JVD 2014 deck

Question 1

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what are some clinical signs of endodontic disease in dogs?

Answer 1

fever, pain on chewing, irritability, diminished appetite, selective rejection of hard food, dropping food, unilateral chewing (more calculus on affected side), sensitivity to hot/cold, pawing at mouth, rubbing head/chin on ground or furniture, head shy, ptyalism, tooth discoloration, drying tracts, facial swelling with abx responsiveness

Question 2

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what are the WHO 5 major categories of apical periodontitis in HUMANS?

Answer 2

acute apical periodontitis of pupal origin, chronic apical periodontitis, periapical abscess with sinus, periapical abscess w/o sinus, radicular cysts

Question 3

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what are the histopathologic categories of apical periodontitis?

Answer 3

acute apical periodontitis– primary; acute apical periodontitis– secondary (exacerbation of chronic apical periodontitis)- NON- epithelialized; acute apical periodontitis-secondary (acute exacerbation of chronic apical periodontitis)– epithelialized; chronic apical peridontitis (apical granuloma)– NON-epithelialized; chronic apical periodontitis (apical granuloma)– epithelialized; piratical true cyst; periapical pocket cyst

Question 4

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what are some pseudonyms for condensing osteitis?

Answer 4

sclerosising osteitis, chronic focal sclerosising osteomyelitis, chronic local sclerosis osteomyelitis, local chronic sclerosis osteomyelitis, chronic productive osteitis, periapical pulpo-osteosclerosis, pulpo-periapical osteosclerosis, reactive osteosclerosis, apical condensing osteitis, periapical osteosclerosis, periapical condensing osteitis, exostosis, bone whorl, periradicular bone condensation, osteitis condensans

Question 5

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what is the primary etiology of apical periodontitis? via what routes?

Answer 5

infection of the root canal and its contents; through breaches in dental hard tissue, severed periodontal blood vessels, anachoresis

Question 6

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what is the most common cause of persistent, asymptomatic periapical disease following endodontic tx in humans?

Answer 6

continued intraradicular microbial presence within the complex apical root canal system: lack of ascetic control, poor access cavity design, missed apical and non-apical ramifications, inadequate instrumentation and debridement, marginal temporary or permanent restoration leakage

Question 7

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what are the four stages in the development of apical periodontitis?

Answer 7

pulp exposed, pulp becomes colonized by oral bacteria, inflammatory response (pulpitis) occurs, pulp becomes necrotic

Question 8

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what is condensing osteitis? does it occur in dogs?

Answer 8

in low grade pulpitis, residual infection following endo tx leads to a net increase in bone production rather than destruction as a result of increased osteoblastic acvitiy; dogs can, however, typically it is seen as asymptomatic and the diagnosis needs to be supported with histopathology not just rads so underrepresented in dogs

Question 9

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what type of bacteria is associated with endodontic infection?

Answer 9

90% bacteria are obligate anaerobes in intact teeth, pulp exposure teeth almost 70% obligate anaerobes within their apical third

Question 10

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, how quickly can changes be detected at the periapical region histologically? radiographically? with cone-beam CT?

Answer 10

7d, 15d, 7d

Question 11

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what are listed outcomes of acute apical periodontitis?

Answer 11

spontaneous resolution, further intensification, granuloma formation, abscess formation, sinus formation, spread into bone

Question 12

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, in humans more than half of periapical granulomas contain epithelial tissue of which <20% are cysts. Of those cysts, <50% are pocket cysts and the remainder are true cysts. Are these common in dogs? Where do true cysts originate from? pocket cyst?

Answer 12

Uncommon in dogs (mostly dentigerous cysts, no true cysts in dogs); true cysts originate from proliferation of the cell rests of Malassez (from Hertwig’s epithelial root sheath); molecular mechanisms stimulate epithelial cell proliferation and promote bone resorption; pocket cysts are an extension of the root canal cavity wall of neutrophils at apical foramina forms in response to microbes in root canal; periapical cysts do NOT occur in same frequency or presentation as in humans. Periapical cysts in dogs are RARE in literature and frequently don’t have histo to support their origin

Question 13

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, Grossman adapted Fisher’s theory of different zones related to bone infection and applied it to endodontic infection to explain endo infections resulting in periapical osteolytic (radiolucent) and periapical osteosclerotic (radiopaque) lesions. What are the four zones? which zone is condensing osteitis associated with?

Answer 13

in order of increasing pathos’s: bone of stimulation, zone of irritation, zone of contamination, zone of infection; zone of stimulation

Question 14

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, condensing osteitis is thought to be associated with what? where is it most likely to occur in humans?

Answer 14

irreversible pulpitis; 10x more likely to occur in mandible than maxilla most often in premolar-molar region (anecdotally around 309/409)

Question 15

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what is the primary differential for condensing osteitis? What are its pseudonyms?

Answer 15

idiopathic osteosclerosis; dense bone island, bone scar, bone eburnation, bone whorl, exostosis, local bone sclerosis, focal periapical osteopetrosis

Question 16

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, how are condensing osteitis and idiopathic osteosclerosis differentiated radiographically?

Answer 16

Difficult and still not 100%; ideally teeth with large deep carious lesions or previous endodontic tx have condensing osteitis (inflammatory); teeth with no evidence of endo dz or only superficial carious lesions are deemed idiopathic osteosclerosis (human differentiation)

Question 17

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what are the goals of tx for apical periodontitis? Is it repair or regeneration?

Answer 17

goals: maintain tooth, resolve pain/symptoms, regression or resolution of periapical radiolucencies on rads, wound healing (resolve inflammation at a tissue, cellular or molecular level); repair bc regeneration is not possible to restore original architecture post-natal; most post-natal healing is combo of regeneration and repair

Question 18

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what is the Hayflick limit?

Answer 18

Somatic cells have a limited life span and capability for division known as Hayflick limit

Question 19

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what is the treatment of choice for endodontic disease in dogs? Is there a benefit to staging procedure in dogs? is there a difference in instrumentation?

