JVD 2015 deck Flashcards
1
Q
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?”
A
lateral luxation, intrusive luxation, extrusive luxation, avulsion, enamel-dentin-pulp fx, crown-root fx w pulp involvement, and root fracture
2
Q
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?
A
26.2% accounting for 959 total injuries
3
Q
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?
A
92.7% dogs; 7.3% cats. 48.3% males(73.4% MC), 51.7% females (not split up by dogs/cats)
4
Q
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?
A
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
5
Q
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?
A
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%)
6
Q
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?
A
92.2%
7
Q
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?
A
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%
8
Q
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?
A
overall premolar teeth (39%), canine (33.3%), incisor (21%), molar (6.7%); 82.4%
9
Q
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?
A
in canines (40.1%)– more common in canines, and premolars (35.6%)– more common enamel-dentin
10
Q
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?
A
molars (yay molars!)
11
Q
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?
A
premolar teeth (57.4%); incisor teeth (73.5%) primarily of the mandible
12
Q
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?
A
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
13
Q
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?
A
641 (66.8%); incisor, canines, premolars; molars
14
Q
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?
A
in human literature yes; in vet med, previous studies have involved maxillofacial trauma/fractures specifically so the % has been higher (71.4-72.1%)
15
Q
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?
A
dental fractures (consistent w human studies)
16
Q
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?
A
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)
17
Q
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)?
A
60-70%; only 18 cats.
18
Q
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what are common locations of SCC in cats?
A
sublingual/lingual, maxilla, mandible, buccal mucosa, lip, caudal pharynx/tonsillar region
19
Q
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what are some mentioned etiologic factors for SCC?
A
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
20
Q
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?
A
lingual/sublingual and caudal maxilla
21
Q
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, ddx for SCC include what?
A
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)
22
Q
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, how should one best diagnosis this tumor?
A
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.
23
Q
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?
A
30-50%
24
Q
According to “Feline oral SCC: clinical manifestations and literature review” by Biologic, Lewis et al, what staging should be done for SCC?
A
Regional LN aspirate (if evidence of neoplasia or suspicion, LN B/E), thoracic radiographs or CT for pulmonary met check
25
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
26
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
27
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
28
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?)
29
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?)
30
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
31
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
32
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
33
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
34
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
35
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%
36
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.
37
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
38
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
39
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.
40
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
41
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
42
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
43
According to JVD spring 2015, Suspect Odontogenic Infection Etiology for Canine Lymphoplasmacytic Rhinitis,
What is the structure outlined by arrows below?
Maxillary recess
44
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
45
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.
46
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
47
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.
48
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
49
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
50
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;
51
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
52
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
53
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
54
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
55
According to "Bilateral Rostral mandibulectomy in the dog" by Domnick, Smith, what vessels need to be ligated?
Middle mental a. and n. transected
56
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)
57
According to "Bilateral Rostral mandibulectomy in the dog" by Domnick, Smith, what is the most common post op complication primarily at bone margins?
dehiscence!
58
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.
59
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
60
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)
61
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)
62
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
63
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
64
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
65
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
66
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.
67
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.
68
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
69
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
70
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.
71
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.
72
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.
73
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.
74
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
75
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
76
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
77
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.
78
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.
79
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
80
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)
81
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).
82
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.
83
According to "Peripheral Giant Cell Granuloma in a Dog" by Hiscox, Dumais, what is the circled structure?
MNGC=multi-nucleated giant cells
84
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)
85
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
86
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.
87
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
88
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
89
According to "The negative effects of volatile sulphur compounds" by Milella, what effect do VSCs have on fibroblasts?
increased level of ROS via hydrogen sulfide induce apoptosis and break DNA strands in fibroblasts, increased phosphorylated p53 (apoptosis factor), methyl mercaptan inhibits proliferation of gingival fibroblasts and reduces collagen synthesis by 39% with enhanced degradation of newly synthesized collagen by 62%
90
According to "The negative effects of volatile sulphur compounds" by Milella, what effect do VSCs have on osteoclast and osteoblast activity?
Hydrogen sulphide induces osteoclast differentiation, in conjunction with LPS had added effect on RANKL and inure activation of osteoclasts via RANK
91
According to "The negative effects of volatile sulphur compounds" by Milella, how do VSCs effect periodontal disease?
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92
According to "The negative effects of volatile sulphur compounds" by Milella, what is the normal pH of dogs saliva? how does this effect the degree of PD dz in dogs?
pH is 8.5; permeability of oral mucosa is a base-catylized reaction, a more alkaline pH would have higher effect leading to increased permeability
93
According to "The negative effects of volatile sulphur compounds" by Milella, what effect do VSCs have on PD dz?
methyl mercaptan induces IL-1B which acts synergistically with LPS to increase PGE2 and colagenase (mediators of inflammation and tissue destruction); modify wound healing, exacerbate the progression of PD dz,
94
According to "The negative effects of volatile sulphur compounds" by Milella, what are some available tx for VSCs?
Zinc chloride restores permeability of oral mucosa, blocks inhibition of protein synthesis and secretion by methyl mercaptan; dental prophylaxis; daily brushing +/- chlrohexidine rinse daily; chewing to release saliva; dental diets and chews may also help
95
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, in one study referenced, what happened to PTH levels as GFR declined in human CKD patients?
