JVD 2014 deck Flashcards

Question

According to "Assessment of apical periodontitis in dogs and humans: a review" by Menzies, Reiter, Lewis, what is the minimum amount of mineralized bone loss required for focal bone resorption to be detected radiographically in humans? what about demineralization required to detect generalized osteoporosis?

Answer 1

7.1%; 30-50% (same # for dogs)

Answer 2

cortical bone (cancellous bone does not accurately reflect bone loss)

Answer 3

in dogs: recommended 3-6 mo recheck rads then annually for remainder of life (we say 5y); in humans: recheck rads 3, 6, 12, 24mo and as long as 4y to see resolution of chronic periodontitis radiographically within 1y

Answer 4

it affected tooth is asymptomatic despite rad changes, decrease in radiographic lucency, no change in size of periapical radiolucency, initial increase in size of periapical radiolucency but no further change, resolve in radiographic abnormalities

Answer 5

plaque induced demineralization of teeth caused by bacteria fermenting carbohydrates leading to production of acids that demineralize enamel and dentin. Dentin is invaded by bacteria undermining enamel which collapses leading to cavitation. They are dark brown/black in appearance. More common in humans than dogs. In dogs typically distal mandibular M1 occlusal surface, maxillary molar teeth, and prominent developmental grooves (really maxillary M1 occlusal surface and mandibular M1 distal occlusal surface)

Answer 6

if no near pulp exposure, R/C; if near pulp exposure, blushing within 2mm of pulp indirect pulp capping should be performed; if pulp exposure RCT or XSS; if advanced enough and loss of architecture of tooth necessary recommend extraction

Answer 7

first outline form (or outer circumference of cavity) and resistance form (shape and placement of cavity walls); slight undermining is performed to provide retention form (restoration withstand dislodgment during mastication); final cavity prep to remove unsupported enamel and decayed dentin (usually w margin trimmers or curette)

Answer 8

5.3%; much less common than humans, dogs eat a diet with fewer fermentable carbs and have a higher salivary pH that buffer acid by products from bacteria, also conical shaped teeth w wider interdental spacing for less food impaction and retention.

Answer 9

pits and fissures on the occlusal surface; NO!

Answer 10

8 dogs had it applied everyday, 7 dogs missed 1-2 days, 3 failed to have it applied for 7d, and 2 had missed for 4-5d; gingivitis and plaque score were not statistically significant, calculus score was statistically significant forming less on the side receiving wax by 22.1%

Answer 11

salivary proteins adhere to enamel serving as basis for biofilm formation; EPS is produced by bacteria matrix forming majority of nonmicroblal biofilm matrix;

Answer 12

maintain structure, notably viscoelastic properties and resistance to shear; GTF or glucose transferases metabolize dietary sucrose to glucose and fructose incorporating free glucose to glucans that then facilitate bacterial adhesion to biofilm

Answer 13

calcium phosphate and carbonate, food particles, organic matter

Answer 14

anthroquinones inhibit GTFs, are non-bactericidal but reduce EPS and disrupt bacterial cell membrane integrity; therefore it is the barrier not the antimicrobial effect (in theory) that helps reduce calculus formation... ?

Answer 15

bc just had professional dental cleaning one month prior to re-evaluation.

Answer 16

dimensions of preparation, performances of restoration material, luting cement

Answer 17

preservation of tooth structure, retention and resistance forms, structural durability, marginal integrity, preservation of periodontist (and more importantly biologic width, not mentioned)

Answer 18

5/32 unsuccessful (15.6%) and 27/32 successful; of those 5, 2/5 were fractures 40% and 3/5 were adhesive/cohesive failure 60%; successful mean SA 1.9, adhesive/cohesive failure SA 1.23, fracture 1.7

Answer 19

NOT statistically significant between SA and success; however, positive correlation btwn increasing surface area and likelihood of clinical success with a trend toward success w higher mean SA

Answer 20

SA changes with changes in underlying variables (ht, diameter, CA); when surface area increases, force needed to unseat a crown increases

Answer 21

decrease effective CA to improve resistance and retention form by increasing preparation surface area and allowing increased micro mechanical bonds

Answer 22

both had previous caudal maxillectomy 2-3y prior

Answer 23

lateral surgical approach to remove the parotid gland salivary duct and superficial parotidectomy; facial neuropraxia (in this case manifested as loss of palpaberal for 2 weeks then resolved)

Answer 24

confluence fo 2-3 parotid gland salivary duct branches, curves rostrally over masseter m. passes buccinator m and ends on parotid papilla intraorally

Answer 25

results in stenosis and secondary atrophy of the salivary gland. In this case probably underwent atrophy then became productive again leading to dilation secondary to ductal stenosis

Answer 26

duct ligation, duct anastomosis, marsupialization, resection of parotid salivary gland. This case no marsupialization bc dilation caudal to oral cavity and cutaneous marsupialization not thought to be advantageous

Answer 27

Dull cutting edges will reflect light and sharp edges do not; acrylic test sticks can be used: dull edge will slide across, sharp will stick

Answer 28

natural stone or synthetic; most common is fine grit Arkansas stone (natural, white), synthetic medium grit India stone also common, fine and medium grit ceramic stones; Arkansas and India stones require lubricant; Ceramic stones do NOT but can use a small ant of water

