Oral Surgery Flashcards
In Bach 2014 paper “Bacterial Meningitis After Sinus Surgery in Five Adult Horses”, what was the onset of time to neurologic clinical signs from sinus surgery?
Vet Surg 2014
5–11 days after initial surgery and 4–11 days after last surgery in all 5 horses
In Bach’s 2014 paper, “Bacterial Meningitis After Sinus Surgery in Five Adult Horses”, what were the 4 pathways hypothesized to have caused meningitis secondarily to sinus surgery?
Vet Surg 2014
- osteitis/erosion of thin bones → fracture of cribiform plate
- vascular spread (hematogenous‐metastatic, thrombophlebotic)
- along cranial nerves (more common in ruminants - listeriosis), hypoth optic nerve in sphenopalatine sinus involvement
- direct bacterial inoculation caused by (iatrogenic) head trauma
In Mendez-Angulo’s paper “Extensive Rostral Mandibulectomy for Treatment of Ameloblastoma in a Horse” to what extent was the rostral mandibulectomy performed?
Vet Surg 2014
Caudal aspect of symphysis - The day after surgery, the remaining mandibular symphysis (<5 mm) fractured
In Gilsenan’s case series “Headshaking in 5 Horses After Paranasal Sinus Surgery”, what dose of gabapentin was effective in resolution of clinical signs in 2/5 horses?
Vet Surg 2014
5–10 mg/kg orally every 6–8 hours
What is the presumed MOA of neuropathic pain?
Gilsenan et al Vet Surg 2014
neuropathic pain are caused by spontaneous ectopic neuronal firing that may result from upregulation of sodium channels in injured nerves in various phases of repair
In the 2015 study by Langeneckert et al, “Cheek Tooth Extraction Via a Minimally Invasive Transbuccal Approach and Intradental Screw Placement in 54 Equids,” what was the success rate of MITSE?
47/58
In the 2015 study by Langeneckert et al, “Cheek Tooth Extraction Via a Minimally Invasive Transbuccal Approach and Intradental Screw Placement in 54 Equids,” what were the post-operative complications described by the authors?
- 4/58 (7%) animals w/ hemorrhage from trocar incision
- 3/58 procedures diffusion of local anesthetic caused temporary loss of facial nerve motor function
- 1/58 had oroantral communication
In the 2015 study by Langeneckert et al, “Cheek Tooth Extraction Via a Minimally Invasive Transbuccal Approach and Intradental Screw Placement in 54 Equids,” what was the most common intraoperative complication described by the authors?
Screw pullout
Mechanical lockage of the target tooth w/in the extraction path resulted in screw pullout in 13/32 procedures
Friable tooth material responsible for screw pullout in 19/32 procedures
In the 2015 study by Langeneckert et al, “Cheek Tooth Extraction Via a Minimally Invasive Transbuccal Approach and Intradental Screw Placement in 54 Equids,” MITSE was found to be favorable when compared to repulsion and invasive lateral buccotomy techniques for which reasons?
Repulsion:
- 3/14 (21%) of horses w/ repulsion of mandibular CT developed chronic draining tracts
- 6/30 (20%) of horses w/ entire apical repulsion of maxillary CT developed chronic nasal discharge w/ or w/o oroantral fistula formation (Prichard et al., 1992)
-vs. 2/33 (6%) of animals in this study
Invasive lateral buccotomy techniques:
- 3/112 (3%) of horses developed prolonged or permanent paralysis of the ventral buccal ramus of the facial nerve w/ drooping of the lower lip observed more than 2 months after surgery (O’Neill et al., 2011)
In Lorello’s 2016 paper “Clinical treatment and prognosis of equine odontoclastic tooth resorption and hypercementosis”, what was the mean age of diagnosis of EOTRH?
EVJ 2016
24 years (17-29 y range)
In Jansson’s 2016 paper “Conservative Management of Unilateral Fractures of the Mandibular Rami in Horses”, how many of the horses returned to their intended use?
Vet Surg 2016
23/24 (96%)
1 horse had dental problems and subsequent non healing fracture, later euth
In Jansson’s 2016 paper “Conservative Management of Unilateral Fractures of the Mandibular Rami in Horses”, how many horses were diagnosed with open fractures?
Vet Surg 2016
67%
9 of them developed cutaneous fistulas
In this intraoperative image from “True Cementomas (cementoblastomas) Associated with a Nonvital Left Maxillary Second Premolar in an 11-year-old Miniature Horse,” what muscle and nerve were retracted ventrally?
Leudke, Rawlinson, EVE 2016
Levator nasolabialis m
Infraorbital nerve
In Leudke’s 2016 paper ““True Cementomas (cementoblastomas) Associated with a Nonvital Left Maxillary Second Premolar in an 11-year-old Miniature Horse,” how is a cementoma histologically defined?
Rawlinson EVE 2016
Rare odontogenic tumors caused by abnormal proliferation of neoplastic or reactive cementoblasts that produce single or multiple nodular masses comprising sheets of mineralized cementum-like material
Differs from the Easley 2022 text that distinguishes reactive nodular hypercementosis from true cementomas as histologically different but clinically identical entities
What bone is fractured in the image below?