PTH levels increased as GFR declined
96
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, in a study of 80 cats with CKD what was the incidence of renal secondary hyperparathyroidism? what about a second study of dogs with CKD?
84%; dogs hyperparathyroidism was 75.9% with CKD
97
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what is fibrous osteodystrophy? where is renal osteodystrophy most common in dogs?
severe renal osteodystrophy which demineralized bone becomes replaced by fibrous CT aka rubber jaw; mandibles, hence rubber jaw
98
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what is hyperostotic osteodystrophy?
renal secondary hyperparathyroidism resulting in swelling and distortion of the skull and mandibles where fibrous replacement of demineralized bone in YOUNG DOGS; older dogs typically get rubber jaw and bones are not swollen (isostatic osteodystrophy)
99
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what are the most important regulators of calcium metabolism? phosphorous metabolism?
PTH and vitamin D metabolites for calcium; PTH and fibroblast growth factor 23 (FGF 23) for phosphorous
100
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what are the two theories of renal hyperparathyroidism?
phosphate trade off hypothesis: nephrons lost and GFR declines, less phosphorous can be excreted into urine and hyperphosphatemia develops reducing ionized calcium (hypocalcemia) triggering PTH production, here calcium homestasis maintained but trade was hyperparathyroidism (debunked bc in absence of hypocalcemia, hyperparathyroidism develops); kidney disease results in relative or absolute deficiency of metabolically active vitamin D (calcitriol): reduced calcitriol leads to less calcium absorption, animals cannot synthesize cholecalciferol in their skin via sunlight, damage to renal proximal tubular cells in CKD reduces calcitriol synthesis (new for intestinal absorption of dietary calcium and phosphorous) leading to progressive hypocalcemia and PTH secretion
101
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what 3 ways to PTH levels increase in response to reduction is serum ionized calcium levels and restore normocalcemia?
1-PTH secretion stimulates osteoclastic resorption of bone releasing ca and phos, 2-PTH acts on renal proximal tubular cells to increase Ca reabsorption and FGF 23 enhances renal excretion of Phos; 3- PTH stimulates increased renal production of calcitriol from calcidiol by increasing 1-alpha-hydroxylase activity (enhances intestinal absorption of dietary calcium; as renal disease progresses not enough renal proximal tubular cells and rely too much on bone destruction for ca/phos homeostasis.
102
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what are the 3 types of hyperparathyroidism?
Primary: excessive and inappropriate secretion of PTH occurs, adenoma/parathyroid gland carcinoma, ionized hypercalcemia ins presence of normal or elevated PTH; secondary: elevated PTH is compensatory physiologic response to maintain ca/phos homeostasis (nutritional or renal); tertiary: secondary has been present for so long that despite eliminating inciting cause, PTH secretion continues (requires parathyroidectomy)
103
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, define osteopenia, osteoporosis, and osteomalacia.
Osteopenia: decreased opacity of bone on rads; osteoporosis: generalized age-related decrease in bone density, primary disease in humans not described in dog or cat; osteomalacia clinical diagnosis refers to soft malleable bones
104
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what is meant by rickets?
osteomalacia secondary to CKD is renal rickets; rickets is secondary to deficiency of Vet D (calcitriol); in children with hypominerliazation of osteiod= rickets (prior to epiphyseal closure); in adults=osteomalacia (same process affects bones after cessation of growth)
105
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what are some oral radiographic findings of renal osteodystrophy?
diminished radiopacity of lamina dura, ground glass appearance of trabecular bone, reduced thickness of cortical bone, pathological bone fractures
106
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what is uremic leontiasis osier?
swelling or distortion of skull and jaws in humans with CKD and fibrous osteodrystrophy (lion head), all ages, not just children
107
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what are some dental lesions seen in human patents with renal secondary hyperparathyroidism?
delayed tooth eruption, hypo plastic enamel (children), dental erosions, pulpal obliteration duets soft tissue calcification within pulp cavity in adults
108
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, how does renal osteodystrophy in dogs manifest orally?
facial swelling, excessive malleability of mandibular bones, mobile teeth despite normal probing depths, pathological bone fx which may result in malocclusion (teeth are floating in space), ground glass appearance of bone
109
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what are some oral soft tissue complications reported in dogs with CKD?
uremic halitosis, xerostomia, mucosal ulcerations, sloughing of rostral aspect of tongue. Dental dysplasia
110
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, in the case report of a 10y weimereiner, what was the outcome?
Severe secondary renal hyperparathyroidism with mandibular pathologic fx, IRIS 3, severe bone loss with fibrous osteodystrophy; prognosis was guarded to poor. Patient was able to continue eating despite distorted maxillofacial region. Dx made based on rads, BW, PTH levels.
111
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what are some potential treatments?
pet foods for renal disease, calcitriol therapy
112
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what is similar to hyperostotic osteodrystrophy in young dogs in humans?
lentiasis ossea (bony proliferation)
113
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, are osseous changes in cats with CKD and renal secondary hyperparathyroidism common?
NO!
