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Human Diseases > HD 8 – Dental Management of patients with musculoskeletal disorders > Flashcards

HD 8 – Dental Management of patients with musculoskeletal disorders Flashcards

1
Q

What is osteogenesis imperfecta?

A

Brittle bone disease

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2
Q

What is the genetics behind having osteogenesis imperfecta?

A

Autosomal dominant/ sporadic (mutation)

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3
Q

What does blue sclera show?

A

Colloidal layer of eyeball shows through sclera due to the impact on collagen formation

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4
Q

How can osteoporosis lead to impaired respiratory function?

A
  • Thoracic spine vertebral bodies become less dense – mechanical collapse
  • Vertebral collapse may lead to chest deformity
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5
Q

Why do people with osteoporosis take bisphosphonates?

A

Alter bone metabolism, impacting osteoclast function

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6
Q

How is a patient on bisphosphonates treated when extractions are needed?

A

If taking IV bisphosphonates – refer for specialist to extract teeth

If taking oral bisphosphonates – can treat in primary care
= Unless bone very unstable, don’t remove as will impact healthy bone deep to the surgery site

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7
Q

What is osteopetrosis?

A

Spongy bit of bone doesn’t exist – all bone is compact (MARROW SPACE DISSAPEARS)

As marrow is absent, less haematopoiesis = ANAEMIA

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8
Q

What could happen post extraction in osteopetrosis case?

A

Possibility of post-extraction osteomyelitis
= Brittle bone, tooth will snap in socket – no room for tooth to move = difficult surgical extraction (refer to hospital)

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9
Q

What are the genetics behind fibrous dysplasia?

A

Monostotic/polyostotic - not inherited

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10
Q

What increases risk of fibrous dysplasia?

A
  • Increased risk of hyperthyroidism

* Diabetic tendency

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11
Q

What is seen in a bone biopsy of fibrous dysplasia?

A

Islands of bone shaped like Chinese letters

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12
Q

What genetics are behind cherubism?

A

Rare = autosomal dominant

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13
Q

What occurs in cherubism?

A
  • Males predominate
  • Large cheek bones
  • Cellular and vascular fibrous tissue with giant cells
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14
Q

Why are blood tests carried out in cherubism?

A

To exclude hyperparathyroidism

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15
Q

What is the treatment of cherubism?

A

Surgery

Males (18)/ females (17) = when stop growing

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16
Q

What does the bone look like in Paget’s disease of the bone?

A
  • Periods of bone deposition/ resorption – end up with reversal lines
  • Mosaic appearance
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17
Q

What are the symptoms of Paget’s disease of the bone?

A
  • Patients may be in cardiac failure – high output cardiac failure
  • Chest deformities
  • Dentures get tighter = bone deposition (or hats don’t fit anymore)
  • Saber tibia – due to mechanical weight on bone modelling in an asymmetric fashion
  • Glass in concrete syndrome – like trying to take teeth out of bone = TEETH (GLASS)/ BONE (CONCRETE); Teeth likely to break (brittle) and bone very tough
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18
Q

Why is OH poor in rheumatoid arthritis?

A

Ulnar deviation (fingers drifting in direction of baby fingers)

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19
Q

Why does dental treatment need to be completed before cytokine inibitor medication is started?

A

Alpha-TNF inhibitors = Affect immune response

20
Q

If extractions are done before radiotherapy treatment, what should occur to aid healing?

A

Cover bone with soft tissue

21
Q

How long after radiotherapy should extractions be avoided for?

A

6 months to 1 year

22
Q

How is osteoradionecrosis treated?

A

Do not treat surgically (i.e., drilling bone) = provide antibiotics instead

23
Q

What steps should be carried out to aid healing if post-radiotherapy extractions take place?

A
  • Minimal trauma (minimise periosteal lifting) – small flaps, for higher perfusion of blood for healing
  • No vasoconstrictor
  • Trim sharp bone edges
  • Close soft tissues accurately
  • Prophylactic antibiotics for 1 month or until sockets heal
24
Q

Why does radiation caries occur? And how is this treated?

A
  • Caused by very bad xerostomia
  • Optimise oral hygiene
  • Use topical fluoride
25
Q

What genetics are behind marfan’s syndrome?

A

Autosomal dominant

26
Q

What lung problems occur in marfan’s syndrome?

A
  • Collapsed lungs = pointy lung tip – more likely for lung to peel away causing pneumothorax
  • Pulmonary cysts leading to spontaneous pneumothorax
27
Q

What heart problems occur in marfan’s syndrome?

A

Aortic and mitral incompetence

28
Q

What spinal problems occur in marfan’s syndrome?

A
  • Kyphosis (A-P spine curvature)

* Scoliosis (lateral curvature)

29
Q

When looking in the mouth of a marfan’s syndrome patient what are you likely to see?

A

High arched palate

30
Q

What heart and blood defects are seen in Ehler’s Danlos syndrome?

A
  • Mitral valve prolapses = FLOPPY MITRAL VALVE
  • Cardiac conduction defects
  • Platelet anomalies – haemostatic function usually ok
31
Q

What are the dental problems encountered in ankylosing spondylitits?

A
  • Decreased mouth opening – intubation/treatment difficulties
  • Question mark posture
  • Spinal deformities may lead to secondary thoracic deformity
32
Q

What heart problmems are seen in ankylosing spondylitits?

A

Aortic valve problems

33
Q

What conditions does Gout increase the risk for?

A
  • Hypertension
  • Ischaemic heart disease
  • Diabetes Mellitus
34
Q

What bone problems are seen in cleidocranial dysostosis?

A

Affects skull, jaws and clavicle

35
Q

What dental problems are seen in cleidocranial dysostosis?

A

Delayed/ non-eruption/ supernumerary teeth

36
Q

How do NSAIDs protect against periodontal disease?

A

Interfere with prostaglandin synthesis

37
Q

What dental problems are associated with COX2 inhibitors?

A

Taste disturbances

Stomatitis

38
Q

What dental problems are associated with penicillamine?

A

Lichenoid reactions

Oral ucleration

39
Q

What type of drug in penicillamine?

A

Anti-rheumatic drug

40
Q

What dental problems are associated with ciclosporin?

A

Gingival overgrowth

41
Q

What drugs should be avoided if taking methotrexate?

A

NSAIDs
Corticosteroids
Penicillin

42
Q

What dental problems are associated with methotrexate?

A

Oral ulceration, probably due to low folic acid

43
Q

What is allopurinol used to treat?

A

Gout

44
Q

What dental problems are associated with allopurinol?

A

Taste disturbance and paraesthesia

45
Q

What is baclofen used to treat/manage?

A

Used as antispasmodic agent – may be used in multiple sclerosis as well as musculoskeletal disorders

46
Q

What dental problems are associated with baclofen?

A

Xerostomia

Human Diseases (17 decks)

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