Operative Dent Flashcards
1
Q
In Dixon’s 2014 study “Critical evaluation of ex vivo restoration of carious equine maxillary cheek teeth infundibulae following high-pressure gas and micro-particle abrasion”, at what depth was there a correlation with incomplete restoration of an infundibula?
TVJ 2014
A
15mm
2
Q
In Dixon’s 2014 study “Critical evaluation of ex vivo restoration of carious equine maxillary cheek teeth infundibulae following high-pressure gas and micro-particle abrasion”, what % of infubibulae were incompletely restored?
TVJ 2014
A
54%
This study has demonstrated that high-pressure abrasion with aluminium hydroxide particles is ineffective at removing food debris and carious dental material from carious infundibulae >15 mm in depth. Stat sig association of overall depth of infundibular defect and depth of defect unrestored
3
Q
In Suske’s paper “Infundibula of equine maxillary cheek teeth Part 2: Morphological variations and pathological changes”, how prevalent was cemental hypoplasia at the occlusal and subocclusal level on CT respectively?
TVJ 2016
A
Cemental hypoplasia was present in at least one infundibulum in CT of 351/688 (51%) cases at the occlusal surface and in CT of 100/177 (56%) cases at a subocclusal level
4
Q
In Suske’s paper “Infundibula of equine maxillary cheek teeth Part 2: Morphological variations and pathological changes”, what was the most commonly affected tooth by cemental hypoplasia (triadan position)
TVJ 2016
A
09s (75% of affected teeth)
5
Q
In Borkent’s 2016 study “An epidemiological survey on the prevalence of equine peripheral dental caries in the United Kingdom and possible risk factors for its development”, what was the prevalence of PCs in this UK population of horses?
EVJ 2016
A
51.7%
In contast to Ramzan 2011 on referral cases – 61%
In contrast to other post-mortem studies (3-6%)
6
Q
In Borkent’s 2016 study “An epidemiological survey on the prevalence of equine peripheral dental caries in the United Kingdom and possible risk factors for its development”, what Triadan positions were more likely affected? Was maxilla or mandible more likely affected?
EVJ 2016
A
09s-11s
Mand > Maxilla
Peripheral caries preferentially affects the
caudal upper and lower cheek teeth indicating an environmental change in the caudal oral cavity that favours the growth of cariogenic bacteria
7
Q
In Borkent’s 2016 study “An epidemiological survey on the prevalence of equine peripheral dental caries in the United Kingdom and possible risk factors for its development”, what concurrent dental disorder increased the chances of PC presence the most?
EVJ 2016
A
Presence of infundibular caries
Horses with diastemata and horses multiple other dental disorders sig more likely to have PC than horses without any other dental disorders
8
Q
In Uldahl’s 2019 study “Lesions associated with the use of bits, nosebands, spurs and
whips in Danish competition horses”, which of the following increased the risk of lip commissure lesion?
A. Type of bit
B. Type of bridle
C. Breed of horse
D. Level of competition
EVJ 2019
A
D. Level of competition
Oral lesions or blood were visible at the commissures of the lips in 9.2% of horses and increased with level of competition but did not differ between bit types or bitless bridles.
9
Q
In Lundstrom’s case report on “Equine peripheral cemental defects and dental caries: Four case reports”, one case tested the water pH on farm. What was the level detected and what ws the clinical signficance?
EVE 2020
A
A test of the acidity of the water that supplied the stable showed a pH of 6.2, which is below the critical level for human dental cementum
Water filtration system installed and all horses on farm resolved PCs
10
Q
What are the 3 main factors to caries development
EVE 2020 Lundstrom
A
(1) the host (the tooth surface and the salivary factors)
(2) the substrate (diet and feeding regime) and
(3) the microbes of the oral cavity and formation of dental plaque
11
Q
In Pearce’s paper “Long-Term Follow-Up of Restorations of Equine Cheek Teeth Infundibula (2006–2017)” what teeth and grade of caries were most likely to be treated?
Frontiers 2021
A
09s, grade 3, mesial INF
12
Q
In Pearce’s paper “Long-Term Follow-Up of Restorations of Equine Cheek Teeth Infundibula (2006–2017)” what was the most common material used to fill?
Frontiers 2021
A
dual-cured resin composite (Starfill, Danville, USA) - 80% of procedures layered technique
direct bulk fill (10%) of procedures
13
Q
In Pearce’s paper “Long-Term Follow-Up of Restorations of Equine Cheek Teeth Infundibula (2006–2017)” on follow up, what % of horses were deemed successful and how many failed?
Frontiers 2021
A
Of horses re-examined (n=77), 83% of horses (or 86% of all restorations in these horses) restorations were shown to have minimal or no loss of the restoration material
20 restorations (10.8% of procedures) from 10 horses had restorations with partial or complete loss, or absence of restorative material
14
Q
In Pearce’s paper “Long-Term Follow-Up of Restorations of Equine Cheek Teeth Infundibula (2006–2017)” what factors were statistically signficant in predicting success of treatment?
Frontiers 2021
A
grade 3 is more successful than grade 2
Material used – flowable dual cured composite (Starfill) most successful
The Triadan position of the restored tooth, the age of the horse, and the site of infundibulum restored (mesial vs. distal) were NOT related to success (P > 0.25).
The degree of apical debridement (complete vs. incomplete) was also NOT related to success (P = 0.1, 1d.f).
15
Q
In Lundstrom’s 2020 paper “Equine saliva components during mastication, and in vivo pH changes in the oral biofilm of sound and carious tooth surfaces after sucrose exposure” what electrolytes changed in equine saliva as flow increased?
BMC 2020
A
Chewing resulted in increased values for all electrolytes except bicarbonate in horses after 50 min
which differs from humans when only bicarb and Na increase with inc saliva flow
16
Q
In Jackson’s 2021 paper “Traumatic injury to the parotid salivary gland or duct and the subsequent development of ipsilateral severe peripheral dental caries in two horses,” what pathology was identified in both horses?
A
Severe (grade 2-4) peripheral caries on side that had parotid duct/gland pathology, with diastemata with feed packing and periodontal pocketing most severe on same side
17
Q
In Ramzan’s 2011 paper, “The incidence and distribution of peripheral caries in the cheek teeth of horses and its association with diastemata and gingival recession,” were peripheral caries were associated with any factors (age, arcade, presence of diastema)?
Ramzan 2011 Vet Journal
A
Not associated with any factor
Peripheral caries was uniformly distributed between the maxillary and mandibular CT, being most prevalent on the most caudal three teeth (87%).
18
Q
What is the difference between dental caries and dental erosion?
Borkent 2017 EVE Review Article “Equine peripheral and infundibular dental caries: A review and
proposals for their investigation”
A
Dental caries is caused by the direct action of acids on teeth by dissolving exposed calcified dental surfaces (cementum, enamel and/or dentine).
Dental erosion occurs over a larger dental area compared to caries and without the need for bacteria
19
Q
What are the 4 prerequisites for caries development?
Borkent 2017 EVE Review Article “Equine peripheral and infundibular dental caries: A review and proposals for their investigation”
A
tooth, substrate, plaque and bacteria
20
Q
Define acquired pellicle and its role in the oral cavity
Borkent 2017 EVE Review Article “Equine peripheral and infundibular dental caries: A review and proposals for their investigation”
A
A thin (0.5–1 lm), largely proteinaceous layer, containing some carbohydrates and lipids that form on the surface of normal teeth.
The normal thin biofilm adherent to the surface of the teeth that if it becomes thicker it becomes plaque
Normal pellicle formation starts within seconds of a tooth being exposed to saliva and plays an important role in oral lubrication, regulation of mineral homeostasis and host defence
21
Q
In Dickey’s 2023 study “A retrospective observational cohort study on the expiration of maxillary cheek teeth infundibula in 217 horses,” what was the association of breed and sex on age of senescence of the infundibula?
