JVD 2015 deck Flashcards
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, what TDI were considered to be “Severe?”
lateral luxation, intrusive luxation, extrusive luxation, avulsion, enamel-dentin-pulp fx, crown-root fx w pulp involvement, and root fracture
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, this retrospective study looked at 621 patients with at least one TDI out of 2523 patients examined during time period. What was the prevalence of TDI?
26.2% accounting for 959 total injuries
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, what percent were dogs/cats? Males/females?
92.7% dogs; 7.3% cats. 48.3% males(73.4% MC), 51.7% females (not split up by dogs/cats)
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, what were the most common dog and cat breeds presented with TDI?
Labs (17.9%), GSD (8.6%), golden ret (16.8%), border collie (4.1%), mixed breed (3.3%); DSH (62.5%), DMH (10.4%), DLH *6.3%) 4 exotic cat breeds
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, where did the majority of TDI occur (maxilla/mandible, rostral/caudal)? What were the most commonly injured teeth?
Maxilla (70.7%), rostral– incisors/canines (58.7%), canines (35.5%) and premolars (33.6%); majority in strategic teeth (canines and carnassial at 60.9%)
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, given the majority of TDI were in carnassial teeth (60.9%), what percent were sustained by maxillary fourth premolars?
92.2%
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, what was the frequency of combined luxation injuries? to what teeth?
Luxation (concussion, subluxation, lateral luxation, intrusive luxation, extrusive luxation, avulsion) was 17.3%; canine and incisor teeth (79.4%); concussive injuries most commonly in canine teeth 46.4% or incisors 29.7%
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, what teeth had the highest prevalence of fracture injuries? what was the frequency of tooth fractures overall?
overall premolar teeth (39%), canine (33.3%), incisor (21%), molar (6.7%); 82.4%
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, where were enamel-dentin fractures and enamel-dentin-pulp fractures more commonly located?
in canines (40.1%)– more common in canines, and premolars (35.6%)– more common enamel-dentin
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, what tooth types were least likely to be affected by TDI?
molars (yay molars!)
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, where did crown-root fx (w and w/o pulp involvement) occur most commonly? root fractures?
premolar teeth (57.4%); incisor teeth (73.5%) primarily of the mandible
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, what were the most common age groups to sustain injury? what about luxation injuries? did reproductive status matter?
3-6y and 7-10y (33%; 31.3%); consistent with ages of concussive injuries, and fractures; <3y had more luxation; intact animals were more likely to sustain a lateral luxation
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, how many severe injuries were identified? what teeth were significantly more likely to be affected? least likely?
641 (66.8%); incisor, canines, premolars; molars
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, is the prevalence of TDI consistent with other studies?
in human literature yes; in vet med, previous studies have involved maxillofacial trauma/fractures specifically so the % has been higher (71.4-72.1%)
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, what was the most common TDI?
dental fractures (consistent w human studies)
According to “Classification and epidemiology of traumatic dentoalveolar injuries in dogs and cats: 959 injuries in 660 patient visits (2004-2012)” by Soukup, Hetzel, Paul, what was the prevalence of concussive injuries? Is this accurate per the authors?
14.4%; likely underestimated.If young, PDL may heal from minor luxation or concussive injury, however, may lead to pulp necrosis which may not be diagnosed until later (when radiographically evident). In humans, easier to diagnose based on feedback (percussion)
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what percent of feline oral tumors are SCC? What is the problem with the study referenced that found a metastatic rate of 35.7% in mandibular LN’s (higher than previously reported)?
60-70%; only 18 cats.
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what are common locations of SCC in cats?
sublingual/lingual, maxilla, mandible, buccal mucosa, lip, caudal pharynx/tonsillar region
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what are some mentioned etiologic factors for SCC?
multifactorial: possible environmental tobacco smoke (ETS) w 2-fold increase in SCC by increased mutations of p53, wearing flea collars via oral grooming leading to 5.3x more likely SCC, canned food with 3.6x more likely to develop oral SCC, tuna canned food 4.7x more likely for SCC, papillomavirus (HPV noted to be correlated in humans), altered epidermal growth fracture receptor (EGFR) expression can inhibit with tyrosine kinase inhibition, COX-2 activation with PGE2 production in inflammatory response
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, where are the most common locations anatomically in the oral cavity?
lingual/sublingual and caudal maxilla
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, ddx for SCC include what?