Answer 19

standard (orthograde) RCT (or ext, not mentioned) with surgical (retrograde) RCT less common; no difference in long-term success between 2 staged RCT vs 1 stage, however in short-term studies dogs and superior healing with inter-appointment root canal dressing (2 stage); no difference between manual or rotary instrumentation for shaping and debriding

Question 20

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, how is condensing osteitis treated in humans?

Answer 20

if asymptomatic: not treated; if symptomatic: RCT or XSS

Question 21

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, in 2 previous studies, when no radiographic abnormalities detected, histo analysis confirmed apical periodontitis in how many cases? when periapical disease was interpreted radiographically, how many roots had apical periodontitis diagnosed histologically?

Answer 21

40%; 90%

Question 22

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, how does one differentiate between reactive bone, condensing osteitis, and idiopathic osteosclerosis?

Answer 22

many don’t even try; condensing osteitis has increase in periapical radiopacity and is associated with endo dz; reactive bone is less well defined; osteosclerosis is typically unassociated with endo dz or periapical region

Question 23

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what are the five radiographic patterns of condensing osteitis?

Answer 23

most common: target lesions where radiolucent border surrounded by radiopacity; less common: focal lesions which was homogenous and lacked the circumferential halo, lucent lesions which periapical radiolucency w fibre-osseous pattern on histo, multi confluent lesions w multiple confluent opacities, resorptive lesion involving external root resorption

Question 24

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, idiopathic osteosclerosis is defined by what 5 categories in humans?

Answer 24

most common: focal lesion; same as condensing osteitis categories (not most common, target)

Question 25

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 25

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

Question 26

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, what type of bone needs to be lost in some proportion or demineralized to be visible on radiographs?

Answer 26

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

Question 27

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, how does post RCT follow up differ btwn dogs and humans?

Answer 27

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

Question 28

According to “Assessment of apical periodontitis in dogs and humans: a review” by Menzies, Reiter, Lewis, in humans what is associated with success of apical periodontitis?

Answer 28

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

Question 29

According to “Class I restoration of maxillary first molar caries in a dog” by Ritchie, what are dental caries? are they common in dogs? if so, where?

Answer 29

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)

Question 30

According to “Class I restoration of maxillary first molar caries in a dog” by Ritchie, what are treatment options?

Answer 30

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

Question 31

According to “Class I restoration of maxillary first molar caries in a dog” by Ritchie, what “forms” need to be created to provide the proper cavity prep?

Answer 31

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)

Question 32

According to “Class I restoration of maxillary first molar caries in a dog” by Ritchie, what is the incidence of dental caries in dogs? why is it less common than in humans?

Answer 32

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.

Question 33

According to “Class I restoration of maxillary first molar caries in a dog” by Ritchie, what is the most likely region within a tooth to develop a carious lesion? is there any breed, age, or gender predisposition for caries?

Answer 33

pits and fissures on the occlusal surface; NO!

Question 34

According to “Dental wax decreases calculus accumulation in small dogs” by Smith, Smithson, 21 client owned dogs had half their mouth randomly assigned to receive wax daily following a dental prophylaxis (stage 1 perio only). What were the results?

Answer 34

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%

Question 35

According to “Dental wax decreases calculus accumulation in small dogs” by Smith, Smithson, what forms the pellicle? what is extracellular polysaccharide?

Answer 35

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

Question 36

According to “Dental wax decreases calculus accumulation in small dogs” by Smith, Smithson, what proprerties does the non-microbial biofilm have to stay firmly adhered? What bacterial enzyme is particularly important?

Answer 36

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

Question 37

According to “Dental wax decreases calculus accumulation in small dogs” by Smith, Smithson, what is calculus made of?

Answer 37

calcium phosphate and carbonate, food particles, organic matter

Question 38

According to “Dental wax decreases calculus accumulation in small dogs” by Smith, Smithson, what was the active ingredient in the wax that helped inhibit biofilm?

Answer 38

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… ?

Question 39

According to “Dental wax decreases calculus accumulation in small dogs” by Smith, Smithson, what is the theory why gingivitis and plaque scores were not significant?

Answer 39

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

Question 40

According to “Effect of preparation surface area on the clinical outcome of full veneer crowns in dogs” by Riehl, Soukup, Snyder, what does the clinical outcome of a full veneer crown depend on?

Answer 40

dimensions of preparation, performances of restoration material, luting cement

Question 41

According to “Effect of preparation surface area on the clinical outcome of full veneer crowns in dogs” by Riehl, Soukup, Snyder, what are important concepts that are generally accepted for operative dentistry?

Answer 41

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

Question 42

According to “Effect of preparation surface area on the clinical outcome of full veneer crowns in dogs” by Riehl, Soukup, Snyder, this study reviewed 32 maxillary and mandibular canine teeth with preps for full veneers. How many were unsuccessful? Successful? What type of failure? What were the mean surface areas in each category?

Answer 42

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

Question 43

According to “Effect of preparation surface area on the clinical outcome of full veneer crowns in dogs” by Riehl, Soukup, Snyder, were the results statistically significant? was there a correlation?

Answer 43

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

Question 44

According to “Effect of preparation surface area on the clinical outcome of full veneer crowns in dogs” by Riehl, Soukup, Snyder, what conclusions can be drawn from this study?

Answer 44

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

Question 45

According to “Effect of preparation surface area on the clinical outcome of full veneer crowns in dogs” by Riehl, Soukup, Snyder, what does the introduction of axial grooves provide?

Answer 45

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

Question 46

According to “Parotid salivary duct stenosis following caudal maxillectomy” by Mestrinho, Niza, what was the history for this case and one other case of parotid duct dilation in vet med?

Answer 46

both had previous caudal maxillectomy 2-3y prior

Question 47

According to “Parotid salivary duct stenosis following caudal maxillectomy” by Mestrinho, Niza, what surgery was performed to correct the dilated duct and atrophied gland? what is the biggest complication with this surgery?