Answer 29

2 edges; 1 edge for Gracey; Gracey is offset at an angle to engage the surface better

Answer 30

Left: scaler (triangular on cross section, 2 cutting edges), middle: universal curette (rounded on cross, 2 cutting edges), right: Gracey (offset, 1 cutting edge, rounded on cross)

Answer 31

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Answer 32

remove rounded or worn edges with light pressure to the bevel (restore effective edge); intersection of 2 surfaces that form an acute angle ideally 70deg btwn bevel and face of the instrument for most perio hand instruments

Answer 33

when'd needed to remove any burrs that may be created during sharpening process

Answer 34

110deg angle; no, there are 2 settings as the terminal shank and the face maintain a set relationship one for Gracey and one for universals must be set

Answer 35

a rounded sharpening stone by hand; maintaining 45deg angle to the face of the instrument

Answer 36

ideally never, unless to smooth gouges bc it will weaken the instrument and change the contour of the face

Answer 37

the bevel on the back of the instrument... NOT the face as this may weaken the instrument and change the face's contour; periosteal elevators, wing tip elevators, locators, osteotomes

Answer 38

at a 20deg angle

Answer 39

uneruppted/impacted tooth or deciduous tooth (humans); primarily first premolar teeth esp mandible and maxillary canines esp in toy/small breeds and brachycephalic; large fluctuant swelling, missing tooth on oral exam

Answer 40

significant bone destruction w possible secondary pathologic fx, external root resorption, pulpitis of adjacent teeth due to lytic, expansile nature of dz

Answer 41

perio-endo lesion, blunt trauma, systemic bacterial infection, internal root resorption, hyperthermia (thermal injury)

Answer 42

in human lit possibility of malignant transformation to ameloblastoma

Answer 43

no evidence of cyst recurrence or RCT failure, but increased bony opacity at apex of 304 (RCT tooth): condensing osteitis, cementoma, idiopathic osteosclerosis, possibly normal maturation and incorporation of bone graft material

Answer 44

central cavity, epithelial lining, fibrous capsule

Answer 45

odontogenic cyst, derived from odontogenic epithelium: cyst encapsulates the crown of the unerupted tooth and is attached to the CEJ, dentigerous cysts are typically asymptomatic but can become large expansile and destructive to surrounding bone

Answer 46

fluid accumulates btwn either the REE and enamel or in between layers of enamel organ, fluid accumulation occurs as a result of pressure exerted by an erupting tooth on an impacted follicle which obstructs venous outflow leading to rapid transudative mvmt across capillary wall. This increased hydrostatic pressure separates follicle from crown.

Answer 47

necrotic deciduous teeth; bc most dentigerous cysts associated with underuppted mandibular first premolar with no deciduous precursor

Answer 48

new literature speculates that MMPs (2 and 9) might be a growth mechanism of odontogenic cysts, PTHrP involved in many physiological processes including endochondral bone growth and tooth eruption associated with osteoclastogenesis, PTHrP induces RANKL production by osteoblasts, PTHrP noted in fibrous and cystic lining, OPN expression pattern in epithelial lining of dentigerous cysts might be an early indicator of neoplastic transformation of dentigerous cyst into a unicystic ameloblastoma, IHC association with RANK, RANKL, OPG

Answer 49

ameloblastoma and SCC

Answer 50

endothelium lined vascular spaces, inflammatory infiltration (PMNs, lymphocytes, plasma cells), ulceration, and granulation tissue/proliferating fibroblasts

Answer 51

unilateral or bilateral (50/50) soft tissue oral mass located on the caudovestibular aspect of the mandibular first molar tooth; 2 had no noted clinical signs at home, 6 had changes to eating, head tilt, pawing at mouth, etc.

Answer 52

red, focal raised, ulcerated, friable, lobulated, easily hemorrhagic with fibrinous membrane. 50% had upper fourth premolar traumatically contacting lesion

Answer 53

1 class 3 malocclusion, 1 TMJ laxity. ALL had TR and perio

Answer 54

ALL; 1 case had RTR of mandibular first molar

Answer 55

not associated with mass, but there was some alveolar bone loss associated with mandibular first molar or upper fourth premolar

Answer 56

granulation tissue with variable degrees of edema and neutrophilic inflammation; thin layer of fibrin and necrotic debris, surface bacterial colonization, lymphoplasmacytic inflammation and disruption of native collagen,

Answer 57

surgical excision with 100% recurrence rate; surgical excision and odontoplasty of upper fourth premolar with 25% recurrence rate, surgical excision and surgical extraction of maxillary fourth premolar tooth with 10% recurrence rate requiring ext of mandibular first molar

Answer 58

Yes, 5% of pregnant women due to hormonal influence, higher female:male ratio; In this study males were overrepresented (5/8, 62.5%) but not statistically significant

Answer 59

surgical excision of soft tissues and elimination of etiologic irritants; cryosurgery, chemical and electric cauterization, laser surgery (CO2), intralesional injections (corticosteroids)

Answer 60

extracting maxillary fourth premolar and mandibular first molar teeth and surgical excision with histopath

Answer 61

bupivacaine hydrochloride is a long-lasting amide-type local anesthetic used in regional and local blocks. half life of 2.7h in adults and 8.1h in human neonates. Lasts 6-8h in nerve block and 5-7h in local infiltration in adult humans. Goal was to determine duration of greater palatine and nasopalatine nerve blocks in infant pigs.

