is not replaced after it is damaged

A

True

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16
Q

Which teeth do not have deciduous versions?

A

Molars

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17
Q

What is the dental formula for deciduous teeth in a dog?

A

I3 - C1 - P3

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18
Q

What is the dental formula for adult teeth in a dog?

A

I3 - C1 - P4 - M2/3

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19
Q

What is the dental formula for deciduous teeth in a cat?

A

I3 - C1 - P3/2

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20
Q

What is the dental formula for adult teeth in a cat?

A

I3 - C1 - P3/2 - M1

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21
Q

How do you number a cats maxillary premolars? Mandibular premolars?

A

Maxillary - 2,3,4

Mandibular - 3,4

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22
Q

What is the “Rule of 4 and 9”?

A

The canine is always the 4th tooth and the first molar is always the 9th. Any teeth missing or added should not disrupt these numbers

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23
Q

Which tooth is most commonly affected by crowding?

A

Maxillary 3rd premolar

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24
Q

What is fusion and gemination?

A 
Fusion = joining of two teeth
Gemination = incomplete splitting of two teeth
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25
Q

T/F: It is common that if you do not see a deciduous teeth erupt, the adult tooth is most likely not going to erupt either

A

True

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26
Q

How can you confirm if a tooth is missing or retained?

A

Radiograph

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27
Q

Where should the mandibular canine be with a scissors bite?

A

Between the lateral maxillary incisor and maxillary canine

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28
Q

What class of malocclusion has a normal jaw length? Longer mandible? Shorter Mandible?

A

Class 1, Class 3, Class 3 respectively

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29
Q

What class of malocclusion is it when the incisors of the mouth are have a leveled bite?

A

Class 3

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30
Q

What is wry mouth?

A

When the midline of the maxillary and mandible do not line up

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31
Q

What are some treatments for malocclusions?

A

Interceptive orthodontics, exodontics, crown reduction, orthodontic appliances, incline planes

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32
Q

What can form if an un-erupted [canine] tooth is left unattended?

A

Cyst

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33
Q

How can you treat enamel damage?

A

Extraction, composite restoration, crown

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34
Q

What does enamel hypoplasia look like?

A

Areas of the defect is thinner and discolored (brownish yellow)

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35
Q

Tetracycline causes teeth staining. What layer of the tooth is affected and what is a good alternative non-staining antibiotic?

A

Dentin is affected

Use Doxycylcine

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36
Q

How is attrition of the teeth caused and how do you treat it?

A

Caused by wear from opposing teeth from malocclusion. Treat with orthodontic correction, crown reduction, and extraction

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37
Q

What causes teeth abrasion and how is it treated

A

Trauma contact on the crown surface (rocks, balls, chewing)

Treated by removing the objects and monitoring for pulp exposure or fractures

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38
Q

What happens to teeth with endodontic exposure?

A

Extract or do root canal

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39
Q

What causes dental caries and where are the usually seen?

A

Bacteria producing organi acids that decalcify the enamel and dentin

Locations 9,10 of maxillary
9 of the mandible

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40
Q

What clinical signs are seen with periapical infection?

A

Nasal disease, abscesses, intraoral fistulas, retrobulbar disease, pathologic fractures

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41
Q

What is a parulis?

A

The draining tract associated with teeth

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42
Q

What teeth are affected that lead to retrobulbar nerve signs?

A

Maxillary molars 1 and 2. (109, 110, 209, 210)

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43
Q

What causes (3) gingival hyperplasia and how do you treat it?

A

Focal - periodontal disease
Generalized - Breed (boxers)
Drugs.

Treat via removal of excessive tissue (gingivectomy)

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44
Q

What two methods of gingivectomy are used, and which one is preferred?

A

Electrosurgery and radiosurgery (preferred)

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45
Q

T/F: Pulpitis is usually reversible

A

False. <10% chance

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46
Q

How do you treat pulpitis?

A

Monitor, root canal, extraction

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47
Q

What are three signs of endodontic disease?

A

Decreased wall size, Lucency around the apex, and Apical Resorption

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48
Q

Discuss the following fracture classifications:

Enamel infraction, enamel fracture, uncomplicated/complicated crown fractice, uncomplicated/complicated crown/root fracture, root fracture

A

Root fracture is the one that is extracted.

Complicated ones have the pulp exposed.

Enamel infraction have no loss in structure

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49
Q

How should you treat complicated fractures?