114
According to "Oral manifestations of chronic kidney disease and renal secondary hyperparathyroidism: a comparative review" by Davis, what is cystic osteodystrophy? is it seen in dogs/cats?
cystic structures with blood by products (hemosiderin) making them appear brown grossly, may be focal aggressive osteolytic lesions in cortical bone, seen in humans, cats and dogs with CKD
115
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what is the previously reported bite force for humans and dogs?
humans 109-500N (high of 740); dogs 256-937N
116
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what types of forces are applied to canine teeth of working dogs?
compression, shear, tensile
117
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what are the "base metals of choice" for prosthodontic crowns. Why? what are the nobel metals? corrosion resistant?
titanium, nickel, copper, silver zinc. Have more strength and flexibility. ruthenium, rhodium, palladium, silver, osium, iridium, platinum, gold; corrosion resistant: titanium, niobium, tantalum
118
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what is the downside to placing a prosthodontic crown on a vital tooth (cage-bar chewing or 3/4 crown)?
Crown prep removes enamel and exposes dentinal tubules which can lead to dental pain and sensitivity; tooth prep can be irritating to vital pulp leading to irreversible pulpitis and pulp necrosis
119
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, in this 13y retrospective the authors looked at what types of prosthetic crowns?
full jacket metal crowns, partial and 3/4 crowns made of different metals/zirconia
120
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what was considered successful?
crown remained in place with no further structural injury to tooth until time of death of dog
121
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what percent were working dogs? what was the average chewing activity score? what was the location of the crowns? how many were partial crowns? did they all receive RCT?
29/41 or 70.7%; 2.7; 92.6% (63/68 teeth) were canines, 7.4% (5/68 teeth) were maxillary fourth premolars; 8.3% (12/68 teeth) were partial crowns; 1 had RCT, 2 had Type I CR/L, 9/12 did not require RCT or perio surgery prior to crown prep
122
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, of the 56/68 teeth that were full jacket crowns, what types of endodontics were performed?
48.2% (27/56) had RCT, 3.6% had RCT and post-and-core procedure, 7.1% (4/56) had RCT and type I CR/L, 30.4% had RCT and type II CR/L, 1.8% (1/56) had RCT, type II CR/L, and post-and-core procedure, 7.1% (4/56) did not receive endodontic or perio surgery
123
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what types of margins were used for full jacket and partial crown preps?
all were supra gingival 1-2mm; partial crown: vertical margins knife or feathered edge, horizontal margins chamfer; full jacket: chamfer
124
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what were the different types of cast metals used?
semi-precious nickel-free alloy 54.4%, non-precious nickel-free alloy 17.6%, base metal nickel-free alloy 13.2%, stainless steel 11.8%, zirconium 2.9%
125
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what type(s) of luting cement was used?
all were resin-based luting cement (100%, 68 teeth)
126
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what percent of teeth had bone failure? fracture? successful?
4.4% had bond failure, 1 full crown on upper fourth premolar and 2 3/4 crowns on canines; 10.3% (7/68) fractured, 6 full crowns and 1 partial; 85.3% successful in 58
127
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what is the purpose of an prosthetic crown as an onlay? how many were full and partial?
protects damaged tooth, improves fx, allows occlusal forces to be distributed more favorably; 56/68 full, 12/68 partial
128
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what is suboptimal about the feather edge?
has a bevel of 70deg or greater, very minimal enamel/dentin removal leading to poor CA
129
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what are the 3 types of luting cements? what are their properties?
water-based: glass ionomer, zinc polyacrylate, zinc phosphate, low bond to tooth and no anticariogenic properties; oil-based for temporary restorations most often ZOE; resin-based a resin matrix w inorganic fillers bonded to matrix via an organosilane coupling agent, used for crowns, inlays, bridges, veneers, and orthodontic brackets, stronger that water and oil-based our to their virtual insolubility in oral fluids and molecular potential to effectively bond to dentin, high compressive and tensile strengths, also less micro leakage at crown compared to zinc phosphate
130
According to "Assessment of 68 prosthodontics crowns in 41 pet and working dogs (2000-2012)" by Fink and Reiter, what are the goals in crown prep to increase retention and resistance form?
increase retention/resistance form leads to lower CA and higher height/diameter ratio
131
According to "CO2 laser excision of lingual calcinosis circumscripta in a dog" what was the histologic diagnosis of the lingual mass? Describe calcinosis circumscripta
CC Stage III; uncommon non-neoplastic syndrome of ectopic mineralization in dogs/cats, idiopathic, dystrophic, metastatic and iatrogenic forms have been noted. Calcium salts deposited in the form of nodular lesions in soft tissues. Usually solitary and mostly affecting the skin, limbs, tongue. Make up 4% of lingual pathology. Surgical excision is curative.
132
According to "CO2 laser excision of lingual calcinosis circumscripta in a dog" what are differentials for a lingual mass?
abscess, FB pyogranuloma, chronic inflammation, mycoses, eosinophilic granuloma, uremic ulcer, neoplasia, CC
133
According to "CO2 laser excision of lingual calcinosis circumscripta in a dog" describe the 3 stages of CC.
Stage 1: early lesions, absence of or minimal fibroplasia and inflammation. Stage 2: intermediate lesions, mild to moderate granulomatous reaction and fibroplasia. Stage III: late lesions, marked granulomatous inflammation, fibroplasia and mineralization. Clinically Stage I and II are fluctuant or cystic while stage III are firm. Surgical excision is curative for all.
