E2: Dentistry and Periodontal disease Flashcards
_______: Toward the midline of the dental arch
_______: Away from midline (caudal)
_______: (contact) surface facing adjoining teeth
_______: betwee the contact surfaces of adjoining teeth
Mesial : Toward the midline of the dental arch
Distal: Away from midline (caudal)
Proximal: (contact) surface facing adjoining teeth
Interproximal: betwee the contact surfaces of adjoining teeth
What is a wider space between teeth called?
Diastema
What are the chewing surfaces of molars called?
Occlusal
_______ means toward the root or away from the crown. _______ means toward the crown.
Apical
Coronal
What is a Chevron Sign?
Widened periodontal ligament spaces in the apical areas of endodontically sound (healthy) teeth
What is the lamina lucida? What is the lamina dura?
Periodontal ligament
Cortical bone
What absorbs shock, supplies nutrients to alveolar bone and cementum as well as providing tactile and proprioceptive info?
Periodontal ligament
What can excessive vitamine D in cat food cayse?
Ossification of the periodontal ligament
What is the anatomical system for numbering teeth? What is the Triadan system?
Anatomic: Teeth labled based on type of tooth (M=molar, I=incision, C=canine) plus a number to the right or left of the letter as a sub or superscript (side of mouth, mandible vs maxilla)
Triadan: each tooth assigned 3-digit number; right maxilla = quadrant 1 = number start with 1, etc. (for deciduous 5, 6, 7, 8 instead of 1, 2,3,4)
What is the dental formula for a dog? Cat?
Dog: 3/3, 1/1, 4/4, 2/3 x2 =42 total
Deciduous: 3/3, 1/1, 3/3 x2= 28 total
Cat: 3/3, 1/1, 3/2, 1/1 x2= 30 total
Deciduous: 3/3, 1/1, 3/2 x2=26 total
Which teeth are considered carnassial in carnivores? What does this mean?
PM 4 on maxilla
M1 on mandible
Largest teeth in the mouth, essential for shearing flesh
What layer of the tooth is the largest?
Dentin
Where do the nerves and vessels enter the pulp cavity?
Apical delta
What is this? What does it overlie?
Incisive papilla
Vomeronasal organ
What does pulp consist of?
Blood vessels
Lymphatics
Nerves
Connective tissue
What quadrant (Triaden system) is the left mandible? Right maxilla?
3
1
What is the rule of 4 and 9?
The 4th tooth is always the canine tooth
The 9th tooth is alwats the first molar
In relation to the deciduous tooth, where do the adult teeth erupt?
Lingual/Palatal
Except maxillary canines which erupt mesial
What breeds are predisposed to crowding? Which tooth is most commonly affected?
Brachycephalics
Upper PM3
Which tooth is often supernumary in Boxers?
Upper PM1
_______ is the joining of two teeth, typically there will be ____ crown(s) and _____ root(s).
_______ is the incomplete splitting of two teeth, typically there will be ____ crown(s) and _____ root(s).
Fusion: 1 crown, 2 roots
Gemination/twinning= 2 crowns, 1 root
T/F: If the deciduous tooth is congenitally absent, the adult tooth will also be missing.
True
What is the Triadan classification of the left maxillary canine?
204
What is the most common malocclusion?
Base narrow canines (Class 1 malocclusion)
What is the difference between a class 1, class 2, and class 3 malocclusion?
Class 1: One or more teeth are not in the normal scissor alignment
Class 2: Mandibular brachygnathism, mandible too short or maxilla too long
Class 3: Mandibular prognathism, mandible too long or maxilla too short
What is the difference between attrition and abrasion?
Attrition = wearing away of crown by tooth against tooth contact
Abrasion= wearing away of crown by abnormal contact with structures other than teeth (E.g. bones, cage bars, balls)
What is the malocclusion called that when the midlines of the top and bottom arcades not to line up?
Wry mouth
What are the treatment options for maloclusions?
Interceptive orthodontics/Orthodontic appliances: incline planers
Exodontics: Removing deciduous or adult teeth
Crown reduction
What relationship should the mandibular and maxillary canines have to each other?
Mandibular canine should be ROSTRAL to Maxillary canine
What is the recommended treatment for impacted teeth? What can form if you do not treat these and what does it look like?
Extraction
Dentigerous cyst- swelling with a blue hue
What types of teeth are most commonly supernumery?
Premolars
Incisors
What are the 2 methods for obtaining dental radiographs? What are the 2 digital imaging systems?
Extraoral or Intraoral
Direct or Indirect (reusable plates)
If you are using dental firm for rads, where is the dimple placed?
Coronally and poining toward the x-ray tube (facing up)
What is the Triadan classification of the left mandibular 4th premolar?