JVD 2023
A
No stat sig association of breed or sex with age of senescence of infundibula
22
Q
In Dickey’s 2023 study “A retrospective observational cohort study on the expiration of maxillary cheek teeth infundibula in 217 horses,” what was the order of infundibular senescence for the mesial and distal right maxilla and mesial left maxila?
JVD 2023
A
109, 110, 106, 111, 108, 107
23
Q
In Dickey’s 2023 study “A retrospective observational cohort study on the expiration of maxillary cheek teeth infundibula in 217 horses,” what was the order of infundibular senescence of the left maxilla?
A
209, 210, 211, 206, 207, 208
in both quadrants the mesial infundibula disappeared prior to the distal
24
Q
In Dickey’s 2023 study “A retrospective observational cohort study on the expiration of maxillary cheek teeth infundibula in 217 horses,” what was the first tooth and infundibula to disappear and what was the mean age, and what was the mean age of the last tooth and infundibula to disappear?
A
mesial 09s: 23 years
distal 07s, 08s: 35.4 years, 35.3 years
Average difference between the mesial and distal disappearance 4.5 years
25
In Dickey's 2023 study "A retrospective observational cohort study on the expiration of maxillary cheek teeth infundibula in 217 horses," infundibular expiration followed the eruption pattern for which teeth and was different for which teeth?
## Footnote
JVD 2023
followed for 09s, 10s, 06s
faster for 08s, 11s
slower for 07s
26
What grade infundibular caries of the mesial and distal infundibular of 109 are shown below?
## Footnote
du Toit. Advances in dental management in the equine geriatric patient: strategies for improved welfare. JAVMA 2023.
Mesial: grade 3
Distal: grade 2
27
In Fitzgibbon's 2010 study "Anatomical studies of maxillary cheek teeth infundibula in clinically normal horses," what percent of infundibula are completely filled with cementum?
## Footnote
Dixon, du Toit. Eq Vet Journal 2010
11.7%
28
What Honma grade of infundibular caries is shown below?
## Footnote
Schneider, Pearce, du Toit. "Presentation and management of advanced occlusal caries affecting the maxillary cheek teeth of four horses." EVE 2023
Grade 4
29
In Borkent's 2020 study "A histological and ultrastructural study of equine peripheral caries," what patterns of cemental caries were discovered in this study?
## Footnote
Dixon EVJ 2020
Type A → perpendicular flake like lesions
Type D → small ellipsoid, lytic lesions
30
In Borkent's 2020 study "A histological and ultrastructural study of equine peripheral caries," what pattern of cemental caries is most associated cariogenic destruction?
## Footnote
Dixon EVJ 2020
Type B caries - vertical flake line parallel to tooth
Cariogenic destruction of cementum most commonly proceeded within or parallel to LAGs
31
In Borkent's 2020 study "A histological and ultrastructural study of equine peripheral caries," why are lines of arrested growth (LAGs) in cementum most susceptible to caries?
## Footnote
Dixon EVJ 2020
they are hypermineralized and are more susceptible to bacterial demineralization
32
Which of the following bacteria is most associated with equine infundibular caries?
A. Streptococcus
B. Olsnella
C. Veillonella
D. Acidaminococcus
## Footnote
Ch 8
D. Acidaminococcus
## Footnote
other 3 are associated with peripheral caries
33
In the following image what grade caries is present in the rostral infundibulum (marked R)
## Footnote
Ch 10
Grade 3
34
Which hard dental tissue is most susceptible to a decrease in pH?
## Footnote
Ch 10
Cementum
## Footnote
Cementum affected at pH 6.7
Dentine affected at pH 6.0
Enamel affected at pH 5.5
35
What are the grades of peripheral cemental caries and the tissues involved in each?
## Footnote
Ch 10
0 - Normal tooth i.e. no macroscopic peripheral caries visible
1.1 - Only cementum affected: lesions appear as superficial erosions or pitting lesions or even as extensive erosions of the cementum surface, although there is still some underlying cementum left.
1.2 - Only cementum affected: more severe peripheral caries where the cementum is completely lost in some areas of the tooth, exposing the underlying (but unaffected) enamel.
2 - Cementum and underlying enamel are affected.
3 - Cementum, enamel and dentine are affected.
4 - Tooth integrity is affected (e.g. secondary dental fracture present).
36
In Horbal's paper "Evaluation of ex vivo restoration of carious equine maxillary cheek teeth infundibulae following debridement with dental drills and Hedstrom files" what was the success of debridement and the success of filling?
## Footnote
TVJ 2017
effectively debrided 27/30 infundibulae (90%)
6/30 infundibulae, including 3 that were incompletely debrided, to have defects between the restoration and the infundibular wall/apex.
21/24 infundibulae contained air bubbles, largely within restorations (87%)
37
In Borkent's study, "Epidemiological survey on equine cheek tooth infundibular caries in the United Kingdom" what was the prevalence of IC and what factors were significant risk factors?
## Footnote
Borkent Vet Rec 2017
45.5% of population
Risk Factors: presence of periph caries, age, if multiple concurrent dental disorders were present, and region (lower in North England and South West England)
## Footnote
Having just one of those dental disorders concurrent was not stat sig for more likely to have IC
Feed and pasture times were NOT SIG factors, nor was water fluoridation
38
In Borkent's study, "Epidemiological survey on equine cheek tooth infundibular caries in the United Kingdom" what was the most common Triadan position and infundibulae affected?
## Footnote
Borkent Vet Rec 2017
Triadan 09s
Rostral > distal
## Footnote
No incisor IC recorded
39
In Jackson’s paper, “Retrospective case review investigating the effect of replacing oaten hay with a non-cereal hay on equine peripheral caries in 42 cases”, which Triadan tooth showed significant improvement in PC on follow up?
## Footnote
Jackson EVJ 2021
Triadan 09
40
In Jackson's paper "Retrospective case review investigating the effect of replacing oaten hay with a non-cereal hay on equine peripheral caries in 42 cases" what % of cases showed improvement with diet changes?
## Footnote
Jackson EVJ 2021
69%
41
In Jackson's paper "Retrospective case review investigating the effect of replacing oaten hay with a non-cereal hay on equine peripheral caries in 42 cases" what diet change showed a difference in PC improvement?
## Footnote
Jackson EVJ 2021
The removal of oaten hay (typically with a high WSC) from the diet was associated with a 2.5-fold increase in the odds of having inactive (improving) peripheral caries at follow-up.
42
In Jackson's paper "A new equine peripheral caries grading system: Are the caries likely active or inactive?" what would you grade the below image PC?
## Footnote
Jackson EVJ 2020
1.1:1.1:0
43
What is the prevalence of infundibular caries and which tooth do they affect the most?
## Footnote
Easley ch 27
Up to 90% of horses over the age of 15 yo
Triadan 09s
44
What is the range of length of infundibulum?
## Footnote
Pearce 2016 EVE (Intro)
2mm - 89mm
45
What developmental condition can lead to periapical disease in young adult cheek teeth with no pulp exposure?
## Footnote
Pearce 2016 EVE
infundibular dysplasia that allowed inoculation of the periapical tissue with contaminated oral contents -- both enamel and cemental defect
## Footnote
Not cemental hypoplasia alone
46
A, B, C, D show what type of Black's classification of caries?
## Footnote
Hostrom Vet Dental Techniques
A. Class I: cavities beginning in tooth's pits and fissure
B. Class II: cavities in proximal surfaces of premolars and molars
C. Class III: cavities in proximal surfaces of incisors and canines that do not invovle the removal and restoration of the incisal angle
D. Class IV: cavities in proximal surfaces of incisors and canines that involve removal and restoration of the incisal angle
47
E and F show what type of Black's classification of caries?
