Verstraete Flashcards
1
Q
What is the primary directional force of the following muscles of mastication: temporalis, pterygoid, masseter?
Ch 27
A
Rostrodorsal
2
Q
What surface of the mandible undergoes the maximal tensile force?
Ch 27
A
Oral/tooth surface
3
Q
Define the symphyseal separation types:
Type I
Type II
Type III
Ch 30
A
Type I - no soft tissue laceration
Type II - soft tissue laceration present
Type III - soft tissue trauma, comminution, exposed bone and fractured teeth
4
Q
What are the key mediators of wound healing?
Ch 1
A
Platelet derived growth factors (PDGFs)
Transforming growth factor beta (TGF-Beta)
5
Q
What cell type regulates formation of granulation tissue?
Ch 1
A
Macrophages
6
Q
What is the primary difference between oral and extraoral re-epithelialization?
Ch 1
A
Oral epithelial cells migrate directly onto the moist, exposed surface of the fibrin clot instead of under dry exudate of dermis
7
Q
Alveolar osteitis occurs when…
Ch 1
A
The extraction site blood clot fails to form or disintegrates
8
Q
Likelihood of wound infection increases substantially when bacteria proliferate to levels greater than…
Ch 1
A
10^5 organisms per gram of tissue
9
Q
Does the canine/feline mandible contain hematopoietic cells?
Ch 2
A
No
10
Q
How much osteoid may be produced per day?
Ch 2
A
1 µm
11
Q
Which forms first in fracture healing, woven or lamellar bone?
Ch 2
A
Woven bone
12
Q
How much bone can osteoclasts resorb per day?
Ch 2
A
50-100µm
13
Q
What is the fracture gap cutoff (µm) for direct vs indirect bone healing?
Ch 2
A
800µm
14
Q
True or false - the term antibiotic refers only to natural compounds of microbial origin?
Ch 3
A
True
15
Q
Verstraete Chapter 3 on antibiotics reports that for each minute in orthopedic surgery involving stainless steel plating the risk of infection increases by what percent?
Ch 3
A
2%
16
Q
What are the positive benefits of local anesthesia mentioned in Verstraete Chapter 3?
Ch 3
A
Suppresses cortisol and catecholamine levels
Reduces muscle breakdown postoperatively
17
Q
The AVDC antibiotics use position statement indicates that antibiotics should be used in what cases?
Ch 3
A
“For animals that are immune compromised, have underlying systemic disease (such as clinically evident cardiac, hepatic, and renal diseases) and/or when severe oral infection is present.”
18
Q
What are the most common bacterial causes of canine infective endocarditis in order of frequency?
Ch 3
A
Staphylococcus spp
Streptococcus spp
Escherichia coli
Bartonella (affects almost exclusively the aortic valve)
19
Q
In people the prevalence of bacteremia following third molar surgery was 67% at 15 minutes after finishing oral manipulations. This prevalence is almost as high as that for daily living true or false?
Ch 3
A
True
20
Q
True or false: Most veterinary studies do not support the association between bacterial endocarditis and either dental/oral surgery or oral infections in dogs.
Ch 3
A
True
21
Q
What is the only cardiac disease statistically shown to predispose dogs to infective endocarditis?
Ch 3
A
subaortic stenosis
22
Q
True or false: There is no evidence that dogs with myxomatous mitral valve disease have increased risk of infective endocarditis
Ch 3
A
True - use of prophylactic antibiotics prior to dental procedures for dogs with MVD controversial, further studies needed
23
Q
Examples of clean contaminated oral surgeries
Ch 3
A
Noninfected dental extraction
Bone grafting
Orthognathic surgery
24
Q
Infection rate of contaminated surgeries when antibiotics not used
Ch 3
A
20-30%
25
Infection rate of dirty surgeries when antibiotics not used
## Footnote
Ch 3
50%
26
Mandibular or maxillary fractures have a higher rate of infection?
## Footnote
Ch 3
Mandibular
27
Review of 547 human patients with major contaminated oncologic head and neck surgery concluded (Johnson 1988 Ann Surg)
## Footnote
Ch 3
Perioperative antibiotic administration should be performed
No evidence exists to support prolonged antibiotic administration beyond first 24 hours
28
What are the 2012 guidelines of the International Association of Dental Traumatology's recommendations for antibiotic usage following reimplantation of luxated/avulsed teeth?
