JVD 2011 deck Flashcards
1
Q
According to “Dental eruption chronology in degus (Octodon degus)” by Jell, Knotek, et al, 50 baby degus were anesthetized 3-4h after birth, at 24h, then daily until day 40, then every 2 d until day 75 to look for eruption time and point of functional occlusion. What is the permanent degu dentition? What type of teeth do they have? was there a deciduous formula?
A
2(I1/1, C0/0, P1/1, M3/3); monophydont, elodont cheek teeth and incisors, octodontids (unilateral and propalinal bilateral chewing; no! They were born with incisors and by 2-3d had PM4.
2
Q
According to “Dental eruption chronology in negus (Octodon negus)” by Jell, Knotek, et al, what were the last teeth to emerge? at what age?
A
3rd molars; maxillary emerged on 38-44 in functional occlusion 48-58d, mandibular 3rd molar emerged on 39-46d and into occlusion on 58-72d
3
Q
According to “Dental eruption chronology in negus (Octodon negus)” by Jell, Knotek, et al, does the rabbit have a deciduous formula? what about hystricomorphic rodents (other than guinea pigs) have monophydont dentition. Was this true of degus?
A
yes: 2 deciduous maxillary incisor teeth, 2 deciduous mandibular incisor teeth, 3 deciduous maxillary and 2 mandibular molar teeth, corresponding deciduous molar teeth are replaced by permanent premolar teeth (are they really deciduous molars or deciduous premolars???); degus were indeed monophydont
4
Q
According to “Nasopharyngeal tooth FB in a dog” by King, Park, et al, what is the structure noted by white arrows? what treatment option was pursued?
A
nasopharyngealFB: right mandibular second premolar tooth; CT revealed the tooth and rhinos copy with vigorous flushing and grabbing with forceps was used to remove the tooth, patient was kept on abx and prednisone, owner did not pursue periodontal surgery/exodontia
5
Q
According to “Oral examination and occlusal equilibration in rodents and lagomorphs” by Legendre, what is the most common cause of overgrown incisors? What is the most common reason rabbits/lagomorphs present to the vet? what is the most common cause of cheek tooth elongation? how is the malocclusion treated?
A
cheek tooth malocclusion leading to secondary overgrown incisors; elongation of cheek teeth forcing mouth open and interfering w mastication; inappropriate diet not sufficient in abrasive forces; fix cheek teeth first (spurs/elongation), then fix incisor teeth, then start proper diet (d/c pellets, soft veggies)
6
Q
According to “Oral examination and occlusal equilibration in rodents and lagomorphs” by Legendre, what is this instrument?
A
oral speculum
7
Q
According to “Oral examination and occlusal equilibration in rodents and lagomorphs” by Legendre, what are these instruments?
A
cheek pouch dilators
8
Q
According to “Oral examination and occlusal equilibration in rodents and lagomorphs” by Legendre, what are these instruments?
A
cutting bur with filing bur in the middle
9
Q
According to “Oral examination and occlusal equilibration in rodents and lagomorphs” by Legendre, what is this instrument?
A
bivalve speculum
10
Q
According to “Oral examination and occlusal equilibration in rodents and lagomorphs” by Legendre, what is noted on this radiograph?
A
Normal occlusion
11
Q
According to “Oral examination and occlusal equilibration in rodents and lagomorphs” by Legendre, what is the adjacent radiograph revealing?
A
Spurs
12
Q
According to “Oral examination and occlusal equilibration in rodents and lagomorphs” by Legendre, what does the adjacent radiograph show in regard to occlusion?
A
elongated cheek teeth (roots)
13
Q
According to “Oral examination and occlusal equilibration in rodents and lagomorphs” by Legendre, both radiographs are normal. What is the difference between C and D?
A
C- normal horizontal occlusal table of a rabbit; D- normal V shaped (30deg angle) of occlusal table in a guinea pig
14
Q
According to “Oral exam results in rescued ferrets: clinical findings” by Erosion, Reiter, Lewis et al, what is the dental formula for a ferret? In the 63 ferrets examined, what was the most common pathology? Second most common?
A
2 (I3/3, C1/1, P3/3, M1/2)=34; most common pathology was malocclusion (most commonly linguoversion of mandibular teeth) 95%; second most common was extrusion of canine teeth at 94% (super eruption)
15
Q
According to “Oral exam results in rescued ferrets: clinical findings” by Erosion, Reiter, Lewis et al, periodontal disease was common in ferrets. How prevalent? What was normal sulcus depth determined to be in 88% of ferrets? How common were tooth fractures? What teeth were most affected?
A
65% had evidence of PD; <0.5mm in 88% of ferrets; not as common as malocclusion, extrusion, or abrasion/attrition at only 32% of ferrets, mostly maxillary canines
16
Q
According to “Oral exam results in rescued ferrets: clinical findings” by Erosion, Reiter, Lewis et al, what was the third most common anomaly in the study population of 63 rescued ferrets? What were the 5 most common anomalies?
A
Abrasion/attrition at 76%; malocclusion at 95%, canine tooth extrusion at 94%, abrasion/attrition 76%, PD 65%, tooth fracture 32%
17
Q
According to “Repair of secondary cleft palate in the dog” by Beckman, why is this von lagenbeck technique modified? How many layer closure is there?
A
not necessarily full thickness, only partial (do not need to elevate and move all periosteum isolating around the major/minor palatine, but can); 2 layer closure SI or SC with nasal and palatal mucosa separated and knots tied inverted (not into oral cavity)
18
Q
According to “Repair of secondary cleft palate in the dog” by Beckman, what surgical technique is being shown here for a secondary palate repair?
A
(modified) von Lagenbeck
19
Q
According to “Repair of secondary cleft palate in the dog” by Beckman, name the structures pointed out by the large and small white arrows that should be carefully avoided during all palatal surgeries? which is more rostral?
A
large white: major palatine a leaving foramina, small white: minor palatine a leaving foramina; major is more rostral (large white arrow)
20
Q
According to “Treatment of a periradicular lesion in an Alpaca (Vicugna pacos)” by Parker, Barakzai et al, a 5y MI alpaca presented with right rostral mandibular swelling. Radiographs, intraoral exam and surgery revealed a unilocular cyst associated with 404. What was the treatment and outcome in this case? what are differentials for the type of cyst removed? Etiology?
A
Extraction of 404 and enucleation w biopsy of cystic lining, 9mo post op radiographs resolution and healed mandible with minor deviation of mandible from cyst; no unerupted tooth (not dentigerous), paradental cyst, odontogenic keratocyst (no keratinized epithelium in cystic lining), lateral periodontal cyst, gingival cyst (not gingival, apical), dental follicle…. the only theoretical one with an inflammatory component might be a paradental cyst or odontogenic cyst (also mostly macrophages, was this inflammatory?)
21
Q
According to “Treatment of a periradicular lesion in an Alpaca (Vicugna pacos)” by Parker, Barakzai et al, what is the adult alpaca (camelid) dental formula? what other diagnostic modality would have been helpful to determine if the cyst was associated with the canine?