## Footnote
Hostrom Vet Dental Techniques
E. Class V: cavities that are not pit cavities in the gingival third of the crown of the labial, buccal, palatal or lingual surfaces of teeth
F. Class VI: defects on the incisal edges of anterior teeth or cusp tips of posterior teeth
48
What are the 5 steps of restorative dentistry?
## Footnote
Holstrom Vet Dent Techniques
1. Preparation of the surface.
2. Placement and curing of the bonding agent.
3. Placement and curing of the restorative agent.
4. Shaping of the restoration.
5. Smoothing of the restoration.
49
The polymerization reaction of light cured composite resins is activated by what wavelength of visible blue light?
## Footnote
Holstrom Vet Dent Techniques
468-480nm
50
What are unfilled resins vs filled resins?
## Footnote
Holstrom Vet Dent Techniques
Unfilled resins: do not have fillers, flow readily, are translucent, used to coat cavity preparations before application of filled resins
Filled resins: contain fillers, more viscous, opaque, harder, wear better than unfilled resins
51
Fillers of filled resins give them what properties?
## Footnote
Holstrom Vet Dent Techniques
Hardness
Strength
Color
Resistance to temperature change
Wearability
Control polymerization shrinkage
52
Filled composite resins contain at least how much inorganic filler by weight?
## Footnote
Holstrom Vet Dent Techniques
at least 60%
Usually 70-60%
53
Resin filler particles conventional, intermediate or macrofilled, microfilled, and hybrid have what size particles?
## Footnote
Holstrom Vet Dent Techniques
Conventional: 20-35 micrometers
Intermediate or macrofilled: 1-5 micrometers
Microfilled: Equal to or less than 0.04 micrometers
Hybrid: Contain conventional or intermediate in addition to microfilled
54
What are the advantages and disadvantages of conventional and macrofilled compounds?
## Footnote
Holstrom Vet Dent Techniques
Advantages: More resistant to fracture, abrasion and concussive wear
Disadvantages: Decreased ability to be finely polished, become pitted with wear
55
What are the advantages and disadvantages of microfilled compounds?
## Footnote
Holstrom Vet Dent Techniques
Advantages: highly polishable
Disadvantages: less strong, tend to fracture more easily
## Footnote
Best used in ares with less exposure to wear and trauma
56
What characteristics of flowable composites make them more flexible?
## Footnote
Holstrom Vet Dent Techniques
Lower filler content
Lower modulus of elasticity
57
What are the disadvantages of flowable composites?
## Footnote
Holstrom Vet Dent Techniques
High polymerization shrinkage
Low wear resistance
58
What are the two types of dental cements?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Resin-based
Acid-based
59
How do acid-based dental cements work?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Acid-base reaction → formation of metal salt → cementing matrix
60
What are the 5 qualities of an ideal dental cement?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
1.) Not harmful to tooth or surrounding tissues
2.) Allows sufficient working time to place restoration
3.) Fluid enough to allow complete seating of restoration
4.) Quickly forms hard structural layer strong enough to resist functional forces
5.) Does not dissolve and maintains a sealed, intact restoration
61
What property of dental cements in humans is the most common cause of endodontic failure?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Microleakage
## Footnote
In humans endodontically treated teeth without crowns lost at 6 times greater rate than endodontically treated teeth with crowns
62
What type of strength is used as a predictor of clinical performance for dental cements?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Compressive strength
63
What is the definition of elastic modulus?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Measure of a material's resistance to being deformed elastically (non-permanently)
Assess the stiffness of a material
64
What type of resin composites have an elastic modulus that is very near dentin?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Resin composites with hybrid filler
65
What is fracture toughness and what tooth structure has the greatest fracture toughness?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Describes the ability of a material containing a crack to resist fracture
Enamel (343kg/mm^2) > Dentin > Cementum
66
What dental cements have the greatest bond strength?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Resin based cements 6-10x higher than RMGI
Resin based cements > RMGIs > glass ionomers
67
How does solubility of a dental cement affect the marginal integrity of the restoration?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Dental cements with high solubility are not resistant to disintegration and dissolution when submerged in water or solutions
High solubility → affects marginal integrity of restoration leading to increased plaque accumulation
68
What dental cements have high vs very low solubility?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
High solubility → zinc phosphate, polycarboxylate
Very low solubility → resin-based cements
69
What is nonadhesive cementation?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Reliance on geometric form of tooth preparation for restoration retention
70
What is micromechanical bonding of a dental cement?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Surface irregularities enhanced through sand blasting, pumice polishing, acid etching of tooth
Creates larger defects for cement to fill with high tensile strength material
71
What are two categories of commonly used dental cements that utilize micromechanical bonding for cementation?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Resins and resin-modified glass ionomers
72
What is molecular adhesion for restoration cementation?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Van der Waals forces and weak chemical. bond between dental cement and tooth
73
What are two examples of dental cements that utilize molecular adhesion for cementation?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
polycarboxylate
glass ionomer
74
Should dental cements exhibit low or high film thickness?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Low film thickness
improves setting of crown and decreases marginal discrepancies → reduces plaque accumulation, PD, cement dissolution and caries (humans)
75
What dental cements have the lowest to highest film thickness?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Glass ionomers < polycarboxylate, RMGI, zinc phosphate, resin-based cements
76
What are water-based cements?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Zinc phosphate
Polycarboxylate
Glass Ionomer
Zinc oxide eugenol (ZOE)
Ethoxybenzoic acid (EBA)
77
How do water-based cements compare to resin based cements?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Increased solubility
Lower strength
Greater microleakage and lower bond strength
78
What are the components of glass ionomers?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Polycarboxylate acid
Fluoroaluminosilicate (FAS) glass
Water
Tartaric acid
## Footnote
Tartaric acid → increases working time and improves setting reaction, increases postsetting hardening
79
What are the strength and modulus of elasticity properties of glass ionomers?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Low flexural strength, high modulus of elasticity→ very brittle and prone to bulk fracture
## Footnote
Strength properties much inferior to resin cements → should not be used in high stress locations
80
What is the compositional difference between glass ionomers and resin-modified glass ionomers?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
RMGIs have water soluble resin polymers added to conventional glass ionomers
81
RMGIs have how much more bond strength than glass ionomers?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Double
## Footnote
inferior to self-adhesive resin-based and conventional resin-based cements
82
What are the components of compomers?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Composite resins + conventional glass ionomers
83
How do resin-based cements bond to enamel and dentin respectively?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Enamel: micromechanical interlocking into acid etched surface
Dentin: micromechanical but requires removal of smear layer and surface demineralization followed by application of unfilled resin bonding agent or primar to which resin chemically bonds
84
What are the advantages of resin-based cements?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
* Reduce microleakage, have remarkably low solubility, improved strength and improved retention compared to water-based cements
* Compressive and tensile strength, toughness, resilience of resin cements equal or exceed other dental cements
* Strongest, least soluble, best bonding cements
85
What is the primary constituent of self-adhesive resin based cements?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
Phosphoric acid-modified methacrylate monomers
86
What is the main disadvantage of self-adhesive resin-based cements that self etch?
## Footnote
Wingo. A Review of Dental Cements. JVD 2018
They do not remove the smear layer→ lower long-term tensile bond strength than resin-based cements
87
What dental cements have the highest durability, strength and cost in descending order?