A

Vital pulpotomy, root canal, crown restoration, extraction

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50
Q

What are the advantages of endodontics?

A

Less invasive than extraction, and saves the tooth, its function, and jaw integrity

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51
Q

What is the goal when performing a vital pulpotomy?

A

Maintain a viable tooth that will continue to mature

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52
Q

What will happen to a tooth without viable pulp?

A

It will become dehydrated and brittle over time

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53
Q

What age of animals do you typically perform a vital pulpotomy?

A

Young animals, <18-24 months

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54
Q

T/F: Crown fractures are considered an emergency if you want to preserve the tooth

A

True

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55
Q

How do you perform a vital pulpotomy?

A

Fracture exposes pulp, removal coronal portion of pulp, flush, apply cement material to seal, apply artificial crown later

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56
Q

What does the ProRoot MTA or calcium hydroxide do for the tooth?

A

Stimulates odontoblasts to form dentin and seal the pulp canal

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57
Q

What age of the animal do you perform a complete root canal on a patient?

A

> 24 months

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58
Q

Is the tooth still considered viable after a complete root canal?

A

No

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59
Q

How do you perform a root canal?

A

Access pulp cavity, remove pulp, clean canal, fill canal, seal canal

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60
Q

What is the difference between a tooth luxation and avulsion?

A

Luxation - partial dislocation

Avulsion - complete displacement

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61
Q

How long after a tooth is luxated or avulsed will the success of surgical treatment go down exponentially?

A

30 minutes

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62
Q

What part of the tooth is a successful tooth luxation/avulsion surgery based on?

A

The survival of periodontal ligament

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63
Q

What are the five stages of tooth resorption?

A

Stage 1 - mild, noticeable loss of enamel. Periodontal ligament is there

Stage 2 - moderate dental loss, but has not reached pulp cavity

Stage 3 - Loss of dentin extends to pulp chamber but most of tooth is still viable

Stage 4 - Most of tooth has lost its integrity, most of the hard structure is destroyed (3 sub categories)

Stage 5- Only remnants of the tooth are there, most has been resorbed, leaving a raised area on the gum

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64
Q

What are the three substages of Stage 4 tooth resorption?

A

4a - crown and root are equally affected
4b - crown is more affected
4c - root is more affected

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65
Q

How do type 1 tooth resorption lesions look like on radiographs?

A

focal/multifocal radiolucencies. gingivitis present and periodontitis

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66
Q

How do type 2 tooth resorption lesions look like on radiographs?

A

focal/multifocal radiolucencies, disappearance of periodontal ligament. No signs of periodontal disease

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67
Q

How can tooth resorptions become painful in cats?

A

When the lesions extend coronally and bacteria cause inflammation and pain

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68
Q

What is ankylosis?

A

The process of bone fusing across the normally non-calcified periodontal ligament

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69
Q

What is the most common treatment option for tooth resorption?

A

Extraction

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70
Q

How to you treat tooth resorption with ankylosis?

A

Amputate the crown and superficial root but leave the ankylosed part since it is being reabsorbed anyway

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71
Q

What signs do you see with lymphocytic plasmacytic gingivostomatitis (LPGS)?

A

excess saliva, halitosis, dysphagia, anorexia, weight loss

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72
Q

What does pytalism mean?

A

excess saliva

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73
Q

Where are the lesions in an animal with severe marginal gingivitis?

A

The commisures of the lips, palatopharyngeal arches, and the palate

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74
Q

How do you diagnose gingivostomatitis?

A

Histopathology, clinical signs, history

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75
Q

What is the most effective treatment for gingivostomatitis?

A

Teeth extraction

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76
Q

What oral disease is seen in siamese, main coons, and DSH breeds?

A

Juvenile-onset periodontitis

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77
Q

What do you see with eosinophilic granulomas?

A

Ulcerations, linear granuloma

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78
Q

What do you see with canine ulcerative paradental stomatitis? (CUPS)

A

fetid halitosis, pytalism, anorexia, kissing lesions

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79
Q

How do you treat CUPS?

A

extractions, home care

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80
Q

What is considered a subtotal glossectomy?

A

Entire free portion of the tongue and rostral part of the base of the tongue caudal to the frenulum

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81
Q

What is considered a partial glossectomy?

A

removal of the free portion of tongue rostral to the frenulum

82
Q

What would an indicator for a total glossectomy?

