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Module 16 > Small Animal Dentistry > Flashcards

Small Animal Dentistry Flashcards

1
Q

what is the dental formula for canines

A

3-1-4-2/3-1-4-3

= 42

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2
Q

what is the feline dental formula

A

3-1-3-1/3-1-2-1

= 30 teeth

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3
Q

what are the steps to filling out a dental chart (3)

A
  1. count the teeth
  2. log calculus level in CI box – buccal
  3. log gingival inflammation in GI box
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4
Q

why might there be missing teeth? (4)

A
  1. removed or fell out
  2. congenitally missing
  3. crown missing: root still present
  4. tooth embedded and unable to erupt
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5
Q

what is the scale to calculus level

A

0 = none

1 = <25%

2 = 25%-75%

3 = > 75%

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6
Q

what is the scale to gingival inflammation

A

0 = no inflammation

1 = red line/edema etc

2 = bleeds on probing

3 = bleeds spontaneously

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7
Q

why are dental radiographs important

A

70% of a tooth structure is invisible on gross exam

almost all common pathology is below the gum line

diagnosis, prognosis and treatment planning is not possible without radiographs

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8
Q

when are dental radiogrpahs indicated

A
  1. all missing teeth or developmental defects
  2. all periodontal pockets >4mm deep
  3. all teeth suffering trauma
  4. full mouth survey of cats when TR lesions found
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9
Q

what is shown here

A

a missing 405 and 406 dog presented for another problem, owner aware of blister from time to time that bursts clear fluid

no pain or discomfort described

roots are resorbing and attachment loss

odontogenic detigerous cyst

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10
Q

what are the findings in these radiographs and how would you treat this

A

missing teeth

enamel is in poor conditions

pre molar 2 embedded, root apices formed large lucent area –> remove the tooth

pre molar 4 close to or in inferior alveolar canal (blood supply, nerves) –> remove the tooth

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11
Q

what is show in this radiograph

A

missing molars 310 and 311

pericoronitis – painful

dilacerated roots also

roated 90 degrees and erupted ventrally into the lower jaw

painful because there is enamel in the area

roots are trying to erupt into an area which is not easy to erupt into and have become disfigured

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12
Q

what is the normal sulcus depth in dogs

A

3mm max in dogs

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13
Q

what is shown here

A

periodontal pocket of 9mm

more than 50% of bone attachment is lost

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14
Q

why is 3mm the max periodontal pocket? (3)

A
  1. difficult to root plane a deep pocket
  2. impossible to brush >3mm at home
  3. deep pockets require advanced skills, expensive graft materials with “uncertain” outcome
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15
Q

what is a fracture without pulp exposed called

A

uncomplicated crown fracture

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16
Q

what is a fracture with pulp exposed called

A

complicated crown fracture

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17
Q

what type of fractures are most common in cats

A

most commonly expose pulp because the pulp is very close to the surface

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18
Q

what can occur if the pulp is compromised by trauma

A

bruised or ischemic

change of color

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19
Q

what is the anatomy of the tooth shown here

A
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20
Q

what is the purpose of periodontal ligament

A

tough fibres that hold the bone between the cemental surface and the alveolar bone

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21
Q

what is pulp

A

live tissue well innervated

subject to inflammation and necrosis

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22
Q

what is dentin

A

majority of tooth

made by cells within the live pulp

varies in thickness during life –> laid down throughout life

sensitive if exposed

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23
Q

what is the apical delta

A

blood/nerve/lymph supply to pulp via hundreds of small canals

could be crushed by trauma and loss of blood supply

24
Q

what is shown on this radiograph

A

recent damage to pulp

and damage on the crown surface

25
Q

describe the changes seen here

A

tooth was killed when it was developing

all the cells became necrotic and non-viable

no further dentin developed

26
Q

what is shown here

A

draining sinus upper left carnassial

no visible fracture damage

often called malar abscess

  1. the rubber cone shows the origin of the sinus

2 lytic lesions in bone around all roots

  1. wide pulps compared with neighbours
  2. concussion/intrusion damage to apical delta and subsequent ischemic necrosis
27
Q

what is shown here

A

doscoloured and suspect non-vital upper K9’s

left side longer term: lucency in apex, normal chevron lucency due to thin bone in area

right side recent: loss of dentin and pulp chamber wide, dead tooth

28
Q

what is the flow chart if there is a retained root

A

more or less than 4mm?

>4mm = surgical removal

<4mm and superficial = surgical removal

<4mm and deep = eventual surgical removal unless patient very unstable

29
Q

what type of radiographs should you take if there are tooth resorption lesions in cats

A

full mouth rads every time

30
Q

what is shown here

A

tooth resorption lesions in cat

31
Q

what is the difference between type 1 and 2 tooth resorption lesions in cats

A

type 1: focal or multifocal area of resorption on tooth surface. Look for pulp and/or PL

type 2: full root replacement with new bone

32
Q

how do you evaluate TR lesions (6)