PD dz, other malignant tumors (FSA, PNST, LO, MM, OSA, chondrosarcoma, salivary adenocarcinoma, granular cell tumor, HSA, MCT, PCT, ectopic thyroid tissue ), benign oral lesions (GH, eosphinophilic granuloma, nasopharyngeal polyps, ABE, osteomalacia, epiulides, FIOT, APOT), infections of oral cavity (bacterial or fungal– crypto and blasto)
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, how should one best diagnosis this tumor?
Can aspirate, however, difficult on awake patient but can get good sample for cytology; if under GA B/I is best (leave enough tissue behind for surgical excision, so no B/E), mention edge of tumor not necrotic center…. take central core w/o necrosis. Surgical planning should include rads, CT, or MRI for tumor extent.
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what percent of mineral changes are required for bone loss to be seen on radiographs?
30-50%
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what staging should be done for SCC?
Regional LN aspirate (if evidence of neoplasia or suspicion, LN B/E), thoracic radiographs or CT for pulmonary met check
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what percent of oral SCC cats have mandibular LN involvement? pulmonary mets?
Study based on 18 cats: 37.5% have regional LN involvement; 10-20% have pulmonary mets
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what histologic appearance is associated with oral SCC?
cords and islands of pleomorphic neoplastic squamous epithelial cells with prominent desmosomes and occasional formation of keratin pearls
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what is the indicated treatment?
large surgical excision (when possible), radiation, chemotherapy, adjunctive treatments, or combo. High recurrence rate. MST <6mo w sx alone
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, is SCC a radiosensitive of chemosensitive tumor? What type of radiation/chemo works best?
radiosensitive; not responsive to chemo. Best radiation option is SRT following surgical excision; gemcitibine used as radio sensitizer, but really we don’t know. So many new chemo drugs (toceranib?)
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what are other adjunctive treatments?
pred vs NSAID (piroxicam shown in dogs, less COX2 in cats, maybe Onsior?), opioids (buprenorphine or tramadol), gabapentin vs amitryptilline, nutritional support (e-tube?)
According to “Focal GH in a Donkey (Equus asinus)” by Rodrigues et al, what was the likely inciting cause of the gingival hyperplasia in this donkey?
food entrapment in the vestibule causing chronic irritation and GH secondary to shear mouth
According to “Focal GH in a Donkey (Equus asinus)” by Rodrigues et al, what was the outcome?
Following correction of shear mouth, the GH did not recur
According to “maxillary third incisor tooth extraction in the dog” by Crocker, how long should the MG flap be?
1.5x the length of visible crown
According to “maxillary third incisor tooth extraction in the dog” by Crocker, how much bone should be removed from the tooth root?
50% height and 180 degrees circumferentially
According to JVD spring 2015, Effect of Frequency of Brushing Teeth on Plaque and Calculus Accumulation, and Gingivitis in Dogs,
What was the effect of brushing for plaque accumulation based on the frequency of brushing?
Daily 37% controls - NSD
According to JVD spring 2015, Effect of Frequency of Brushing Teeth on Plaque and Calculus Accumulation, and Gingivitis in Dogs,
What was the effect of brushing on the accumulation of calculus based on frequency of brushing?
Daily 80%
According to JVD spring 2015, Effect of Frequency of Brushing Teeth on Plaque and Calculus Accumulation, and Gingivitis in Dogs,
What was important about the methodology used in this study with respect to how the brushing was conducted?
Used a standardized, clearly defined procedure for brushing with defined sets of teeth and strokes, bristle angles etc.
According to JVD spring 2015, Effect of Frequency of Brushing Teeth on Plaque and Calculus Accumulation, and Gingivitis in Dogs,
Why did the authors theorize that there was a greater effect on calculus than plaque, esp. in the EOD group?