A
2(I 1/3, C1/1, PM1-2/1-2, M 3/3); Dental radiographs (intraoral) OR (not mentioned in article) CT
22
Q
According to “Treatment of oral abscesses in rodents and lagomorphs” by Legendre, what are treatment options for these animals? why is debridement so important?
A
Debride thoroughly and marsupialize, complete debridement is ideal but almost impossible; their purulent discharge is often caseous/mucoid and difficult to drain, marsupialization prevents re-epithelialization
23
Q
Abstract: According to “Odontogenic myxoma in an 8y Lab” by Barigye, Dyer et al, how was this tumor described histologically? What IHC stains were used? What did the authors request regarding WHO?
A
low mitotic index, moderate # of spindle, stellate, round cells sparsely distributed in an alcian blue reactive myxomatous matrix; positive for vimentin, negative for cytokeratin and actin; request it be added to WHO list of vet med tumors, prognosis unknown longterm thought to be locally agressive/invasive.
24
Q
Abstract: According to “Clinicopathologic characterization of odontogenic tumors and focal fibrous hyperplasia in dogs: 152 cases (1995-2005), by Fiani, Verstraete et al, what was the most common finding (CAA, POF, FFH) in the study sample? second most common? third? was there an equal representation in males/females? Were there breed associations? age association?
A
most common CAA 45%; POF 37%, FFH 16%; male/female equal representation for CAA and FFH, MN over-represented for POF; Goldens, akitas, cockers, shetland sheepdogs had most CAA, no breed predisposition for FFH or POF; dogs w FFH were older than CAA or POF
25
Abstract: According to "Clinicopathologic characterization of odontogenic tumors and focal fibrous hyperplasia in dogs: 152 cases (1995-2005), by Fiani, Verstraete et al, where were CAA most commonly located? POF and FFH?
CAA most common in rostral mandible; POF/FFH more common rostral maxilla
26
Abstract: According to "Acanthomatous ameloblastoma in dogs treated with intralesional bleomycin" by Kelly, Schaefer, et al, in this retrospective of 6 dogs (1 additional for palliative treatment), how many dogs had complete response within 4 mo from starting treatment? Was local recurrence observed during study period (how long was follow up time)? What were the major adverse effects?
6/7 dogs had complete resolution, 7th palliative dog had 25% shrinkage of tumor; local recurrence was not observed, median follow up time was 842d; major adverse effects included wound formation with bone exposure in 4/7, mild tissue reactions 3/7, local swelling 2/7, local infection 1/7
27
Abstract: According to "Comparison of 2 sampling methods for microbiological evaluation of periodontal disease in cats" by Perez-Salcedo, Herrera et al, what was the aim of the study? Were their findings significant?
Pilot study comparing sampling 10 cats GCF with CTA vs paper points in cats esp anaerobic (Porphyromonas) and other hard to grow bacteria; paper points had statistically significant higher counts of anaerobes, increased frequency detection of most pathogens (and reducing false negatives for P. gulae by 100% compared to 80% of cotton swabs)
28
Abstract: According to "Histologic evaluation of root response to intrusion in mandibular teeth in beagle dogs" by Ramirez-Echave, et al, in 8 beagle dogs intrusive forces of 50, 100, and 200g per tooth were applied to the 2nd, 3rd, 4th mandibular premolars. The teeth were prepared histologically to look for root resorption after 98d. Was there root resorption? Cementum repair? were there differences btwn the amount of force applied? where was the resorption most commonly seen?
yes, all teeth had resorption; cementum repair in 24%; no sig differences btwn groups of applied forces; apices and furcation; no relationship btwn root resorption, position of posterior mandibular teeth in the arch, and amount of intrusive force applied
29
Abstract: According to "Craniomandibular osteopathy w a unique neurological manifestation in a young Akita" by Ratterree et al, the 4mo MI Akita had a life long history of facial swelling, and failure to thrive. He had an enlarged cranium, laxity of many joints, CP deficits, endosteal thickening of femurs/ilium. What was the case outcome?
PE, radsiographs, histo from necropsy were consistent with CMO. Thought was the severe hyper-static lesions caused brainstem compression leading to neurologic deficits
30
Abstract: According to "Tongue entrapment by chew toys in 2 dogs" Rubio, et al, what were the outcome in each of the 2 cases? what should treatment involve?
Case 1: veterinary surgeon removed toy under GA, tongue was vital; Case 2: toy forcefully removed by owner, caused partial necrosis and required partial amputation; eliminate negative pressure inside toy by piercing it or even by insufflation of positive pressure inside the toy and atraumatic manipulation to remove
31
Abstract: According to "The incidence and distribution of peripheral caries in the cheek teeth of horses and its association with diastemata and gingiva recession" by Ramzan, Palmer, the retrospective looked at peripheral caries in cheek teeth in 108 cases retrospectively including 298 diastemata and 445 cheek teeth with peripheral caries. Where were diastemata noted primarily and how frequent were they? Peripheral caries located and how frequent? were diastemata associated w peripheral caries? Was there any association made in this article?
Diastemata in mandibular arcades (80%) with 75% of animals having them; uniform btwn maxillary and mandibular cheek teeth most prevalent in the most caudal three teeth (87%); diastemata and peripheral caries were NOT associated by tooth or patient; however, sig association btwn presence of trapped food within diastemata and gingival recession
32
According to "Alternative extraction techniques in the dog and cat" Beckman, Smith, what was the proposed technique for maxillary canine flaps? Deciduous maxillary canine teeth?
making a mesial release only to an envelope flap; same for deciduous teeth or use H-file to engage dentinal walls and elevate out deciduous teeth; upper fourth premolars mesial release only
33
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, what are the five principles of preparation design? what is meant by retention form? resistance form? what is "taper" defined as? "Convergence angle"?
preservation of tooth structure, retention and resistance, structural durability, marginal integrity, and preservation of periodonium (biologic width); retention form: ability of a restoration to resist forces along long axis; resistance form prevents dislodgment of restoration under occlusal forces directed in an apical or oblique direction; taper= angle between one axial wall of preparation and long axis of the preparation; convergence angle= angle btwn 2 opposing axial walls of a preparation and equals the sum of the taper of 2 opposing axial walls
34
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, what is the previously published ideal CA? what is the limiting average taper? The equation for it?
3 to 14; point at which resistance form is lost, taper lower than this value do not have resistance form; T=1/2arcsin (H/D)
35
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, what is depicted by T, CA?
this is a medial-distal measured die: T is the taper angle while CA is convergence angle
36
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, 32 stone die of maxillary and mandibular teeth were evaluated and long-term follow up for final restorations were received from 31/32 owners. What were the 3 clinical outcomes evaluated? what were the outcomes?
adhesive/cohesive failure, tooth fracture failure, and non-failure (crown intact at time of data collection); restorations that failed via adhesive/cohesive failure had numerically higher CAs (50deg) than those that failed via tooth fracture or did not fail but NOT statistically significant; restorations that failed from tooth fracture had higher mean H/D that those that did not fail or failed from adhesive/cohesive failure, but NOT statistically significant; number of adhesive/coheive failure w a CA that exceeded the CAlim was higher than fracture failures and non-failures but NOT statistically significant
37
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, in regards to association between CA, H/D, and CAlim and clinical outcome, was there any statistical significance? was the overall or mesiodistal CA for any tooth <12deg (ideal CA)?