Resin based > self-adhesive resin based > RMGI > Glass ionomer > zinc phosphate > polycarboxylate > zinc oxide eugenol > zinc oxide noneugenol
88
What are the basic steps outlined by G.V. Black for caries restorations?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Resistance, retention, convenience, pathology removal, wall and preparation cleansing forms
89
Beveling the occusal cavosurfaces in what Black's classification of caries is contraindicated?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Class I or II
## Footnote
Enlarges the surface area of the restorative in occlusion
90
Why are restorations polished pumice paste?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Because the fluoride and glycerin in other prophylaxis pastes may couteract the effect of the etchant and decrease bonding strength of the sealant
91
Does A or B show the impact of over drying collagen fibrils of the dental matrix?
A. Over drying collapses the collagen fibrils and decreases the size of interfibrilar spaces that are necessary for resin uptake
## Footnote
B. the water used in wet bonding or primers re-expands the collagen matrix
92
What are the three ways that acid etching improves bond strength of the composite restoration?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
1.) Dentin is demineralized exposing connective tissue for bonding
2. )Collagen fibers within the the dentinal tubules are opened exposing more micropores for infiltration by resin --> greater micromechanical interlock --> increases resistance to microleakage
3. Removes the smear layer created during odontoplasty which improves retention
93
What percent phosphoric acid should be used on dentin vs enamel?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Dentin: 10-38%
Enamel: 35-38%
94
How long should acid etch be left on enamel vs dentin?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Enamel: 20 seconds
Dentin: 10-15 seconds
95
Bonding agents penetrate dentin to what depth?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
200-400 microns/micrometers
96
Does deep or superficial dentin have more tubules for bonding?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Deep dentin
97
What was bond strength based upon for 1st and 2nd generation bonding agents?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Bond to smear layer (organic debris) because dentin was not etched
## Footnote
Early generation agents had poor bonding strengths and easily hydrolyzed and cracked
98
What were the changes made for 3rd generation bonding agents that improved their bond strength?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Oxalate bonding agents that had a separate primer and adhesive
Primer contained hydrophilic resin monomers that infiltrated smear layer and increased adhesion
Used acid etchants to partially remove and modify smear layer and open dentinal tubules
99
What were the disadvantages of 3rd generation bonding agents?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Time-consuming
Unpredictable because they did not completely remove the smear layer
Could cause discoloration
100
What is the hybrid layer of bonding agents and what generation of bonding agents first utilized it?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Forms from polymerized methacrylate and dentin when dental hard tissues are demineralized
Allows resin monomers to penetrate the demineralized dentin and polymerize
Requires total etch technique --> 4th generation bonding agents
101
What was the main difference of 5th generation bonding agents?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
First 1 bottle system that combine primer and adhesive into one solution after using total etch technique
102
5th generation bonding agents create a micromechanical interlock with etched dentin through what mechanisms?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Resin tags
Adhesive lateral branches
Formation of a hybrid layer
## Footnote
High bond strength to both enamel and dentin
103
What was the main difference between 6th and 7th generation bonding agents vs 5th?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
6th and 7th gen are one-step agents that do not require acid-etching and rinsing
104
What is the difference between 6th generation bonding agents Type I and Type II?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Type I: Acidic primer placed on tooth followed by adhesive
Type II: Acidic primer and adhesive mixed prior to placing on tooth
105
Do 5th or 6th and 7th generation bonding agents have greater bond strengths and better marginal seal?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
5th generation
## Footnote
6th and 7th gen do not etch enamel well and leave the residual smear layer
106
What are the disadvantages of amalgam as a restorative?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Contains toxic mercury
Requires mechanical retention form to hold filling
107
Do composite resins require retentive form?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
No
They have strong bonding strenth and bond directly to teeth
108
Composite ligh-cured resins are polymerized at what wave length of visible light?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
460-480nm
109
Light-cure resins should be applied in what depth of layers to limit shrinkage?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Layers < 2mm deep
110
What are the filler particle sizes of microfil, nanohybrid and nanofil composites?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Microfil: 0.1 micrometers
Nanohybrid: 0.01 micrometers
Nanofil: 0.001 micrometers
111
What are the filler particle sizes of macrofill, intermediate and microhybrid composites?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
Macrofill: 100 micrometers
Intermediate: 10 micrometers
Microhybrid: 1 micrometer
112
A, B and C show what type of composite filler particles?
A. Macrofill
B. Intermediate
C. Microhybrid
113
How long does it take a vital tooth with exposed dentinal tubules to repair itself?
## Footnote
Domnick. Use of Composite Restoration Materials. JVD 2014
At least 8 weeks to begin
114
How much does acid etching increase the enamel surface area?
## Footnote
Greenfield. Enamel Defect Restoration of the Left Mandibular First Molar Tooth. JVD 2012
10-20 fold
115
What is the clinical importance of linear coefficient of thermal expansion (LCTE) for restorations?
## Footnote
Greenfield. Enamel Defect Restoration of the Left Mandibular First Molar Tooth. JVD 2012
the closer the LCTE of a material to that of enamel, the less chance for voids or openings at junction when material and tooth change temperature
116
What is the modulus of elasticity of microfil composites relative to macrofil/conventional composites?
## Footnote
Greenfield. Enamel Defect Restoration of the Left Mandibular First Molar Tooth. JVD 2012
Microfil have a low modulus of elasticity → more flexible → restoration can bend with tooth → better protection of bonding interface
117
What is the MOA of light curing?
## Footnote
Greenfield. Enamel Defect Restoration of the Left Mandibular First Molar Tooth. JVD 2012
Light absorbed by diketone → starts polymerization process in presence of organic amine
118
What are the pros of photoinitiator vs chemical activation for curing composites?
## Footnote
Greenfield. Enamel Defect Restoration of the Left Mandibular First Molar Tooth. JVD 2012
Increased strength
Enhanced color stability
Better control of working time
119
What are the four types of restorative materials that release fluoride?
## Footnote
McCoy. Fluoride-Releasing Restorative Materials. JVD 2015
Resin composite
Compomer
Resin-modified glass ionomer
Traditional glass ionomer
120
What is the association between fluoride release and compressive strength?
## Footnote
McCoy. Fluoride-Releasing Restorative Materials. JVD 2015
Negative correlation between amount of fluoride release and compressive strength
121
What categories of restorative materials demonstrate the greatest fluoride release and recharging capacity?
## Footnote
McCoy. Fluoride-Releasing Restorative Materials. JVD 2015
Resin modified glass ionomers
Conventional glass ionomers
## Footnote
Compomers contin more resin than RMGIs release less fluoride than RMGIs and glass ionomers but more than resin composites
122
What type of cement is the least soluble?
A. Resin Composite
B. Glass Ionomer
C. Polycarboxylate
D. Zinc phosphate
## Footnote
JVD 2018 issue 1, Review of Dental Cements
A. Resin Composite
123
Define elastic modulus
## Footnote
JVD 2018 issue 1, Review of Dental Cements
Elastic modulus (EM) measures the ability of a material to resist elastic deformation under loading, representing the relative stiffness of the material within the elastic range.
124
What mechansims of adhesion are observed in restoration cements, and give examples of materials for each:
Non-adhesive
Micomechanical bond
Molecular bond
## Footnote
JVD 2018 issue 1, Review of Dental Cements
Nonadhesive: cement fills the restoration-tooth gap and holds by engaging in small surface irregularities - I.e. relies on geometric form of tooth preparation - zinc phosphate
Micromechanical: surface irregularities are enhanced through air abrasion or acid etching to provide larger defects – good for materials with large tensile strength – resins, resin-modified GIC
Molecular: bipolar Van der Waals forces and weak chemical bond (material ions bind to Ca of hydroxyapetite) - polycarboxilate, GIC
125
What reaction occurs to set glass ionomer (GIC)?
Acid-base reaction
reaction of (a basic) silicate glass powder and an ionomer liquid containing carboxylic acids (or polyacrylic acid). (They form ion cross-linked polymer matrices surrounding glass-reinforcing filler particles).