134
According to "CO2 laser excision of lingual calcinosis circumscripta in a dog" what was the benefit to using the CO2 laser?
tongue is muscular and highly vascular, direct hemostasis by cutting and coagulating vessels up to 0.5mm in diameter, increases visibility, decreases operative time, minimizes muscle or nerve stimulation compared to electrosurgical excision.
135
According to "Ventral approach for surgical management of feline sublingual sialocele" by Papazoglou, Tzimitris et al, describe a sialocele and its treatment.
Sialoceles are subcutaneous, sublingual, or pharyngeal accumulations of saliva that extravasated through a salary gland/duct defect. The paraoral extravasation of saliva from the defect results in sublingual sialocele/ranula. Tx includes removal of mandibular and sublingual salivary gland/duct complexes with marsupialization of the sialocele.
136
According to "Ventral approach for surgical management of feline sublingual sialocele" by Papazoglou, Tzimitris et al, what is the most common location for a sialocele in the cat?
sublingual
137
According to "Lateral approach for surgical management of feline sublingual sialocele" by Smith, what are the most common diseases of the salivary gland n cats?
sialocele and neoplasia
138
According to "Lateral approach for surgical management of feline sublingual sialocele" by Smith, what is different about a cervical sialocele? what are sialoliths?
cervical sialoceles are inflammatory; sialoliths are concretions of calcium phosphate or calcium carbonate
139
According to "Lateral approach for surgical management of feline sublingual sialocele" by Smith, what is the difference btwn a sialocele and a cyst?
A cyst is an epithelial lined structure while a sialocele is a reactive encapsulating structure
140
According to "Lateral approach for surgical management of feline sublingual sialocele" by Smith, why is removal of both sublingual and mandibular salivary glands/ducts necessary?
bc of their anatomic intimate association
141
According to "Lateral approach for surgical management of feline sublingual sialocele" by Smith, does bilateral resection of mandibular and sublingual gland/duct complex result in xerostomia?
Nope!
142
According to "Lateral approach for surgical management of feline sublingual sialocele" by Smith, from the lateral (or dorsal) approach, what structures are first identified and incised?
incise the platysma m. and the SQ tissues; note the bifurcation of the external jugular v.; mandibular gland is btwn maxillary and linguofacial v.
143
According to "Lateral approach for surgical management of feline sublingual sialocele" by Smith, instead of marsupialization what does the author do?
penrose drain in mandibular salivary gland resection site; no marsupialization or removal of the sublingual sialocele, it will drain through the penrose in the mandibular resection site
144
According to "Measurement of incisor overate and physiological diastemata parameters in quarter horse foals" by Omura, Gioso, et al, what is an overjet bite? overbite? mandibular brachygnathism?
protrusion of the maxillary incisor teeth rostral and horizontally beyond the limits of the mandibular incisor teeth in centric occlusion; overbite refers to a greater extent of horizontal, rostral and vertical overlap of maxillary incisor teeth; Class II malocclusion aka parrot mouth condition in which maxillary incisor teeth protrude more rostrally than mandibular incisor teeth resulting in absence of occlusal contact btwn maxillary and mandibular incisors. Mal II leads to overbite or overjet and may be caused by maxillary prognathism.
145
According to "Measurement of incisor overate and physiological diastemata parameters in quarter horse foals" by Omura, Gioso, et al what is the most common cause of malocclusion in the horse?
Mandibular brachygnathism, 2-5% in equines
146
According to "Measurement of incisor overate and physiological diastemata parameters in quarter horse foals" by Omura, Gioso, et al was there a significant difference btwn maxillary and mandibular physiologic diastema? was there a correlation btwn age and physiologic diastemata lengths? when does maximum uniform growth of rostral components of maxilla and mandible occur in foals?
yes; positive correlation, yes; 4-5mo of age
147
According to "Measurement of incisor overate and physiological diastemata parameters in quarter horse foals" by Omura, Gioso, et al, how many had overjet? how many were female? how many had overbite? was there correlation btwn age and overjet values? what was the prevalence of overjet in each type of horse group?
51%; 61.5% female; none had overbite; no correlation; 72.2% in show, 44% in race, 25% working lineage foals
148
According to "Measurement of incisor overate and physiological diastemata parameters in quarter horse foals" by Omura, Gioso, et al, what was noted about Quarter horse foals and overjet condition?
overjet was more common in female Quarter horses of show lineage perhaps due to their imbreeding for shorter more convex faces,
149
According to "Fluoride-Releasing restorative materials" by McCoy, Random review question: How does the physical and
mechanical properties of the 4 different categories of fluoride-releasing restorative materials compared?
```
Resin composites (RC) : better mechanical properties, better wear resistance, but provide the smallest amount of fluoride release.
Conventional glass ionomers (CGI): are adhesive, have thermal-expansion coefficients similar to those of tooth structure, and release comparatively
high levels of fluoride, but do not have good wear resistance.
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150
According to "Fluoride-Releasing restorative materials" by McCoy, what are the 4 categories of fluoride releasing materials?