Answer 62

~1-3h; at least 1h, with a great deal of individual variation

Answer 63

first blocks C fibers (pain), then Adelta fibers (pain/temperature) and last Abeta fibers (mechanoreceptors); as it begins to be metabolized, sensation returns in the reverse order

Answer 64

unlike gastronomy and jejunostomy tubes e-tubes are fast, easy and inexpensive to place; nasoesophageal feeding tubes are easy to place but require liquid diet and are only appropriate for short term (<10d); e-tubes can be placed in anticipation w maxillofacial trauma under GA, can be maintained up to 8 weeks with home care.

Answer 65

esophageal disease or dysfunction (megaesophagus, esophagitis, stricture), uncontrolled vomiting, reduced gag reflex, reduced consciousness, acute vomiting can lead to aspiration pneumonia or displacement of tube; complications include infection at stomatitis site, gastroesophageal reflux (if tube placed across lower sphincter), removal of tube by patient, kinking or obstruction of tube, esophageal perforation, swelling of head and neck due to tight wrap

Answer 66

12-14 French; 14-18French

Answer 67

dorsal to jugular v, ventral to wing of atlas, between ramus and thoracic inlet, measuring end of tube to 7-9th rib space to ensure catheter placed in distal esophagus and not across lower esophageal sphincter

Answer 68

a VPS impression of a prepared tooth has fine ground high strength gypsum dental stone poured into the impression on a vibrator to prevent air bubbles. it is allowed to set and removed from the impression. The cast has a base made with gypsum. A die is cut from the cast for the prepped tooth. A sealant is placed on the die to act as the cement space, it is light cured and liquid separating agent is brushed onto surface to provide ability to manually remove dental wax pattern from die. Die is dipped in heated dental wax. pattern wax is applied to the die to create a replica of the prepared tooth. A wax sure is attached to act as a channel for molten metal to create prosthetic. The wax pattern, sprue, and sprue base are placed inside casting ring, Gypsum based investment material poured inside casting ring and in pressure container to remove air bubbles, and placed in oven for 1h to burn out the wax. Once the wax melts a space will remain where the sprue and wax pattern were. To cast the meta alloy (typically nickel-based) centrifuged crucible ring and molten metal is cast by centrifugal force into space previously occupied by wax.The investment is removed, allowed to cool and removed from the underlying metal prosthesis that is then micro blasted inside and outside to remove gypsum and created rougher bonding surface for cement. Sprue is cut away and calipers used to check thickness of restoration and rubber disk used to smooth outside.

Answer 69

Cast is positive reproduction ; die represents a single tooth replicated

Answer 70

surfactant spray is applied to render the surface of the impression material hydrophilic (as it is hydrophobic). This enhances the ability of gypsum product to flow into the impression and capture maximum detail.

Answer 71

synthetic waxes and natural waxes from minerals, plants, or animals; pigments are added for color. Can have added gums, fats, fatty acids, oils, and various resins.

Answer 72

Steps in lost waxing technique 1. Impression 2. Stone model and base 3. Die cut from model 4. Sealer on die and wax applied 4. Wax sprue and wax base attached and place in casting ring and filed with gypsum and pressure and fired 5. Investment casting made from burned out wax with centrifuge then cooled and casting removed sandblast inside cut of sprue and polish to shape

Answer 73

casting waxes used to create model of dental restoration such as a crown. Lost wax technique uses a wax pattern to define a space within a stone like material. Wax is eliminated by melting or burning pattern and casting the space into metal. Wax should not leave a residue!

Answer 74

cheaper, strength, biocompatibility, resistance to wear

Answer 75

Once the investment is cooled and the metal has solidified, the investment material is broken away from the casting=divesting.

Answer 76

ultrafine aluminum oxide particles

Answer 77

benign neoplasm composed of histologically normal mature compact and/or trabecular bone, a continuously slow growing mass, does not cause clinical signs unless it interferes w adjacent structures or causes occlusal dysfunction. Does not cause bone destruction or lysis, no documentation of malignant transformation.

Answer 78

in humans either peripheral (periosteum), central (endosteum) or extraskeletal (soft tissue usually muscle).

Answer 79

proliferative mass with bone opacity, distinct rounded margins and no radiographic signs of bone lysis

Answer 80

2 cases: proliferative, well differentiated mineralized bone; 3 had proliferation of mature trabecular and/or compact bone; 1 had neo-ossification of mature trabecular bone. No mitotic activity or atypic of proliferative bone in all cases.

Answer 81

B/E no recurrence, minimal progression for surgically debulked osteomas

Answer 82

Gardner's syndrome (familial adenomatous polyposis), associated with multiple maxillofacial osteomas, supernumerary and impacted teeth, cutaneous sebaceous cysts, colorectal polyposis ; peripheral most common maxillofacial and most common in paranasal sinuses

Answer 83

Central in jaws is most common in mandible and can lead to displacement of dentition or expansion of bone due to endosteal location; peripheral osteoma are pedunculated or sessile and attached to cortical plate of bone of origin

Answer 84

exostosis has limited growth and is associated with inflammation or trauma-- osteoma is continuously slow growing. Exostosis is a hamartoma; Best way to dx is based on clinical (timeline, continuous growth), radiographic (bone density with no lysis), and histopathological findings (normal or increased bone)

Answer 85

chondroma, odontoma, condensing osteitis, osteosclerosis, peripheral odontogenic fibroma, osteochrondroma, exostosis of jaw, fracture callus

Answer 86

complete surgical excision, however in non-resectable cases marginal excision periodically may be warranted given the slow growing nature. Periodic monitoring for recurrence warranted.

