Digestion & Metabolism 2: Periodontal & Oral Dz Flashcards
periodontal disease…
= definition
4 components?
caused by..
often has a ____ cause
ULTIMATELY causes what presentation?
= INFLAMMATORY DISEASE OF ALL PERIODONTAL TISSUES, including…
1. Gingiva
2. Periodontal ligament
3. Alveolar bone
4. Cementum
CAUSED by IMBALANCE BETWEEN BACTERIAL FLORA/PLAQUES in mouth & HOST IMMUNE SYSTEM
often has a MULTIFACTORIAL cause
ULTIMATELY causes…
–> LOSS OF BONE and DETACHMENT OF THE TOOTH
function of periodontal tissues?
help ATTACH TOOTH TO HEAD
what is a TOOTH FURCATION?
the area where the roots divide and branch into multiple teeth at a time
describe this STAGE OF PERIODONTAL DZ..?
weird one
likely STAGE II PERIODONTAL DISEASE, see <25% ATTACHMENT SEPARATION between TOOTH FURCATION and GINGIVA
5 stages of PERIODONTAL DISEASE?
include % attachment loss, furcation #, probe use and RADIOGRAPHIC findings
Stage I
–> ONLY GINGIVITIS
–> Don’t see ANYTHING ON RADIOGRAPHS because ANATOMY MAINTAINED & NO BONE LOSS
Stage II
–> <25% attachment loss at the tooth
–> Furcation 1
–> Can use PROBE to GO BETWEEN TOOTH ROOTS to determine if FURCATION SEPARATION is present!
Stage III
–> 25-50% attachment loss
–> Furcation II
–> Can use the probe to go INTO THE FURCATION and should go BEYOND HALF THE WIDTH OF THE BONE
–> BONE IS STILL PRESENT
Stage IV
–> >50% attachment loss
–> Furcation III
–> SEVERE = see BONE LOSS AND DETACHMENT OF THE TOOTH
describe the 3 parts of this picture in relation to PERIODONTAL DISEASE
T = tooth
G = gingiva
1 = NORMAL
–> gingiva and tooth can be separated by 1-3 mm sulcus
2 = GINGIVAL RECESSION & PERIODONTAL DZ
–> TOOTH ROOT EXPOSED and LARGER SULCUS CAN FORM
3 = POCKET FORMED and PERIODONTAL DZ
–> LARGER SULCUS FORMS
–> PERIODONTAL LIGAMENT LOST, so GINGIVA IS THICKENED
identify TOP and BOTTOM bubble findings on this radiograph
TOP = PERIODONTAL LIGAMENT
BOTTOM = BONE LOSS
ID the stage of periodontal DZ on LEFT and RIGHT tooth
LEFT = STAGE 4
RIGHT = STAGE 2
TREATMENT for PERIODONTAL DZ…
can be VARIABLE depending on what 5 things?
3 treatment options?
variable depending on…
1. severity
2. tooth affected
3. functional ability
4. owner compliance for toothbrushing/cleaning
5. patient
3 Tx options?
1. PROFESSIONAL dental cleaning
2. BONE & GUIDED tissue REGENERATION
3. GINGIVAL GRAFTS
TOOTH RESORPTION…
= definition?
what SPECIES/AGE is this most common in?
dz over time?
etiology? (2)
= OSTEOCLASTS start to DESTROY & RESORB the tooth and can REPLACE W/ OSTEOID
common in MIDDLE-AGED CATS
tends to be a PROGRESSIVE DZ
etiology?
1. IDIOPATHIC largely
2. potentially due to EXCESS VITAMIN D IN DIET
DESCRIBE LESION & WHAT AGE/SPECIES THIS IS MOST COMMON IN
TOOTH RESORPTION
MOST COMMON IN MIDDLE-AGED CATS
CLASSIFICATION of tooth resorption…
TYPE 1? (2 findings & treatment)
TYPE 2? (1 finding, & overall how the animal feels)
TYPE 1 = INFLAMMATORY resorption
1. bone loss USUALLY ASSOCIATED
2. PERIODONTAL LIGAMENT still present
tx = EXTRACTION of affected teeth
TYPE 2 = REPLACEMENT RESORPTION
1. PERIODONTAL LIGAMENT is REPLACED or GONE and becomes PART OF TURNOVER OF THE BONE
overall, animal feels USUALLY NON-PAINFUL unless inflammation remains
ID TYPE OF TOOTH RESORPTION
TYPE 1
ID TYPE OF TOOTH RESORPTION
TYPE 2
5 stages of TOOTH resorption?