No! not significant; no! 75% MD were >25 deg and 50/50 split 12-25deg and >25 for overall CA;
38
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, what is the previously published desired taper? is this possible in the canine tooth in a dog? why?
5-7 deg; no!; bc of distal axial wall would require major structural reduction;
39
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, what happens to the force needed to dislodge a restoration as CA increases? why is CA of 12deg or less not achievable?
it decreases, big wide CA (near parallel prep) would require less force to dislodge crown; distal curvature of canine tooth (natural CA btwn facial/lingual is near parallel);
40
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, what is the relationship btwn CA and height of crown prep? why is this counterproductive? what factors influence retention/resistance form that are in operator control?
as crown height increases CA decreases; bc as clinical height decreases achieving a low CA becomes more important to maintain retention/resistance; CA (crown prep), H/D
41
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, for a given base diameter and CA, what happens to retention if height is increased? given a height and diameter, how is CA related to dislodgment resistance?
it increases; CA is inversely proportional to dislodgment resistance; in other words, a tall skinny tooth with narrow CA has high force needed for dislodgment (will not dislodge!), and for a short fat wide based crown with large CA dislodgment is easy (low force required)
42
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, does cement play a role? what was the overall clinical success? failure? what is the relationship between high CA and retention/resistance form? what is true of preparations with a high H/D ratio in regard to retention/resistnace and fracture resistance?
in dislodgment yes! resin-based cement is strongest! zinc oxide weakest; 80% success, 19.5% failure; high CA has better retention/resistance form; have retention and resistance form, but are more likely to clinically fail via fracture
43
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, what is the ideal CA for the canine tooth in a dog per the authors? what happens if CA exceeds 12 deg? if there is more clinical crown available (high H/D) what does this mean clinically for CA? when does achieving low CA become important?
12 deg; usually acceptable for resistance/retention form; dentist can be less concerned with CA as the retention/resistnace form is present and dislodgment is low risk; when H/D decreases
44
According to "Achievable convergence angle and the effect of preparation design on the clinical outcome of full veneer crowns in dogs" Soukup, Snyder, Riehl, what type of cement is always recommended? what happens to risk of tooth fracture as H/D increases? CAlim can be used as a guide for determining necessary CA for retention/resistance according to what formula?
Resin-based; risk of fx increases; CAlim= arcsin(H/D)
45
According to "Bonded sealants for UCF" Theuns, Niemiec, what percent of enamel is inorganic material? what is the proposed theory of sensitivity in dentin? how long does it take a vital tooth to produce tertiary/reparative dentin? how long does a bonded sealant last? what is the goal of sealing UCF teeth? prior to etching/sealing what must be done?
96%; fluid dynamics!; 8 weeks; individual dependent 3-12mo; decrease sensitivity of dentin while tertiary dentin forms, still need recheck rads q6mo to ensure vitality; recontouring w diamond/white stone and/or polishing discs
46
According to "Crown reduction and RCT for malocclusion in a dog" a 6y MN Lab had Class II with Class I/LV 404 causing palatal trauma and bone loss associated w 104, mandibular incisors contacting the palate and Mal I/DV 304. Why did the authors elect RCT for 404 over VPT? What happened to the other teeth?
RCT in an adult dog with closed apex has success rate of 94% vs VPT of 88% (this article had combo of CaOH and MTA), and less follow up according to authors w RCT vs VPT; other teeth mandibular incisors were extracted, 104 extracted, recheck was successful
47
According to "Maxillary osteomyelitis in 2 scottish terrier dogs w chronic ulcerative parental stomatitis" by Boutoille, Hennet, a 10y and 4y MC Scottish terrier were presented for ulcerative stomatitis (necrotizing as well). both had received medical management and biopsies indicated CUPS. What was the treatment plan? what happened at follow up?
Both dogs had complete BW (r/o other causes), repeat biopsy (lymphocytic plasmacytic stomatitis), full mouth radiographs and charting, and debridement of necrotic tissue (rostral maxillectomy) and extraction of periodontally diseased teeth and teeth associated w contact mucositis/necrosis; at 6mo dog #1 and 3mo for dog #2 the had new ulcerative lesions and remaining teeth were extracted from dog #1 and those associated w ulcers were extracted in dog #2, at 8 and 10mo dogs were doing well. Owners were not compliant wit at home oral care; brushing.
48
According to "Maxillary osteomyelitis in 2 scottish terrier dogs w chronic ulcerative parental stomatitis" by Boutoille, Hennet, what are some autoimmune diseases mentioned as differentials of CUPS?
MMP (mucous membrane pemphigoid) makes up 50% of dogs w autoimmune sub epidermal blistering diseases; bullies pemphigoid second most common (vesicles on haired skin), epidermolysis bulls acquisitor w basement membrane specific autoantibodies (great danes), lupus erythematous (systemic and discoid) not vesiculobullous dz can cause ulcerations in mouth, autoimmune dz characterized by sub epithelial cleating
49
According to "Measurement of clinical crown length of incisor and premolar teeth in clinically healthy rabbits" by Schumacher, what type of teeth and dental formula do adult rabbits have? what is the growth rate of incisor teeth/wk? cheek teeth/mo? cheek tooth occlusal surfaces are tilted at an angle of 10deg ventrolaterally to result in what natural malocclusion?
aradicular hypsodont (and elodont, not mentioned); 28 teeth 2(I2/1, C 0/0, P3/2, M3/3) where maxillary I2 is peg tooth; incisors grow 3mm/week; cheek teeth grow 2-3mm/mo; natural anisognathism
50
According to "Measurement of clinical crown length of incisor and premolar teeth in clinically healthy rabbits" by Schumacher, group 1 was made up of 20 M 4-15mo rabbits, group 2 20 M rabbits. what was the normal sulcus depth for cheek teeth? describe the grading system for mandibular cheek teeth in rabbits.
0.5-1mm;
51
According to "Molecular detection of human periodontal pathogens in oral swab specimens from dogs in japan" by Katy, Asai et al, oral swabs from 26 dogs were analyzed for periodontal pathogens and sequenced using PCR. What are the 3 bacteria present in the red complex? P. gulae is similar to P. gingivalis in people. Was it common in the current study? What bacteria were most common?
Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, (Campylobacter rectus is highly virulent); yes!; 81% of dogs (21/26) had T. forsythia, C. rectus, and P. gulae
52
According to "Molecular detection of human periodontal pathogens in oral swab specimens from dogs in japan" by Katy, Asai et al, were dogs w periodontitis older/youngeR? P. gingivalis has a known virulence factor. What is it and does P. gulae have something similar?
older; 41kDa cell surface fimbriae (FimA) major virulence factor for P. gingivalis, while P. gulae also has a fibril protein the same size and antigenicity w 94% homology;
53
Abstract: "Lingual arch bar application for treatment of rostral mandibular body fractures in cats" Cetinkaya, et al, 16 cats with rostral mandibular fracture (10 bilateral, 6 unilateral) caudal to canine teeth had orthodontic wire in a lingual arch bar placed with cirum-mandiular wires passed interdentally. Was it tolerated? Were they eating right away? Time to fracture union and appliance removal was what? Malocclusion occurred in how many cats? Did they require correction?
well tolerated; 11/16 cats w/o a feeding tube were eating in 24h; 28-64d; malocclusion in 5/16 its; only 1 required correction
54
Abstract: According to "Association btwn CKD and severity of PD in dogs" by Glickman, Glickman et al, 164,706 dogs w perio and CKD were age matched to dogs w/o perio. According to the authors, hazard ratios for azotemic CKD increased w severity of PD when adjusting for age, gender, neuter status, breed, weight, # of visits, and dental procedures. Increasing severity of PD was associated w serum Crea >1.4 and BUN >36. What were the problems w this article?
sample size not the issue, but diagnosis of CKD (r/o of pre-renal azotemia), lack of dental radiographs, and charting leads to incorrect staging of PD. Causation and correlation were never proven, just increased hazard ratio.
55
Abstract: According to "Evaluation of composite resin materials for MMF in cats for tx of jaw fx and TMJ luxations" Hoffer, Marretta, et al, 88 cadavers were split into 4 groups: 22 acid etch and composite resin, 22 acid etch, bonding agent, composite resin, 22 partial surface acid etch, flowable composite resin, and 22 complete surface acid etch, flowable composite resin. Was there a difference in load to failure amongst groups? Time for material removal? Complicate rate? What method do the authors recommend?
Load to failure similar for groups 1/2 and 3/4, load to failure was higher for groups 3/4; time for material removal was longer in group 4 (complete etch and composite) but no difference btwn the other 3 groups; complication was highest in group 4 (complete etch and composite) causing crown fx; authors recommend partial coronal surface acid etch before use of flowable composite maintained a strong bone but was easy to remove w low complication rate
56
Abstract: According to "Association of PD w systemic health indices in dogs and systemic response to tx of PD" Rawlinson, Reiter, et al, 38 healthy dogs w clinical signs of PD were included and had CBC/Chem/UA, CRP, microalbuminuria test performed prior to tx for PD and 4 weeks post. What were the findings?
BUN concentration was higher after tx than before; correlation btwn AL and platelet #, Crew concentration, and within-dog difference in CRP; increasing severity of PD was associated w systemic inflammatory variables and renal indices, decrease in CRP concentration after tx correlated w severity of PD, BUN increased after tx for PD.... so who knows... ?
57
According to "Sublingual Reactive Histiocytosis in a dog" Cornegliani, Roccabianca, et al, what are the most common lingual lesions? what is reactive histiocytosis?
54% neoplasia (MM, SCC, HSA, FSA most common malignant), glossitis 33%; proliferation of activated perivascular interstitial dendritic antigen-presenting cells w lymphocytes and neutrophils, in 2 forms cutaneous or systemic;
58
According to "Sublingual Reactive Histiocytosis in a dog" Cornegliani, Roccabianca, et al, an 8y MN Min Pin presented w left sided sublingual mass that was soft but not flocculant and causing dysphagia. What are some Ddx? Initially incisional biopsies and LN aspirates were taken. What were those results?
neoplasia, pyogranuloma, reactive histiocytosis, mycobacteriosis, FB granuloma/abscess, trauma, unlikely rankle given location and firm nature; lymphoid aggregates w plasma cells neutrophils and Mott cells, neg polarized light exam (FB neg), PAS and Ziehl-Neelsen stain neg (no fungi/bacteria), severe granulomatous glossitis, LN reactive for R and non-diagnostic for L
59
According to "Sublingual Reactive Histiocytosis in a dog" Cornegliani, Roccabianca, et al, what other tests performed besides B/I and FNA LN? How did the dog look at 3 weeks post op? What was performed next?
IFA for Leishmania titer was negative, PCR Ehlirchia, Leishmania, Ricketsia all neg, FNA of L LN normal; at 3 weeks bigger ulcerated mass with LN enlargement unchanged; Repeat B/I, tissue samples for PCR Leishmania, FNA/FNI mass, surgical removal of abnormal tissue
60
According to "Sublingual Reactive Histiocytosis in a dog" Cornegliani, Roccabianca, et al, what were the results of the second round of B/I? FNA/FNI of mass? what was the diagnosis?
B/I: histolytic cells, no cytological atypic or mitotic figures seen, neutrophils, plasma cells, angiocentricity and angioinvasion seen w anti-factor VIII stain, PAS, ZN, Giemsa negative, PCV neg for Leishmania,; Cytology: low cellularity w many single histiocytes, chronic non-specific inflammation, IHC was used including primary monoclonal antibodies recognizing leukocyte surface antigens (CD18, CD11b, CD3, CD11c, CD21, CD1a, CD1c) and vimentin stain, histiocytoid cells were vimentin, CD18, CD11c, CD1c positive consistent w dendritic origin; based on histo, IHC, clinical and cytological findings reactive histiocytosis
61
According to "Sublingual Reactive Histiocytosis in a dog" Cornegliani, Roccabianca, et al, what was the treatment of choice? What was the outcome? what IHC was most helpful diagnosing this lesion? why this tx? what other disorders is it used for?
started tetracycline and niacinamide TID; 1mo no change, by 2 mo lesion started regressing and had completely resolved after 4mo (meds tapered and d/c), p remained free of clinical signs 2y follow up; CD1c, CD11c, vimentin by histiocytic cells; often used for other immune-mediated dermatoses and evidence of effective tx for reactive histiocytosis (cutaneous), drug combo has immunomodulatory properties, tetracycline suppresses in vitro antibody production and inhibits complement, PGs, and lipases/collagenases, niacinamide blocks in vivo and in vitro IgE induced histamine release, prevent mast cell degranulation, decrease protease release, and inhibit phosphodiesterase; discoid lupus erythematous, bullies pemphigoid, pemphigus foliaceous, pemphigus erythematous, sterile granuloma/pyogranuloma syndrome
62
According to "Major Glossectomy in the dog" by Buelow, Marretta, define the black, red and blue lines in regard to glossectomy.
Black line: partial glossectomy (rostral to frenulum, free portion of tongue), red line: subtotal (entire free portion with part of the muscles caudal to it), blue line: near total (>75% of the tongue), and total (not shown)
63
According to "Major Glossectomy in the dog" by Buelow, Marretta, what are the most common complications following glossectomy? Can dogs eat/drink after major glossectomies?
ptyalism, dehiscence; yes, by flipping food to the back of their mouth and sucking water out of a bucker (no lapping), BUT recommend e-tube or PEG tube placement following surgery to ensure proper nutrition while dogs are learning to adapt;
64
According to "Major Glossectomy in the dog" by Buelow, Marretta, what structures must be addressed prior to sub total glossectomy? What are the recommended margins for lingual tumors?
if taking the sublingual carbuncles, MUST ligate the mandibular and sublingual salivary ducts, sublingual a/v/n; 2cm;
65
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, please note the anatomical structures shown.
root attaches to basihyoid bones by extrinsic m., body attached to floor by lingual frenulum, apex rostral unattached free portion, median sulcus,
66
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, name the extrinsic muscles of the tongue. What is the innervation of the tongue? what is the blood supply to the tongue? what salivary open on or near sublingual caruncles? what part of the sublingual salivary gland do cats often not have?
