E2: Oral Sx, jaw fractures and Head/neck Sx Flashcards
What is a curved root tip called? What is it called when there is apical expansion of the root?
Dilaceration
Hypercementation
What is the first step when extracting a single rooted tooth?
Severe epithelial attachment with #11 or 15c blade and enter periodontal space
In which species should you try to always suture an extraction site?
Cats
How are multi-rooted teeth simply (i.e. not surgically) extracted?
Section tooth at furcation of roots
Elevate and remove each root segment individually
What is the first step in surgical tooth extraction?
Creating a buccal mucoperiosteal flap (either envelope or single pedicle flap)
When making a flap for a canine root extraction, where do you begin your incision?
At diastema
What is an important landmark when removing the entire lateral alveolar bone?
Apex of the root
What is the most significant cause of suture failure after closing the gingiva?
Tension
What part of the flap do you suture/secure first?
Corners
How long should a dog not get any crunchy food after a gingival flap placement?
10-14 days
What are causes of oronasal fistulas in dogs?
Dental disease and extractions
Pressure necrosis from foreign body
Complications (surgery, radiation therapy, hyperhermia therapy)
Trauma (electrical cord burns, bites wounds)
Why do you need to monitor a cat for respiratory concerns after an electrical burn?
Pulmonary edema can occur
What technique do you use if you cannot use a two layer technique for closing an acute oronasal fistula?
Single pedicle advancement flap
What type of closure is indicated for congenital defects and chronic oronasal fistulas where the oral mucoperiosteum has healed to the nasal mucosa? From where does the flap get its blood supply?
Double flap technique
Nasal mucosa
What are the salvage techniques for animals with uncorrectable palate defects?
Intraoral appliances: Acrylic device or Nasal Septal buttons
What is the most common location for jaw fractures in cats?
Symphysis and ramus
What is the most important consideration when repairing jaw fractures? What else is important?
Maintaining occlusion
Minimize soft tissue disruption
Put fixation on the tension side of the bone (the dental arcade)
Avoid placing implants through tooth roots
What techniques can you use to avoid having to extubate and re-intubate during jaw repair?
Intramandibular intubation
Pharyngotracheal intubation
Temporary techeostomy
What is indicated to maintain occlusion while a simple, minimally displaced, stable jaw fracture heals?
Tape muzzle
What is the best way to repair a symphuseal separation in cats?
Circummandibular cerclage pass wire through skin and under oral mucosa/gingiva as much as possble
What is the triad of injuries seen with High Rise Syndrome?
- Oral/facial trauma
- Fractures/dislocations of forelimbs
- Thoracic trauma
When is treatment not needed for a hard palate fracture?
When the fracture is closed and occlusion is ok
What is the best technique for mandibular fracture stabilization? What does it require?
Composite Resin Intraoral splint
Adequate tooth surface (enough teeth) to secure material
Why is composit resin preferred to arylic material for making intraoral splints?
Aryclics are exothermic
What is the most common error made when placing external fixators?
Drilling through/hitting the tooth roots
What fixation technique would be best for complex unstable fractures where occlusion has been lost? What is important to communicate to the owner adn ensure the owner is prepared for?
Interarcade wiring
Must provide instructions for emergency removal, and tell them to remove if they suspect the dog may vomit to prevent aspiration
What do you do to prevent stress on your suture site after a rostral partial mandibulectomy?
Place supportive sutures, can drill holes in jaw to help keep in place
Also suture lip higher than before
What are your differentials when the vertical ramus is stuck lateral to the zygomatic arch when the mouth is fully opened?
TMJ luxation
Intermittent open mouth jaw locking
What are the surgical treatment options for intermittent open mouth jaw luxation?
Excise portion of ventral border of zygomatic arch
or
Excise dorsal portion of the ramus
Why is surture reconstruction ineffective for a lower lip avulsion? What can you do to repair this type of avulsion?
Heavy lower lip
Place interdental stent sutures first and then suture mucogingical junction
When performing a lip reconstruction where do you begin suturing? What type of suture pattern do you use?
Lip margin (to prevent step deformity)
Figure-of-Eight suture (for good lip margin apposition)
Which salivary gland is most commonly affected by adenocarcinoma in dogs? Cats?
Dogs: Parotid
Cats: Mandibular
What is the most common salivary gladn disorder?
Mucoceles
How do you treat a dog with severe pain and systemic clinical signs associated with salivary gland enlargement?
Phenobarb
+/- surgical removal of gland
What is the most commonly affected salivery gland with mucoceles?
Sublingual (monostomatic portion)
What lines a salivary mucocele?
Granulation tissue
What breeds are most affected by salivary mucoceles?
GSD
Poodle
What is an accumulation of saliva below the oral mucosa along the side of the tongue called?
Ranula
What is the definitive treatment for mucoceles?
Surgical removal of the involved gland
What is the most common presenting sign in a dog with a pharyngeal mucocele?
Respiratory distress
What approach do you take when removing the sublingual and mandibular salivery glands?
Along mandible
or
Ventral - From mandibular space (no need to cut digastricus muscle)
What vessels must you ID and ligate when removing the mandibular and submandibular salivery glands?
Branches of the greater auricular artery and vein (which enter capsule on dorsomedial aspect)
Why should you trace the duct to the oral mucosa near the sublingual caruncle when removing the salivery gland?
To make sure you got all of the salivary tissue out
What do you do when you cannot tell which sublingual salivary gland is affected by the mucocele?
Remove both
T/F: The mucocele must be removed in addition to the affected salivary gland to prevent recurrence.
FALSE
Don’t need to remove, ti will resolve if the affected gland is removed. You can drain it though.
If there is damage to the parotid duct that has resulted in fistula formation which cannot be repaired surgically, what do you do?
Ligate the ductproximal to the defect that is causing the fistula (gland will eventually atrophy)