Answer 47

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)

Question 48

According to “Parotid salivary duct stenosis following caudal maxillectomy” by Mestrinho, Niza, describe the anatomy of the parotid duct

Answer 48

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

Question 49

According to “Parotid salivary duct stenosis following caudal maxillectomy” by Mestrinho, Niza, what normally happens following transection of salivary duct?

Answer 49

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

Question 50

According to “Parotid salivary duct stenosis following caudal maxillectomy” by Mestrinho, Niza, what are treatment options for parotid salivary duct injury?

Answer 50

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

Question 51

According to “Sharpening periodontal instruments” by Angel, how can you grossly tell the difference between dull and sharp cutting surfaces? What test can you use?

Answer 51

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

Question 52

According to “Sharpening periodontal instruments” by Angel, what types of sharpening stone can be used? which stones require lubrication? which do not?

Answer 52

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

Question 53

According to “Sharpening periodontal instruments” by Angel, how many cutting edges do a scaler and universal curette have? what about a Gracey curette? what is grossly the difference btwn Universal and Gracey curette?

Answer 53

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

Question 54

According to “Sharpening periodontal instruments” by Angel, name each instrument.

Answer 54

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)

Question 55

According to “Sharpening periodontal instruments” by Angel, what are differences btwn the scaler and curette?

Answer 55

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Question 56

According to “Sharpening periodontal instruments” by Angel, what is the goal of sharpening? what is the edge?

Answer 56

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

Question 57

According to “Sharpening periodontal instruments” by Angel, when should you sharpen the face of an instrument?

Answer 57

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

Question 58

According to “Sharpening periodontal instruments” by Angel, what angle should be formed between a Gracey curette face and a flat stone for sharpening? is the same rotary disks?

Answer 58

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

Question 59

According to “Sharpening periodontal instruments” by Angel, what is recommended to round the toe of a curette? with what angle?

Answer 59

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

Question 60

According to “Sharpening periodontal instruments” by Angel, when do you sharpen the face of the instrument?

Answer 60

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

Question 61

According to “Sharpening periodontal instruments” by Angel, what surface do you sharpen a winged elevator and osteotome? what other instruments is this intended for (bevel sharpening at 45deg angle)?

Answer 61

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

Question 62

According to “Sharpening periodontal instruments” by Angel, how is an Ochsenbein chisel sharpened differently?

Answer 62

at a 20deg angle

Question 63

According to “Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst” by MacGee, what is typically associated with a dentigerous cyst? in what teeth/breeds? how does it clinically present?

Answer 63

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

Question 64

According to “Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst” by MacGee, if left untreated what is the complication of a dentigerous cyst?

Answer 64

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

Question 65

According to “Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst” by MacGee, what are reasons for a diffusely discolored tooth?

Answer 65

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

Question 66

According to “Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst” by MacGee, why should all cystic linings and teeth be submitted for histopathology?

Answer 66

in human lit possibility of malignant transformation to ameloblastoma

Question 67

According to “Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst” by MacGee, what occurred at 9mo post op exam?

Answer 67

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

Question 68

According to “Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst” by MacGee, what are the 3 components of a cyst?

Answer 68

central cavity, epithelial lining, fibrous capsule

Question 69

According to “Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst” by MacGee, how does a dentigerous cyst develop?

Answer 69

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

Question 70

According to “Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst” by MacGee, what is the suspected pathogenesis of a dentigerous cyst?

Answer 70

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.

Question 71

According to “Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst” by MacGee, in human dentistry what is a cause of some dentigerous cysts? why is this not typically the case in vet med?

Answer 71

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

Question 72

According to “Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst” by MacGee, what are some new literatures speculations for dentigerous cyst pathogenesis?

Answer 72

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

Question 73

According to “Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst” by MacGee, what type of malignant transformation of dentigerous cysts occurs in humans?

Answer 73

ameloblastoma and SCC

Question 74

According to “Clinicopathologic characterization of oral pyogenic granuloma in 8 cats” by Riehl, Soukup, et al, what were the histopathological characteristics for oral pyogenic granuloma?

Answer 74

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

Question 75

According to “Clinicopathologic characterization of oral pyogenic granuloma in 8 cats” by Riehl, Soukup, et al, of the 8 cats with 12 lesions what was the presenting complaint?

Answer 75

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.

Question 76

According to “Clinicopathologic characterization of oral pyogenic granuloma in 8 cats” by Riehl, Soukup, et al, what was the appearance? how many had traumatic occlusion with upper fourth premolar?

Answer 76

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

Question 77

According to “Clinicopathologic characterization of oral pyogenic granuloma in 8 cats” by Riehl, Soukup, et al, were there other structural changes besides 50% of cases with upper fourth premolar causing traumatic occlusion?

Answer 77

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

Question 78

According to “Clinicopathologic characterization of oral pyogenic granuloma in 8 cats” by Riehl, Soukup, et al, what percent of cats had TR, perio, both, attachment loss, or bone loss?

Answer 78

ALL; 1 case had RTR of mandibular first molar

Question 79

According to “Clinicopathologic characterization of oral pyogenic granuloma in 8 cats” by Riehl, Soukup, et al, were there bony changes associated with pyogenic granulomas?

Answer 79

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

Question 80

According to “Clinicopathologic characterization of oral pyogenic granuloma in 8 cats” by Riehl, Soukup, et al, histologically what was noted?

Answer 80

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,

Question 81

According to “Clinicopathologic characterization of oral pyogenic granuloma in 8 cats” by Riehl, Soukup, et al, what were the treatment options and recurrence rates for each?

Answer 81

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

Question 82

According to “Clinicopathologic characterization of oral pyogenic granuloma in 8 cats” by Riehl, Soukup, et al, in humans is their a gender predilection? was there a sex predilection in this study?

Answer 82

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

Question 83

According to “Clinicopathologic characterization of oral pyogenic granuloma in 8 cats” by Riehl, Soukup, et al, what is the most common treatment of pyogenic granulaoms in humans? What are some different treatment modalities?