Extrinsic: styloglossus, hyoglossus, genioglossus; hypoglossal n (CN12), braches of trigmeninal (lingual n/ CN5), facial n (ventral branch of facial CN7), glossopharyngeal (CN9) taste, pain, heat, sensation; branch off external carotid a (lingual a), arteriovenous anastomoses on dorsal surface for heat dissipation; monostomatic sublingual salivary and mandibular salivary glands; polystomatic often absent in cats
67
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, what is the lyssa and where is it located? what is the best method for incisional biopsy? what are other options? what limits glossectomy in cats? in a case of 5 dogs, successful outcome following major glossectomies were noted. How were the dogs fed post op? how long did it take to eat/drink on their own?
lyssa acts as a stretch receptor for the apex of the tongue, rod-shaped composed of skeletal m. and fat surrounded by thick fibrous capsule; punch biopsy (best sample); can use needle core biopsy, FNA, FNI, or marginal excision (avoid necrotic centers), CO2 lasers; their ability to groom; 4/5 dogs had a PEG tube for up to 3 weeks at which time they were all eating on their own; dog w/o PEG tube was eating 24h post op; 4/5 dogs learned to drink water by sucking out of a bucket 1 dog had to be syringe fed water the remainder of its life
68
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, what is the lesion depicted here? Best tx?
Ranula; debridement, marsupialization of mucocele and removal of associated salivary glands (sublingual and mandibular)
69
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, what is depicted in the image? What is the best treatment?
plant FB (burdock) causing generalized glossitis; NSAIDs/pain meds and removal of visible plant material
70
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, in a cat what is the lesion depicted? Treatment? Does this occur in dogs?
Eosinophilic granuloma complex; corticosteroids; yes, eosinophilic granulomas in dogs esp Huskeys and Cavaliers
71
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, what is this lesion? how is it treated?
vasculopathy; pentoxyfylline +/- tetracycline and niacinamide if immune mediated skin dz
72
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, what is this lesion? Tx?
MM lingual; surgical resection +/- chemo for mets
73
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, what is the lesion depicted here? Tx?
SCC; surgery +/- radiation therapy (says not affective in the article, but this is untrue), mentions piroxicam (?)
74
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, what is this lesion? Tx?
papilloma; spontaneously regresses, can use cryosurgery, resection, steroids, etc
75
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, what is this lesion in a cat w upper respiratory signs? Tx?
Likely FCV (maybe FHV); recommend supportive care and anti-virals
76
According to "Lingual lesions in the dog and cat: recognition, diagnosis, treatment" by Buelow, Marretta, et al, what is this lesion? Tx?
electrical cord burn; let necrosis declare itself 2 days to 3 weeks then debride necrotic tissue, closure, pain meds, in acute phase can use abx, pain meds, sucralfate slurry
77
According to "Interceptive extraction of a persistent deciduous incisor tooth in a young horse" what is interceptive orthodontics? In this case, 703/803 were still present despite 303/403 also being present in the oral cavity. What was the treatment of choice? Why? The outcome?
extraction of deciduous tooth allows adult tooth to drift into correct position, prevents malocclusion; extraction of 703/803 to allow proper alignment of 303/403 and prevent malocclusion; outcome in 6mo was resolution of starting malocclusion
78
According to "Essential considerations for equine oral examination, dx, tx" by Menzies, Lewis, Reiter et al, what is depicted in the image?
short arrows: pulp exposure; arrowheads: abnormal pulp horns; long arrows: cement hypoplasia; concave arrows: hypercementosis
79
According to "Essential considerations for equine oral examination, dx, tx" by Menzies, Lewis, Reiter et al, what pathology is 109?
dysplastic roots
80
According to "Essential considerations for equine oral examination, dx, tx" by Menzies, Lewis, Reiter et al, what is depicted by the black arrowheads?
periapical lucency associated with 108, black arrow is endodontic file
81
According to "Essential considerations for equine oral examination, dx, tx" by Menzies, Lewis, Reiter et al, which pulp horn is being affected by the tissue shown w black arrow in tooth 209?
4
82
According to "Comparison of radiography and CT to identify changes in the skulls of four rabbits w dental disease" by Caelenberg, Gielen et al, what was the difference between radiographs and CT? Was it clinically significant?
all rabbits had overgrown cheek teeth w some primary pathology of cheek teeth leading to a sequelae of incisor malocclusion and abscessation leading to facial deformity, the only noted abnormality seen on CT and NOT rads was fragmented reserve crown in case #2 and swelling at the left arches zygomaticus in case #4, but RADS picked up general demineralization in case #3 that CT did NOT detect;
83
According to "Comparison of radiography and CT to identify changes in the skulls of four rabbits w dental disease" by Caelenberg, Gielen et al, know all of these structures.
Yup.
84
According to "Comparison of radiography and CT to identify changes in the skulls of four rabbits w dental disease" by Caelenberg, Gielen et al, know all of these structures.
yup
85
According to "Comparison of radiography and CT to identify changes in the skulls of four rabbits w dental disease" by Caelenberg, Gielen et al, know all of these structures
yup
86
According to "Comparison of radiography and CT to identify changes in the skulls of four rabbits w dental disease" by Caelenberg, Gielen et al, know all of these structures on CT
Yup
87
According to "Comparison of radiography and CT to identify changes in the skulls of four rabbits w dental disease" by Caelenberg, Gielen et al, know all of these structures on CT
Ok
88
According to "Area of desensitization following mental nerve block in dogs" by Krug, Losey, what are complications of nerve blocks listed? 7 mixed breed dogs had nerve blocks w bupivacaine in 1 mental n. after 30-40min desensitization was tested w hemostats at mucocunatenous junction, curette at mucogingival junction (rostral), and application of pressure to canine tooth for thermal testing w astringent. how many dogs had evidence of contrast enhancing block in the mandibular canal following mental block? what were the results?
focal trauma, systemic rxn to agent, focal tissue necrosis from rxn, spread of infectious dz, dissemination of neoplastic cells, blocking the tongue w inferior alveolar block; 100%; desensitization of mucogingival junction at canine, thermal desensitization of canine, and only 1 dog had any desensitization at mucocutaneous junction (caudal lip)
89
According to "Comparison of radiography and CT to identify changes in the skulls of four rabbits w dental disease" by Caelenberg, Gielen et al, where was the block most consistent at desensitizing? what are reasons listed for lack of anesthesia from the middle mental block?