## Footnote
Ch 3
Recommend antibiotics for 7 days following tooth reimplantation
First choice is tetracycline followed by penicillin or amoxicillin
29
True or false: Subgingival microflora was highly susceptible to commonly used antibiotics in 1995 (Harvey CE, Thornsberry C, Miller BR, Shofer FS. Antimicrobial susceptibility of subgingival bacterial flora in dogs with gingivitis.J Vet Dent. 1995;12:151–155.)
## Footnote
Ch 3
True
30
True or false: In a 2006 study resistance of subgingival aerobic and anaerobic flora to commonly used antibiotics in dogs with perio was high (Radice M, Martino PA, Reiter AM. Evaluation of subgingival bacteria in the dog and susceptibility to commonly used antibiotics. J Vet Dent.2006;23:219–224.)
## Footnote
Ch 3
True
Resistance to amox-clav lowest of commonly used antibiotics → still significant
Prevotella intermedia 33%, Porphyromonas gingivalis and Peptostreptococcus spp 25%
Bacteroides fragilis resistant to all antibiotics
31
Doxirobe (subgingivally delivered, sustained release doxycycline polymer) is registered for veterinary patients for treatment of...
## Footnote
Ch 3
periodontal pockets with probing depths 4mm or deeper after periodontal debridement
32
What is the subantimicrobial dose of doxycycline according to Verstraete?
## Footnote
Ch 3
20mg PO q12h for 9 months or 2mg/kg PO q24h for 8 weeks
33
Concentrations of antibiotics needed to inhibit subgingival plaque in biofilms reported to be how many times greater than concentrations needed to inhibit the same strains grown planktonically?
## Footnote
Ch 3
250-1000
34
What is primary hyperalgesia?
## Footnote
Ch 4
Primary → related to changes in sensitivity of peripheral neurons
Release of various mediators → reduce the threshold for further stimulation of nociceptors in the injured area
35
What is secondary hyperalgesia?
## Footnote
Ch 4
Secondary → due to changes in central processing of neuronal input
Nociceptive input into the spinal cord interacts with adjacent neurons and sensitizes them to further stimuli
Manifests as change in nociceptive threshold outside the area of injury
36
What is the definition of allodynia?
## Footnote
Ch 4
Pain due to a stimulus which does not normally provoke pain
37
What is the volume of collagen scaffold recommended to fill a critical size bone defect for regeneration?
## Footnote
Ch 53
Volume of collagen scaffold = 1/2 to 3/4 of the mandibular height and a length 2 mm greater than the defect span
38
What % volume should a collagen scaffold be infused with rhBMP-2 for regeneration of critical size bone defect?
## Footnote
Ch 53
50%
39
How does light cure composite become solid?
## Footnote
Ch 31
Polymerization reaction by the induction of free radical formation through a specific wavelength of blue light (400-500 (470) nm)
40
What concentration of light source is needed for light-curing composites?
## Footnote
Ch 31
400-500 nm → 470 nm
41
Name that wiring technique
## Footnote
Ch 31
Ivy loop
42
Name that wiring technique
## Footnote
Ch 31
Risdon
43
Name that wiring technique
## Footnote
Ch 31
Essig
44
Name that wiring technique
## Footnote
Ch 31
Stout
45
What is the definition of hypotension in mmHg?
## Footnote
Ch 4
systolic pressure <90mmHg or mean pressure < 70mmHg
46
What percent of crystalloids administered will remain in the vascular space?
## Footnote
Ch 4
50%
47
What is the standard for determining efficiency of ventilation in the anesthetized patient?
## Footnote
Ch 4
Blood gas analysis
48
What nerve provides sensory innervation to the hard palate?
Major palatine nerve
| branch of the pterygopalatine n
## Footnote
Ch 4
49
Which branches of the infraorbital nerve primarily supply the maxillary fourth premolar tooth?
## Footnote
Ch 4
Middle superior alveolar branches
50
Which branches of the infraorbital nerve supply the rostral premolar, canine and incisor teeth?
## Footnote
Ch 4
Rostral superior alveolar branches
51
Which opioids can take up to 30 minutes to achieve maximal effect?