Dental calculus takes 2-3 days to be detectable, thus more frequent brushing, particularly daily or every other day, will interrupt the deposition of calcium carbonate and calcium phosphate from salivary and dietary sources at an early stage
According to JVD Spring 2015, Traumatic Intrusion of a Maxillary Canine Tooth: 3 Cases,
What are the 2 classes of traumatic dental alveolar injuries?
Separation - Separation injuries occur when a tooth is displaced away from the socket, severing the periodontal ligament fibers.
Crushing - injuries occur when the tooth is traumatically forced into the socket or alveolar bone, causing extensive damage to the periodontal ligament (PDL) and neurovascular supply
According to JVD Spring 2015, Traumatic Intrusion of a Maxillary Canine Tooth: 3 Cases,
What are the 6 types of tooth luxation injuries?
concussion, subluxation, lateral luxation, extrusion, intrusion, and avulsion.
According to JVD Spring 2015, Traumatic Intrusion of a Maxillary Canine Tooth: 3 Cases,
What size off apical foramen must be present in immature teeth to have the greatest chance of healing by revascularization?
> 0.5mm
According to JVD Spring 2015, Traumatic Intrusion of a Maxillary Canine Tooth: 3 Cases,
What are the treatment options and recommendations in people with intruded teeth, if the goal is to save the tooth?
The general guideline in human literature is to await spontaneous re-eruption in patients 17-years-old of age or those with complete root development
in cases of complete intrusion where the incisal edge is at or below the alveolar bone level, surgical repositioning is the preferred method of treatment since the tooth may be deeply wedged in the alveolar tooth socket, thus inhibiting spontaneous eruption
According to JVD spring 2015, Suspect Odontogenic Infection Etiology for Canine Lymphoplasmacytic Rhinitis,
What are the reported differentials for lymphoplasmacytic rhinitis?
neoplasia, fungal rhinitis, foreign bodies, parasitic rhinitis, lymphoplasmacytic (inflammatory) rhinitis, nasopharyngeal pathology, and rarely dental disease
According to JVD spring 2015, Suspect Odontogenic Infection Etiology for Canine Lymphoplasmacytic Rhinitis,
What is the structure outlined by arrows below?
Maxillary recess
According to JVD spring 2015, Suspect Odontogenic Infection Etiology for Canine Lymphoplasmacytic Rhinitis,
What were the authors conclusions based on all evidence with respect to odontogenic origin?
odontogenic infection was likely the cause of the lymphoplasmacytic histological findings in 55% of the cases.
Odontogenic infection was unlikely to have caused LPR in 10% of the cases.
In the remaining 35% (7 cases), it cannot be determined if odontogenic infection was related to LPR
According to JVD spring 2015, Suspect Odontogenic Infection Etiology for Canine Lymphoplasmacytic Rhinitis,
Why are bacterial cultures commonly not performed in vet med?
a normal flora or secondary infection is presumed, challenge is to obtain the cultures prior to a variety
of empirical antimicrobial therapies.
According to JVD spring 2015, Suspect Odontogenic Infection Etiology for Canine Lymphoplasmacytic Rhinitis,
What type of tooth resorption did the authors specifically identify as a potential cause of damage to the respiratory mucosa?
External inflammatory
According to JVD spring 2015, Suspect Odontogenic Infection Etiology for Canine Lymphoplasmacytic Rhinitis,
What was a major flaw with the design of this study?
There was no treatment and follow-up phase, it was simply designed to look at the diagnosis of LPR and association with odontogenic infection.
According to “Comparison of diagnostic image quality of the canine maxillary dentoalveolar structures obtained by cone beam CT and 64 multi detector row CT” by Soukup, Schwarz, et al, what is the difference in image quality of multi-detector row CT and radiography?
CT provides lower spatial resolution and limited detail of dentoalveolar structures
According to “Comparison of diagnostic image quality of the canine maxillary dentoalveolar structures obtained by cone beam CT and 64 multi detector row CT” by Soukup, Schwarz, et al, what sturctures were evaluated in the maxillary slices embedded in methymethacrylate?
trabecular bone, lamina dura, PDL space, dentin, enamel, pulp cavity
According to “Comparison of diagnostic image quality of the canine maxillary dentoalveolar structures obtained by cone beam CT and 64 multi detector row CT” by Soukup, Schwarz, et al, which modality had higher kVp? mAs? field of view?