PM2-PM4, soft tissues were not dependably blocked; collateral and redundant innervation from nearby branches of trigeminal n., fibers from contralateral mandibular n. overlap rostrally to a degree, CN V and VII have anastomoses, somatic sensation can be maintained after transection of sensory root of CN V, must achieve 6mm of n. fibers to achieve anesthesia (3 nodes of Ranvier or 1.8mm internodal distance), mylohyoid n is small n from mandibular or inferior alveolar n moving rostral (provides moths to diagstricurs and anastomoses w ventral buccal br of CN VII to provide cutaneous innervations to ventral lip/cheek),
90
According to "Comparison of radiography and CT to identify changes in the skulls of four rabbits w dental disease" by Caelenberg, Gielen et al, what n. fibers transmit thermal perception? where is the highest n. density of the tooth?
primarily C fibers; apical region of PDL, periosteum also highly innervated w nociceptive receptors
91
Abstract: According to "An anatomical study to evaluate the risk of pulsar exposure during mechanical widening of equine cheek teeth diastemata and 'bit seating'" by bettiol, dixon, 30 horse skulls were used to assess the location of pulp horns inerproximally for knowledge regarding diastema widening. What did they find?
4/5th pulp horns were closer to inter proximal surfaces than the remaining pulp horns, a small portion of pulp horns are only 1.3mm from inter proximal surface and 1.6mm beneath occlusal surface, puts them at risk for pulsar exposure and thermal injury; pulps closer to inter proximal space and occlusal surface w increase age
92
Abstract: According to "Repulsion of maxillary and mandibular cheek teeth in standing horses" by Coomer, Fowke, McKane, 12 horses and 6 ponies had failed oral extraction attempt of maxillary/mandibular cheek teeth. Retropulsion was initiated and alveoli packed post op. What was the post op outcome?
10 horses (59%) had resolution of nasal discharge after 1 tx; 41% of extractions required follow up medical or surgical tx to resolve signs (6/12 maxillary sinusitis, 1/5 persistent mandibular drainage), standing retropulsion is an option fo extraction when oral approach fails, chronic sinusitis increased the risk of postextraction surgical tx for sinusitis
93
Abstract: According to "Equine paranasal sinus dz: A long term study of 200 cases (1997-2009): Tx and long-term results of tx" by Dixon, Parkin, et al, 200 cases were treated for varying degrees of sinusitis. what were the different types of sinusitis? what were the tx? which had the best prognosis? what was the conclusion?
subacute primary sinusitis 52, chronic primary sinusitis 37, dental sinusitis 40, sinus cyst 26, traumatic 13, dental related oromaxillary fistula 8, sinus neoplasia 10, mycotic sinus 7, ethmoid hematoma 7; sinoscopic lavage, sinusotomy, removal of intrasinus inspissated pus; best prognosis was removal of cyst, most others had excellent follow up after 1 tx (dental extractions if failed intraorally followed by retropulsion did well); conservative tx and management was best choice w small maxillary site for sinus flap suitable for most cases in adult horses
94
Abstract: According to "Disease prevalence in geriatric horses in the UK: Veterinary clinical assessment of 200 cases" by Ireland, Cleff, McGowan et al, horses >15y 200 had records reviewed for overall health/pathology. What were the dental findings? Prevalence?
95.4% of horses had dental abnormalities; cheek teeth diastemata, excessive wear/cupped out teeth and focal overgrowths most frequently identified conditions
95
Abstract: According to "Extraction of cheek teeth using a lateral buccotomy approach in 114 horses (1999-2009)" by O'Neill, Boussawus, et al, what percent had short term complications (<2mo)? what were other complications? how many horses had persistent sinusitis following sx due to dental remnants? what was the longterm outcome?
31% (primarily wound dehiscence); temporary, permanent facial n paralysis, myositis and oroantral fisulta; 2, 1 from packing material in the sinus, and 2 of unknown cause; 92% of horses returned to previous work >2mo after sx w/o complications
96
Abstract: According to "Extraction of Fractured Cheek teeth under oral endoscopic guidance in standing horses" by Ramzan, Dallas, et al, 30 horses w fractured cheek teeth had 31 fx teeth removed. what was the most common type of fx? what were the second and third most common? how often was extraction under endoscopic guidance successful? what was the age of the horses in the surgical failure group?
midline sagittal fx 42%; buccal/palatal 32%; transverse or multiple 16%; 87%; median 7y (5-8y) younger than surgical success group
97
Abstract: According to "Investigation of sensitivity and specificity of radiological signs for diagnosis of periapical infection of equine cheek teeth" by Townsend, Hawkes et al, 41 apically infected cheek teeth and 41 control teeth were reviewed by 3 clinicians for presence of 12 predetermined radiographic signs of cheek tooth apical infection. What were the results of sensitivity/specificity in regard to apical infection? periapical sclerosis, clubbing of 1-2 roots, degree of clubbing and periapical halo formation?
76%/90%; 73-90%; 61-63%; severity of periapical sclerosis and extensive periapical halo were strongly associated w cheek tooth apical infection
98
Abstract: According to "Osteoclast progenitors from cats w and w/o TR respond differently to 1,25-deihydroxyvitamin D and IL-6" by Booji-Vrieling, Vries, et al, peripheral blood mononuclear cells from cats w and w/o TR were tested for osteoclast precursors at 7 and 14d. What affect on osteoclasts in cats w and w/o TR did IL-6 and Vit D have?
more osteoclasts formed from TR on bone slices in presence of M-CSF/RANKL w Vit D; Cats w TR when culture on bone are sensitive to Vit D whereas cats w/o TR are more sensitive to Il-6 suggesting osteoclast precursors from cats w and w/o TR respond differently to osteoclast stimulating factors
99
Abstract: According to "Oral masses in 2 cats" Bock, Hach et al, what tumor type did both cats have despite different clinical and histologic presentations?
amyloid producing odontogenic tumor (APOT) really probably FIOTs.... ?
100
Abstract: According to "Osteoma of the oral and maxillofacial regions in cats: 7 cases (1999-2009)" by Fiani, Arzi, et al, 7 cats w oral or maxillofacial osteoma or both were reviewed. Clinical signs present in 5 cats. 3 cats euthanized, 2 w surgical excision, 2 w debunking. What was the long term follow up?
>1y following surgery all 4 cats treated were alive. Owners reported good QOL.
101
Abstract: According to "Tx of oral SCC w accelerated radiation therapy and concomitant carboplatin in cats" by Fiedel, Lyons, et al, 31 cases of oral SCC, 14 fractions of 3.5Gy were given w 9d period in addition to carboplatin at 90-100mg/m2 on day 1 and day 4.5. What was MST? Which tumor sites had the best MST?
overall 319d; tonsil and cheek tumor responded best to therapy w long term MST of 724d, continued survival in 4 cats
102
According to "Unilateral mandibular hyperostosis in a cat" by Niemiec, a 9y DSH MC w left mandibular bony proliferation was biopsied as bony proliferation. Oral exam revealed PP of 309, occlusal trauma from 208, and a few other teeth w PD. What was the treatment plan? What was the outcome? what other modality could have been performed to r/o primary lesion elsewhere?
XSS 309, 208, other diseased teeth, 208 to alleviate occlusal trauma, debulk bony proliferation, rebiopsy; 5mo later no bony recurrence, doing great; CXR
103
According to "Guided Tissue regeneration for infra bony pocket tx in dogs" by Gingerich, Stepaniuk, what # walled defect is most favorable? Is GTR regeneration or repair? what is the purpose of a membrane? what types of membranes are there?