## Footnote
GIC/composite hybrid) using liquid water-free polyacid monomer in place of polyacrylic acid that leads to a polyacid-modified composite resin. These materials possess a combination of characteristics of composites and glass-ionomers- but are essentially polymer-based composites that have been modified to permit fluoride release from the glass phase.
126
In vad den Enden's 2008 study "Prevalence of occlusal pulpar exposure in 110 equine cheek teeth with apical infections and idiopathic fractures," pulpitis was thought to be caused via exisiting occlusal fissures in what percent of apically infected cheek teeth?
## Footnote
Dixon, Vet J 2008
2.5% (2/79)
127
The image below shows what type of fissure fracture according to the 2018 Pollaris classification?
Type 2
128
In Pollaris' 2020 study "Occlusal fissures in equine cheek teeth: a prospective longitudinal in vivo study," what percent of fissures overall evolved into partial crown fractures and were they uncomplicated or complicated?
## Footnote
Frontiers 2020
7.4%
all uncomplicated
129
In Pollaris' 2020 study "Occlusal fissures in equine cheek teeth: a prospective longitudinal in vivo study," what were the statistically significant risk factors for development of a cheek tooth fracture?
## Footnote
Frontiers 2020
fissure of any type, mandibular cheek teeth, the lingual side of cheek teeth and follow up
130
In Pollaris' 2020 study "Occlusal fissures in equine cheek teeth: a prospective longitudinal in vivo study," what type of fissure had the greatest odds of developing into a fracture and what fissure configuration factor was present in all fissures that evolved into fractures?
## Footnote
Frontiers 2020
Type 2 (follow by Type 1b)
all fissures that evolved into a partial crown fracture involved or crossed the outer enamel ring
131
In Windley's 2009 study "Two- and three-dimensional computed tomographic anatomy of the enamel, infundibulae and pulp of 126 equine cheek teeth. Part 1: Findings in teeth without macroscopic occlusal or computed tomographic lesions," where was enamel found to be thickest and thinnest?
## Footnote
Tremaine, Eq Vet J, 2009
Thickest in areas where enamel was parallel to the long axis of the mandible or maxilla
Thinnest where the enamel formed invaginations
132
According to Easley's 2022 textbook, our current understanding of the bacteria implicated with dental caries most closely fits what plaque hypothesis?
ecological plaque hypothesis
Dental caries is a complex disease and is thought to be caused by a dysbiosis, i.e., an imbalance of the resident oral bacteria community following a change in the local environment.
133
What percent of bacteria associated with human dental caries are facultative anaerobes and obligate anaerobes respectively?
## Footnote
Easley 2022
Facultative anaerobes: 72%
Obligate anaerobes: 28%
134
What bacteria are though to be the most important cariogenic bacteria in humnas and are thought to be the initiators of caries?
## Footnote
Easley 2022
Streptococcus spp (Especially S. mutans)
135
What bacteria implied in human dental caries has been described as an acid sink?
## Footnote
Easley 2022
Veillonella
Can convert lactic acid into weaker acids causing dental plaque pH to rise which allows other fermentative bacteria to survive
136
What characteristics of Streptococcus spp make them cariogenic?
## Footnote
Easley 2022
The mutans group: highly acidogenic (lactic acid) and aciduric, can produce intracellular polysaccharides and can metabolise sucrose to form extracellular polysaccharides
## Footnote
facultative anaerobic, Gram positive coccus
Associated with peripheral caries
137
According to Easley's 2022 textbook what three bacteria are most associated with equine peripheral caries?
Streptococcus
Olsenella
Veillonella
138
According to Easley's 2022 textbook, what bacteria is most associated with infundibular caries?
Acidaminococcus
139
Describe the Dacre's 2005 modified Honma system for grading severity of peripheral caries grades 0, 1.1, and 1.2.
0: No caries
1.1: pitting or partial loss of the peripheral cementum
1.2: Total loss of peripheral cementum
140
Describe the Dacre's 2005 modified Honma system for grading severity of peripheral caries grades 2, 3, 4.
2: Total loss of peripheral cementum and also involves enamel
3: Involves dentin
4: loss of integrity of tooth
141
The image below shows an example of what grade of peripheral caries according to the modified Honma system?
## Footnote
Lee, Reardon, Dixon. A post-mortem study on the prevalence of peripheral dental caries in Scottish horses. EVE 2019
1.2
## Footnote
Lee, Reardon, Dixon. A post-mortem study on the prevalence of peripheral dental caries in Scottish horses. EVE 2019
142
The image below shows an example of what grade of peripheral caries according to the modified Honma system?
## Footnote
Lee, Reardon, Dixon. A post-mortem study on the prevalence of peripheral dental caries in Scottish horses. EVE 2019
1.1
143
According to Honma's 1962 study "Statistical study on the occurrence of dental caries of domestic animals: I: horse," what percent of skulls older than 12 years had maxillary cheek teeth infundibular caries?
## Footnote
Japanese journal of research. 1962. Arbattoir study of 365 equine skulls
100%
143
According to a 1970 UK abattor study of 218 skulls by Baker, what were the prevalences of periodontal and infundibular caries in horses greater than 15 years old?
## Footnote
Easley 2022, chp 10
periodontal disease 60%
infundibular caries 79%
144
What is the reported range of prevalences of shear mouth according to Easley's 2022 textbook?
## Footnote
Chp 10
0.6-12%
## Footnote
One study of 30,000 young cavalry horses found a prevalence of 0.03%
145
According to Easley's 2022 textbook, was shear mouth prevalence associated with age in two donkey studies (Du Toit 2008, Du Toit 2009)?
## Footnote
chp 10
Not associated with age in donkeys
146
According to Easley's 2022 textbook, a Dixon 2000 study found that what percent of step mouth cases were caused by dental maleruption?
## Footnote
Chp 10
40%
147
According to Easley's 2022 textbook, what exam findings are suggestive that the entire endodontic system of the tooth is dead?
## Footnote
Chp 10
Multiple pulp exposures
Pulpar exposure with marked surrounding dentinal caries (dark discoloration) of dentin surrounding exposed pulp
Pulps that on probing are deeply exposed (> 2cm)
148
In Jackson's 2018 paper "Equine peripheral dental caries: An epidemiological survey assessing prevalence and possible risk factors in Western Australian horses" what were factors signficantly associated with PC presence?
## Footnote
Jackson 2018 EVJ
Breed: TB > WB and Western breeds
Hay: Oaten hay > meadow hay
Husbandry: Less pasture and rainwater/drinking water more likely to have PC than more pasture and groundwater
Dental disease: Periodontal disease, feeding packing, hooks
## Footnote
Infundibular caries NOT assoc with PC presence in this study
149
What is demonstrated by the white arrows in the scanning electron microscopy image below?
## Footnote
Easley 2022. Borkent 2020 JVD
Carious dentin lining a pulp chamber with loss of integrity of intertubular dentin
150
According to Easley's 2022 textbook, what pH cause dissolution of cementum, dentin and enamel respectively?
## Footnote
Chp 10
cementum: 6.7
dentin: 6.0
enamel: 5.5
151
What grade of infundibular caries according to the modified Honma system from Dacre 2005?
Grade 1: only infundibular cementum affected?
152
What grade of infundibular caries according to the modified Honma system from Dacre 2005?
## Footnote
Easley 2022, Chp 10
Grade 3: cementum, enamel and dentin are affected
153
What prevalence range of infundibular caries is cited in Easley's 2022 textbook Chp 10 from what sources?
Colyer 1906: 13%
Honma 1962: 100%
154
What patterns of infundibular hypoplasia as decribed by Horbal 2019 are shown with the yellow and red arrows respectively?
