SA dentistry

Question 1

Dog dental formulae: primary and permanent?

Answer 1

Primary: I 3/3 C 1/1 P 3/3 = 38
Secondary: I 3/3 C1/1 P 4/4 M 2/3 = 42

Question 2

Cat dental formulae: primary and permanent?

Answer 2

Primary: I 3/3 C 1/1 P 3/2
Permanent: I 3/3 C 1/1 P 3/2 M 1/1

Question 3

What is dentine?

Answer 3

Produced by odontoblasts lining the pulp system

Made of calcium hydroxyapatite

Question 4

What is cementum?

Answer 4

Avascular bone like tissue covering the root surface

Provides anchorage for the periodntal ligament

Question 5

When do deciduous teeth erupt in kittens and puppies?

Answer 5

All present at 6 weeks

Question 6

When do permanent teeth erupt?

Answer 6

Central and middle incisor: 2-5 months
Corner incisor: 4-5 months
Canines: 5-6 months in dogs, 3-5 months in cats
First premolar: 4-5 months 
Second and third premolars: 6 months
Fourth premolar: 4-5 months
First molar: 5-6 months
Second and third molars: 6-7 months

Question 7

Gingival index for gingivitis?

Answer 7

0 - no inflammation
1 - mild gingivitis: reddening and swelling, no bleeding on probing
2 - moderate gingivitis: reddening, swelling, bleeds on probing
3 - severe gingivitis: swelling, spontaneous bleeding at margin

Question 8

Normal gingival sulcus depth in dogs and cats? hat if increased?

Answer 8

Dog: 1-3mm
Cat: 0.5-1mm
Increased = periodontitis

Question 9

What is gingival recession?

Answer 9

Distance from the cemento-enamel junction to free gingival margin in mm

Question 10

Periodontal index?

Answer 10

Periodontal probing depth and gingival recession
0 - no attachment loss
1 - up to 25% attachment loss
2 - between 25-50% attachment loss
3 - greater than 50% attachment loss

Question 11

Furcation exposure stages? What does it mean?

Answer 11

Bone within the roots is destroyed due to periodontitis
0 - no furcation exposure
1 - furcation felt with probe, bone loss <1/3 width of furcation
2 - periodontal probe >1/3 width of furcation
3 - probe can be placed through furcation from buccal to palatal side

Question 12

Tooth mobility stages?

Answer 12

Stage 0 - physiological mobility: 0.2mm
Stage 1 - horizontal mobility <1mm
Stage 2 - horizontal mobility >1mm
Stage 3 - horizontal and vertical mobility

Question 13

Which is the only instrument able to be used to scale deep pockets?

Answer 13

Hand curette if >2mm (can use US scalers for shallow sub gingival)

Question 14

What is brachygnathism and prognathism?

Answer 14

Brachygnathism = mandible too short
Prognathism = mandible too long

Question 15

What makes plaque?

Answer 15

Biofilm = bacteria + derby + inflammatory cells:

• pellicle = acellular film of salivary glycoproteins etc
• gram positive aerobic bacteria
• mature plaque = gram negative anaerobic bacteria (formed in 48h, maximum harm in 7 days)

Question 16

Feline odontoclastic resorptive lesions (FORL): Aetiology? What happens? Types?

Answer 16

Aetiology:
- unknown
- abnormal destruction of dental hard tissues and replacement with granulation tissue
Type 1:
- cement-enamel junction (neck of tooth/furcation if multi rooted)
- root often unaffected
- signs: lesions on gingival margin, gingivitis
- radiography: focal or multifocal radiolucency present in neck of tooth, extending to crown
- 70% of cases
Type 2:
- root surface
- signs: pink discolouration of crown, scalloped defect on neck covered by granulation tissue
- radiography: loss of periodontal ligament space and root structure, crown missing in advanced disease and root undergoing resorption
Type 3:
- features of type 1 and 2 on same tooth on radiograph
- areas of narrow or lost periodontal ligament space, and focal or multifocal radiolucency, and decreased radiopacity in other areas

Question 17

What are the stages of Feline odontoclastic resorptive lesions (FORL)?