3 walled (palatal maxillary canines); regeneration, will provide new bone and cementum formation; prevent epithelial down growth into pocket while awaiting bony formation; synthetic reservable, synthetic non-resorbable, natural biodegradable
104
According to "Guided Tissue regeneration for infra bony pocket tx in dogs" by Gingerich, Stepaniuk, what is the only membrane labeled for use in dogs? what are the benefits to using a graft in addition to a membrane? what are the different types of grafts?
freeze-dried demineralized cortical bone allograft (natural biodegradable), exclusion of non-osteogenic tissues and formation of new bone; while it is not necessary, may increase osteoconduction, osteoinduction, osteogenesis, clot stabilization, and structural support for membrane; autograft, isograft, allograft, xenograft, alloplastic graft
105
According to "Guided Tissue regeneration for infra bony pocket tx in dogs" by Gingerich, Stepaniuk, synthetic alloplast bioglass particulate graft and allograft of freeze dried cancellous bone chips and demineralized bone matrix. What are the benefits of each? when do the authors recommend performing GTR?
bioglass is cheaper, provides osteoconduction (scaffolding) and no histologic reports, while allograft is osteogenic (source of cells), has BMPs (osteoinductive) as well as osteoconduction; not at time of dental cleaning, but after 2 weeks of at home oral care and healing of any other necessary extractions/root planing.
106
According to "Guided Tissue regeneration for infra bony pocket tx in dogs" by Gingerich, Stepaniuk, following open root planing and lavage, perio-mix is made how? how many mm beyond the defect is the membrane trimmed? a sling suture is placed around the tooth attached to the membrane then closure using what pattern? how often is recheck necessary?
either rehydration w sterile saline or patent's blood for 5 min; 2mm following rehydration by saline for 5 min; horizontal mattresses; oral abx and soft food 2-3 weeks then recheck, recheck rads in 6 mo
107
According to "Effectiveness of a Vegetable dental chew on periodontal disease parameters in toy breed dogs" by Clarke, Kelman, Perkins, 2 groups of dogs (8 in each) were acclimated to a diet for 7 days, then to a veggie dental chew or not for 7 days, then had their teeth cleaned ultrasonically. They were placed in 2 separate groups for 28d when scoring of strategic teeth was performed. What were the significant findings? the groups were switched and they were again scored at 56d. Was there an issue with scoring?
11.2% reduction in gingivitis; 37% reduction in plaque; 70% reduction in calculus, no sig change in halitosis; Each dog was its own control, scoring was only analyzed at day 26
108
According to "Comparison of shear bonding strength for 2 different etching systems in canine and human dentin" by Kimberlin, Brown, do dogs or humans have thicker enamel? what were the 4 groups separated into (dog/human teeth)? what group had the strongest shear bond strength? Reportedly which has stronger bond strength, fifth generation or seventh generation?
humans; etch and rinse in canine teeth, self-etching in canines, etch and rinse in human molars, self-etching in human molars 15 each; human w self-etch method, then human etch/rinse, then canine self etch, then canine etch and rinse; fifth, which is why this study is bunk
109
According to "Comparison of shear bonding strength for 2 different etching systems in canine and human dentin" by Kimberlin, Brown, the article recaps dentinal tubules sizes superficial and deep between small/large breed dogs and humans. Which has the greater diameter? density? did the current study show more adhesive or cohesive failure?
Deep always larger diameter small breed
110
According to "Canine periodontal disease control using a clindamycin hydrochloride gel" Johnston, Alur, et al, 48 dogs separated into control group (cleaning only, 16) and cleaning with clindamycin 2% gel (32 dogs) were only included if healthy and PP >3 but <6mm (stage 2), Teeth were cleaned and gel applied on day 0, PE with oral eval on day 14 and repeat anesthetized exam on day 90 with scoring. What were the findings? Were they significant? what was the amount of PP reduction?
19% pocket reduction, 16% gingivitis index reduction, and reduction in # of bleeding sites by 64% in clindoral group, there was a NOT significant decrease in suppurating sites by 93% at day 90; significant >0.5mm in clindoral group vs <0.2mm reduction in control group;
111
According to "Canine periodontal disease control using a clindamycin hydrochloride gel" Johnston, Alur, et al, what were the two most prevalent bacteria culture at 14 and 90d? what are benefits of clindoral?
Fusobacterium and Treponema; gelation (solution to gel transition), mucoadhesive properties, physical barrier to bacterial migration, sustained erosion of matrix over 7-10d, ease of use, biocompatible, bioresorptive, nontoxic, control PP bacterial burden at day 14 and day 90;
112
According to "Bisphosphonate related osteonecrosis of the jaws: a review" by Stepaniuk, what regulates bone metabolism? what is the goal of bisphosphonates? what is the overall half-life of bisphosphonate in dogs?
RANK (on osteoclast precursor cells), RANKL (on osteoblasts), OPG (osteoblasts, decoy receptor binding RANKL preventing activation of RANK); inhibit osteoclasts (bone resorption) but not impeding osteoblasts (bone deposition); half-life 1-2h, but can recirculate as bone is remodeled, overall half-life of 3y;
113
According to "Bisphosphonate related osteonecrosis of the jaws: a review" by Stepaniuk, what hormones are involved in bone metabolism?
https://s3.amazonaws.com/classconnection/387/flashcards/16477387/png/screen_shot_2018-11-27_at_91021_am-1675600DD7774758562.png
114
According to "Bisphosphonate related osteonecrosis of the jaws: a review" by Stepaniuk, what are some negative side effects of bisphosphonates in people? in vet med? why is the maxillofacial region susceptible to ONJ?
diarrhea/GI upset, esophagitis/ulceration, renal insufficiency, A-fib, electrolyte disturbances (hypocalcemia, hypophosphatemia, hypomagnesemia), acute phase protein reaction, MS pain; high turnover of bone, dental infections and maxillofacial radiation may already lead to necrosis of the jaw, when bone dies and becomes necrotic, osteoclasts remove dead bone tissue, loss of osteoclastic activity results in increased accumulation of necrotic bone (nothing to remove it);
115
According to "Bisphosphonate related osteonecrosis of the jaws: a review" by Stepaniuk, define BRONJ. What are predisposing factors? co-factors? what is the most potent bisphosphonate?
area of exposed bone in maxillofacial region does not heal within 8 weeks after identification in p receiving bisphosphates but no radiation therapy; in humans: long-term corticosteroid use, chemo drugs, dental disease, oral surgery; co-factors in humans: poor oral hygiene and DM; zoledronate;
116
According to "Bisphosphonate related osteonecrosis of the jaws: a review" by Stepaniuk, what is the best treatment of BRONJ?
prevention, treaty diseased teeth and use great oral hygiene prior to initiating therapy and no concurrent corticosteroids;
117
According to "Acquired myasthenia gravis associated w oral sarcoma in a dog" by Stepaniuk, Legendre, Watson, what is the difference between congenital and acquired MG? This case report of a 7mo MI Mastiff presented for oral bleeding and pelvic limb weakness. The initial assumption was a herniated disc, but following oral exam for suspected oral mass the thoughts were somewhat different. What did they find? why were CXR taken? What did they find?
congenital: very rare, no autoantibody toward AChR just low # of AChR, acquired can be paraneoplastic and is associated with autoantibody to AChR; large lobulated gingival mass with missing 204 extending to 209 and palatal with displacement of 206; CXR were taken bc of episode of vomiting/regurge; found initially interstitial pattern for suspected aspiration pneumonia, but 2 days later when taken again megaesophagus no mets;
118
According to "Acquired myasthenia gravis associated w oral sarcoma in a dog" by Stepaniuk, Legendre, Watson, what tests were performed? was there improvement after starting pyridostigmine? once the dog was ambulating what tests were performed? what were the test results?