## Footnote
Horbal, Dixon. A computed tomographic (CT) and pathological study of equine cheek teeth infundibulae extracted from asymptomatic horses. Part 1: Prevalence, type and location of infundibular lesions on CT imaging. Frontiers 2019.
Yellow: central linear defect
Red: apical cemental hypoplasia
155
What modified Honma grade infundibular caries of the mesial infundibula (R) and distal (C) are shown below?
## Footnote
Easley 2022, Chp 10
R: Grade 3
C: Grade 2
156
What grade of peripheral caries according to the Honma grading system modified by Borkent et al is shown below?
## Footnote
Easley 2022, Chp 10
Grade 1.2: only cementum affected, more severe peripheral caries where the cementum is completely lost in some areas of the tooth, exposing the underlying (but unaffected) enamel.
157
What grade of peripheral caries according to the Honma grading system modified by Borkent et al is shown below?
## Footnote
Easley 2022, Chp 10
Grade 2: Cementum and underlying enamel are affected.
158
What is the difference between dental erosion vs dental caries according to Easley's 2022 textbook?
## Footnote
Chp 10
Dental erosions are caused by exogenous acids like those found in feed stuffs with low pH vs dental caries which occur due to oral bacterial acids
They are clinically identical so need to know the diet and water pH etc to differentiate
159
What type of fissure according to the Pollaris 2018 classification configuration is shown below?
## Footnote
Easley textbook, Chp 11
Type 1a
Type 1 fractures involve secondary dentin, Fissure orientation is perpendicular to the surrounding enamel fold and
variably extending into the enamel and even the peripheral cementum
160
What type of fissure according to the Pollaris 2018 classification configuration is shown below?
## Footnote
Easley textbook, Chp 11
Type 1b
Fissure orientation is parallel to the long axis of the dental arcade, often
connecting the secondary dentine of the adjacent pulp horns
161
What type of fissure according to the Pollaris 2018 classification configuration is shown below?
## Footnote
Easley 2022, chp 11
Type 2
Fissure does not involve secondary dentine. Location can be in enamel or peripheral cementum (Figure 1E), or in primary dentine oriented parallel to the adjacent enamel fold (Figure 1F)
162
What structures are the yellow arrows indicating?
## Footnote
Easley 2022, Chp 37
Infundibular vascular channels, normal occlusal surface
163
What is the difference between the Modified Honma classication system by Dacre 2005 and the modifications made up by Pearce?
## Footnote
Easley 2022, Chp 37
Pearce's modification has grade 4 defined as Caries affecting both mesial and distal infundibula with coalescence and grade 5 as caries progressing to affect the integrity of the tooth: development of an apical abscess, fracture or tooth loss
164
According to Pearce's modification of the modified Honma Dacre 2005 infundibular caries grading system, what grade is the tooth below?
Grade 5
165
According to Pearce's modification of the modified Honma Dacre 2005 infundibular caries grading system, what grade is the tooth below?
## Footnote
Easley 2022, Chp 37
Grade 4
166
According to Easley's 2022 textbook Chp 37, what infundibular depth is considered to be likely to be at risk and warrant infundibular restoration/investigation?
> 10mm
## Footnote
Aged horses with shallow or expired infundibula, and young horses with shallow occlusal defects (‘cups’) do not need restoration
167
In the image below what type of GV Black's caries classification modified for equine teeth is shown below?
## Footnote
Easley 2022, Chp 38
Class I
## Footnote
A lesion that involves a pit, fissure or developmental groove of all teeth except the canines (incisors, premolars and molars). In equine dentistry the infundibular caries is a very common type of Class I lesion
168
In the image below what type of GV Black's caries classification modified for equine teeth is shown below?
## Footnote
Easley 2022, Chp 38
Class II
## Footnote
A lesion that affects the proximal surface of a premolar or molar
169
In the image below what type of GV Black's caries classification modified for equine teeth is shown below?
## Footnote
Easley 2022, chp 38
Class III
## Footnote
A lesion that affects the proximal surface of an incisor or canine
170
In the image below what type of GV Black's caries classification modified for equine teeth is shown below?
## Footnote
Easley 2022, chp 38
Class IV
## Footnote
A lesion that affects the proximal and incisive edge of a canine or incisor
171
In the image below what type of GV Black's caries classification modified for equine teeth is shown below?
## Footnote
Easley 2022, Chp 38
Class V
## Footnote
A lesion that affects the labial, buccal or lingual surface of any tooth (incisors, canines, premolars or molars)
172
In the image below what type of GV Black's caries classification modified for equine teeth is shown below?
## Footnote
Easley 2022, chp 38
Class VI
## Footnote
A lesion that affects the incisive edge of any tooth that is not included in the previous five classifications
173
What type of internal cavity prep wall is being measured below?
## Footnote
Easley 2022, Chp 38
Pulpal wall
## Footnote
A pulpal wall is orientated in cross section over a pulp horn
174
What type of internal cavity prep wall is being measured below?
## Footnote
Easley 2022, chp 38
Axial wall
## Footnote
Lies parallel to the long axis of the tooth
175
What is the definition of the cavosurface angle?
## Footnote
Easley 2022, chp 38
The line angle formed between an external wall and the unprepared (original) tooth surface
176
What is the outline step of cavity preparation defined by GV Black?
## Footnote
Easley 2022, Chp 38
The entire combined cavosurface margins are collectively referred to as the preparation outline (also termed cavity outline).
177
What is the resistance step of cavity preparation defined by GV Black?
## Footnote
Easley 2022, chp 38
Resistance refers to the shape of the preparation. Internal line angles should be rounded in order to withstand occlusal forces. Rounding of the internal line angles helps to reduce the external flexing.
178
What is the convenience step of cavity preparation defined by GV Black?
## Footnote
Easley 2022, chp 38
Convenience refers to the shaping of the cavity preparation to allow adequate access and placement of the restoration while maintaining conservative principles to preserve normal dental tissue.
179
Pulp capping material should be placed if the floor or wall of a cavity preparation comes within what distance of a pulp horn?
## Footnote
Easley 2022, Chp 38
0.5mm
180
The grind and sieve technique or the hydrolysis or precipitation method produce filler particles of what diameter?
## Footnote
Easley 2022, Chp 38
Grind and sieve: 0.1 to 100micrometers
Hydrolysis or precipitation method: 0.06 to 0.1micrometers
181
What filler particle production technique can create nanometer sized particles?
## Footnote
Easley 2022, Chp 38
Sol-gel chemistry
182
According to Easley's 2022 textbook, what is the most common coupling agent applied to filler particles that bonds them to the polymer matrix/resin?
## Footnote
Chp 38
Silane (organic silicone compound)
## Footnote
Carbon covalent bonding between silane and polymer matrix/resin
183
What is an acclerator of composites?
## Footnote
Easley 2022, chp 38
initiates the polymerization process allowing the different components (phases) of the composite to combine and harden
184
What is the acclerator that makes light activation of composites occur and what wavelength?
## Footnote
Easley 2022, chp 38
0.2% –1.0 % of camphorquinone
wavelength 470nm
185
What GV Black class of defect has been created in this canine tooth?
## Footnote
Easley 2022, Chp 38
Class V
186
In this histological image from Dacre and Dixon's 2008 study "Pathological studies of cheek teeth apical infections in the horse. 1: Normal endodontic anatomy and dentinal structure of equine cheek teeth," what types of dentin are shown on the left vs the right and what are their distinguishing features?
## Footnote
Vet J 2008
Left: primary dentin with the typical honeycomb pattern of intertubular dentin, also has intratubular dentin
Right: secondary dentin has intertubular dentin and lacks intratubular dentin
187
In Dacre and Dixon's 2008 study "Pathological studies of cheek teeth apical infections in the horse. 3: Quantitative measurements of dentine in apically infected cheek teeth," significant changes in what types of dentin and pulp were found in diseased vs control cheek teeth?
