Small animal dentistry

Question 1

Normal dog occlusion?

Answer 1

• scissor bite (maxillary incisors infront of mandibular)
• mandibular canine should occlude between maxillary canine and third incisor
• premolars should interdigitate in a zig-zag pattern
• posterior scissor bite - upper PM 4 should be buccal to mandiubular M 1

Question 2

What is mixed dentition?

Answer 2

when a puppy/kitten is teething - mix of permenant and deciduous teeth

Question 3

Persistent deciduous teeth?

Answer 3

pathology - malocclusion and peridontal disease

extract it

Question 4

supernumerary?

Answer 4

remove most abnormally positioned

Question 5

missing teeth?

Answer 5

congenital, impacted tooth, traumatic crown fracture, previous extraction

Question 6

Enamel hypoplasia?

Answer 6

normally develops before eruption so trauma / virus during development can leave enamel defects

Question 7

4 trauma induced dental problems

Answer 7

abrasion - eg ball
attrition - tooth against tooth
intrinsic staining - blunt trauma
fractures

Question 8

What to do with a fracture?

Answer 8

will be painful and get an abcess in time and if microbes get in then get pulp necrosis and jaw abnormalities

extract, vital pulp treatment, root canal therapy

Question 9

How to determine between pulp exposure and reparative dentin?

Answer 9

use the tip of a sharp explorer..if pulp is exposed it will sink in the hole

Question 10

What is the difference between plaque and calculus (tartar)

Answer 10

plaque - biofilm of bacteria

calculus - mineralised plaque

Question 11

4 stages of peridontal disease

Answer 11

1) gingivitis, no evidence of attachment loss

2) mild peridontitis 50% loss

Question 12

What is gingivities?

Answer 12

plaque induced

hyperaemia, oedema, tendency of gingiva to bleed

Question 13

How get from stage 2-4?

Answer 13

plaque in sulcus has reduced o2 conc so get G-ve obligate anaerboes which invade the unkeratinised peridontal tissue. the immune response destroys the tissue

Question 14

Systemic risk of peridontal disease?

Answer 14

bacteria in blood -

cardiac lesions, myocardial disease, renal disease, hepatitis

Question 15

2 complications of peridontal disease?

Answer 15

oronasal fistula

risk of jaw fracture

Question 16

What is stomatitis?

Answer 16

infl of the oral mucosa extending beyond the muco-gingival junction
usually bilateral and symmetrical

Question 17

What is the difference between a luxator and an elevator?

Answer 17

Luxator - thin working end with a sharp blade

Elevator - rounded, spoon shaped blade

Question 18

5 step direct extraction technique?

Answer 18

1) cut gingival attachment - walk scalpel round the tooth
2) insert luxator into peridontal ligament space - hold at 30 degrees to tooth and wedge into space and hold. At each corner of tooth
3) Insert and rotate elevator - insert until its wedged and rotate and hold. mesial and distal aspect or 4 corners
4) use extraction forceps - go as far apically as possible and rotate and traction
5) inspect apex for complete root

Question 19

Direct extraction of a multi-rooted tooth?

Answer 19

1) cut gingival attachment
2) reduce crown height if needed
3) first cut between palatal and 2 buccal roots, then cut between two buccal roots
4) confirm each root can move independently
5) extract each root

Question 20

What special technique is needed for extraction of PM 4?

Answer 20

cut distal overhang to create space for elevator

Question 21

Possible complications of direct extraction?

Answer 21

• root fragmentation
• jaw bone necrosis
• iatrogenic jaw bone fracture
• oro-nasal fistula

Question 22

Why would you extract a tooth surgically?

Answer 22

big rooted teeth, perisistent deciduous canines, limit risk of iatrogenic jaw bone fracture, dealing with / preventing extraction complications

Question 23

2 main flap designs for surgical extraction

Answer 23

envelope - no vertical release

vertical release incisions - 2 for bigger teeth

Question 24

Name 3 structures that needed to be avoided when carrying out a surgical extraction

Answer 24

• neurovascular bundle from infraorbital foramen (above PM 3)
• neurovascular bundle from mental foramen ( below PM 2)
• parotid papilla (above PM 4)

Question 25

on a radiograph what do the lamina dura and peridontal ligament look like?

Answer 25

Lamina dura (really dense alveolar bone) - white line around root

Peridontal ligament - thin black line around root

Question 26

What is the pathogenesis of tooth resorption?

Answer 26

Teeth are attacked by odontoclasts which release acid - damages enamel and dentine - resoptive lacunae - vascular granulation tissue fills the lesion and may be replaced by bone and cementum like tissue

Question 27

What is the difference in tooth resorption between cats and dogs?

Answer 27

Cats - common and increased prevalence with age

dogs - normally coincidental, leave in if sub-gingival and no pain / infl

Question 28

Outline the 3 types of tooth resorption

Answer 28

Type 1 - focal lesion, ligament intact - standard extraction

Type 2 - partial loss of ligament - crown amputation with root retention

Type 3 - mix of 1 and 2