Answer 87

her history of dermatomyositis or ischemic dermatopathy, palatal ulceration, immune-mediated disease, and stomatitis, it was suspected that she would have poor wound healing and if failure of the surgery site occurred it would be more challenging to place an obturator.

Answer 88

It has flanges on either side of a flexible post to allow placement within the nasal and oral cavities, it is soft and pliable making it easier to place, it can be easily removed cleaned and replaced, it can be easily trimmed to fit a defect, easy to make adjustments with a new obturator if the defect progresses over time, and can help prevent post op complications like oral ulceration and fluid reflux; appropriate for 5-25mm defects (comes up to 30mm in diameter), the larger the defect the less likely obturation is a good option.

Answer 89

authors suspect secondary to incomplete obturation of the palatal defect, underlying autoimmune disease, or irreversible mucosal changes prior to surgery

Answer 90

severe periodontal disease, prior extractions, trauma (gun-shot, FB penetration, electrocution injury, high-rise syndrome), pressure necrosis, neoplasia, complications following maxillectomy, radiation necrosis

Answer 91

well vascularized flaps that are tension free; dehiscence

Answer 92

acrylic, stainless steel, resins, and silicone

Answer 93

long-term management w/o intervention, operculectomies to remove overlying gingiva; operculectomies preferred instead of monitoring to prevent formation of dentigerous cyst

Answer 94

pre-eruptive phase where dental germ moves to keep in position in the developing jaw as the jaw grows, pre-functional phase once the crown has formed and root formation begins, functional phase that begins once the tooth comes into occlusion and ends when the tooth is ankylosed or lost (or animal dies); pre-functional often divided into intraosseous and supra osseous phase

Answer 95

start when tooth crown is complete and starts with an intraosseous phase where the tooth moves through the bone (osteoblasts and osteoclasts which in turn appear to depend on presence of dental follicle an ectomesenchymal CT and surrounds enamel organ)

Answer 96

soft tissue connection btwn enamel organ and oral epithelium

Answer 97

dental follicle

Answer 98

describe the moment of appearance of any part of the cusp crown through the gingiva

Answer 99

following supra osseous eruption and mucosal penetration junctional epithelium forms on tooth surface with the attachment deriving from enamel epithelia

Answer 100

impaction is prevention of eruption of a tooth due to a physical barrier; primary retention is cessation of eruption of a normally placed and developed tooth germ before emergency for which no physical barrier can be identified

Answer 101

when only apparent physical barrier to eruption is gingiva; can be attributed to persistent operculum or touch fibrous gingival covering over the crown of a tooth

Answer 102

may actually be due to retention from failure of eruption mechanism rather than impactions from physical barrier (gingiva)

Answer 103

hereditary (usually generalized), local (trauma, or inflammation) or systemic factors (viruses or fever affecting several or all teeth)

Answer 104

chewing fish as opposed to normal habit of swallowing fish whole, reluctant to take smaller fish. Her history of TR abscess led them to think this was the cause.

Answer 105

oral exam revealed chronic perio (GR), rads revealed sub gingival TR of premolars (2, only 1 extracted)

Answer 106

domestic cat, dog, horse, man; external TR (suspect inflammatory)

Answer 107

GE- pseudo pocketing leading to PD dz; CCF- endodontic dz; cyclosporin causing GH (cannot lower dose or take dog off, so GV indicated)

Answer 108

apically repositioned flap using a reverse (internal bevel) at the gingival margin and scalloped contour of gingiva splitting IP; the full thickness (buccal and lingual) flaps were then elevated, thinned w a diamond bur, and scalloped margins to fit in the IP.

Answer 109

2mm Free gingival margin to establish biologic width; should be 1-2mm free gingival margin in dog, attached gingiva begins at root cementum connected by junctional epithelium and more apically by CT attachment to alveolar bone

Answer 110

gingival sulcus, junctional epithelium, CT attachment

Answer 111

cyclosporin: drug induced; unknown MOA but believed to involve alterations of calcium influx in gingival tissue; GE in the IP begins as early as 20wks after cyclosporine therapy

Answer 112

re-establish normal gingival levels and contour by reducing pseudo pockets and restoring biological width

Answer 113

On Day 29: plaque mean was lower in small and medium/large breed groups w gel (test group) than that of negative and positive controls; gingival segment plaque was also lower in test group; gingivitis score was lower in test groups

Answer 114

Brushing daily with toothpaste or gel will improve decreased plaque and gingival health more than just brushing alone

Answer 115

interferes with the biofilm: disrupts matrix via sponins in yucca (papain); breaks bond that anchor biofilm cells to glycoprotein of pellicle (papain); antimicrobial activity in cinnamon and clove (proantocyanidins, eugenol); pomegranate extract antibacterial; redox-active scavengers or anti-oxidants; fluid viscosity maintains gel in oral cavity (xanthin gum)