## Footnote
Ch 4
Morphine and buprenorphine
52
How long does it take for fentanyl patches to reach peak plasma concentrations?
## Footnote
Ch 4
6-24 hours
53
What is the mechanism of action of grapiprant?
## Footnote
Ch 4
Prostaglandin EP4 Receptor Antagonist
54
What are these instruments used for?
## Footnote
Ch 4
Percutaneous needle catheter technique for esophagostomy tube placement
## Footnote
esophagostomy tube set: esophagostomy introduction tube, 10G 50mm needle with Peel-away sheath needle, 10 F silicone catheter
55
What is the allometric RER formula?
## Footnote
Ch 5
RER (kcal/day) = 70( BW (kg) ^ 0.75)
56
Why does cone beam CT have poorer contrast resolution than conventional CT?
## Footnote
Ch 6
More scatter
57
What does increasing pitch do to signal:noise ratio for CT?
## Footnote
Ch 6
Increasing pitch reduces signal:noise ratio
An increase in pitch negatively impacts image quality for pitch >1.5
58
What is the dose for iodonated contrast?
## Footnote
Ch 6
600-800 mg/kg
59
What force does an elevator apply to the Sharpey fibers?
## Footnote
Ch 13
Rotational (lever)
60
What are the three requirements for acceptable retained tooth root?
## Footnote
Ch 13
<3-4 mm in size, deeply embedded in bone, no periapical lucency
61
How frequently are dichotomous roots of cats MaxP2s seen?
## Footnote
Ch 14
Greater than 50%
| 27.7% single root, dichotomous root 55.1%, two roots 9.2%
62
Which two arteries are located near the maxillary canine tooth alveolus in a dog?
## Footnote
Ch 15
Lateral nasal artery and branch of major palatine artery
63
What is the definition of asepsis?
## Footnote
Ch 7
Complete absence of any bacteria, viruses, fungi, molds or parasites capable of causing infection
64
What is the most common needle holder grip in oral surgery?
## Footnote
Ch 7
Wide-based tripod grip
65
What is the maximum speed of a high speed handpiece?
## Footnote
Ch 7
40,000rpm
66
Have emphysematous complications from using a high speed hand piece been documented in animals?
## Footnote
Ch 7
No
67
Why is deionized water used in dental machines?
## Footnote
Ch 7
Tap water is harmful to canine fibroblasts
Microorganisms may be present in tap water and biofilm may form in waterline
68
What does low level disinfection achieve?
## Footnote
Ch 7
least effective - does not kill bacterial endospores or Mycobacterium tuberculosis. Can kill most bacteria, some viruses and some fungi
69
What is intermediate level disinfection?
## Footnote
Ch 7
kills M. tuberculosis bu not bacterial endospores. kills vegetative bacteria, most viruses, most fungi
70
What is high level disinfection?
## Footnote
Ch 7
kills some but not all bacterial endospores, M. tuberculosis
71
Monocryl loses what percent of its tensile strength after 2 weeks?
## Footnote
Ch 8
20-30%
72
What is the most commonly used suture needle in oral surgery?
## Footnote
Ch 8
3/8 circle needle
73
What are the most recommended sutures for intraoral use?
## Footnote
Ch 8
Monocryl and Vicryl-Rapide sizes 4-0, 5-0, 6-0
74
What is the frequency needed to cut mineralized tissue with a piezotome?
## Footnote
Ch 9
25-35 kHz
75
What is the cutting rate of the piezotome?
## Footnote
Ch 9
0.25-0.3mm per second
76
Which of the following is correct in the prevalence of traumatic dental injuries?
a. The majority of cases affected cats more than dogs
b. The most common age of animal affected is >5 years old
c. Concussion is the most common type of injury
d. Avulsion is the most common type of injury
## Footnote
Ch 24
c. Concussion is the most common type of injury
"Concussion (with tooth discoloration) was the most common periodontal injury (83.1%), followed by avulsion (9.0%), lateral luxation (4.8%), extrusive luxation (1.2%), intrusive luxation (1.2%), and subluxation (0.6%) injuries."
77
Which teeth are most commonly affected by TDI?