Resin composite : better mechanical properties, better wear resistance, LEAST amount of fluoride release; conventional GI : adhesive, thermal expansion coefficients similar to those of tooth structure, release HIGH levels of fluoride, no wear resistance compared to resin composites. RMGI: elements of GI and light cured resins, increased fluoride release, smoother restoration surface, prone to abrasion, decreased flexural strength, cannot be used on load-bearing surfaces. Compomers : blends of GI and resin composite, more resin the RMGI, more fluoride than resin composites but less than GI/RMGI, better physical and mechanical properties more like composites.
151
According to "Fluoride-Releasing restorative materials" by McCoy, what are the benefits to fluoride being release from dental materials?
can induce remineralization of demineralized tooth structure secondary to carious lesions, leads to reduced enamel solubility and therefore decreased caries rates, inhibits bacterial acid production, alter environment to reduce bacteria succession.
152
According to "Fluoride-Releasing restorative materials" by McCoy, what is better for fluoride release, larger or smaller amounts of fluoride in solution? what is the correlation to compressive strength and fluoride?
smaller levels of fluoride ion have larger % absorbed by enamel than larger amounts; negative correlation btwn fluoride release and compressive strength, high fluoride release usually have lower strengths
153
According to "Fluoride-Releasing restorative materials" by McCoy, what is the effective zone of fluoride release from restoratives? when is the release greatest for GI?
1mm from restoration's margins; on the first day, then declines
154
According to "Fluoride-Releasing restorative materials" by McCoy, what is recharge? which materials have the greatest amount of recharge?
ability of fluoride releasing restorative materials to be recharged and release more fluoride in the presence of an external source (topical); RMGI and conventional GI, compomers have some. Thought to be due to GI and resin-modified GI.
155
According to "Fluoride-Releasing restorative materials" by McCoy, KNOW THIS CHART!!!
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156
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, what is the prevalence of dental fractures in dogs? what is the most commonly fractured tooth?
27%; canine tooth 35.5 to 57.1% (depending on the study quoted)
157
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, what is "moment" the formula, and what does each part mean?
M=Fa, M=moment, F=force, a=moment arm. Crown height is moment arm for a force applied perpendicular to the long axis of the tooth. Longer the moment arm (taller the crown) the greater the moment generated at the base of the tooth. Moment is directly proportional to bending stress, tensile and compressive stresses it produces
158
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, how were the 30 beagle teeth measured for hard tissue volume?
H/D ratio measured, total crown volume calculated w elliptical cone formula, lateral rad of each tooth measured pulp chamber diameter, pulp chamber volume measured using cone formula, pulp chamber volume subtracted from total crown volume to yield hard tissue volume
159
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, how did the authors come up with their margin of safety bite force number?
avg biting force during exercises of 6 military dogs was 480-1000N, took this by half as this model is on a single tooth, not using both maxillary canines
160
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, what were the mean forces required to fracture teeth in groups A, B, and C? what does each group represent?
Group A (normal tooth, intact): 494N; Group B (10% height reduction): 573N; Group C (20% height reduction): 630N
161
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, what was the relationship btwn H/D and mean force applied to fracture teeth? Was there a significant difference between mean force applied to each group? what about between groups?
inverse relationship btwn H/D and mean force to fracture tooth observed (shorter crown requires more force); no sig difference btw mean force to fracture between groups A/B or B/C; sig difference of mean force to fracture between A and C!
162
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, what was the probability of tooth fracture in each group? what was the decreased probability of tooth fracture in group B and C?
A=36.7%, B=27.8%, C-14.5%; B decreased by 24.1%, C decreased by 60.4%
163
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, using paired MoS analaysis how did a 20% H/D decrease probability of tooth fracture? what about unaltered contralateral canine?
decreased probability of fracture by 86.5%; increased probability of fracture of unaltered contralateral canine tooth by 54.4%
164
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, what is the overall conclusion?
reduction in H/D increases fracture resistance
165
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, what are other fractures besides H/D that contribute to fracture resistance of a tooth?
mechanical properties: modulus of elasticity, hardness, toughness; differences in hard tissue volume, other unknown factors
166
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, what are some limitations of this study?
small sample population, high biting pulling force used as reference (from military bite dogs), other factors affecting tooth fracture (dog breed/size, pre-existing wear, habits of dog, work demand, chewing enthusiasm), estimating hard tissue volume in a structure with non-uniform shape, testing outside warm moist environment, load at 45deg angle is speculative, no compliance of PDL in study (stiffness of potting may have increased stress at base of tooth)
167
According to "The influence of crown height to diameter ratio on the force to fracture of canine teeth in dogs" by Soukup, Ploeg, what angle was used to fracture teeth and what forces were applied by this load vector?
45deg angle to long axis of tooth; compressive and bending stresses within tooth
168
According to "Lingual malignant peripheral nerve sheath tumor in a chinese pug dog" by Baratt, Rawlinson, Jones, what is the previously references rate of lingual tumors and what are the most common types?
2-4% of all oral tumors in the dog; MM and SCC malignant, squamous papilloma, plasma cell tumor and granular cell tumor (GCT) benign
169
According to "Lingual malignant peripheral nerve sheath tumor in a chinese pug dog" by Baratt, Rawlinson, Jones, what is the cell lineage of GCT and MPNST? What special immunohistochemistry can be used for both?