Answer 17

Stage 1: 
- mild dental hard tissue loss
- cementum +/- enamel
- impossible to detect clinically
Stage 2:
- moderate dental hard tissue loss
- cementum + enamel, and dentine but not extending to the pulp cavity
Stage 3: deep dental hard tissue loss
- cementum +/- enamel, with loss of dentine that extends into the pulp cavity
- most of tooth retains its integrity
Stage 4:
- extensive dental hard tissue loss 
- cementum +/- enamel, with loss of dentine that extends to pulp cavity
- most of tooth has lost its integrity
- 4a = crown and toot affected equally
- 4b = crown affected more than root
- 4c = root affected more than crown
Stage 5:
- remnants of dental hard tissue are visible only as irregular radiopacities, and gingival covering is complete

Question 18

Treatment for Feline odontoclastic resorptive lesions (FORL)?

Answer 18

Type 1:
- complete extraction
- surgical extraction to avoid root fracturing
Type 2:
- radiographs required for treatment
- if pulp and ligament intact, remove the root
- if pulp and ligament not present, crown amputation (monitor radiographically)

Question 19

Feline chronic gingivostomatitis (FCGS): Definition? Pathogenesis? Signs? Diagnosis? Treatment?

Answer 19

Definition: inappropriate inflammation (marked and severe), extending onto the oral mucosa and often the caudal oral mucosa/palatoglossal folds
Pathogenesis:
- unknown
- aberrant reaction to plaque?
- decreased salivary IgA, excessive immune response
- 100% of FCGS cats are positive for calicivirus (diagnose with dry oropharyngeal swab for PCR)
- diet?
Signs:
- pain!!!
- anorexia
- halitosis and hypersalivation
- dysphagia
- poor grooming
- inflammation on gingiva and mucosa (palatal and lingual not usually involved)
- can occur even with no teeth
Diagnosis:
- oral exam
- radiographs
- biopsy
Surgical Treatment:
- radical extractions
- always premolars and molars
- any other diseased teeth
- 40% good outcome: no medical treatment needed
- 40% adequate outcome: medical management may be needed
- 20% refractory to treatment
Medical treatment: - buprenorphine orally
- meloxicam
- clindamicin, amoxiclav or cefovecin for 1 week pre-op and 4-6 weeks post-op
- ciclosporin (good if no surgical response)
- steroids (rescue treatment)
- interferon (intralesional best, then oral)
- oral chlorhexidine
- vitamins or omega 3 and polyunsaturated fatty acids
- allergy?
Euthanasia if unresponsive and painful

Question 20

What radiograph views are used for teeth?

Answer 20

Parallel: mandibular premolars and molars

Bisecting angle technique: all other teeth

Question 21

When is an open/surgical technique for tooth extraction mandatory?

Answer 21

Bizarre morphology of roots on radiology
Extensive tooth resorption
Canines (all in dogs, lower in cats)

Also beneficial for:

• retained root
• multicoated teeth
• feline teeth

Question 22

What local anaesthetic blocks could you do for dog/cat dentals for intra-op and post-op analgesia?

Answer 22

Infraorbital:
- affects maxillary incisors, canines and premolars 1-3, and soft and hard tissue rostral to the upper fourth premolars
- inject near infraorbital foramen, bit back from canines
Maxillary:
- affects maxillary fourth premolar, molars and soft and hard tissue caudal to maxillary fourth premolars
- inject behind last tooth
Inferior alveolar:
- affects all mandible teeth and hard and soft tissue
- inject on inside of mandible, behind last tooth
Middle mental:
- affects mandibular incisors and soft tissue
- insert needle into middle metal foramen at level of second premolar on mandible