## Footnote
Ch 24
Incisors and canines
78
How long does the clinician have before necrosis of the PDL starts to occur for an avulsed tooth without storage in an appropriate solution?
## Footnote
Ch 24
60 minutes
79
What properties are important to preserve an avulsed tooth?
## Footnote
ch 24
Osmolarity
pH
Temperature
80
How long does the clinician have before necrosis of the PDL starts to occur for an avulsed tooth WITH storage in an appropriate solution?
## Footnote
Ch 24
3 hours
81
What are complications of TDI replantation?
## Footnote
ch 24
Coronal discoloration
Marginal bone loss
Pulp necrosis
Ankylosis and resorption
## Footnote
The removal of the blood clot prior to replantation of experimentally avulsed dog teeth resulted in less ankylosis and resorption
82
Where do the efferent lymphatics of palatine tonsils drain to?
## Footnote
Ch 63
Medial retropharyngeal lymph nodes
## Footnote
No afferent lymphatics
83
What is the arterial and venous anatomy of the palatine tonsils?
## Footnote
Ch 63
Lingual artery --> tonsilar artery --> branches 2-3 times to enter base of each tonsil
Numerous small veins leave each tonsil and empty into palatine venous plexus
84
What are the indications for tonsillectomy?
## Footnote
Ch 63
Chronic recurrent tonsillitis, adjunct therapy to radiation for canine tonsillar SCC, removal of benign tonsillar polyps and cysts, less commonly to treat brachycephalic syndrome
85
The tonsillar pathology in images A and B are most consistent with what neoplasms?
## Footnote
Ch 63
A. Malignant lymphoma
B. Unilateral tonsillar SCC
86
For what tonsillar neoplasia is tonsillectomy not indicated?
## Footnote
Ch 63
Malignant lymphoma
## Footnote
Chemotherapy treatment of choice
87
What is the most commonly reported tonsillar tumor in dogs? Ch 63
## Footnote
Ch 63
SCC
88
What surgical tonsillectomy technique has not been described in dogs?
A. Parker-Kerr suture pattern
B. CO2 laser
C. Bipolar vessel sealing device (Ligasure)
D. Transection with monopolar cautery
B. CO2 laser
## Footnote
commonly performed in people but not described in dogs. A and C most recommended
89
What suture pattern is demonstrated in this image?
## Footnote
Ch 63
Parker-Kerr suture pattern
90
What is the arterial blood supply of the hard palate?
## Footnote
Ch 62
Major palatine arteries, lesser extent from minor palatine arteries caudally, sphenopalatine arteries dorsally
## Footnote
Venous drainage via diffus venous plexus to maxillary vein
91
Bilateral carotid artery ligation may result in death in what species?
## Footnote
Ch 62
Cats
92
The image below demonstrates which procedure and technique?
## Footnote
Ch 62
Temporary carotid ligation using a Rummel tourniquet
93
What surgical techniques for control of hemorrhage during nasopharyngeal surgeries are recommended?
## Footnote
Ch 62
Temporary carotid artery ligation, lavage with cold saline, suction, epinephrine 1:100,000, bipolar electrocautery for individual vessels
94
What oral approach is recommended for acess to the caudal nasal passages and nasopharynx?
## Footnote
Ch 62
Ventral approach through hard palate
95
What is the difference between a pharyngostomy and a pharyngotomy?
## Footnote
Ch 61
A pharyngostomy is a surgical formation of an artifical opening into the pharynx for a feeding tube that will remain in place after surgery.
A pharyngotomy is a surgical incision into the pharynx for placement of an endotracheal tube or feeding tube that will be removed immediately after the procedure.
96
What are the names of the labeled neurovascular structures?
A. Hypoglossal nerve
B. External carotid artery
C. External jugular vein
D. Linguofacial vein
E. Lingual artery
F. Linguofacial vein
G. Epihyoid bone
97
During a staphylectomy what tissue layer is not included in the closure?
## Footnote
Ch 60
The palatine muscles are not included. Nasopharyngeal mucosa and oropharyngeal mucosa are sutured together with a simple continuous pattern.
98
What are the two types of unerupted teeth?
## Footnote
Ch 59
Embedded teeth - do not erupt due to lack of eruptive force
Impacted tooth - failure to erupt due to physical obstruction
99
What is pericoronitis?