Neural in origin, Schwann cell lineage; stain positive for PAS (glycoproteins), S-100 (neurofilament marker), vimentin (intermediate filament protein exp. in mesenchymal cells) and NSE (marker for neoplastic cells of neuronal and neuroendocrine lineage)
170
According to "Lingual malignant peripheral nerve sheath tumor in a chinese pug dog" by Baratt, Rawlinson, Jones, histologically on the incisional biopsy what was noted? The excisional biopsy?
no mitotic figures, neoplasia of uncertain lineage suspect GCT with positive PAS stain, vimentin, S-100 and NSE; 6mitotic figures/10hpf, neoplastic cells associated with numerous peripheral nerves, same stain and immunohistochemistry
171
According to "Lingual malignant peripheral nerve sheath tumor in a chinese pug dog" by Baratt, Rawlinson, Jones, what type of surgical approach was taken for the rostral glossectomy? what are the most common complications of glossectomy?
Scalpel blade (better regeneration of lingual papillae compared to CO2, cautery, etc), ligation of lingual a/v, electrocoagulation for smaller vessels, single layer closure with simple interrupted. 2cm margins obtained; dehiscence and ptyalism
172
According to "Lingual malignant peripheral nerve sheath tumor in a chinese pug dog" by Baratt, Rawlinson, Jones, what is the most common site for GCT?
tongue
173
According to "Comparison of dorsal and buccal approaches for surgical extraction of the mandibular canine tooth in cat specimens using radiographic and CT analysis" by Somrak, Marretta, Matheson, et al what are the mentioned risks of traditional buccal approach mandibular canine extraction?
iatrogenic mandibular fracture or symphyseal separation (big ones), hemorrhage, tissue trauma, root fractures or retained root tips, iatrogenic nerve injury, trauma to frenulum, to middle mental
174
According to "Comparison of dorsal and buccal approaches for surgical extraction of the mandibular canine tooth in cat specimens using radiographic and CT analysis" by Somrak, Marretta, Matheson, et al, what approaches have been previously described?
buccal, lingual, this study looked at dorsal approach
175
According to "Comparison of dorsal and buccal approaches for surgical extraction of the mandibular canine tooth in cat specimens using radiographic and CT analysis" by Somrak, Marretta, Matheson, et al, what was measured?
12 cadaver specimens, one side buccal one side dorsal approach; measured extraction time, closure time, volume of bone lost during alveolectomy, occurence of iatrogenic jaw fracture or symphyseal separation
176
According to "Comparison of dorsal and buccal approaches for surgical extraction of the mandibular canine tooth in cat specimens using radiographic and CT analysis" by Somrak, Marretta, Matheson, et al, was there significant difference between mean extraction times, closure times, total times, bone loss, iatrogenic complications?
no sig btwn mean extraction times, statistically sig slower buccal closure times, overall times no statistical sig diff, greater bone loss with dorsal but no sig diff, no complications were noted
177
"Managing endodontic instrument separation" by McCoy, what are the two most common causes of instrument separation?
instrument fatigue from overuse, applying excessive apical pressure (rotary motion); separation from manufacturing defect is rare
178
"Managing endodontic instrument separation" by McCoy, where are NiTi files designed to break?
at the shaft-thank jnctn under extreme force/torque, but it can occur anywhere along the file
179
"Managing endodontic instrument separation" by McCoy, what should you do if an instrument breaks?
take a radiograph, use loupes or surgical microscope for visualization, strong attempts to remove (file braiding, magnetized instruments, ultrasonic endo tips), enlarge access, owner informed, then consider switching to different option
180
"Managing endodontic instrument separation" by McCoy, what if you can't get the file out?
can obturate around it (?!) as long as cleaning, shaping is adequate with regular radiographs monitored, can convert to an apico, can extract
181
"Managing endodontic instrument separation" by McCoy, how often should NiTi files be changed? what about path finderS?
3-6 uses; only use once!
182
According to "management of TMJ luxation in a cat using a custom-made tape muzzle" by Somrak, Maretta, what is the most common TMJ luxation presentation in a cat?
rostrodorsal displacement of one mandibular condyle with mandibles shifted to the side opposite of the luxation; clinical sign: inability to close mouth
183
According to "management of TMJ luxation in a cat using a custom-made tape muzzle" by Somrak, Maretta, how does a caudoventral TMJ luxation present?
with the mandibles shift caudally and toward the lunated side
184
According to "management of TMJ luxation in a cat using a custom-made tape muzzle" by Somrak, Maretta, once an uncomplicated TMJ luxation is reduced (closed under GA), what must be done to prevent relaxation while soft tissues are healing?