Answer 116

cementum contains 65% inorganic material (45-50% hydroxyapatite crystals) with 1200-1500 H; dentin contains 70% inorganic material (66-70% hydroxyapatite crystals) with 1600-1800H; enamel is 96-98% inorganic (96% hydroxyapatite crystals) with 2400-2600H

Answer 117

Older horses had hypercementosis (26y), younger horses had no signs of hypercementosis (20y) 7/16

Answer 118

103, 203, 303, 403 (lateral incisors); on axial and lingual aspects of roots

Answer 119

PDL space of incisors was always homogenous and distinct but often widened; no evidence of resorption except in 1 horse on the root apically that was minimal

Answer 120

more acute incisor angle

Answer 121

tooth resorption or PD dz; yes!

Answer 122

around roots of teeth with severe wear, likely related to focal occlusal stress; occlusal pressure/stress as it is greater in horses with an acute, low angle btwn maxillary and mandibular incisor teeth where angle is most acute (103, 203, 303, 403) and roots of short worn cheek teeth

Answer 123

tooth resorption

Answer 124

vehicular trauma, falls (hi-rise syndrome), bite wounds, etc; intraoral rads/CT, meticulous debridement/lavage, repair of mandibular fractures/symphyseal separation and fractured teeth

Answer 125

dehiscence and infection; tension free closure with large labial mucosal flaps +/- intraosseous repair techniques with meticulous debridement/lavage and delicate tissue handling; also very important to restore the gingival collar!

Answer 126

11.3-23%; luxation of TMJ, fracture of TMJ, and mandibular fx, also impingement of coronoid process on zygomatic arch, mechanical obstruction (including teeth), neuropathy

Answer 127

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Answer 128

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Answer 129

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Answer 130

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Answer 131

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Answer 132

right rostrodorsal TMJ luxation

Answer 133

synchondrosis; coronoid process, condylar process (part of TMJ), angular process

Answer 134

lateral aspect is thickened which limits lateral mvmt of the condyle, also sometimes a caudal capsular reinforcement may be present

Answer 135

masseter, temporalis, medial and lateral pterygoids, rostral and caudal bellies of the digastricus m.; all innervated by mandibular branch of trigeminal n except caudal belly of digastricus which is innervated by the facial n.; masseter, pterygoid and temporalis hold condylar process in mandibular fossa

Answer 136

rostrodorsal luxation of condylar process w or w/o fracture or symphyseal separation; presents w open mouth jaw dropped and pushed rostral locating away from the side of TMJ luxation (unless bilateral); least common is unilateral caudal luxation.

Answer 137

fracture of the condylar process causing collapse of the mandibles towards the side of the fracture resulting in asymmetrical malocclusion

Answer 138

away from luxation in rostrodorsal; toward for caudal or mandibular fracture

Answer 139

Uncommon in cats; shallow manidbualr condylar head and fossa, hypo plastic articular eminences, hypo plastic or thickened retroarticular processes, joint capsule laxity; chrondrodyrstrophic and brachycephalics (Bassets, CKCS, boxers, few cases in cats but including Persians)

Answer 140

partial osteotomy of the ventral margin of the zygomatic arch, coronoidectomy, partial resection of the rostral portion of the zygomatic arch in combo with partial resection of coronoid process, temporary MMF, imbrication-plication of the lateral aspect of the TMJ capsule, mandibular condylectomy

Answer 141

symphysiotomy,symphysiectomy and intermandibualr arthrodesis have been successful in the cat

Answer 142

maxillary canine tooth deviation causing tooth-to-tooth contact secondary to perio/TR; tx w extraction

Answer 143

acute onset of dropped jaw, difficulty pretending, messy eating, drooling, mouth hangs passively, can be closed but flops back open, NON-PAINFUL; Dogs carrying heavy objects, traumatic TMJ luxation after days waiting for reduction

Answer 144

dogs 2-3 weeks; cats 15-20d for movement, 32d for resolution

Answer 145

caries are disease of calcified tissues of the tooth resulting from demineralization of cementum, dentin and enamel esp premolar teeth; sugars ferment in cracks of infundibula leading to formation of lactic acid and dropped pH (thanks bacteria) causing demineralization making teeth appear black; staphylococcal bacteria (S. devriesei) produce polysaccharides from sucrose increasing their adhesion to tooth surface; maxillary molar teeth in old horses and mandibular molar teeth in young horses overall >7y

Answer 146

10 excluded due to trauma during ext, 41 study #, shape, diameter of foramina, 18 to examine internal apical characteristics

Answer 147

all had apical delta; 85.44% had <50micrometer foramina; 234.19micrometers was largest

Answer 148

no statistical diff in diameters of apical foramina in 3 types of teeth; significant diff in number of apical foramina in 3 types of teeth; mandibular first molar had greatest # of foramina over maxillary fourth premolar and canine teeth

Answer 149

formed a sieved plug that closed the root canal at the apical level separating pulp from periodontium. Extension of cementum into root canal (typically centered sometimes lateralized) had a height of 2mm

Answer 150

apical surface generally smooth but can have protrusions; similar # of apical foramina btwn studies, morphology of apical region varies, entire apical delta is included in the CEMENTUM