308
What is the SLOB rule?
Re: Dental Rads
Same Lingual Opposite Buccal
When the tube head horizontally and angled 1-20deg, then the root that movies in the same direction as the tube head is lingual/palatal and the one that moves in the opposite direction is buccal
What is the Triadan classification of the right mandibular first molar?
409
What can cause enamel hypoplasia/hypoclassification? What is the treatment?
High fevers
Distemper
Periapical inflammation
Trauma
Endocrine dysfunction early in life
Tx- focal: Restore with composite
Tx-several teeth: Cap to prevent wear
What tool can be used to establish whether there is endodontic exposure?
Dental explorer probe (sharp tip)
What does reparative dentin look like?
Brown and hard
Which teeth are commonly affected by periapical infection?
Carnasial teeth
(upper PM4, lower M1)
What is a draining tract associated with the teeth?
Parulis
What drugs can cause gingival hyperplasia?
Cyclosporin
Ca channel blockers
Anticonvulsants
What is the normal depth of a gingival sulcus?
Cats: 0-1mm
Dogs: 1-3mm
What is the post-op care protocol after a gingivectomy?
Analgesics
Decaffeinated tea, chlorhex or other oral rinse
Which teeth are most commonly fractured?
Upper 4th PMs - 108 and 208
What are the DDx for this? How would you diagnose it?
Gingival hyperplasia
Peripheral odontogenic fibroma
Dx: Rads, marginal excisional biopsy, incisional if suspect malignancy
What are the treatment options for an adult who has a tooth with pulpitis? How can you diagnose this?
Extract or Root canal
Dx: Transilluminate tooth, Rads
What are the cardinal signs of endodontic disease?
Decreased wall size
Lucency around apex
Apical resorption
What is the Triadan classification of the right maxillary middle incisor?
102
What is the main factor for tooth fracture classification
Exposure of the pulp chamber/ endodonic system
What is an abraction?
Type of tooth fracture in which there are cracks in the enamel but there is no loss of structure
Aka Enamel infraction
What is the difference between an uncomplicated an a complicated crown fracture?
Pulp exposure
What is the treatment for a tooth with a fractured root?
Extraction
What are the treatment options for tooth fractures that do not involve pulp exposure?
Indirect pulp capping
Crown restoration
What are the treatment options for tooth fractures that DO involve pulp exposure?
Vital pulpotomy or Root canal
followed by Crown restoration
Or
Extraction
What is indicated by the single red arrow at the crown of the tooth? The multple red arrows at the root? The multple yellow arrows at the root?
Treatment options?
Red arrow: Fractured crown
Red arrows: Apical lucency
Yellow arrows: Apical tooth resorption
Tx: Root canal or extraction
What are the indications for endodontics?
Fractured teeth
Pulpitis
Tooth luxation/avulsion
Crown reduction (Disarming, base narrow canines, soft tissue trauma post-resection)
Certain types of dental caries
What is the main objective for a vital pulpotomy? When is it indicated?
Maintain viable tooth that will continue to mature
Immature tooth, very wide pulp cavity, apex not completely closed
What improves the outcome of a vital pulptomy?
Young animals
Recent pulpal exposure
What is the main objective of a complete root canal?
Maintain functionality of a ‘dead’ tooth
What is the most common oral disease and the most common cause of tooth loss?
Periodontal disease
What are the 2 major requirements for a successful root canal?
Complete removal of pulp contents
Seal apex (prevent bacteria from escaping tooth)
What is the most commonly used canal sealant used for vital pulpotomies?
ProRoot MTA
Less good: Calcium hydroxide powder
What are the 2 indicatons that a vital pulpotomy was successful?
Dentin continuing to thicken
Root canal continuing to get smaller
What is the major disadvantage of doing a root canal to maintain tooth functionality?
Tooth will become dry and brittle and thus more likely to fracture
What does ‘obturation of the root canals’ mean?
Filling the root canal completely
What is the most important thing for long term success following a tooth luxation or removal?
Survival of the periodontal ligament
What should you tell an owner who’s dog has avulsed a tooth and the owner wants to re-seat the tooth?
Keep the tooth moist- milk or saline
What are the 2 steps to repairing a tooth avulsion?
Re-seat tooth (after flushing with saline if dirty) in alveolus and splint (for 4 weeks)
Root canal after tooth has reattached
What characterizes the types of tooth resportion lesions?
Type 1: multifocal or focal radiolucencies, periodontal ligament intact, moderate to severe gingivitis and peridontitis
Type 2: multifocal or focal radiolucencies, disappearance of periodontal ligament with varying degrees, no or minimal evidence of periodontitis
Type 3: Features of both type 1 and type 2 in the same tooth
What types of teeth typically get Type 3 resporptive lesions?