CBCT kVp 90< MDRCT 120kVp; MDRCT 163mAs>CBCT 13mAs; MDRCT field of view 13cm/8.9cm> CBCT 6cm;
According to “Comparison of diagnostic image quality of the canine maxillary dentoalveolar structures obtained by cone beam CT and 64 multi detector row CT” by Soukup, Schwarz, et al, was there a statistical difference between 13cm and 8cm MDRCT? which modality had statistically better resolution? What was the interpretation associated with the one structural exception?
no statistical significance, CBCT superior to both; CBCT overall except for exp #1 where pulp cavity was not statistically significant; authors interpret this as an outlier
According to “Comparison of diagnostic image quality of the canine maxillary dentoalveolar structures obtained by cone beam CT and 64 multi detector row CT” by Soukup, Schwarz, et al, what are some uses of CBCT in human dentistry and oral surgery?
finding accessory root canals (cause of RCT failure); external and internal root resorption; planning for orthognathic surgery; cleft palates
According to “Comparison of diagnostic image quality of the canine maxillary dentoalveolar structures obtained by cone beam CT and 64 multi detector row CT” by Soukup, Schwarz, et al, what are advantages to CBCT over MDRCT?
3d image with better resolution, cheaper, lower radiation, more like oral radiography
According to “Bilateral Rostral mandibulectomy in the dog” by Domnick, Smith, what is the most common indicator for bilateral rostral mandibulectomy in the dog?
benign or malignant oral neoplasms that cross midline rostral to mandibular second premolar teeth; or salvage procedure for severe osteitis, rostral mandibular fx, or trauma w severe bone comminution, necrosis or PD dz is present
According to “Bilateral Rostral mandibulectomy in the dog” by Domnick, Smith, what vessels need to be ligated?
Middle mental a. and n. transected
According to “Bilateral Rostral mandibulectomy in the dog” by Domnick, Smith, what should be done to the bone to reduce tension on the suture line?
taper bone to 30-60deg caudodorsally (+/- bone tunnels)
According to “Bilateral Rostral mandibulectomy in the dog” by Domnick, Smith, what is the most common post op complication primarily at bone margins?
dehiscence!
According to “Bilateral Rostral mandibulectomy in the dog” by Domnick, Smith, how many layers should closet intraoral portion?
1-2: mucoperiosteal layer and submucosa, labial and lingual mucosa.
According to “Bilateral Rostral mandibulectomy in the dog” by Domnick, Smith, there are 2 skin closure shown, what is the difference?
symphyseal sparing or not
According to “Bilateral Rostral mandibulectomy in the dog” by Domnick, Smith, how many layers should the chelioplasty site be closed in?
3: superficial m, SQ tissue, skin (or subcuticular)
According to “Bilateral Rostral mandibulectomy in the dog” by Domnick, Smith, what are some structures that should be preserved if possible?
sublingual caruncles, if margins cannot be obtained must ligate salivary ducts; lingual frenulum as it contains genioglossus m. (trauma results in dysphagia)
According to “Bilateral Rostral mandibulectomy in the dog” by Domnick, Smith, when the symphysis cannot be spared, what is another procedure that can improve mandibular congruity? what are pros? cons? when should this be performeD?
mandibular stabilization with cortical screws and crossing K-pins inserted in both mandibular bodies and secured with figure 8 wires; can prevent degenerative changes of TMJ; cons: increase surgery time, cost, morbidity, high implant failure rate, seeding tumor cells; prior to ostectomy to ensure proper mandibular alignment and occlusion
According to “Elodontoma in 2 guinea pigs” by Capello, Lennox, Ghisleni, describe guinea pig teeth.
simplicendata: only one pair of maxillary incisor teeth; all rodent sp lack canine teeth and have large diastema btwn incisor and premolars; premolars/molars are anatomically the same and are called “cheek teeth”= 1 PM, 3M (total of 16); hypsodont (long crown), elodont (continuously growing and erupting), aradicular (no true anatomic roots); lateral convexity of mandibular cheek teeth and medial convexity of maxillary cheek teeth leads to 30 deg oblique occlusal plane sloping from dorsal to ventral, lateral to medial
According to “Elodontoma in 2 guinea pigs” by Capello, Lennox, Ghisleni, what is the most common cause of abnormalities of incisor teeth with the exception of trauma?