Some form of fixation: MMF, labial reverse suture through buttons, bignathic encircling and retaining device (BEARD), tape muzzle
185
According to "management of TMJ luxation in a cat using a custom-made tape muzzle" by Somrak, Maretta, what are 2 methods of closed reduction techniques?
wooden dowel or pencil caudal mouth and close swiftly; pull mandible on lunated side rostral to disengage from articular eminence, and ventral to direct it toward the mandibular fossa, then pressure redirected caudally and ventrally to engage the masseter and temporal muscles during reduction of the condyle back
186
According to "management of TMJ luxation in a cat using a custom-made tape muzzle" by Somrak, Maretta, what are some common complications of tape muzzles? how long should they be left in place?
moist dermatitis, alopecia, aspiration, incomplete fracture stabilization resulting in non or malunion fx w subsequent malocclusion, delayed return to fx, patient noncompliance; 1-4 weeks
187
According to "management of TMJ luxation in a cat using a custom-made tape muzzle" by Somrak, Maretta, what are complications of more rigid fixation?
soft tissue swelling, discharge, appliance loosening, aspiration, difficulty eating/breathing, detrimental thermoregulation (should still be able to pant and vomit)
188
According to "management of TMJ luxation in a cat using a custom-made tape muzzle" by Somrak, Maretta, what are some contraindications for a tape muzzle?
fx canines preventing canine interdigitation, brachycephalics, pre-existing or post-traumatic respiratory distress, vomiting or regurge, bilateral mandibular fx, complicated/displaced/comminuted fractures
189
According to "Excision of sublingual granuloma" by Durand, Smith, what is the cause of sublingual granuloma? where do they normally appear?
self-inflicted masticatory trauma on the sublingual or buccal mucosa, common in small breeds and sometimes cats, slow growing, typically bilateral
190
According to "Excision of sublingual granuloma" by Durand, Smith, what is the treatment of choice? what are the two approaches mentioned?
surgical excision (marginal) +/- tooth extraction (or really, odontoplasty); over sew (simple continuous over hemostat slowly drawn closed while hemostat removed) or cut and sew technique (debulk then close)
191
According to "Evaluation of the natural crown convergence angle of dog carnassial teeth" by Zimmerman, Soukup, what is the ideal CA (convergence angle) published for humans? what factors in crown prep design influence CA for appropriate resistance and retention forms?
<12deg; height, diameter, H:D, surface area all influence CA for resistance and retention form
192
According to "Evaluation of the natural crown convergence angle of dog carnassial teeth" by Zimmerman, Soukup, were there any significant associations between 108CA and weight, age, or skull type? 409?
No sig difference
193
According to "Evaluation of the natural crown convergence angle of dog carnassial teeth" by Zimmerman, Soukup, what is the definition of convergence ange? what is the primary vector during mastication for the carnassial teeth?
angle between two opposing axial walls of a tooth crown; shearing force in a palatobuccal oblique direction for 08s
194
According to "Evaluation of the natural crown convergence angle of dog carnassial teeth" by Zimmerman, Soukup, what was the mean convergence angle of 08 and 09's in this study? How does this compare to the previously reported "ideal" CA?
08: 42.89+/- 9.46; 09: 36.14 +/- 4.94; 3-4x greater than previously reported 12deg.
195
According to "Evaluation of the natural crown convergence angle of dog carnassial teeth" by Zimmerman, Soukup, what was the previously reported CA of canine teeth? what was the retention rate in this study and what was the majority CA?
35.5 +/-1.99 for canines; clinical retention rate was 90%, 75% of teeth in the study possessed a CA >25deg
196
According to "Evaluation of the natural crown convergence angle of dog carnassial teeth" by Zimmerman, Soukup, based on the authors previous studies, what is the best luting cement for resistance and retention?
resin-based cement
197
According to "Evaluation of the natural crown convergence angle of dog carnassial teeth" by Zimmerman, Soukup, what do the authors suggest for creating a natural convergence angle that has resistance and retention w/o taking down too much of the axial walls?
parallele axial wall reduction only in the cervical 1-2mm of prep while maintaining the natural convergence angle for the remainder of the preparation
198
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, what are treatment options for deep infra bony pockets? how is the choice of treatment made?
exodontia, osseous respective, osseous additive (GTR, bone augmentation) perio sx; tx depends on severity of PD dz, tooth involved, purpose of the patient, concurrent medical problems, client wishes/finances/compliance/time
199
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, what are biological requirements for GTR?
presence of blood, firing clot stabilization, space maintenance, epithelial exclusion, periodontal flap coverage since periosteum is rich in osteoprogenitor cells
200
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, what is the goal of GTR?
preparing tooth surface for re-attachement of healthy periodontium (PDL, alveolar bone) to gain new attachment and eliminate periodontal pocket
201
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, what is the purpose of a membrane? what are types of membranes available?
stabilize fibrin clot, guide new bone and PDL tissues, exclude gingival CT and epithelium (periodontal barrier); resorbable, non-resorbable (must be removed by second surgery), bioabsorbable, non-bioabsorbable, synthetic, natural, biodegradable
202
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, are grafting materials required for GTR? what is the benefit of including grafting material?
No!; provide added membrane support, osteoconductive (ALL) and sometimes osteoinductive (auto and allograft, SOMETIMES alloplast if BMPs involved) or osteogenic (only autograft) properties
203
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, how far past the defect was the mucoperiosteal flap made? once RPO performed, how much larger than the defect was the membrane cut to? what is used to prepare freeze dried demineralized bone graft? the membrane?