A
  1. rads are a snapshot in time
  2. some TR teeth will appear as ‘missing’/some currently affected/some teeth may appear normal
  3. lesions normally progressive – how fast?
  4. multiple rads required over life to evaluate progress
  5. dog TR is often later in life and is mainly premolars
  6. T1 vs T2: is there pulp or PL present? is there bone replacement of root?
33
Q

what is shown here and how would you treat

A

lower canine 404 resorption

stage 4 type 2

treated by crown amputation and intentional root retention

34
Q

what is shown here and how would you treat

A

upper canine 104

early resorption root apex

stage 3 type 2

tooth not mobile not sensitive to percussion still functional

more rads in 4-6 months

35
Q

what is shown on these radiographs

A

upper right carnassial

  1. abnormal crown morphology
  2. unusual calculus deposition
  3. young dog
  4. only one tooth affected

on rads

  1. shell like morphology

2 compare with adjacent teeth

  1. compare with contralateral carnassial
  2. huge lucencies surrounding roots – osteomyelitis
36
Q

why are CT more favorable

A

more detailed/accurate than dental radiography in most dental conditions

higher diagnostic yield due to unobstructed views especially in multiplanar recontrsuction mode (MPR)

tri dimensional rendering (3D) and reconstructed panoramic allows an overall impression of oral health and disease

37
Q

what is disclosing solution

A

dental plaque disclosed

38
Q

what is plaque

A

biofilm slime

comes off with a brush

daily

owner responsibility

true prophylaxis

39
Q

what is calculus

A

mineralized plaque

comes off with an instrument or machine

by you under GA

professional dental procedure

40
Q

what are the stages of periodontal disease

A

stage 0: healhty periodontium

stage 1: gingivitis

stage 2: perio up to 25% loss

stage 3

stage 4: >50% loss

41
Q

what stage of periodontal disease is this

A

Gingiva is inflamed as a result of calculus building up both above the gum line (supra-gingival calculus) and below the gum line (sub-gingival calculus). If material is not removed the inflammation will get worse.

stage 0

42
Q

what stage of periodontal disease is this

A

Stage 2 Periodontal ligament loss up to 25%: gingiva sulcus deepened. Bone support has receded away as well as periodontal ligament. Filled with necrotic debris. Still treatable with cleaning —> healing

43
Q

what stage of periodontal disease is this

A

stage 4

with >50% loss: bone receded away and periodontal ligament is almost gone. Necrotic and food debris is almost down to the apical delta —> possibility of infection coming up into the pulp (endodontic disease). Removal of these teeth.

44
Q

what stage of periodontal disease is this

A

Healthy Stage 0 Periodontium: the gingiva is healthy and the alveolar bone and periodontal ligament are where they should be

45
Q

describe the 3 steps in periodontal disease progression

A
  1. Plaque, leading initially to gingivitis.
  2. Deepening of sulcus during active disease it is common for the sulcus to deepen as the junctional epithelium becomes inflamed. The tissues become oedematous and infiltrated with polymorphonuclear granulocytes.
  3. Proliferation of subgingival plaque. The accumulation of the supragingival biofilm reduces the oxygen available to the plaque in the sulcus. As a result, there is a transition from aerobic or facultative anaerobic to an overwhelmingly anaerobic microflora within the subgingival area. As the junctional epithelium swells from oedema and begins to break down, the gingival sulcus is deepened and the three deepest periodontal tissues - periodontal ligament, alveolar bone and cementum - all risk being exposed to the disease process occurring in the tissues close to them
46
Q

what is home dental care not a substitute for

A
  1. for regular professional exam and treatment
  2. not an over the counter concept
  3. a treatment for established disease
  4. the best and only tool in the owner’s box is a brush
47
Q

what are the options for tooth pastes

A
  1. chlorhexidine paste 0.12% – highly effective antibacterial but not for long term use, stains teeth badly and eliminates natural flora
  2. enzymatic paste: stops formation of calculus amd removes plaque effectively
48
Q

what are the options when there is a complicated cornw fracture

A
  1. extract
  2. endodontics (root canal)
  3. never lets wait and see
49
Q

how is a root filling done

A

remove organic material – pulp, etc

sterilize canal – bleach/saline/EDTA

dry canal

fill with rubber and cement

close access and reshape to smooth

50
Q

what are the 3 bite classifications

A
  1. dolicocephalic
  2. mesaticephalic
  3. bracycephalic
51
Q

what are the four requirements of a healthy bite classification

A
  1. the mandibular premolars biscuit the interproximal (interdental) spaces rostral to the corresponding maxillary premolar teeth. This has been described as ‘shear mouth’
  2. the mandibular canine tooth bisects the space between the opposing maxillary third incurs tooth and canine tooth. The lower canines are inclined labially
  3. the maxillary incisor teeth are all rostral to the mandibular incisors. The cusps of the mandibular incisor teeth contact the cingulum of the maxillary teeth (rest on the singular ridge) —> ‘scissor bite’
  4. the teeth are symmetrical in the sagittal plane
52
Q

what is an ‘overshot’ called

A

mandibular distoclusion

53
Q

what are the issues with mandibular distoclusion

A

likely to contact soft tissues on maxilla

54
Q

what are the options for treatment of mandibular distoclusion

A
  1. crown amputation/partial pulpectomy
  2. surgical extraction
  3. orthodontic tipping
55
Q

what is an undershot called

A

mandibular mesioclusion

Module 16 (26 decks)

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