Tooth resorption Flashcards
Describe TR – tooth resorption in cats & dogs.
More in cats but also in dogs.
2 types:
type 1. inflammatory (painful)
type 2. non-inflammatory/replacement (non-painful unless crown is involved)
Generally, the process begins at root level,
painful only when reaching the crown.
Progressive, currently no way to stop
the process.
With Changes at root level, monitor
progression (Xray, regular checking under
GA).
With Defects at crown level, do extraction (or crown amputation in qualifying cases).
RADIOGRAPHIC IMAGING is essential!
Types of tooth resorption broadly.
2 types:
type 1. inflammatory (painful)
type 2. non-inflammatory/replacement (non-painful unless crown is involved)
odontoblasts do what
odontoclasts do what
odontoblasts build
odontoclasts destroy/take apart
tooth resorption lesion that has reached the crown and granulation tissue as formed a strawberry red uloke
tooth resorption at the stage of healing where the crown has already fallen off and the gingiva has healed over leaving a faint bump where P3 used to be
Periodontal disease leads to what loss
attachment loss!
Tooth resorption stages.
Note that this is out of date and in fact, no longer clinically useful.
Describe:
FCGS
CUPS
+ tx?
FCGS = Feline chronic gingivostomatitis
CUPS = Canine ulcerative paradental stomatitis
Immune background?
Painful!
Severe gingivitis + stomatitis (oral mucosal
inflammation) (+/- ulcers), often only minimal amounts of plaque present.
For owners, “plaque allergy” might be an OK simplification sometimes to include.
Not the same disease in dog and cat but similar enough to each other. It’s not exactly known why they happen.
Tx: COHAT, impeccable homecare, use of
medicines, extraction of (all or most) teeth.
FCGS = Feline chronic gingivostomatitis response to tx
80-90% respond to total teeth extraction treatment
10-20%/the rest of them will sometimes have relapses despite the teeth already having been removed.
stomatitis
stomatitis
Juvenile hyperplastic gingivitis
- (3) 6-8 mo kittens after eruption of permanent dentition
- Some breed predispositions, but also common european shorthair.
- Removal of calculus and plaque,
gingivectomy, establishing
homecare. - Usually needs several repeat procedures; may either disappear upon adulthood or progress into periodontitis.
what breed of cat is predisposed to Juvenile hyperplastic gingivitis?
maine coons
drug sometimes used in the treatment of FCGS
FCGS = Feline chronic gingivostomatitis response
Interferon omega, Interferon alfa-2b drugs etc., e.g. product Roferon-A
inj. commonly diluted into an oral liquid
normal probing depth in cats?
0.5-1 mm
Majority of oral procedures are prevention, periodontal treatment, extractions, traumas.
How should you consider the above in your client communication?
Do not talk to client about ‘dental cleaning’
or ‘calculus removal’ – this sounds like a
cosmetic procedure – favor terms like
professional oral health procedure or
comprehensive oral health treatment and
assessment (COHAT) – this MUST include
oral examination under GA, diagnosing and
treatment.
This is a continuously developing aspect of vetmed.
Recording data, follow-up and owner’s role
are important!
Dental Treatment sequence.
Treatment options and pricing info –
communicate with owner thoroughly!
Decision making
Procedure(s)
Homecare instructions – communicate with
owner!
Follow-up checks: short and long term.
Talk to people!
Requirements for dental procedures. (11)
Large part is prevention, periodontal
disease Tx, extractions, some trauma.
Do what you are reasonably competent
at. Refer the rest!
Do according your means – start small
and grow :)
Continuously developing and changing area of vet med.
Recording info and case follow-up is
important.
Separate room for ‘dirty procedures’ is essential.
Light, assistant/nurse, anesthesia support.
Intubation for most procedures (e.g. xrays can be taken without)
Good instruments + (heat)sterilization
Regular maintenance of equipment and
instruments.
X RAY! (intraoral/dental the best)
Dental procedure Work safety.
Protect eyes, respiratory tract, clothes
Protective eyewear is a MUST (additional
light and magnification are a bonus)
Surgical mask, cap, (gown), non-sterile
gloves
Ergonomics: posture, instrument grip, headlight, saddle chair, table with adjustable height
Dental Instrument grips.
Either modified pen grip, (sometimes
3.),4. and 5. finger support and ‘fix’ the hand being in contact with table or patient
OR a grip with handle resting in palm, instrument grasped mainly w thumb and 3. finger, 4. and 5. acting as support and 2. (index) finger as a ’finger stop’ (elevators, luxators, luxating elevators)
or as an additional fixating point on top of the instrument/handpiece (an alternative grip for polishing handpiece or periosteal elevator).
Wrist in neutral position.
neuropraxia =
nerve damage simply
is the mildest form of peripheral nerve injury commonly induced by focal demyelination or ischemia.
Beware that mouth openers can cause this.
left: dental explorer & right: periodontal probe