WHAT ARE THEY BASED ON?
BASED ON DESTRUCTION OF THE TOOTH
Stage 1 = CANNOT BE SEEN ON RADS, ONLY affects the CEMENTUM
Stage 2 = affects SURFACE and goes IN, DENTIN now affected
Stage 3 = AFFECTS PULP
Stage 4 = affects CROWN or ROOT
Stage 5 = EVERYTHING IS RESORBED, CROWN NOT PRESENT & GRANULATION TISSUE IN GINGIVA
ID STAGE of TOOTH RESORPTION
STAGE 4
ID STAGE of TOOTH RESORPTION
STAGE 5
ENDODONTIC DZ…
affects WHAT part of the tooth?
caused by ____, WITH or WITHOUT ___ ___ and results in ____ or later ____ of the _____
if a tooth is DISCOLORED w/ this dz, it’s likely….
reversible vs. irreversible?
affects the DENTAL PULP
caused by TRAUMA, WITH or WITHOUT DENTAL FRACTURE and results in INFLAMMATION or later NECROSIS of the PULP
if a tooth is DISCOLORED, likely NON-VITAL bc becomes PALE BLACK FROM NECROSIS
reversible? = RECENT & ONLY PULPITIS
irreversible? = NECROSIS/NON-VITAL
ID lesion
TOOTH NECROSIS from ENDODONTIC DZ
ID lesion
PERIODONTAL LIGAMENT SEPARATED FROM THE TOOTH due to TOOTH NECROSIS from ENDODONTIC DZ
ABSCESSES & DRAINING TRACTS…
can occur in WHAT types of diseases? (3)
DRAINAGE of ABSCESSES more commonly occurs where?
how do teeth grossly present? (2)
what types of dz?
1. PERIODONTAL DZ
2. ENDODONTIC DZ
3. BOTH
draining abscesses more commonly OCCUR IN MUCOGINGIVAL JUNCTION
gross presentation?
1. teeth can be FRACTURED
2. teeth could also look NORMAL
TOOTH FRACTURES…
2 types?
3 ways it can present grossly?
what 3 things are needed for a tooth to stay healthy?
2 types?
1. COMPLICATED = PULP AFFECTED
2. UNCOMPLICATED = pulp NOT AFFECTED OR EXPOSED
3 gross presentations?
1. CROWN ONLY can be involved
2. ROOT ONLY can be involved
3. BOTH
3 things for healthy tooth?
1. healthy crown
2. functional root system
3. healthy pulp
what TYPE of tooth fracture is this?
COMPLICATED (pulp affected/exposed)
what TYPE of tooth fracture is this?
UNCOMPLICATED (pulp NOT affected/exposed)
PULP exposure in ____ fractures causes WHAT DZ?
COMPLICATED fractures
causes ENDODONTIC disease
TWO TREATMENT OPTIONS for COMPLICATED tooth fractures?
- EXTRACTION
- ENDODONTIC TREATMENT via ROOT CANAL or VITAL PULP THERAPY
TOOTH LUXATION & AVULSION…
= definition of both?
LUXATION is more common in WHAT age animal/why? what TYPE of luxation is more common?
LUXATION = DISPLACEMENT of the tooth from the ALVEOLUS
AVULSION = tooth is COMPLETELY OUT of ALVEOLAR SPACE
LUXATION more common…
1. in YOUNG animals because PERIODONTAL LIGAMENT/CARTILAGE is SOFTER
2. more often LATERAL luxation
ID what’s happening with the tooth
tooth AVULSION
ID what’s happening with the tooth
tooth LUXATION
tooth ABRASION…
= definition? (& what part of the tooth is LOST)
3 reasons it can occur?
an IMPORTANT sequelae?
= WEAR of the tooth DUE TO CONTACT WITH AN OBJECT causing a LOSS OF DENTIN & stimulation of ODONTOBLASTS to MAKE REPAIR DENTIN
3 reasons?
1. ROUGH TOYS
2. chewing on METAL BARS
3. TENNIS BALLS
can POTENTIALLY cause PULP EXPOSURE and PULPITIS –> PAIN/INFLAMMATION
ID LESION
tooth ABRASION
DENTAL ATTRITION…
= definition?