Answer 151

non-allergenic, create minimal or no tissue reaction, absorb at a dependable and predictable rate regardless of inflammation or infection, little or no capillary action, good suture strength, suture size ratio, handling characteristics, know security, tensile strength until wound strength is achieved, non-carcinogenic, inexpensive, and unfavorable to bacterial growth; there is no one perfect ideal suture

Answer 152

natural (biologic) or synthetic; natural: collagen, cotton, silk, linen; monofilament vs multifilament; capillary action; antibacterial coatings

Answer 153

synthetic suture cause less tissue drag and have more predictable absorption rates; monofilaments harbor less bacteria, have less tissue drag, have less capillarity, and create less tissue reaction, multifilament are easier to handle; capillary action means suture acts as a wick and can harbor infection; absorbable sutures lose tensile strength and degrade in less than 60d, non-absorbable sutures maintain tensile strength for >60d but must be removed in 7-21d

Answer 154

PDS, monofilament, paradioxanone polymer, tensile strength greater than nonabsrobable nylon or polypropylene, degraded by hydrolysis, much slower rate, 42% tensile loss at 28d, longest absorption of absorbable sutures at 182d, excellent for wounds w slow healing (bone tunnels, etc), also available in antibacterial form

Answer 155

natural, absorbable multifilmanet, from submucosa of sheep and serosa of cow sm intestines, polished to create smoother surface, has a lot of capillary action; gut degrades rapidly in 24-48h, chromic gut has chromium salts and glycerol added to increase longevity, absorption via collagenolysis and proteolytic enzyme digestion and absorption; chromic gut causes significant tissue reaction; premature absorption if infected tissue, low pH, or protein depleted patients, loses knot security when wet, allergic run in cats

Answer 156

Polyglycolic acid=PGA, polyglactin 910=PG 910, synthetic absorbable, multifilament, PGA has coating of N-laurin and L-lysine over polyglycolic acid, PG 910 from glycol and lactic acids in 9:1 ratio, both degrade by hydrolysis (like all absorbable synthetic sutures); predictable absorption times, decreased tissue drag, degrade slower than chromic gut, no detectable tensile strength by 28d, easy to handle, stable in contaminated wounds, minimal tissue run, remain at surface for 4-6 weeks accumulating debris; PG910 comes w coating of triclosan: inhibits S. aureus, S. epidermis, MRSA, MRSE

Answer 157

synthetic absorbable monofilament, lowest amoutn of tissue drag of all suture, most pliable of all absorbable sutures, decreased memory, smooth surface, highest initial tensile strength and strength:size ratio; loses tensile strength rapidly (50% at 7d, all gone by 21d), completely absorbed by 120d, absorption is predictable even in infected tissue, minimal tissue reaction, low bacterial adherence, comes w coating of triclosan (antibacterial)

Answer 158

non absorbable (must be removed), monofilament that are good for long-term support and function w minimal tissue reaction but may be uncomfortable

Answer 159

strength: suture must be as strong as tissue it apposes, size: smallest size possible but still achieve strength; handling and care: protect from heat/moisture, do not autoclave or place in hot water/saline; tissue factors: loss of suture strength shoudl be proportional to gain in wound strength, minimum time for gingival flaps in 5d; healing: all sutures to increase risk of wound infections, over tightening causes strangulation; mechanics: durability and knot security with good handling

Answer 160

swaged (less tissue drag/damage), 3/8 or 1/2 circles (1/4 for ocular sx), reverse cutting (taper good for viscera, cutting good for denser tissues but can cut tissue), smoother inner surface of reverse cutting (rec for all gingiva/mucosa)

Answer 161

SI is standard allows for precise apposition, good under tension, simple continuous an option to minimize suture material and decrease time, close in single layer double for max/mandibulectomy, place sutures 2-3mm from flap margin (too close and suture tears through tissue when knot tied), place 2-3mm apart,

Answer 162

blood clot forms in 24h, space btwn flap and tooth or bone decreases in size and epithelium forms and migrades during first 3d, epithelial attachment begins and granulation tissue forms at 7d, immature collagen fibers appear at 2 weeks, flap fully epithelialized by 1 mo. Dehiscence is biggest complication caused by excessive tension or lack of bony support.

Answer 163

No one knows in vet med; mandibular P1s more common in brachycephalics; lack of eruptive forces

Answer 164

Complete enucleation of the cyst and ext of associated teeth 301-307 with histopath; more conservative option of extracting 305-307, remove cystic lining that was visualized and marsupialize the remaining cyst to drain 301-304 (requires at home oral care of daily rinsing and follow up); OR extraction of 305-307 and removal of accessible cyst lining w/o marsupialization in hopes that removing the inciting cause of the cyst (305) the remainder of the cystic lining would regress, requires follow up +/- second surgery if cyst recurs; The last option is what the owners selected

Answer 165

No! the theory is that removing the focal point of cystic development, expansion and bone destruction would resolve the cyst, which it did.