Answer 83

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

Question 84

According to “Clinicopathologic characterization of oral pyogenic granuloma in 8 cats” by Riehl, Soukup, et al, what do the authors recommend as best treatment for pyogenic granulomas to prevent recurrence?

Answer 84

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

Question 85

According to “Duration of action of bupivacaine hydrochloride used for palatal sensory nerve block in infant pigs” by Holman, German et al, what is bupivacaine and what was the goal of the study? what is the reported duration of bupivacaine?

Answer 85

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.

Question 86

According to “Duration of action of bupivacaine hydrochloride used for palatal sensory nerve block in infant pigs” by Holman, German et al, how long was the duration of action of bupivacaine in infant pigs? how long did it consistently last in all pigs?

Answer 86

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

Question 87

According to “Duration of action of bupivacaine hydrochloride used for palatal sensory nerve block in infant pigs” by Holman, German et al, how does bupivacaine work?

Answer 87

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

Question 88

According to “Esophagostomy Feeding Tube placement in the dog and cat” by Fink, Reiter et al, what are benefits to an e-tube over nasoesophageal feeding tube?

Answer 88

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.

Question 89

According to “Esophagostomy Feeding Tube placement in the dog and cat” by Fink, Reiter et al, what are contraindications of e-tube placement? what are complications?

Answer 89

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

Question 90

According to “Esophagostomy Feeding Tube placement in the dog and cat” by Fink, Reiter et al, what size red rubber is appropriate for cats and small dogs? for larger dogs?

Answer 90

12-14 French; 14-18French

Question 91

According to “Esophagostomy Feeding Tube placement in the dog and cat” by Fink, Reiter et al, what are the landmarks for placement of an e-tube?

Answer 91

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

Question 92

According to “Esophagostomy Feeding Tube placement in the dog and cat” by Fink, Reiter et al, how long does it take a stoma to heal following removal of the e-tube?

Answer 92

24-48h.

Question 93

According to “Lost wax casting technique for metal crown fabrication” by McCoy, what is the basic process of making a metal cast from an impression?

Answer 93

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.

Question 94

According to “Lost wax casting technique for metal crown fabrication” by McCoy, what is a cast? a die?

Answer 94

Cast is positive reproduction ; die represents a single tooth replicated

Question 95

According to “Lost wax casting technique for metal crown fabrication” by McCoy, what is the purpose of surfactant spray applied over the VPS impression prior to gypsum stone?

Answer 95

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.

Question 96

According to “Lost wax casting technique for metal crown fabrication” by McCoy, what are dental waxes made up of?

Answer 96

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.

Question 97

According to “Lost wax casting technique for metal crown fabrication” by McCoy, steps of lost wax casting.

Answer 97

Steps in lost waxing technique

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

Question 98

According to “Lost wax casting technique for metal crown fabrication” by McCoy, what are pattern waxes?

Answer 98

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!

Question 99

According to “Lost wax casting technique for metal crown fabrication” by McCoy, what is the benefit to using a metal alloy?

Answer 99

cheaper, strength, biocompatibility, resistance to wear

Question 100

According to “Lost wax casting technique for metal crown fabrication” by McCoy, what is divesting?

Answer 100

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

Question 101

According to “Lost wax casting technique for metal crown fabrication” by McCoy, what is used to remove the remaining gypsum and slightly roughen the interior surface of the restoration?

Answer 101

ultrafine aluminum oxide particles

Question 102

According to “Oral osteoma in 6 dogs” by Volker, Luskin, what is an osteoma?

Answer 102

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.

Question 103

According to “Oral osteoma in 6 dogs” by Volker, Luskin, in humans what are the characteristics of an osteoma?

Answer 103

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

Question 104

According to “Oral osteoma in 6 dogs” by Volker, Luskin, what was the radiographic description of all 6 osteoma cases?

Answer 104

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

Question 105

According to “Oral osteoma in 6 dogs” by Volker, Luskin, what were the histopathologic findings?

Answer 105

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.

Question 106

According to “Oral osteoma in 6 dogs” by Volker, Luskin, different treatments were performed depending on location of mass (rostral max/mand, marginal excision, etc). What was the recurrence of each?

Answer 106

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

Question 107

According to “Oral osteoma in 6 dogs” by Volker, Luskin, in humans, what is Gardner’s syndrome? What is most common type of osteoma in humans?

Answer 107

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

Question 108

According to “Oral osteoma in 6 dogs” by Volker, Luskin, describe the presentation of central vs peripheral osteoma.

Answer 108

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

Question 109

According to “Oral osteoma in 6 dogs” by Volker, Luskin, what is exostosis? What is the best way to diagnose an osteoma?

Answer 109

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)

Question 110

According to “Oral osteoma in 6 dogs” by Volker, Luskin, what are some differentials for the clinical and radiographic appearance of an osteoma?

Answer 110

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

Question 111

According to “Oral osteoma in 6 dogs” by Volker, Luskin, what is the treatment of choice for osteoma?

Answer 111

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

Question 112

According to “Prosthetic appliance for oronasal communication obturation in a dog” by Smith, why did the owners opt for a prosthetic obturator instead of surgery for the 11y FS Chinese crested dog?

Answer 112

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.

Question 113

According to “Prosthetic appliance for oronasal communication obturation in a dog” by Smith, what are some benefits to the use of the silastic nasal septal button over other obturation materials? what size defect is obturation appropriate for?

Answer 113

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.

Question 114

According to “Prosthetic appliance for oronasal communication obturation in a dog” by Smith, placement of the nasal obturator did not completely resolve clinical signs of rhinitis. Why?

Answer 114

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

Question 115

According to “Prosthetic appliance for oronasal communication obturation in a dog” by Smith, how much perimeter should be added to the defect size to provide material overlap around the defect?

Answer 115

3-5mm

Question 116

According to “Prosthetic appliance for oronasal communication obturation in a dog” by Smith, what are some causes of acquired palatal defects?