= the WEARING of OCCLUSAL or INCISAL surfaces of teeth due to TOOTH-TO-TOOTH CONTACT
ID LESION
DENTAL ATTRITION
2 reasons teeth DO NOT ERUPT?
it can be difficult to DIFFERENTIATE between them WITHOUT _____
what breeds are PREDISPOSED to UNERUPTED teeth?
unerupted teeth are associated with WHAT lesion?
2 reasons?
1. IMPACTED tooth = PHYSICAL BARRIER AVOIDS ERUPTION, can be due to NORMAL anatomy
2. EMBEDDED tooth = ABNORMAL CROWN/ROOT ANATOMY
can be difficult to differentiate WITHOUT RADS
BRACHYCEPHALIC dogs predisposed
associated with DENTIGEROUS CYSTS/EAR TOOTH
ID what’s happening with the tooth
TOOTH WAS NOT ERUPTED
RADICULAR CYSTS…
= definition?
more common in teeth with ____ or ____ ____
2 tx options?
= cysts of ODONTOGENIC origin (around the tooth) caused by PROLIFERATION OF EPITHELIAL CELLS around PERIAPICAL area
more common in teeth with PULPITIS or PULP NECROSIS
3 tx options?
1. CYST REMOVAL
2. MARSUPIALIZATION OF CYST & EXTRACTION OF TOOTH
ID LESION
RADICULAR CYST
4 CLASSES of MALOCCLUSION?
hints: include DENTAL or SKELETAL malocclusion, the name for what’s going on, and for the FINAL stage what tx is needed
CLASS I = DENTAL malocclusion
–> ABNORMAL position of teeth in DENTAL ARCH but NORMAL RELATIONSHIP between MAXILLA & MANDIBLE
CLASS II = SKELETAL malocclusion
–> MANDIBULAR BRACHYGNATHIA
CLASS III = SKELETAL malocclusion
–> MAXILLARY BRACHYGNATHIA
CLASS 4 = SKELETAL malocclusion
–> MAXILLOMANDIUBLAR ASSYMETRY
–> if NOT CAUSING A PROBLEM, NO NEED TO TREAT
GINGIVAL HYPERPLASIA…
= definition?
common in WHAT breeds?
what 3 drugs could cause this/name the most common?
what DIAGNOSTICALLY should we do if we see this?
tx?
= ENLARGEMENT of gingiva due to PROLIFERATION of CT there
common in BRACHYCEPHALIC breeds
3 drugs?
1. CYCLOSPORIN = MOST COMMON
2. ANTICONVULSANTS
3. CA-CHANNEL BLOCKERS (amlodipine, dilitiazem)
should ALWAYS do a BIOPSY because MANY CAUSES OF GINGIVAL HYPERPLASIA
treatment = REMOVE EXESS GINGIVA (in most cases)
ID LESION
GINGIVAL HYPERPLASIA
FELINE CHRONIC STOMATITIS…
= definition?
___ IS CRITICAL because this could be ____ _____ _____ or ____
2 diagnostic tools?
treatment options? (3)
= INFLAMMATION of the ORAL MUCOSA due to DYSREGULATED IMMUNE SYSTEM
DIAGNOSIS is CRITICAL because this could be SQUAMOUS CELL CARCINOMA or LYMPHOMA
2 diagnostic tools?
1. BIOPSY
2. RADIOGRAPHS
3 treatment options?
1. PROFESSIONAL DENTAL CLEANING w/ EXTRACTIONS
2. test for FIV/FeLV to see if we can use STEROIDS for INFLAMMATION
3. GCCs, CYCLOSPORINE, ANALGESICS
ID DZ
FELINE CHRONIC STOMATITIS
CANINE ULCERATIVE STOMATITIS…
= definition?
mediated by WHAT cell?
can PROGRESS to ____ & later ____
4 treatment options?
= INFLAMMATION/ULCERATION of the ORAL MUCOSA in areas that TOUCH THE TOOTH
mediated by T-cells
can progress to OSTEOMYELITIS & later NECROSIS
4 treatment options?
1. PROFESSIONAL DENTAL CLEANING & EXTRACTIONS
2. ORAL HOME CARE
3. ANTI-INFLAMMATORY DRUGS
4. CYCLOSPORINE & METRONIDAZOLE