A

Lingual squamous cell carcinoma

83
Q

What is the most common periodontal disease in the small animal?

A

Periodontal disease

84
Q

What is the #1 cause of tooth loss?

A

Periodontal disease

85
Q

T/F: Periodontitis is a site-specific disease.

A

True

86
Q

T/F: Periodontitis is painful

A

True

87
Q

What is Xerostomia?

A

Dry mouth

88
Q

What are some diseases that make periodontal disease worse?

A

Neutrophil dysfunction, diabetes mellitus, hyperadrenocorticism, autoimmune disease, feline viruses

89
Q

What is plaque?

A

A combination of bacteria, food, debris, oral epithelial cells and mucin

90
Q

What is calculus?

A

Mineralized plaque containing bacteria that releases endotoxins and causes gingivitis. (also called tartar)

91
Q

What happens with periodontal disease?

A

Subgingival plaque accumulates and causes an inflammatory response leading to a destruction of epithelium at the base of the gingival sulcus, exposing periodontium. The exposed pocket allows for bacteria to migrate and destroy the periodontal ligament and alveolar bone

92
Q

T/F: Gingivitis is reverisble

A

True

93
Q

T/F: Periodontitis is reversible

A

False

94
Q

What are some signs with periodontal disease?

A

Halitosis, build up of plaque, gingivitis, pytalism, loss of teeth

95
Q

What is a normal sulcular depth for dogs? cats?

A

Dogs - 1-3 mm

Cats - 0-1 mm

96
Q

What do you see with stage 1 periodontal disease?

A

Gingivitis. Reversible, normal sulcus depth

97
Q

What do you see with stage 2 periodontal disease?

A

Early periodontitis. Minor gum pockets, controllable periodontitis.

98
Q

What do you see with stage 3 periodontal disease?

A

Moderate periodontitis. Gingival hyperplasia, deep pockets, bone loss, tooth mobility

99
Q

What do you see with stage 4 periodontal disease?

A

Advanced periodontitis. Deep pockets, high bone loss, high tooth mobility

100
Q

What are the goals of treatment for periodontal disease?

A

Remove the biofilms, minimize tooth loss and pocket depth, maintain the attached gingiva

101
Q

What is the #1 preventative method for periodontal disease?

A

Mechanical abrasion of plaque

102
Q

T/F: Dental chews and treats are known to help treat periodontitis.

A

False

103
Q

T/F: Antibiotics cure periodontal disease

A

False

104
Q

What are the top 4 systemic antibiotics used for periodontal disease?

A

Clindamycin, clavamox, metronidazole, doxycycline

105
Q

What are some local antibiotic therapies for periodontal disease?

A

Doxirobe gel, Clindoral

106
Q

T/F: With a scaler, you always want to work from the top of the tooth to the base.

A

False. Work away from the sulcus

107
Q

What instrument measures sulcus depth?

A

Periodontal probe/explorer

108
Q

What is the most recommended type of power scaler?

A

Ultrasonic

109
Q

Which type of ultrasonic scaler produces less heat than the other

A

Piezoelectric produces less heat than the Magnetostrictive

110
Q

What are the two ways of identifying any missed calculus after scaling?

A

Disclosing solution, air dry the tooth

111
Q

Describe the stages of the periodontal index

A 
Stage 0 - normal
Stage 1 - gingivitis
Stage 2 - <25% detachment 
Stage 3 - 25-50% detachment
Stage 4 - >50% detachment, inevitable tooth loss
112
Q

Describe the stages of furcation exposure

A

Stage 0 - normal
Stage 1 - probe can enter <1 mm
Stage 2 - probe can enter >1 mm
Stage 3 probe can go through the furcation horizontally

113
Q

What is considered pathologic mobility?

A

Excess physiologic mobility

114
Q

T/F: You need dental radiographs to complete a dental cleaning

A

True

115
Q

What are some indications for tooth extractions?

A

Retained deciduous teeth, severe periodontitis, non-vital teeth, root exposed tooth, resorbing teeth

116
Q

What do you need to do to confirm your dental extractions?

A

Radiographs

117
Q

What are some ways to deal with retained root tips after extraction?

A

Root tip elevator, high speed burr (has complications)

118
Q

Extraction of a multi-root tooth is just like the removal of a single root tooth except what?

A

Section the tooth at the furcation of the roots, and elevate and remove each segment individually

119
Q

If the furcation is not present but the tooth needs to be removed, how do you perform a multi-rooted tooth extraction?