coronal elongation resulting in malocclusion of cheek teeth
According to “Elodontoma in 2 guinea pigs” by Capello, Lennox, Ghisleni, what is a sequelae of cheek tooth malocclusion that occurred in case #2?
tongue entrapment
According to “Elodontoma in 2 guinea pigs” by Capello, Lennox, Ghisleni, what is an odontoma?
odontoma: benign tumor of odontogenic origin or non-neoplastic malformation (hamartoma) of a mixture of dental tissues either compound (pound of denticles) or complex (no true formation of tooth like structures); histologically container dentin, enamel matrix, odontogenic epithelium resembling enamel organ, and cementum. Locally expansile.
According to “Elodontoma in 2 guinea pigs” by Capello, Lennox, Ghisleni, what is odontogenic dysplasia vs elodontoma?
odontogenic dysplasia common in prairie dogs/squirrels and seen in rabbits and rodents. Non-neoplastic dysplastic malformation occurring when normal tooth eruption is impaired or arrested, aka pseudo-odontoma; term used to describe odontomas in squirrels, rodents and animals with elodont teeth avoiding the debate of hamartoma vs odontoma allows for term elodontoma differentiated from odontogenic dysplasia via rads, CT and histopath.
According to “Elodontoma in 2 guinea pigs” by Capello, Lennox, Ghisleni, what are some possible causes of odontogenic dysplasia in prairie dogs and squirrels?
repeated trauma, fx, acquired dental disease
According to “Elodontoma in 2 guinea pigs” by Capello, Lennox, Ghisleni, in the first case it was maxillary with a history of clinical crown amputation prior to referral, no obvious signs of infection with proliferative bony region. what did the histopathology reveal?
neoplastic conglomerates of haphazardly arranged odontogenic hard and soft tissues. Mass made up of odontogenic epithelium closely associated with dentin and cementum-like mineralized tissue. Histo dx: elodontoma
According to “Elodontoma in 2 guinea pigs” by Capello, Lennox, Ghisleni, why was the term elodontoma appropriate for both cases?
lesions were continuous with apices of elodont (open rooted continuously growing) incisor and cheek teeth.
According to “Maxillary calcifying epithelial odontogenic tumor in a Siberian Tiger (Panthera tigris altaica),” what is another proposed name for calcifying epithelial odontogenic tumors (CEOT) in animals? why is this different from humans?
APOT (amyloid producing odontogenic tumor); bc in animals palisades of basal cells and stellate reticulum vs in humans CEOT is dominated by sheets of eosinophilic epithelial cells that exhibit nuclear pleomorphism.
According to “Maxillary calcifying epithelial odontogenic tumor in a Siberian Tiger (Panthera tigris altaica),” what was the outcome of this case?
Bx revealed CEOT (or APOT), tiger died 3 months later from advanced renal disease. Probably primary cause of his decreased appetite.
According to “Maxillary calcifying epithelial odontogenic tumor in a Siberian Tiger (Panthera tigris altaica),” what are some theories for increased neoplasia in zoo felids?
Living longer lives in captivity due to better care, environment including increased carcinogens.
According to “Peripheral Giant Cell Granuloma in a Dog” by Hiscox, Dumais, the mass was marginally resected and recurred twice prior to referral and histopathology. What was the size difference at time of referral?
Originally only a few mm between maxillary incisors; at time of referral 2.5-3cm
According to “Peripheral Giant Cell Granuloma in a Dog” by Hiscox, Dumais, what were the CT findings? what were Ddx?