3mm; 2-3mm past defect, sometimes use sling suture to hold in place; isotonic saline and patients own blood for 5min; rehydrated with sterile saline for 5 min
204
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, radiographic followup for all 8 patients and 11 teeth were performed. What were the findings in regard to probing depth pre and post GTR? was it significant?
pre-GTR PPD was 7.2mm; post GTR PPD was <3mm (gained on average 5.4mm of attachment); PPD gain improvement was statistically significant
205
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, what is GTR? what is the difference between regeneration and repair? Which one more likely occurs in GTR?
GTR is a procedure used to guide reconstruction of the periodontium (keep CT and epithelium out!); regeneration implies histologic architecture is restored while repair it is not identical; likely GTR provides more repair, however, can only know with extracting tooth, PDL and bone post GTR and performing histo which is not feasible in clinical setting
206
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, what type of infra bony pockets and probing depths have the best tx prognosis for GTR? what walled defect to palatal maxillary canines and maxillary fourth premolars typically have?
3 walled infra bony pockets with PPD of >3-4mm have best prognosis; canine typically 3 walled defect, maxillary fourth premolar typically FE2 are 2 walled defect
207
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, how quickly can gingival CT, epithelium, and junctional epithelium recolonize a defect?
days; takes bone 6-8 weeks
208
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, what are properties of an ideal GTR membrane?
biocompatible, excludes unwanted tissue, integrates with natural tissue, maintains space and stabilizes fibrin clot, protects newly formed bone, handles easily, provides support for 6-8 weeks
209
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, what makes a material osteoinductive? osteoconductive? osteogenic?
osteoinductive materials stimulate undifferentiated mesenchymal cells to transform into osteoblasts after contacting the graft bone matrix (autograft, allograft and alloplasts with BMPs); osteoconductive materials allow ingrowth of capillaries, perivascular tissue, and mesenchymal cells from the recipient bed to the graft by acting as scaffolding for new bone growth (ALL grafts); osteogenic osteoblasts and clasts survive in autograft to recipient site (autograft only); DFDBA is osteoinductive and conductive
210
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, what is the purpose of the fibrin clot linkage to the root surface?
necessary and must be maintained for new CT development
211
According to "Evaluation of an Osseous allograft membrane for Guided tissue regeneration in the dog" by stepaniuk, gingerich, in this study, how many teeth gained attachment? to what probing depth?
11 teeth from 8 dogs had GTR and all gained PPD to <3mm (100%)
212
According to "Evaluation of an accelerated chemoradiotherapy protocol for oropharyngeal SCC in 5 cats and 3 dogs" by Reject, Hren, et al, which types of SCC have higher metastatic rates? what have primary treatment options been historically? what is typically the cause of death in cats?
tonsillar and lingual; surgery and radiotherapy; euthanasia secondary to local disease (poor quality of life)
213
According to "Evaluation of an accelerated chemoradiotherapy protocol for oropharyngeal SCC in 5 cats and 3 dogs" by Reject, Hren, et al, what is accelerated radiotherapy? hyper fractionated?
accelerated involves total tx delivered over a shorter time period, multiple small doses delivered at shorter intervals (in this study BID x 9d); larger number of fractions
214
According to "Evaluation of an accelerated chemoradiotherapy protocol for oropharyngeal SCC in 5 cats and 3 dogs" by Reject, Hren, et al, how was radiation delivered? with what protocol? what chemotherapy was used and why?
linear accelerator; BID for 7 tx over 9d 3.5Gy fractions for a total of 49Gy with a minimum of 6h btwn fractions; carboplatin as a radio sensitizer
215
According to "Evaluation of an accelerated chemoradiotherapy protocol for oropharyngeal SCC in 5 cats and 3 dogs" by Reject, Hren, et al, how many cats had regional or distant mets? how many cats had surgery? chemotherapy? radiotherapy? what stages were they?
none!; none!; all at time of radiation; all 5/5; 2 stage 1, 2 stage 2, 1 stage 3
216
According to "Evaluation of an accelerated chemoradiotherapy protocol for oropharyngeal SCC in 5 cats and 3 dogs" by Reject, Hren, et al, how many cats received a complete response (complete regression of all measurable dz)? partial response? what were the side effects?
4/5 cats had complete remission; partial 1/5; grade 2 oral mucositis, grade 2 and 3 cutaneous dermatitis
217
According to "Evaluation of an accelerated chemoradiotherapy protocol for oropharyngeal SCC in 5 cats and 3 dogs" by Reject, Hren, et al, how many cats died secondary to tumor recurrence? due to mets?
1 (stage III); 1 with tonsillar SCC had pulmonary mets
218
According to "Evaluation of an accelerated chemoradiotherapy protocol for oropharyngeal SCC in 5 cats and 3 dogs" by Reject, Hren, et al, how many dogs had SCC mets to regional lymph nodes at time of diagnosis?
1/3; no distant mets noted
219
According to "Evaluation of an accelerated chemoradiotherapy protocol for oropharyngeal SCC in 5 cats and 3 dogs" by Reject, Hren, et al, how many dogs achieved complete remission by 6-10weeks following completion of therapy?
all 3/3
220
According to "Evaluation of an accelerated chemoradiotherapy protocol for oropharyngeal SCC in 5 cats and 3 dogs" by Reject, Hren, et al, how many dogs passed secondary to metastatic disease?
1/3 due to distant mets; 1 to cardiac failure, and 1 still in complete remission