Answer 116

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

Question 117

According to “Prosthetic appliance for oronasal communication obturation in a dog” by Smith, what is necessary for successful surgical repair of a palatal defect? what is the most common complication?

Answer 117

well vascularized flaps that are tension free; dehiscence

Question 118

According to “Prosthetic appliance for oronasal communication obturation in a dog” by Smith, what are some other materials used for obturation of palatal defects?

Answer 118

acrylic, stainless steel, resins, and silicone

Question 119

According to “Soft Tissue tooth impaction in a dog” by Carle, Shope, what are treatment options for impacted teeth?

Answer 119

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

Question 120

According to “Soft Tissue tooth impaction in a dog” by Carle, Shope, what are the 3 stages of tooth eruption in animals?

Answer 120

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

Question 121

According to “Soft Tissue tooth impaction in a dog” by Carle, Shope, what is the start of eruption?

Answer 121

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)

Question 122

According to “Soft Tissue tooth impaction in a dog” by Carle, Shope, what is the gubernaculum dentis?

Answer 122

soft tissue connection btwn enamel organ and oral epithelium

Question 123

According to “Soft Tissue tooth impaction in a dog” by Carle, Shope, what is the only factor demonstrated to be critical for interosseous stage of tooth eruption?

Answer 123

dental follicle

Question 124

According to “Soft Tissue tooth impaction in a dog” by Carle, Shope, what does the term “emergence” refer to?

Answer 124

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

Question 125

According to “Soft Tissue tooth impaction in a dog” by Carle, Shope, when does junctional epithelium form on tooth surface?

Answer 125

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

Question 126

According to “Soft Tissue tooth impaction in a dog” by Carle, Shope, what is primary retention (vs tooth impaction)?

Answer 126

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

Question 127

According to “Soft Tissue tooth impaction in a dog” by Carle, Shope, why do we use the term soft tissue impaction for dogs?

Answer 127

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

Question 128

According to “Soft Tissue tooth impaction in a dog” by Carle, Shope, what do the authors conclude about reasons for disturbances of tooth eruption?

Answer 128

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

Question 129

According to “Soft Tissue tooth impaction in a dog” by Carle, Shope, what are some causes of enamel defects (noted on impacted mandibular first molar and mandibular canines following eruption post operculectomy)?

Answer 129

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

Question 130

According to “Tooth resorption in an Australian sea lion” what clinical signs did the 24y F sea lion present with?

Answer 130

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.

Question 131

According to “Tooth resorption in an Australian sea lion” what did the oral and radiographic exam reveal?

Answer 131

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

Question 132

According to “Tooth resorption in an Australian sea lion”in what species has TR been documented? What type of TR was this?

Answer 132

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

Question 133

According to “Apically repositioned flap for gingival enlargement” by Furman, the dog was on cyclosporin for atopy, had a CCF and diffuse gingival enlargement. What was the concern regarding each of these problems if left untreated?

Answer 133

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

Question 134

According to “Apically repositioned flap for gingival enlargement” by Furman, what was the treatment of choice for the mandibular incisors which were severely effected by GE?

Answer 134

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.

Question 135

According to “Apically repositioned flap for gingival enlargement” by Furman, what was the final gingival margin goal? Why is this important?

Answer 135

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

Question 136

According to “Apically repositioned flap for gingival enlargement” by Furman, what 3 zones make up biologic width?

Answer 136

gingival sulcus, junctional epithelium, CT attachment

Question 137

According to “Apically repositioned flap for gingival enlargement” by Furman, what is the theory for why this dog had GE?

Answer 137

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

Question 138

According to “Apically repositioned flap for gingival enlargement” by Furman, what is the goal of surgical intervention (GV, flap, etc)?

Answer 138

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

Question 139

According to “Evaluation of an anti-plaque gel for daily toothbrushing” by Milella, Beckman, Kane, 90 dogs split into small and medium/large breed groups (A/B) had negative and positive controls and a test group and had daily brushing with or w/o an oral gel containing extracts to decrease plaque accumulation. What were the results?

Answer 139

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

Question 140

According to “Evaluation of an anti-plaque gel for daily toothbrushing” by Milella, Beckman, Kane, what was the overall takeaway?

Answer 140

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

Question 141

According to “Evaluation of an anti-plaque gel for daily toothbrushing” by Milella, Beckman, Kane, by what mechanisms does this product work?

Answer 141

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)

Question 142

According to “Generalized hypercementosis in geriatric horses” by Arnbjerg, what is the estimated % organic material and Hounsfield units of cementum, dentin and enamel?

Answer 142

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

Question 143

According to “Generalized hypercementosis in geriatric horses” by Arnbjerg, hypercementosis was noted in 9/16 horses with normal clinical crowns of incisors in 11/14. What general age were the horses with hypercementosis (all horses were non-clinical and findings were on routine screening).

Answer 143

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

Question 144

According to “Generalized hypercementosis in geriatric horses” by Arnbjerg, what were the most commonly affected teeth? What aspect of the teeth was most affected?

Answer 144

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

Question 145

According to “Generalized hypercementosis in geriatric horses” by Arnbjerg, what’s the general appearance of the PDL in teeth with hypercementosis? Was there resorption?

Answer 145

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

Question 146

According to “Generalized hypercementosis in geriatric horses” by Arnbjerg, what was noted about almost all horses with a greater cementum deposition?

Answer 146

more acute incisor angle

Question 147

According to “Generalized hypercementosis in geriatric horses” by Arnbjerg, in humans no symptoms are associated with radiographic signs of uncomplicated hyercementosis unless there is associated what? Is this true of horses in this study?

Answer 147

tooth resorption or PD dz; yes!

Question 148

According to “Generalized hypercementosis in geriatric horses” by Arnbjerg, where was hypercementosis in cheek teeth seen? what is a possible etiologic factor for hypercementosis?

Answer 148

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

Question 149

According to “Generalized hypercementosis in geriatric horses” by Arnbjerg, oral pain in hypercementosis cases is associated with what?