Grant “Iatrogenic fracture of the premaxilla during standing exodontia” EVE 2016
Premaxilla, bilaterally
In Nottrott’s 2018 JVD case report “Successful Treatment of a Persistent Oroantral Fistula via Transbuccal and Transnasal Endoscopic Debridement in a Horse”, what allowed the surgeons access to the sinuses transnasally? And which sinuses?
JVD 2018 issue 1
The absence of normal turbinate anatomy allows direct access into the maxillary and conchal sinuses on the right of the image.
What were the major outcomes of this ex vivo study in regards to ability to perform the techniques, access to the sinuses, and sinus drainage?
Bach et al. Surgical enlargement of the nasomaxillary aperture and transnasal conchotomy of the ventral conchal sinus: Two surgical techniques to improve sinus drainage in horses. Vet surg 2019
Sinonasal communications were successfully created in all cadavers and affected live horses.
Transnasal endoscopy of all sinuses except the middle conchal sinus was possible in heads 4–9 and in all clinical cases.
Drainage was increased (P = .028) through the surgically created sinonasal communications (combined TCVCSSENMAP) in heads 7–9
In Horbal’s 2016 paper “Gingival Fibrosarcoma in a Horse: A Case Report,” what treatments were performed?
JVD Dixon 2016
Repeated surgical debulking and intralesional cisplatin
In Horbal’s 2016 paper “Gingival Fibrosarcoma in a Horse: A Case Report,” after the final surgical and cisplatin treatments the mass was noted to have regressed how many months later and what was the maximum follow up?
JVD Dixon 2016
3 months
4 years later horse asymptomatic in full work
Last oral exam 8 months after final treatment, mare asymptomatic, no recurrence, gingival recession 107
In Morgan’s 2019 paper “Equine Odontogenic Tumors: Clinical Presentation, CT Findings, and Outcome in 11 horses,” what clinical presentation findings were noted in all horses?
Vet Radiol Ultra 2019
All masses nonpainful, firm, bony swellings palpated externally over dental arcades
Solitary mass 10/11 cases
In Morgan’s 2019 paper “Equine Odontogenic Tumors: Clinical Presentation, CT Findings, and Outcome in 11 horses,” what CT characteristics were present in all cases?
Vet Radiol Ultra 2019
All tumors associated with maxillary/mandibular bone expansion, alveolar and cortical bone lysis and cortical bone thinning
In Morgan’s 2019 paper “Equine Odontogenic Tumors: Clinical Presentation, CT Findings, and Outcome in 11 horses,” what were the only odontogenic tumors in this study found to contain enamel and be differentiable on CT examination?
Vet Radiol Ultra 2019
Complex odontomas
In Morgan’s 2019 paper “Equine Odontogenic Tumors: Clinical Presentation, CT Findings, and Outcome in 11 horses,” what do the short white arrows, long white arrow and white arrowheads represent?
Short white arrows: alveolar bone lysis
Long white arrow: cortical bone thickening
White arrowheads: Smooth periosteal reaction
In Rice’s 2018 paper “Standing intraoral extractions of cheek teeth aided by partial crown removal in 165 horses (2010-2016),” complete intraoral extraction was successful in what percent of horses and what percent of horses required additional intraoral extraction methods to complete extraction?
EVJ 2018 Henry
Complete intraoral extraction successful in 99.4% horses (164/165)
15% (25/165) required additional intraoral extraction methods
In Rice’s 2018 paper “Standing intraoral extractions of cheek teeth aided by partial crown removal in 165 horses (2010-2016),” what additional intraoral extraction method was performed most commonly?
EVJ 2018 Henry
MITSE 21/25 cases
tooth sectioning 4/25 cases
In Rice’s 2018 paper “Standing intraoral extractions of cheek teeth aided by partial crown removal in 165 horses (2010-2016),” what were the most common intraoperative complications and postoperative complications and rates respectively?
EVJ 2018 Henry
Most common intraoperative: fractured root tips 6.7% 11/165 horses
3.6% (6/165) horses developed postop complications - small alveolar sequestra 4/6 horses
In Caramello’s 2020 study “Equine cheek tooth extraction: Comparison of outcomes for five extraction methods,” which complication is highlighted by the arrows following lateral buccotomy extraction of 408?
EVJ 2020
Bone sequestra from damage to alveolar bone
In Caramello’s 2020 study “Equine cheek tooth extraction: Comparison of outcomes for five extraction methods,” in order from highest to lowest, what were the complication rates for the 5 extraction techniques?
EVJ 2020
Oral extraction - 20%
Repulsion by max trephine 42%
Lateral buccotomy 53%
Repulsion via mandibular trephine 54%
Repulsion via max bone flap 80%
In Caramello’s 2020 study “Equine cheek tooth extraction: Comparison of outcomes for five extraction methods,” which extraction technique significantly increased the odds of superficial incisional surgical site infection?
EVJ 2020
Max trephine retropulsion
In Caramello’s 2020 study “Equine cheek tooth extraction: Comparison of outcomes for five extraction methods,” which extraction technique significantly increased the likelihood of fistulation
EVJ 2020
Repulsion via max bone flap (also inc odds of sinusitis post-op)