A

Lift the gingival flap by incising the epithelium attached and expose the furcation, separate the tooth by root, and remove individually

120
Q

How do you perform a canine tooth extraction?

A

Cut the associated epithelial layer at the diastema and free the attached gingiva. Cut the alveolar bone at the rostral and caudal borders, elevate the tooth via rolling motion, remove, and suture back the soft tissue together

121
Q

What suture do you use for suturing the oral gingiva?

A

Absorbable 3-0 to 5-0 suture with reverse cutting needles

122
Q

T/F: Strong tension from the sutures is important when closure of oral mucosa.

A

False

123
Q

What is the post-op protocol for gingival flap procedures?

A

Soft food diet, no chew toys/hard treats, recheck

124
Q

What can cause an oronasal fistula?

A

Dental disease and extractions from complications, radiation, trauma, pressure necrosis from foreign body

125
Q

What is the most common way to receive an oral electrical burn?

A

Chewing electrical cords

126
Q

What signs do you see with oronasal fistulas?

A

Nasal discharge, sneezing, aspiration pneumonia

127
Q

How many layers of closure is there for oronasal fistula repair?

A
  1. Nasal and oral mucosas
128
Q

When would you perform an oral single flap technique on an oronasal fistula?

A

Acute fistulas or too large of a defect for a two layer closure

129
Q

When would you perform a double flap technique on an oronasal fistula?

A

Congenital defects, chronic fistulas

130
Q

What are some salvage procedures for oronasal fistulas?

A

Intraoral appliances - acrylic, nasal septal button

131
Q

How would you treat hard palate trauma?

A

Suture, splint, pin and wire

132
Q

What are the two biggest indicators for oral radiographs?

A

Survey films. Pre and post extraction of tooth

133
Q

Where should the dimple of the radiographic film be placed in the mouth?

A

Coronally, facing the X-ray tube

134
Q

What are the steps to making X-rays films?

A

Develop -> Rinse -> Fix -> Rinse

135
Q

What are the two techniques for taking dental radiographs?

A

Parallel and Bisecting

136
Q

What teeth are captured with the parallel radiograph technique?

A

Mandibular premolars and molars

137
Q

Where is the film placed with the parallel radiograph technique, and the tube of the x-ray?

A

Film is placed in the intermandibular space, Tube head is perpendicular to film and tooth

138
Q

How do you take a radiograph with a bisecting angle technique?

A

Make an angle between the film and the teeth. Focus the beam perpendicular to the bisecting angle between those two structures

139
Q

What does SLOB stand for?

A

Same Lingual Opposite Buccal

140
Q

What is the 4th most common neoplasm in dogs?

A

Canine oral tumors

141
Q

What are the three most common types of malignant canine oral tumors?

A

Malignant melanoma, squamous cell carcinoma, fibrosarcoma

142
Q

What is the most common type of oral feline tumor?

A

Squamous cell carcinoma

143
Q

T/F: Oral melanoma is highly metastatic

A

True

144
Q

What is the pathway of local spreading for oral melanoma?

A

Gingiva -> lips -> palate -> tongue

145
Q

What is an amelanotic melanoma?

A

A melanoma without pigment

146
Q

How do you treat oral melanoma?

A

Surgical resection, radiation, immunotherapy.

biopsy the regional nodes via FNA

147
Q

What are the three lymph nodes that drain the oral cavity?

A

Mandibular, parotid, retropharyngeal

148
Q

What is the prognosis for oral melanoma?

A

Poor. Greater the size, lower the prognosis

149
Q

What is the second most common malignant oral tumor?

A

squamous cell carcinoma

150
Q

T/F: A nontonsillar SCC is highly metastatic

A

False

151
Q

How do you treat nontonsillar SCC?

A

Surgical resection, radiation, chemo

152
Q

T/F: The more caudal the SCC, the worse the prognosis

A

True

153
Q

T/F: Tonsillar SCC are highly malignant and usually are unilateral and metastasize early

A

True

154
Q

Where do you see feline SCC in the mouth?

A

Under the tongue

155
Q

What is the prognosis for feline SCC?

A

Poor

156
Q

Where would oral fibrosarcomas be located normally?

A

Maxilla - caudal to the canine tooth

157
Q

How do you treat fibrosarcomas?

A

Wide surgical resection, radiation

158
Q

What is a peripheral odontogenic fibroma?