Answer 149

tooth resorption

Question 150

According to “Mandibular Lip avulsion repair in the dog and cat” by Viacri, Stepaniuk, what are some common causes of lip avulsion injury? What are the first steps prior to repair?

Answer 150

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

Question 151

According to “Mandibular Lip avulsion repair in the dog and cat” by Viacri, Stepaniuk, what is the most common complication of lip avulsion repair? what can you do to prevent this?

Answer 151

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!

Question 152

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, what percent of fractures in cats are TMJ and mandibular? What are differentials for inability to close the mouth in a cat?

Answer 152

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

Question 153

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, name the bones that make up the fused portions of the maxilla, mandible and calvarium. See pic.

Answer 153

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Question 154

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, name the bones within the maxilla from the palatal aspect. See pic.

Answer 154

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Question 155

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, name the bones and prominences that make up the TMJ on this radiograph. See pic in answer.

Answer 155

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Question 156

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, name the bony prominences seen here that make up the TMJ.

Answer 156

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Question 157

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, which side has coronoid impingement laterally. Note it on the radiograph.

Answer 157

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Question 158

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, given this radiograph, what is the most common cause of the open jaw locking and abnormalities on DV radiograph?

Answer 158

right rostrodorsal TMJ luxation

Question 159

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, what is the cartilaginous symphysis joining the 2 mandibles calleD? what are the 3 processes of the ramus of the mandible?

Answer 159

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

Question 160

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, what is different about the TMJ joint capsule in cats?

Answer 160

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

Question 161

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, what are the muscles of mastication? What is their innervation? What muscles hold the condylar process in the mandibular fossa?

Answer 161

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

Question 162

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, what is the most common type of TMJ luxation? What is its clinical presentation?

Answer 162

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.

Question 163

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, what is a more common maxillofacial injury involving the TMJ (not luxation)?

Answer 163

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

Question 164

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, in what direction does a rostrodorsal luxation, caudal luxation and/or mandibular fracture cause the mandible to drift?

Answer 164

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

Question 165

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, what percent of cases have at least one other injury in addition to symphyseal separation of mandibular fracture when run through CT scan?

Answer 165

35.7%

Question 166

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, what are some structural abnormalities associated with TMJ dysplasia leading to open jaw locking syndrome? in what breeds?

Answer 166

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)

Question 167

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, what are treatment options for lateral impingement of the coronoid process on the zygomatic arch leading to open jaw locking syndrome?

Answer 167

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

Question 168

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, if jaw locking is secondary to excessive laxity of the symphysis what are some treatment options?

Answer 168

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

Question 169

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, what is the most common cause of open mouth dental interlock in cats?

Answer 169

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

Question 170

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, what is the clinical presentation of trigeminal neuropathy? what are causes of mandibular br trigeminal neuropathy?

Answer 170

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

Question 171

According to “Maxillofacial injuries and diseases that cause an open mouth in cats” by Constantaras, Charlier, how long does it takes dogs and cats to return to normal function following trigeminal neuropathy?

Answer 171

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

Question 172

According to “Multiple dental abnormalities in a geriatric horse,” in Chile and Mexico what percent of horses used for work are reported to suffer from dental abnormalities?

Answer 172

73-90%

Question 173

According to “Multiple dental abnormalities in a geriatric horse,”what is the pathogenesis of infundibular caries? what bacteria is associated w caries in horses? what teeth are typically effected?

Answer 173

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

Question 174

According to “Scanning electron microscopic evaluation of tooth root apices in the dog” by Hernandez, Toriggia et al, 30 teeth including mandibular first molars, maxillary fourth premolars, and maxillary canines totally 69 roots, what were the different groupings for this study?

Answer 174

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

Question 175

According to “Scanning electron microscopic evaluation of tooth root apices in the dog” by Hernandez, Toriggia et al, how many roots had an apical delta? how many foramina were <50micrometers? what was the maximum foramen diameter?

Answer 175

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

Question 176

According to “Scanning electron microscopic evaluation of tooth root apices in the dog” by Hernandez, Toriggia et al, was there a significant difference btwn diameters of apical foramina in diff types of teeth? what about the number of apical foramina in diff teeth? which was greatest # of foramina?

Answer 176

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

Question 177

According to “Scanning electron microscopic evaluation of tooth root apices in the dog” by Hernandez, Toriggia et al, what was special about the cementum at the apical level? how big was this region?

Answer 177

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

Question 178

According to “Scanning electron microscopic evaluation of tooth root apices in the dog” by Hernandez, Toriggia et al, what conclusions did the authors make?

Answer 178

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

Question 179

According to “Suture material and needle options in oral and periodontal surgery” by Domnick, what characteristics make up the ideal suture?

Answer 179

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

Question 180

According to “Suture material and needle options in oral and periodontal surgery” by Domnick, what are different types of categories of sutures? what materials make up these categories?

Answer 180

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

Question 181

According to “Suture material and needle options in oral and periodontal surgery” by Domnick,what is the benefit of synthetic suture? monofilament? no capillary action? absorption time?

Answer 181

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

Question 182

According to “Suture material and needle options in oral and periodontal surgery” by Domnick, what is polydioxanone? pros/cons?

Answer 182

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

Question 183

According to “Suture material and needle options in oral and periodontal surgery” by Domnick,what are gut and chronic gut? what are the pros/cons?

Answer 183

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

Question 184

According to “Suture material and needle options in oral and periodontal surgery” by Domnick, what are PGA and PG910? what are the pros/cons?

Answer 184

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

Question 185

According to “Suture material and needle options in oral and periodontal surgery” by Domnick, Poligecaprone 25 is what type of suture? pros/cons?

Answer 185

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)

Question 186

According to “Suture material and needle options in oral and periodontal surgery” by Domnick, why not use nylon or polypropylene in the oral cavity?

Answer 186

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

Question 187

According to “Suture material and needle options in oral and periodontal surgery” by Domnick, what are the suturing guidelines/principles listed?