## Footnote
The Vet J 2008
Significantly reduced regular and irregular secondary dentin and predentin and intertubular dentin
Significantly increased pulp horn widths and resting lines
188
In Dacre and Dixon's 2008 study "Pathological studies of cheek teeth apical infections in the horse. 4: Aetiopathological findings in 41 apically infected mandibular cheek teeth," occlusal pulp exposures were present in what percent of cases?
## Footnote
The Vet J 2008
34%
189
In Dacre and Dixon's 2008 study "Pathological studies of cheek teeth apical infections in the horse. 4: Aetiopathological findings in 41 apically infected mandibular cheek teeth," what percent of cases were suspected to be infected via anachoresis, what percent had fractures involving pulps (including fissures), and what percent had periodontal destruction as the cause of infection?
## Footnote
The Vet J 2008
Anachoresis 59%
Fractures 20%
Perioendo disease 19%
190
In Dacre and Dixon's 2008 study "Pathological studies of cheek teeth apical infections in the horse. 5: Aetiopathological findings in 41 apically infected maxillary cheek teeth," were the three most common causes of periapical infection?
## Footnote
The Vet J 2008
Anachoretic infection 51%
Infundibular caries 16%
Periodontal spread 12%
## Footnote
fractures and fissures 9%, dysplasia 5%
191
In Wellman's 2019 study "A study on the potential role of occlusal fissure fractures in the etiopathogenesis of equine cheek teeth apical infections," standard CT was able to detect how many fissure fractures and how many stained teeth had subocclusal fissures visually identified at ~6mm beneath the surface?
## Footnote
JVD 2019
CT: 1/39 fissures
13/39 (33%)
192
In Wellman's 2019 study "A study on the potential role of occlusal fissure fractures in the etiopathogenesis of equine cheek teeth apical infections," what percent of teeth fissure fractures had deeper staining to a level immediately above or into a pulp horn which could indicate a potential route for bacterial pulpitis?
## Footnote
JVD 2019
69% (9/13)
193
In Ramzan's 2010 study "Occlusal fissures of the equine cheek tooth: prevalence, location and association with disease in 91 horses referred for dental investigation," what was the overall prevalence of occlusal fissures?
## Footnote
EVJ 2010
58%
194
In Ramzan's 2010 study "Occlusal fissures of the equine cheek tooth: prevalence, location and association with disease in 91 horses referred for dental investigation," what pulp horns were most often involved for maxillary vs mandibular cheek teeth, and what was the association between arcades and presence of sig greater number of CT with occlusal fissures?
## Footnote
EVJ 2010
Maxillary 92% caudal aspect of palatal pulp horn
Mandibular 96% buccal pulp horns
Sig greater number of CT with multiple occlusal fissures found in mandibular vs maxillary arcades
195
In Ramzan's 2010 study "Occlusal fissures of the equine cheek tooth: prevalence, location and association with disease in 91 horses referred for dental investigation," what factors were not stat sig associated with the number and location of fissure fractures?
## Footnote
EVJ 2010
No sig correlation between number of CT with fissures and gender or age
No correlation between the presence of fissures and location of individual CT considered to be the primary reason for presentation
## Footnote
Fissures not correlated to the primary site of dental disease
196
In Pollaris's 2018 study "Equine cheek teeth occlusal fissures: prevalence, association with dental wear abnormalities and occlusal angles," what was the overall prevalence of occlusal fissures, and what was the association of fissure prevalence and age and sex?
## Footnote
EVJ 2018
Overall prevalence 72%
Male horses and horses greater than 13 years had more fissures
197
In Pollaris's 2018 study "Equine cheek teeth occlusal fissures: prevalence, association with dental wear abnormalities and occlusal angles," were maxillary or mandibular cheek teeth overrepresented and where were fissure more commonly located on mandibular and maxillary cheek teeth respectively?
## Footnote
EVJ 2018
Similar prevalence between mandibular and maxillary teeth
Mandibular fissures more commonly located on buccal aspect (PHs 1 and 2)
Maxillary fissures no stat difference in prevalence between palatal and buccal aspect but pulp horn 4 had highest frequency
198
In Pollaris's 2018 study "Equine cheek teeth occlusal fissures: prevalence, association with dental wear abnormalities and occlusal angles," what was the most prevalant fissure type?
## Footnote
EVJ 2018
Type 1a
## Footnote
No sig difference found in prevalence of a specific fissure type between the maxilla and mandible
199
In Pollaris's 2018 study "Equine cheek teeth occlusal fissures: prevalence, association with dental wear abnormalities and occlusal angles," what correlation was found between the presence of wear abnormalities or occlusal angle of cheek teeth and prevalence of fissures?
## Footnote
EVJ 2018
No significant correlation
200
In Pollaris' 2020 study "Occlusal fissures in equine cheek teeth: a prospective longitudinal in vivo study," what was the overall prevalence of fissure fractures and what percent of horses developed partial crown fractures during the follow up period?
## Footnote
Frontiers 2020
94% overall prevalence
61% horses developed a partial crown fracture (22/36)
## Footnote
But only 22 horses had 3 years of exams, others lost to follow up…so
201
In Pollaris's 2021 study "Fracture resistance of equine cheek teeth with and without occlusal fissures a standardized ex vivo model," in Group 1 (no fissures) what factors were associated with fracture resistance?
## Footnote
Frontiers 2021
Location on the tooth (highest fracture resistnace for mandibular PH2, maxillary PH4)
Triadan number (310, 410 greatest resistance to fracture)
Increased mesiodistal occlusal length of maxillary teeth (greater distance, increased resistance to fracture)
## Footnote
No association of age with fracture resistance
202
In Pollaris's 2021 study "Fracture resistance of equine cheek teeth with and without occlusal fissures a standardized ex vivo model," what was the association of the presence of fissures with the ability to withstand loading forces?
## Footnote
Frontiers 2021
The presence of occlusal fissures significantly decreased the ability of cheek teeth to withstand loading forces, especially for Type 1a and Type 1b in mandibular teeth, and for all fissure types in maxillary teeth
## Footnote
Mean max force of teeth with fissures 1,974 N
Mean max force teeth without fissures 2,594 N
203
In Pollaris's 2021 study "Fracture resistance of equine cheek teeth with and without occlusal fissures a standardized ex vivo model," what was the association between fracture level and pulp horn exposure?
## Footnote
Frontiers 2021
Sig higher exposed pulp horns when fracture occurred at or below simulated bone level
## Footnote
The presence of an occlusal fissure did not influence the resultant fracture level
204
In Windley's 2009 study "Two-and three-dimensional computed tomographic anatomy of the enamel, infundibulae and pulp of 126 equine cheek teeth. Part 2: findings in teeth with macroscopic occlusal or computed tomographic lesions," what percent of infundibulae had infundibular lesions identified on CT and what percent had infundibular lesions on the occlusal surface?
## Footnote
EVJ 2009
90% changes on CT
65% changes on occlusal exam
205
In Windley's 2009 study "Two-and three-dimensional computed tomographic anatomy of the enamel, infundibulae and pulp of 126 equine cheek teeth. Part 2: findings in teeth with macroscopic occlusal or computed tomographic lesions," what percent of infundibulae had infundibular caries and which infundibulae had higher prevalence and greater severity of lesions?
## Footnote
EVJ 2009
infundibular caries 50%
rostral infundibulae
206
In Hoboken's 2016 paper " Treatment of maxillary cheek teeth apical infection caused by patent infundibula in six horses (2007-2013)," what was the overall outcome?