Answer 166

proliferation of remaining enamel organ or REE that surrounds crown during odontogenesis, cyst forms around crown of tooth attaching to CEJ; absence of tooth +/- intraoral fluctuant swelling with radiographic changes can be unilocular or multilocular; non-keratinized, stratified squamous epithelium that is 4-6 cell layers thick

Answer 167

to rule out odontogenic keratocysts, infection, or malignant transformation to ameloblastoma or carcinoma

Answer 168

complete surgical excision; recurrence of cyst, continued bony destruction, malignant transformation

Answer 169

Broca 1869 stage of development of tooth when abnormal growth began; Malassez 1885 updated this; Pierre Fauchard 1746

Answer 170

Bland-Sutton 1888 nature of cells from which tumor arose; Gabell, James, Payne 1914 3 main groups of odontomas

Answer 171

1946 excluded cysts, odontoma was restricted to tumors w epithelial and mesenchymal components

Answer 172

Pinborg and Clausen 1958 presence of absence of inductive effects, epithelial and mesodermal

Answer 173

Gorlin 1961-63, minor changes to include domestic animals

Answer 174

WHO humans 1966-71, headed by Pinborg; animals 1976, mentioned WHO of humans

Answer 175

Dubielzig 1979-1982, classified epulides

Answer 176

Walsh 1987, first attempt to classify odontogenic tumors in animals

Answer 177

1987, POF, basal cell carcinoma, and ameloblastoma

Answer 178

Head 1990, changes to classification, removal of POFs bc not arise from odontogenic structures

Answer 179

Poulet 1992, inclusion of odontogenic cysts as classifiable group separate from odontogenic tumors

Answer 180

Verstrate 1992, epulides using human classification

Answer 181

added epithelial cysts and tumors and other lesions related to bone

Answer 182

ameloblastoma and CAA occur in companion animals and are distinct

Answer 183

6 main groups of lesions: odontogenic epithelium w or w/o odontogenic mesenchyme, tumors composed primarily of odontogenic ectomesechyme, tumors derived from tissued of PDL, cysts of jaw, tumor-like lesions

Answer 184

Svendenius and Warfinge 2010 classify canine oral lesions in comparison to human; Boehm et al 2011 can use 2005 WHO classification for animals most of the time, but cannot accommodate complex odontogenic tumors in animals

Answer 185

WHO 2005 human-- does not accommodate for tumors specific to domestic animals but can be used and is more efficient; 2003 WHO domestic animals does not accommodate rare or complex odontogenic tumors in animals

Answer 186

adamantinoma=hard, old term used to reference ameloblastoma; acanthomatous refers to prickle cells that resemble those of epidermal stratum spinous; epulis, tumor-like lesion of gingiva

Answer 187

potentially cystic tumor (NOT a CAA), rare and consists of odontogenic epithelium w features of embryonic enamel organ

Answer 188

CAA can arise peripherally or intraosseously where AA in humans is only intraosseous

Answer 189

solid/multicystic ameloblastoma (w histo variants), unicystic ameloblastoma, desmoplastic ameloblastoma, peripheral ameloblastoma

Answer 190

follicular (most common in humans) and plexiform; rare, but has been seen in cats, more plexiform; central ameloblastoma, classical intraosseous ameloblastoma, conventional ameloblastoma.

Answer 191

CEOT is human term, most described in vet literature may truly be more APOT, amyloid may be derived from ameloblasts. Very confusing, CEOT, APOT and keratinizing ameloblastoma are all similar and may still be variants of a single entity

Answer 192

Similar in morphology of epithelium, quality of fibrous storm, presence/absence of calcified hard tissue; POF has odontogenic epithelium! distinctive finely fibrillar, vascular storm, stellate fibroblasts resembling PDL=POF; osseous metaplasia of collagenous matrix (ossifying POF)

Answer 193

gingiva or mucosa characterized by exuberant CT proliferation in response to an injury; uncommon, hyper plastic CT response to gingival injury w exuberant reparative response

Answer 194

Yes! POF, ossifying acanthomatous epulis.

Answer 195

embryonic dental papilla; feline inductive odontogenic tumor characterized by presence of spherical condensations of fibroblasts resembling dental papilla within CT stroma, may resemble DENTAL FOLLICLE

Answer 196

a true neoplasm of mesenchymal odontogenic origin; a dysplastic lesions (asymptomatic in humans); hyper plastic cementum deposition, common in cats

Answer 197

rare in dogs and cats, ameloblastic carcinomas have been reported in dogs; possible reports of odontogenic cysts giving rise to SCC

Answer 198

Very thin orbital floor

Answer 199

perforation at 6 o'clock meridian at or posterior to the equator of ventral aspect of the globe, inflammation of the orbital tissues, and potentially lens capsule rupture and/or presence of bacteria; panophthalmitis is inflammation of all structures and tunics of the eye

Answer 200

Yes! small breed dogs were considered a risk factor for traumatic injury to the globe; panophthalmitis, orbital cellulitis, hyphema, hypopyon, cataract, iris bombe, exophthalmos, buphthalmos, glaucoma, mucopurulent discharge, retinal detachment, blepharospasm, negative dazzle, ONF and pro-orbital fistulae

Answer 201

exophthalmos, redness, discharge, intraocular disease (edema, aqueous flare, sudden cataract formation, vision loss) shortly after dental extraction; refer to ophthalmologist immediately to save eye; tx aggressively: broad spectrum abx, ecollar, NSAID, tarsorraphy (if appropriate); extremely poor for vision and/or globe salvage

Answer 202

rare condition almost exclusively as a late complication of uncontrolled bacterial endophthalmitis from a penetrating injury; intraocular inflammation including retinal detachment, cataract formation, secondary glaucoma

Answer 203

septic implantation syndrome: unique distribution of intralenticular bacteria and lenticular abscess, causes a festering inflammatory process with subclinical uveitis for weeks to a year.