Answer 187

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

Question 188

According to “Suture material and needle options in oral and periodontal surgery” by Domnick, what type of needle is best for the oral cavity?

Answer 188

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)

Question 189

According to “Suture material and needle options in oral and periodontal surgery” by Domnick, what suture pattern and closure is recommended for the oral cavity?

Answer 189

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,

Question 190

According to “Suture material and needle options in oral and periodontal surgery” by Domnick, what happens after flap surgery in regards to tissue healing?

Answer 190

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.

Question 191

According to “Modified conservative treatment of an extensive dentigerous cyst in a dog” by Honzelka, Kressin, Chamberlain, what is the incidence of dentigerous cysts in vet med? What teeth are they usually associated with? What is the theory for the reason teeth are embedded?

Answer 191

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

Question 192

According to “Modified conservative treatment of an extensive dentigerous cyst in a dog” by Honzelka, Kressin, Chamberlain, this dog had a cystic structure associated with unerupted 305 spanning from 301-mesial 308. What were the 3 treatment options discussed with the owner who had cost concerns and did not want to disfigure the dog? Which option did the owners select?

Answer 192

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

Question 193

According to “Modified conservative treatment of an extensive dentigerous cyst in a dog” by Honzelka, Kressin, Chamberlain, in this case, despite only partial removal of the cystic lining w/o marsupialization, did the cyst recur?

Answer 193

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

Question 194

According to “Modified conservative treatment of an extensive dentigerous cyst in a dog” by Honzelka, Kressin, Chamberlain, where do dentigerous cysts originate? How are they diagnosed? what do they look like histologically?

Answer 194

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

Question 195

According to “Modified conservative treatment of an extensive dentigerous cyst in a dog” by Honzelka, Kressin, Chamberlain, why is histopath so important in the diagnosis?

Answer 195

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

Question 196

According to “Modified conservative treatment of an extensive dentigerous cyst in a dog” by Honzelka, Kressin, Chamberlain, what is the treatment of choice for a dentigerous cyst? What is the risk of leaving behind cystic lining?

Answer 196

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

Question 197

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who are Broca and Malassez and what were their contributions? who was the first to describe odontogenic tumors?

Answer 197

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

Question 198

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who are Bland-Sutton and Gabell, James, and Payne and what were their contributions?

Answer 198

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

Question 199

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who are Thoma and Goldman and what was their contribution?

Answer 199

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

Question 200

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who are Pinborg and Clausen and what was their contribution?

Answer 200

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

Question 201

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who is Gorlin and what was his contribution?

Answer 201

Gorlin 1961-63, minor changes to include domestic animals

Question 202

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, what was the WHO human classification contribution? Animals?

Answer 202

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

Question 203

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who is Dubielzig and what was his contribution?

Answer 203

Dubielzig 1979-1982, classified epulides

Question 204

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who is Walsh and what was his contribution?

Answer 204

Walsh 1987, first attempt to classify odontogenic tumors in animals

Question 205

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who are Bostock and White and what was their contribution?

Answer 205

1987, POF, basal cell carcinoma, and ameloblastoma

Question 206

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who is Head and what was his contribution?

Answer 206

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

Question 207

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who is Poulet and what was his contribution?

Answer 207

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

Question 208

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who is Verstreate and what was his contribution?

Answer 208

Verstrate 1992, epulides using human classification

Question 209

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, what was the updated WHO in humans in 1992 contribution?

Answer 209

added epithelial cysts and tumors and other lesions related to bone

Question 210

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who are Gardner, Dubielzig, Baker 1991-1998, and what was their contribution?

Answer 210

ameloblastoma and CAA occur in companion animals and are distinct

Question 211

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, what was the contribution of the updated WHO for animals in 2003?

Answer 211

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

Question 212

According to “Nomenclature and classification of odontogenic tumors– part I: historical review” by Soukup and Bell, who are Svendenius and Warfvinge, and Boehm et al, and what were their contributions?

Answer 212

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

Question 213

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, what are the most common odontogenic tumors in dogs?

Answer 213

CAA, POF

Question 214

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, what is the authors overall thoughts on the 2005 human classification and 2003 WHO domestic animal classification?

Answer 214

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

Question 215

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, what do the terms adamantinoma, acanthomatous, and epulis mean?

Answer 215

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

Question 216

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, describe an ameloblastoma.

Answer 216

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

Question 217

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, what is the difference between CAA and AA in humans?

Answer 217

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

Question 218

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, what are the 4 recognized 2005 WHO human subtypes of ameloblastoma?

Answer 218

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

Question 219

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, what are the two main histologic patterns of solid/multicystic ameloblastoma? Common in dogs/catS? what are synonyms for solid/multicystic ameloblastoma?

Answer 219

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

Question 220

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, are CEOT and APOT the same thing? What is happening here?

Answer 220

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

Question 221

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, what is the main difference between FFH and POF? what is a common feature seen in both?

Answer 221

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)

Question 222

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, what is a pyogenic granuloma? what are peripheral giant cell granulomas?

Answer 222

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

Question 223

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, do cats get epulides?

Answer 223

Yes! POF, ossifying acanthomatous epulis.

Question 224

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, what odontogenic tissue does ameloblastic fibroma and fibro-odontoma resemble? what is a FIOT?

Answer 224

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

Question 225

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, what do the terms cementoblastoma, periapical cementoosseous dysplasia, and hypercementosis mean?

Answer 225

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

Question 226

According to “Nomenclature and classification of odontogenic tumors– Part II: clarification of specific nomenclature” by Bell, Soukup, are there malignant odontogenic tumors?

Answer 226

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

Question 227

According to “Ocular trauma originating from within the oral cavity: clinical relevance and histologic findings in 10 cases (2003-2013) by Duke, Synder, Dubielzig, what thin bone separates the distal root of the upper fourth premolar and molar roots from the orbit?

Answer 227

Very thin orbital floor

Question 228

According to “Ocular trauma originating from within the oral cavity: clinical relevance and histologic findings in 10 cases (2003-2013) by Duke, Synder, Dubielzig, what are characteristics of penetrating ocular injuries from the oral cavity? what is panophthalmitis?