## Footnote
Pearce EVE 2016
5/6 cases showed resolution of clinical signs over a mean follow-up period of 19 months (range 6–48 months).
## Footnote
Treatment in all cases was by debridement and obturation of affected infundibula from their occlusal aspect +/- also endodontic therapy OR extraction
207
In the image below from Suske's 2016 paper "Infundibula of equine maxillary cheek teeth. Part 1: development, blood supply and infundibular cementogenesis," what does the yellow arrow represent and what is significant about it in terms of cementogenesis?
## Footnote
The Vet J 2016
Lateral opening of the distal infundibulum
In over 70% of the teeth investigated, the lateral opening, which contains blood vessels, at the distal infundibulum was wider and reached further apically compared to the mesial opening of the mesial infundibulum --> allows for prolonged cementognesis of the distal infundibulum
208
In Suske's 2016 study "Infundibula of equine maxillary cheek teeth. Part 2: morphological variations and pathological changes," infundibular cemental hypoplasia was present in what percent of cheek teeth with no evidence of dental disease and with dental disease respectively?
## Footnote
The Vet J 2016
> 50% with no evidence dental disease
> 70% with dental disease
209
In Suske's 2016 study "Infundibula of equine maxillary cheek teeth. Part 2: morphological variations and pathological changes," what was the association between infundibular erosion and pulpal infection?
## Footnote
The Vet J 2016
In all diseased teeth infundibular erosion caused pulpal infection that was confirmed on histo exam → infundibular erosion was stat sig correlated with pulpal infection
## Footnote
infundibular erosions present in > 27% diseased cheek teeth and confirmed to be the cause of pulpal infection on histo
210
In Horbal's 2019 study "A computed tomographic (CT) and pathological study of equine cheek teeth infundibulae extracted from asymptomatic horses. Part 1: Prevalence, type and location of infundibular lesions on CT imaging," what percent of all infundibulae examined had some type of subocclusal cemental lesion, and what percent of infundibulae without occlusal caries had subocclusal lesions?
## Footnote
Dixon Frontiers 2019
All infundibulae 91% subocclusal lesions
Infundibulae without occlusal caries 72% had subocclusal lesions
211
In Horbal's 2019 study "A computed tomographic (CT) and pathological study of equine cheek teeth infundibulae extracted from asymptomatic horses. Part 1: Prevalence, type and location of infundibular lesions on CT imaging," what were the two main patterns of developmental cemental hypoplasia identified?
## Footnote
Dixon Frontiers 2019
1.) Apical cemental hypoplasia usually involving the full width of the apical aspect of the infundibulum
2.) Central linear hypoplasia involving the central aspect over most of its length
## Footnote
3.) Combination of 1 and 2
212
In Horbal's 2019 study "A computed tomographic (CT) and pathological study of equine cheek teeth infundibulae extracted from asymptomatic horses. Part 2: MicroCT, gross and histological findings," how many infundibulae had subocclusal cemental hypoplasia and caries out of the 16 examined?
## Footnote
Dixon Frontiers 2019
15/16
213
In Horbal's 2019 study "A computed tomographic (CT) and pathological study of equine cheek teeth infundibulae extracted from asymptomatic horses. Part 2: MicroCT, gross and histological findings," what were the median densities in HU of normal appearing cementum, abnormal cementum, and cementum with gross hypoplasia/aplasia?
## Footnote
Dixon 2019
Normal cementum 3,438 HU (range 2,029-3,725 HU)
Abnormal cementum 501 HU (range -692 to 1,343 HU)
Cementum with gross hypoplasia/aplasia -396 to -560 HU
214
In Pearce's 2022 study "Long-term follow-up of restorations of equine cheek teeth infundibula (2006-2017)," what percent of horses developed no apparent post-restoration complications in the treated teeth, and what percent of treated horses available for follow up had no adverse clinical signs or developed any abnormalities of restored teeth observable on oroscopic exam?
## Footnote
Frontiers 2022
97%
99%
## Footnote
No radiographic follow up
215
What is the eruption pattern for permanent cheek teeth?
## Footnote
Dickey, Carmalt, Reiswig. A retrospective observational cohort study on the expiration of maxillary cheek teeth infundibula in 217 horses. JVD 2023.
First molar, second molar, second premolar, third premolar, third molar, fourth premolar
216
In Gere's 2010 study "Post mortem survey of peripheral dental caries in 510 Swedish horses," what was the prevalence of peripheral caries and where did the majority of peripheral caries occur?
## Footnote
Dixon EVJ 2010
PC prevalence 6.1%
87% PC occurred in molars
217
In Gere's 2010 study "Post mortem survey of peripheral dental caries in 510 Swedish horses," what factor was stat sig associated with the presence of peripheral caries?
## Footnote
Dixon EVJ 2010
Significantly increased levels of diastemata present in PC affected horses
218
In Erridge's 2012 study "Histological study of peripheral dental caries of equine cheek teeth," what grade of gross peripheral caries was found to most underestimate the severity of the disorder as compared to histological grading?
## Footnote
Dixon JVD 2012
Grade 2 (enamel involvement) only 25% correlation between gross findings and histo
## Footnote
83 % (5/6) correlation for 1st degree class 1
86 % (6/7) for 1st degree class 2
219
In van den Enden's 1997 study "Prevalence of occlusal pulpar exposure in 110 equine cheek teeth with apical infections and idiopathic fractures," what percent of apical infections were due to anachoresis and infundibular caries respectively?
Anachoresis 68%
Infundibular caries 5%
220
In van den Enden's 1997 study "Prevalence of occlusal pulpar exposure in 110 equine cheek teeth with apical infections and idiopathic fractures," occlusal pulp exposures were found in what percent of all apically infected teeth and in what percent of teeth extracted due to fractures?
## Footnote
Dixon EVJ 1997
All apically infected teeth 32%
Fractured teeth 42%
221
In Dacre and Dixon's 2007 study "Equine idiopathic cheek teeth fractures. Part 1: Pathological studies on 35 fractured teeth," what were the most common teeth affected and what were the most common fracture patterns?
## Footnote
EVJ 2007
Maxillary CT, particularly the 09s preferentially affected
Buccal slab fractures of maxillary CT pulp horns 1 and 2 most common fracture plane, usually only involved clinical crowns
Buccal slab fractures of mandibular CT through 4th and 5th PHs and midline sagittal fractures through infundibula next most common patterns
## Footnote
Fracture planes involved the pulp chambers in 30/35 CT
Ran through coalesced, carious infundibula in 5/35
222
In Dacre and Dixon's 2007 study "Equine idiopathic cheek teeth fractures. Part 1: Pathological studies on 35 fractured teeth," reduced dentinal thickness probablay indicating prior pathological changes was present in what percent of fractured teeth?
## Footnote
EVJ 2007
25%
223
In Taylor and Dixon's 2007 study "Equine idiopathic cheek teeth fractures. Part 2: a practice-based survey of 147 affected horses in Britain and Ireland," what was the overall prevalence of CT fractures?
## Footnote
EVJ 2007
0.4% (range 0.07-5.9% for various respondents)
## Footnote
Maxillary CT were overrepresented with 09s and 10s comprising 46% of all fractured teeth
Maxillary fractures through PHs 1 and 2 48% of all fractured teeth
Midline sagittal fractures through infundibula next most common followed by mandibular fractures PHs 4 and 5
224
In Taylor and Dixon's 2007 study "Equine idiopathic cheek teeth fractures. Part 2: a practice-based survey of 147 affected horses in Britain and Ireland," what percent of horses did not show clinical signs?
## Footnote
EVJ 2007
39%
## Footnote
Quidding in 33%, bitting and behavioral problems 29%, halitosis 12%