~2cm expansile mass with poorly defined borders localized to incisive bone with secondary osteolysis and periosteal reaction. No mets were noted in regional LNs, chest or abdomen; ddx: neoplasia – FSA, OSA, chondrosarcoma, SCC, melanoma most likely
According to “Peripheral Giant Cell Granuloma in a Dog” by Hiscox, Dumais, what is the classic presentation histologically of PGCG?
numerous type I multinucleate giant cells with up to 20 nuclei within a loose storm composed of spindle cells and minimal to moderate amounts of collagen
According to “Peripheral Giant Cell Granuloma in a Dog” by Hiscox, Dumais, the biopsy revealed PGCG and the dog returned for incisivomaxillectomy 6 weeks later. The final histopath revealed marginal resection dorsally. Why was this not a concern?
This is a benign tumor that is locally expansile and thought to arise from odontogenic tissues.
According to “Peripheral Giant Cell Granuloma in a Dog” by Hiscox, Dumais, what is the definition of exophytic?
exophytic means a growth positioned and originating from an epithelial surface or surface of an organ; in the oral cavity this would be any lesions that projects above the surface of the gingiva or mucosa.
According to “Peripheral Giant Cell Granuloma in a Dog” by Hiscox, Dumais, what are he 2 categories of epulides? what are the four most common reactive epulides in humans?
reactive and POF; FFH, pyogenic granuloma, POF, PGCG; previously reported FFH most common reactive epulides in dog
According to “Peripheral Giant Cell Granuloma in a Dog” by Hiscox, Dumais, how common is PGCG in humans? what tissues is it thought to arise from? in response to what?
7% of all human oral tumors (more common in 50s/60s with slight female predilection); periosteum or PDL; response to local irritants (trauma, tooth ext, poorly finished restorations, plaque, calculus, impacted food)
According to “Peripheral Giant Cell Granuloma in a Dog” by Hiscox, Dumais, what are the 2 types of PGCG? what are the 2 types of MNGC?
Classic and collision; collision PGCG areas of stellate mesenchymal cells in fibrous storm w regularly spaced blood vessels suggestive of fibromatous epulis of PDL (POF); both types most important histo feature is MNGC (multi nucleated giant cells). 2 types of MNGC: Type 1 larger nuclei distinct nucleoli and more basophilic cytoplasm (classic, this case), Type II smaller with more eosinophilic cytoplasm w condense hyper chromatic and irregular nuclei (collision).
According to “Peripheral Giant Cell Granuloma in a Dog” by Hiscox, Dumais, what is the recommended tx for this mass type? what are recurrence rates in humans?
local excision to the level of underlying normal bone and identification of any irritants; highly variable avg of 10%, failure to remove source of irritation.
According to “Peripheral Giant Cell Granuloma in a Dog” by Hiscox, Dumais, what is the circled structure?
MNGC=multi-nucleated giant cells
According to “The negative effects of volatile sulphur compounds” by Milella, what is oral malodor a result of? What are the most frequently associated VSCs in oral malodor?
orla malodor result of microbial metabolism of exogenous and endogenous proteinaceous substrates leading to the production of compounds such as indole, skittle, tyramine, cadaverine, puterscine, mercaptans, and sulphides; hydrogen sulfide (H2S) and methyl mercaptan (CH3SH)
According to “The negative effects of volatile sulphur compounds” by Milella, what do hydrogen sulfide and methyl mercaptan contain that may react with DNA and proteins? what effect do these groups have on mucosal solubility?
Thiol (-SH) groups; penetrate surface epithelium and penetrate across the underlying basal membrane increasing permeability by potentially cleaving disulfide bonds
According to “The negative effects of volatile sulphur compounds” by Milella, how do VSCs cause damage to tissues through increased permeability of mucosa?
cleavage of disulphide bonds in proteins which form the matrix of the oral mucosa. They are both reduction agents.
According to “The negative effects of volatile sulphur compounds” by Milella, what are 3 steps of cleavage of disulphide bonds?
VSC is deprotonated forming a thiolate anion; second thiolate anion attacks and cleaves the disulphide bond; third the remaining anion is protonated
According to “The negative effects of volatile sulphur compounds” by Milella, what effect to VSCs have on epithelial cells?
Hydrogen sulfide indices apoptosis of epithelial cells; cytochrome C (inner membrane of mitochondria) initiates apoptosis and is increased; Caspase 9 and 3 are activated (imp role in apoptosis, necrosis and inflammation); DNA strand breaks increased esp at 48h