A

Proliferation of fibrous connective tissue

159
Q

What is acanthomatous ameloblastoma?

A

Rise of remnants of epithelial cells that produce periodontal ligament

160
Q

What is scary about acanthomatous ameloblastomas?

A

Can locally invade into the bone

161
Q

How do you treat acanthomatous ameloblastoma?

A

Surgical excision, radiation

162
Q

What is a central ameloblastoma?

A

A noninductive tumor that arises from the dental laminar epithelium, that can lead to bone destruction

163
Q

What is an odontoma?

A

An inductive tumor that produces hard tissue. Can be compound and look like teeth, or complex and not

164
Q

How do you treat odontogenic tumors?

A

Surgical excision, radiation

165
Q

What age of dogs do undifferentiated malignant oral tumors affect mostly?

A

Young dogs ~12 months

166
Q

What signs do you see with UMOT?

A

Swelling, loose teeth, pain, exophthalmos

167
Q

How do you treat UMOT?

A

You can’t.

168
Q

How wide do you typically make surgical excision margins?

A

1-2 cm

169
Q

T/F: Electrosurgery is the tool of choice for oral surgery

A

False. Avoid and only use for hemostasis

170
Q

What types of suture material is used for oral surgery?

A

Polyglactin 910, poliglecaprone

171
Q

What does a total mandibulectomy mean?

A

Removal of one side of the entire jaw (left or right)

172
Q

How do you treat a patient post op mandibulectomy/maxillectomy?

A

Fluids for 24 hours, pain meds, feeding tube for 3/4 or more removed

173
Q

What complications can occur with mandibulectomies?

A

swelling, wound dehiscence, mandibular drifting, ability to eat

174
Q

What are some complications with maxillectomy?

A

Wound dehiscence with oronasal fistula, can droop the nose and make it hard to eat

175
Q

How do you treat a labial avulsion?

A

Suture reconstruction

176
Q

Which side does suture reconstruction fail for labial avulsion?

A

Mandibular side

177
Q

What do you need to aide in the labial reconstruction when suturing an avulsion?

A

Interdental stent to support the weight of the lip

178
Q

What do you see with lip fold pyoderma and how do you treat it?

A

Foul odor, pain, dermatitis.

Treat with surgical resection of the lip

179
Q

How do you treat tight lip syndrome?

A

Cheiloplasty - cut the lip along the mucogingival line to form a small avulsion and let heal by second intention

180
Q

What types of dogs usually have nasal folds?

A

Brachycephalic breeds

181
Q

What do deep nasal folds predispose animals to?

A

Dermatitis

182
Q

How can you treat the dermatitis induced nasal folds?

A

Control inflammation with meds, or surgical resection of nasal folds

183
Q

What are some things to consider when performing a lip reconstruction?

A

Species/breed, lesion size and location

184
Q

What are some types of flaps for labial reconstruction?

A

Direct apposition, labial advancement, labial rotation flap

185
Q

Which salivary gland is most susceptible to neoplasia in the dog? cat?

A

Parotid - dog

Mandibular - cat

186
Q

What are the four main salivary glands in the dog?

A

Parotid, mandibular, sublingual, zygomatic

187
Q

What are the additional salivary glands that the cat has?

A

Molar

188
Q

What is a salivary mucocele?

A

Accumulation of saliva within the submucosa

189
Q

What is the most common salivary gland disease in dogs and cats?

A

Mucocele

190
Q

T/F: Mucoceles are not painful

A

True, but can be with inflamed

191
Q

Which gland is most commonly affected by mucocele?

A

sublingual

192
Q

How can you diagnose or confirm the presence of a mucocele?

A

FNA

193
Q

What is the definitive treatment for salivary mucocele?

A

Surgical excision

194
Q

What is the salvage procedure for salivary mucoceles?

A

Masupialization.

195
Q

T/F: You want to perform a vertical incision when exposing the parotid gland

A

True

196
Q

T/F: You want to perform a vertical incision when exposing the mandibular or sublingual glands

A

False!

197
Q

What can you do if, during surgery, the mucocele was not adequately drained?

A

Place a drain

198
Q

T/F: A mucocele does not have to be removed

A

True

199
Q

What is the prognosis for a salivary mucocele?

A

Excellent

200
Q

How does a parotid fistula occur and how do you treat it?

A

Result from trauma to the parotid duct.

Treat - ligate the parotid duct proximal to the defect

Small animal surgery I (8 decks)

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