Multi-rooted
For which type of resorptive lesion can you leave the root in after extraction?
Type 2 (will resorb)
What part of the mouth is more commonly affected by gingivostomatitis?
Caudal
What is typically the treatment choice for a cat with gingivostoatitis?
Full mouth extractions
What is the main difference between juvenile-onset periodontitis and gingivostomatitis in cats?
JOP tends to affect the whole mouth, GS has prediliction for caudal mouth
What artery can be affected by eosinophilic grauloma in cats?
Greater palatine artery
What canine disease causes fetid halitosis, ptyalism and anorexia, and appears similar to gingivostomatitis in cats?
Canine ulcerative paradental stomatitits (CUPS)
What are the indications for a glossectomy?
Trauma
Neoplasia
Macroglossia
When do the first deciduous teeth erupt in dogs? Cats? Which teeth?
Dogs: Canines at 3 weeks (incisors at 3-4 weeks)
Cats: Incisors at 2-3 weeks (canines at 3-4 weeks)
What characterizes stage 1 peridontal disease?
Gingivitis
Erythema
Gums bleed when probed
Loss of stipling
Normal sulcus depth
What characterizes stage 2 peridontal disease?
Normal or hyperplastic gums
Minor picket develpment (3-5mm in dogs, 1-2mm in cats)
+/- minimal bone loss (<25%)
Possible mobility of incisors in small dogs and cats
What characterizes stage 3 peridontal disease?
Moderate to deep pocket foration (5-6mm in dogs, 3mm in cats)
Gingival recession or hyperplasia
25-50% bone loss
Abnormal gingival topography
Slight mobility everywhere, moderate mobility of incisors
Periodontal disease is primarily associated with ______.
Plaque
What type of bacteria are present in early periodontal disease? What about with periodontitis?
Gram +
Gram -
T/F: Gingivitis, which progresses to periodontitis if untreated, is reversible.
True
What is feline buccal bone expansion? How is it managed?
Expression of vertical pocket formation filled in with granulation tissue and osteitis
Surgery
What are the objectives of treating periodontal disease?
Remove biofilm
Minimize attachment loss and pocket depth
Maintain adequate attached gingiva (2-3mm)
Bacteria in a biofilm require _____ times more antibiotics to kill them.
1500
What is the most commonly used systemic antibiotic therapy for peridontal disease?
Clindamycin
Why can polishing teeth cause tooth death?
Generates heat, over-polishing can kill the pulp
What type of scaler is recommended?
Ultrasonic
What formulation of chlorhexidine is recommened for oral use?
Chlorhexidine gluconate (0.12%)
What is included in a basic dental cleaning pack (5 things)?
Scaler
Curette
Explorer/probe combo
Dental mirror
Retractor
What instrument is never used below the gingival margin?
Scaler
What is the most important thing for dental instrument maintenance?
Sharpening (preferrably after each use)
Which hand instrument has only one cutting edge and a rounded tip? What is it used for?
Curette
Supra- or subgingival calculus removal and root cleaning
What is the most important thing to know about the type ofn scaler that you have?
Tip function: amplitude, movement, pattern (which surfaces are active)
T/F: When it comes to power scalers, smaller tip motion means less enamel damage.
True
What is the most common error made when using a high speed handpiece?
Too much pressure (too heavy handed)
Why is it important to look under the tongue during a dental, especially in cats?
Location for SCC and foreign body lodging
Which gingival index indicates moderate inflammation, edema and bleeding on probing?
2
What is the purpose of disclosing solution? What is an alternative?
Missed calculus detection
Using air (Calculus appears chalky white when tooth is dried)
How man spots need to be probed per tooth when assessing pockets?
4
What site must you evaluate closely, especially in small dogs, when looking for deep pockets? Where should you check after you have probed here?
Palatal surface of maxillary canines (104, 204)
Check nostril (for blood)
What term is used for the assessment of the extent of pathological lesions? Which is used for quantitative assessment of severity? Which is used as a quantitiative expression of predefined diagnostic criteria?
Stage
Grade
Index
What can result in a pseudopocket?
Gingival hyperplasia
At what periodontal disease stage does mobility become compromised?
Stage 3
What does “F3” exposure indicate?
Significant furcation exposure, can pass probe horizontally through furcation
What can you use to seal the gingival sulcus?
Barrier sealants
Which teeth are most likely to develop resorptive lesions?
Premolars
Which teeth are most commonly affected by caries?
Maxillary M1 and M2
Mandibular M1
At which teeth do oronasal fistulas most common occur?
Maxillary canines
What teeth are most commonly affected by the genetic defect oligodontia?
PMs