Answer 228

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

Question 229

According to “Ocular trauma originating from within the oral cavity: clinical relevance and histologic findings in 10 cases (2003-2013) by Duke, Synder, Dubielzig, there were 8 dogs, 2 cats all of whom had a dental procedure. Was the breed signalment important? what were some clinical findings at presentation?

Answer 229

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

Question 230

According to “Ocular trauma originating from within the oral cavity: clinical relevance and histologic findings in 10 cases (2003-2013) by Duke, Synder, Dubielzig, following a dental, what clinical signs would warrant further evaluation of the globe? should they be referred? what treatment might be warranted? what type of prognosis is there for globe perforations?

Answer 230

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

Question 231

According to “Ocular trauma originating from within the oral cavity: clinical relevance and histologic findings in 10 cases (2003-2013) by Duke, Synder, Dubielzig, what is usually the cause of panophthalmitis? what are sequelae of intraocular inflammation?

Answer 231

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

Question 232

According to “Ocular trauma originating from within the oral cavity: clinical relevance and histologic findings in 10 cases (2003-2013) by Duke, Synder, Dubielzig, what is SIS?

Answer 232

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

Question 233

According to step-by-step
“Total mandibulectomy in the dog” by Furman, what vessels must be ligated? what muscle bellies must be transected and elevated?

Answer 233

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

Question 234

According to “Treatment and stabilization of beak symphyseal separation using inter fragmentary wiring and provisional bis-aryl composite” by Lothamer et al, define rhamphotheca, rhinotheca, and gnathotheca,

Answer 234

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

Question 235

According to “Treatment and stabilization of beak symphyseal separation using inter fragmentary wiring and provisional bis-aryl composite” by Lothamer et al, the alternative to inter fragmentary wiring and splinting would be allowing the beak to grow back on its own. Why is this less optimal, considering the fixation often becomes loose or falls off secondary to beak growth?

Answer 235

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

Question 236

According to “Treatment and stabilization of beak symphyseal separation using inter fragmentary wiring and provisional bis-aryl composite” by Lothamer et al, what size wire and how many fixation points were placed?

Answer 236

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

Question 237

According to “Treatment and stabilization of beak symphyseal separation using inter fragmentary wiring and provisional bis-aryl composite” by Lothamer et al, what were post op instructions?

Answer 237

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)

Question 238

According to “Treatment and stabilization of beak symphyseal separation using inter fragmentary wiring and provisional bis-aryl composite” by Lothamer et al, what is a dentary? what are properties of the rhampotheca? what bones make up the maxillary beak?

Answer 238

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

Question 239

According to “Treatment and stabilization of beak symphyseal separation using inter fragmentary wiring and provisional bis-aryl composite” by Lothamer et al, what is the greatest complication with beak repair? what is the best outcome associated with?

Answer 239

non-union or malunion fx; proper debridement and stabilization

Question 240

According to “Use of composite restoration materials” by Domnick, when should composite restorations be performed? what substances should not be in polish when doing a restoration and why?

Answer 240

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

Question 241

According to “Use of composite restoration materials” by Domnick, what are the steps of a restoration? based on Black’s cavity classification what are the different forms for preparation? In what class(es) are beveling cavosurface contraindicated? why?

Answer 241

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.

Question 242

According to “Use of composite restoration materials” by Domnick, what tools/burs/etc are used for cavity prep margins? what is the goal?

Answer 242

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

Question 243

According to “Use of composite restoration materials” by Domnick, what percentage is most acid etch and what type of acid? how long is it applied to enamel? exposed dentin?

Answer 243

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

Question 244

According to “Use of composite restoration materials” by Domnick, what is the purpose of acid etchants? how does it perform its function?

Answer 244

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

Question 245

According to “Use of composite restoration materials” by Domnick, what is the risk of overdrying teeth following acid etchant?

Answer 245

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

Question 246

According to “Use of composite restoration materials” by Domnick, what are properties of bonding agents? how long do they last? how deep do they penetrate?

Answer 246

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

Question 247

According to “Use of composite restoration materials” by Domnick, how often should recheck radiographs of sealed teeth be performed? what are properties of an ideal bonding agent? is there a difference in dentinal tubules between superficial and deep dentin?

Answer 247

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

Question 248

According to “Use of composite restoration materials” by Domnick, describe first, second, third, fourth, fifth, sixth, and seventh generation bonding agents, their properties including bond strength.

Answer 248

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Question 249

According to “Use of composite restoration materials” by Domnick, describe properties of fourth through seventh generation bonding agents. Which do we use?

Answer 249

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Question 250

According to “Use of composite restoration materials” by Domnick, which bonding agent is considered the true “all-in-one”? which generations have the least effective bond strength? which generation has the strongest and most consistent bond strength?

Answer 250

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

Question 251

According to “Use of composite restoration materials” by Domnick, which generation of bonding agent leaves a residual smear layer and therefore does not bond as well as fifth generation?

Answer 251

7th

Question 252

According to “Use of composite restoration materials” by Domnick, what are the 2 distinct phases of composite resins? what are some advantages of composites over amalgam?

Answer 252

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;

Question 253

According to “Use of composite restoration materials” by Domnick, what types of composite polymerization are there? what are benefits to light cure composites? what wavelength of light is used?

Answer 253

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

Question 254

According to “Use of composite restoration materials” by Domnick, what property of composites counteracts product shrinkage? what is the maximum thickness light cure resins should be applied before light curing? for how long?

Answer 254

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.

Question 255

According to “Use of composite restoration materials” by Domnick, what are some advantages of flowable composites over packable? what are the filler contents in composite resins? how does the particle size influence durability and strength?

Answer 255

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

Question 256

According to “Use of composite restoration materials” by Domnick, what is the enamel thickness in dogs and cats? what is the proposed theory of nerve stimulation via exposed dentin? how does a vital tooth repair itself?

Answer 256

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);