SA Dentistry (Marin) Flashcards
ID and function
Periodontal Ligament - connective tissue that fills the space b/w tooth & alveolar bone
Pulp
living tissue within tooth; comprised of nn., lymph tissue, blood vessels, connective tissue
ID & function
Dentin
- makes up bulk of the tooth; calcified middle layer that supports enamel and protects inner pulp
- with age, dentin grows
Which tooth is dead and why?
the left – dentin failed to develop (note the wide pulp canal– this should narrow as animal gets older)
Gingiva
mm covering over the teeth
Positional Terminology
Mesial
Distal
Lingual
Labial
Buccal
Mesial = toward midline
Distal = away from midline
Lingual = inside of teeth on bottom
Labial = outside of teeth on bottom
Buccal = outside on top
arrow pointing to each surface!! (and not indicating direction)
ID
Coronal = toward tip of tooth; apical = toward gingival surface
Both dogs and cats: teeth group numbers
Upper teeth on right =
Upper teeth on left =
Lower teeth on right =
Lower teeth on left =
Upper teeth on right = 100s
Upper teeth on left = 200s
Lower teeth on right = 400s
Lower teeth on left = 300s
ID
104 = upper right canine
108 = upper right 4th premolar (Carnassial tooth)
409 = lower right 1st molar
404 = lower R canine
Class 2 Malocclusion
over-bite
Class 3 Malocclusion
Under-bite
COHAT
Comprehensive Oral Health Assessment and Treatment
- thorough assessment of oral cavity in order to address any present diseases
UCF
Uncomplicated crown fracture: crown fracture that does not expose the pulp
CCF
Complicated Crown Fracture: fracture of the crown that does expose the pulp
Tooth resporption (most common in cats) – body breaks down and abosrbs the structures of the tooth // tooth erosion
Pathogenesis of periodontal disease
Plaque builds up –> gingivitis progressess & bacteria colonize –> inflammation –> further bacterial colonization/inflammation + damage from cytokine release –> periodontal disease
Gingivitis
swollen and/or inflammed gingival margins +/- hemorrhage
Periodontitis
Periodontitis is a more severe disease that involves inflammation of the periodontal ligament and alveolar bone, eventually causing loss of attachment (periodontal pocketing, gingival recession, bone resorption).
Plaque calcifies to form dental calculus –> attracts more plaque, promoting periodontal disease
the 5 periodontal disease stages
PD0: normal (puppies, kittens)
PD1: gingivitis w/ no bone loss
PD2: < 25% attachment loss
PD3: 25-50% attachment loss
PD4: > 50% attachment loss
Type 1 tooth resorption - AVDC
can still see periodontal ligament all the way around
Type 2 tooth resorption - AVDC
“ghost tooth” –> tooth is disappearing into surroundings and can’t visualize the periodontal ligament
Type 3 tooth resorption - AVDC
One root that is type 1, other root type 2
ID
Chronic Gingivostomatitis (CGS)
Very painful disease, characterized by severe inflammation of the gingiva, buccal mucosa, and caudal oral mucosa. Affects 0.7-10% of general cat population.
Characterized by varying degrees of excessive immune response leading to inflammation in the oral cavity of cats
Cause is unknown – bacterial (Bartonella), viral (calici) and immunologic processes were suspected in the past but recent studies have disproved this
Immunosuppression from FeLV/FIV may be a factor, although most cats are negative
Risk factor: purebred cats
Stomatitis
Inflammation of the mucous lining of any of the structures in the mouth
- term “stomatitis” should be reserved to describe wide-spread oral inflammation (beyond gingivitis and periodontitis) that may also extend into submucosal tissues
Gingivitis
Inflammation of the gingiva
Infraorbital nerve block
Blocks all teeth rostral to the 4th premolar/carnassial teeth (ideal for maxillary canine, not strong enough to block carnassial itself)
The cranial infraorbital nerve block inhibits stimulation to the following nerves: infraorbital, incisivomaxillary, rostral superior alveolar dental, external nasal, internal nasal, and superior labial.14 This block desensitizes the maxillary first, second, and third premolars, canine, and incisor teeth on the same side on which the block is administered. It also desensitizes the associated soft tissues, skin of the muzzle, and the upper lip on the ipsilateral side of block administration.
Maxillary nerve block
blocks all maxillary teeth rostral to last molar on ipsilateral quadrant. Also blocks ipsilateral alveolar bone, soft tissue, skin of nose, cheek, and upper lip.
The caudal infraorbital nerve block inhibits stimulation to the following nerves: maxillary; infraorbital; caudal, middle, and superior alveolar dental; incisivomaxillary; and rostral superior alveolar dental.14 This block desensitizes the maxillary 1st and 2nd molars and all premolars, canine, and incisors of the ipsilateral quadrant.14 Also blocked are the bone and soft tissues of the maxilla on the ipsilateral side of block administration, along with the skin of the nose, cheek, and upper lip on the ipsilateral side.14
Mandibular nerve block
Blocks entire ipsilateral lower teeth arcade, plus ipsilateral rostral intermandibular tissues and rostral lower lip.
The caudal inferior alveolar nerve block inhibits innervation to the inferior alveolar branch of the mandibular nerve before it dives into the mandible; to the caudal, middle, and rostral mental nerves; and to the incisive nerve.14 Anesthesia to this region desensitizes all teeth (incisors, canine, premolars, molars), associated labial tissues, the rostral lower lip, and the rostral intermandibular tissues on the side in which it is placed.14 There are 2 approaches to the caudal inferior nerve block: intraoral and extraoral.
Best flap approach to the premolars/molars
Envelope flap
Best flap approach to canine, 4th premolar, 3rd incisor
Mesial-Based Pedicle Flap