Suspected MG, ran acetylcholine receptor antibody test, TT4, FT4 and started pyridostigmine presumptively; YES! within 8h; anesthetized oral radiographs and exam, incisional biopsy and histopathology as well as L mandibular LN removal and histo, bony lysis of maxilla and turbinates noted (aggressive oral tumor): T4 normal, FT4 high (not hypothyroid), CXR megaesophagus, dental rads, no bone, displacement and resorption of teeth, unerupted 204, biopsy high grade destructive sarcoma (FSA or non productive OSA, never mentions undifferentiated sarcoma), reactive LN, AChR 3.15 (high positive serum titer)
119
According to "Acquired myasthenia gravis associated w oral sarcoma in a dog" by Stepaniuk, Legendre, Watson, owners elected humane euthanasia. what percent of maxillofacial neoplasms w metastatic dz are identified in the mandibular LN? what other tests could have been run? what are the most common signs of MG? how does pyridostigmine work?
54.5% (M. Smith paper); U/A, EMG, muscle biopsy (can get false negative 7-10d post corticosteroids on AChR antibody test), +/- MRI/CSF to r/o other neurologic diseases (author doesn't mention), edrophonium test; paper dependent numbers but usually generalized or appendicular weakness w or w/o megaesophagus; competitive inhibition of acetylcholinesterase by slow binding and degradation of pyridostigmine allows for longer time Ach in synapse;
120
Abstract: According to "Comparison of 2 sampling methods for microbiological evaluation of PD in cats" by Perez-Salcedo et al, Vet Micro 2011, cat GCF was sampled subgingivally via paper point vs cotton swab over gingiva margin in 10 cats. What was the outcome? Was it significant?
total anaerobic counts in paper point samples had higher counts than cotton swabs, statistically significant; paper points increased frequency detection of most pathogens and reduced false negatives for P. gulae (100% w paper points vs 80% cotton swabs); higher anaerobes and more frequent putative PD pathogens w paper points in cats
121
Abstract: According to "Molecular identification of bacteria associated w PD" by Riggio, Lennon et al, Vet Micro 2011, swabs from gingival margin 3 dogs w gingivitis, 3 healthy controls, and 3 subgingival plaque w periodontitis underwent bacterial culture, 16S rRNA gene sequencing (culture-independent). What bacteria were found in each method?
culture: 12.5% in normal group were uncultured bacteria, Bacteroides heparinolyticus/Pasteurella dogmatis 10% gingivitis, and 19.4% Actinomyces canis PD; rRNA sequencing: 31% Pseudomonas sp normal, P. cangingivalis 16.1% gingivitis, and Desulfomicrobium orale 12% periodontitis; uncultured species normal 13%, gingivitis 2%, perio 11%; possible novel species 38% normal, 38% gingivitis, 35% periodontitis;
122
Abstract: According to "Relevance of FCG, FIV, FelV, FHV, Bartonella henslae in cats w FCGS" Belgard et al, 2010, 52 cats w FCGS and 50 healthy control age-matched cats were tested for FCG RNA, FHV DNA, B. henslae DNA, Fell antigen, FCV, B. henslae and FIV antibodies. What were the significant findingS? Were they consistent w other papers published around the same time?
FCV RNA was significantly more common in cats w FCGS 53.8% than controls (14%)and a significant difference btwn FCV antibodies in cats w FCGS (78.8%) vs 58% controls; no other statistical difference for other infectious agents was noted; Similar to Dowers paper and others being published at the same time
123
Abstract: According to "Inflammation and wound healing in cats with chronic gingivitis/stomatitis after extraction of all premolars and molars were not affected by feeding of 2 diets with different omega-6/omega-3 polyunsaturated fatty acid ratios" Corbee, Booij-Vrieling et al, following extraction, cat food w omega-6: omega-3 10:1 reduces inflammation in FCGS cats and accelerates soft tissue healing compared to diet w omega6:3 40:1. Double blinded study in 2 groups of 7 cats measured plasma cholesterol esters and inflammatory cytokines. What were the findings?
diet w 10:1 lowered PGD(2), PGE(2) and LTB(4) plasma levels significantly compared to diet with 40:1, however feeding either diet to cats w FCGS 4 weeks after caudal mouth extractions did not alter degree of inflammation or wound healing. 10:1 chicken fat; 40:1 fish oil/safflower oil
124
Abstract: According to "Safety and efficacy of a xenogeneic DNA vaccine encoding for human tyrosinase as adjunctive tx for oral MM in dogs following surgical excision of primary tumor" by Grosenbaugh et al, AJVR 2011, 111 dogs with Stage 2/3 MM (58 received vaccine, 53 controls), 4 injections following local surgical control. Surviving dogs received boosters q6mo following vaccine. What was the outcome? Was it statistically significant? what were acute local reactions?
survival time until death attributable to MM was determined to be significantly improved for dogs that received vaccine compared to controls, however, MST could not be determined for vaccines as <50% died of MM before end of observation period. Vaccine may be safe but efficacious is still debatable. Poor prognostic indicator for MM is mets at time of diagnosis. Big diff btwn stage 2 and 3; acute wheal or hematoma, mild pain an injection site, bruising.
125
Abstract: According to "Bone remodeling surrounding primary teeth in skeletally immature dogs" by Randall, et al, bone secants from maxilla and mandible in primary molar region of 5mo beagle dogs were reviewed histologically. Bony remodeling surrounding primary teeth was compared to existing data from bone surrounding permanent teeth. what were the findings? were they significant?
mandibular bone remodeling was significantly higher than maxillary bone; bony remodeling of alveolar bone of primary teeth was NOT significantly different from that of bone supporting permanent teeth
126
Abstract: According to "A study of sub-occlusal secondary dentine thickness in overgrown equine cheek teeth" Mashall, Dixon, et al, cheek tooth subocclusal secondary dentin in regard to overgrowth was studied to determine appropriate crown reduction. What were the findings?
NO significant difference between secondary dentin sub occlusal thickness in overgrown cheek teeth and controls of mandibular cheek teeth, but they WERE significantly thicker in maxillary compared to control; 49% of pulps in overgrown teeth had less sub occlusal secondary dentin overlying them than control teeth; height of dental overgrowth was greater than subocclusal secondary dentin over one or more pulp horns in 14/24 overgrown teeth; recommendation is to reduce overgrown teeth gradually to prevent pulp exposure and thermal injury (only a few mm at a time)