Answer 204

middle and caudal mental, inferior alveolar; genioglossal, digastricus, mylohyoid, medial pterygoid, masseter, lateral pterygoid, temporal m.

Answer 205

Rhamphotheca is a keratinized covering of the maxillary and mandibular bones; rhino theca is maxillary keratinized covering; gnathotheca is the mandibular keratinized covering

Answer 206

Because it allows for stability and food prehension without hand feeding, some grooming, drinking, and normal behavior

Answer 207

22g wire (could have used smaller if needed) with 5-6 twists, 3 pairs of pilot hoes 3-4mm from fx line perpendicular to it

Answer 208

crop gavage if necessary, diet of dry and soaked pellets, dehulled nuts/seeds, fruits and veggies, enclosure with no wire can for climbing/rubbing (smooth walls only)

Answer 209

dentary is the complete bony symphysis of both mandibular bodies (true bony union, unlike small animals), often slower to heal than other bones; rhampotheca is constantly growing, migrates and undergoes desquamation; premaxilla, maxilla, nasal bones

Answer 210

non-union or malunion fx; proper debridement and stabilization

Answer 211

vital teeth w no exposure of root canal system and no radiographic evidence of endodontic involvement; glycerin and fluoride bc they interfere with chemical bonding and decrease bonding strength of sealant

Answer 212

shaping and contouring fracture edges, acid etch, light cured bonded sealant and resin composite, final shaping and finishing; resistance, retention, convenience, pathology removal, wall, and preparation cleansing forms, can bevel cavosurface margins in Class III-VI restorations (provides greater retention strength due to greater enamel surface area), beveling occlusal cavosurfaes in Class I or II preparation is CONTRAINDICATED. bc it enlarges the surface area of the restorative in occlusion.

Answer 213

hand curette to smooth and remove all unsupported enamel or undercuts, round taper find diamond to remove rough edges and unsupported enamel for marginal adaptation, conical Arkansas whitestone bur and sanding/polishing discs to smooth fractured dentin and enamel, or can use carbide bur and shaping discs; to remove the unsupported or sharp edges, irregularities and shape the tooth to achieve the best possible MARGINAL ADAPTATION

Answer 214

37% phosphoric acid (on dentin 10-38%, on enamel 35-38%); 20s on enamel, 15s on exposed dentin

Answer 215

to provide adherence of composite resins to dissolve dental surfaces and provide a strong and durable bond; dentin is demineralized exposing CT for bonding, collagen fibers within tubules are opened exposing more micropores for infiltration by resin, access for bonding agent to flow into tubules creating greater micro mechanical interlock fo composite with dentin and increases resistance to microleakage, also removes the smear layer which also improves retention

Answer 216

decrease bonding strength bc over-drying flattens collagen fibers, decreasing the surface area for bonding, fibrils collapse upon themselves decreasing the size of inter fibrillar spaces that are necessary for resin uptake

Answer 217

either unfilled or lightly filled resins of a primer and adhesive, improve retention of the restorative, prevent leakage at margins, decrease discoloration and pulp sensitivity, they seal exposed tubules and prevent infection, pain, and speed healing (formation of tertiary dentin); 3-12mo depending on chewing activity of dog; 200-400 microns

Answer 218

6-12mo; dissolve or incorporate into the smear layer completely, expose collagen fibers, and form a hybrid layer, strong physiologic bond to dentin enamel or cementum; YES! deep dentin has more dentinal tubules than superficial dentin

Answer 219

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Answer 220

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Answer 221

7th; 1st and 2nd; fifth, which is why we use it

Answer 222

polymerizable resin base and filler particles to improve esthetics and mechanical properties; amalgam requires retention form while composites have strong micromechanical bonds and don't require retention form and amalgam has toxic mercury while composite is non-toxic, biocompatible, insoluble, inexpensive and easy to manipulate;

Answer 223

chemical cure, light cure, dual cure; more controlled and better setting times; visible light (460-480nm)

Answer 224

resin expands as it absorbs moisture from the oral cavity (shrinkage will still negatively impacts bond strength and may contribute to leakage); 2mm deep; for 20s to counteract shrinkage.

Answer 225

flowable has better handling bc less fillers and less viscous, but shrink and war more than paste, apply in thin layers; filler particles of silica or other glass; macrofil, intermediate fil, microfil, and hybrids; macro and intermediate have best durability and strength to resist chewing forces, but least esthetic/grainy, microfils least resistant to fx but polish well (esthetic), hybrids combine micro and intermediate leaving good strength, durability, and esthetics,, can withstand flexural forces, all-purpose universal and wear resistant; nanofil in human dentistry for esthetics

Answer 226

0.1-1mm; fluid dynamics (tubules fluid communicating with nerve endings); takes ~8 weeks to begin, starts with desiccation and mineral deposits that occlude tubules and reduce hydrodynamic forces (decreases sensitivity following tertiary dentin formation);