## Footnote
Ch 59
Inflammation around the operculum (mucosa over an unerupted tooth) or inflammation around a partially erupted tooth
100
What is the defintion of osteonecrosis of the jaws?
## Footnote
Ch 58
Exposed nonvital bone in the maxillofacial region that fails to heal after 6-8 weeks in patients with no history of maxillofacial radiation
101
What breed may be prone to osteonecrosis of the jaws?
## Footnote
Ch 58
Scottish Terriers
102
The following images demonstrate which disease process and etiology?
## Footnote
Ch 58
Osteonecrosis caused by blastomycosis
103
Tight-lip syndrome is seen exclusively in what breed?
## Footnote
Ch 57
Shar-Peis
104
What are the indications for frenuloplasty?
## Footnote
Ch 57. frenuloplasty: repositioning the frenulum
Dermatologic infection of the lower lip, chronic periodontal disease of the distal mandibular canine teeth, Shar-Pei's with tight-lip syndrome
105
Which of the following is true?
a. Odontoma → benign, locally aggressive
b. Odontogenic myxoma → benign, some recurrence potential
c. Canine acanthomatous ameloblastoma → malignant
d. Odontogenic myxoma → malignant
## Footnote
Ch 45
d. Odontogenic myxoma → malignant
106
What % of ameloblastomas are located at the rostral mandible?
## Footnote
Ch 45
41%
## Footnote
6% at caudal maxilla
107
What breeds have predispositions to gingival hyperplasia?
## Footnote
Ch 46
Collie, Great Dane, Boxer, Doberman, Dalmation
108
Oral eosinophilic granuloma in siberian huskies involves lesions typically of what anatomy?
## Footnote
Ch 46
Tongue
## Footnote
ALSO! Oral eosinophilic granuloma in siberian huskies often presents with a peripheral eosinophilia → 80% of cases
109
What breed is associate with Craniomandibular osteopathy (CMO)?
## Footnote
Ch 46
West Highland white terriers
## Footnote
disease is inherited as an autosomal recessive trait
Ddx: Idiopathic calvarial hyperostosis
110
What is the typical presentation of Mandibular periostitis ossificans?
## Footnote
Ch 46
Large-breed puppies around 3–5 months of age are presented for swellings centered on the mandibular first molar tooth, around the time of its eruption.
## Footnote
Characteristic radiographic finding of a double cortex at the ventral aspect of the mandible. (Stanley et al, JVD 2010)
111
What is the most prevalent odontogenic cyst in the dog?
## Footnote
Ch 47
dentigerous cyst
112
What is the most common presentation of a dentigerous cyst?
## Footnote
Ch 47
Age 2-3yo, brachycephalic, 1st premolar impacted tooth
113
What type of odontogenic cyst is depicted?
## Footnote
Ch 47
Perapical/radicular cyst
## Footnote
Note the RCT -- non-vital tooth prereq for this cyst, most commonly secondary to failed RCT in humans
114
What histopatholgic feature distinguishes an Odontogenic keratocyst form other odontogenic cysts?
## Footnote
Ch 47
parakeratotic keratinization of the cyst lining
115
What is the typical location of a OKC in a dog?
## Footnote
Ch 47
Maxilla - may go unnoticed until facial deformity/exopthalmos/bone erosion?
116
Define a lateral periodontal cyst?
## Footnote
Ch 47
developmental, noninflammatory cysts that occur on the lateral aspect or between the roots of vital erupted teeth
## Footnote
typically incidental finding
117
What are the two most common sites of sialoceles in dogs?
## Footnote
Ch 55
Cervical, sublingual
118
What veins does the mandibular salivary glad lay between anatomically?
## Footnote
Ch 55
Jugular and linguofacial veins
119
Define embedded tooth and impacted tooth
## Footnote
Ch 59
An embedded tooth is unerupted usually because of a lack of eruptive force
An impacted tooth is prevented from erupting by some physical barrier in the eruption path, such as crowding from adjacent teeth
120
In shallow unerupted teeth, what % of crown is sufficient to expose via operculectomy?
## Footnote
Ch 59
1/2 - 2/3 of crown
121
What laryngeal structure should the pharyngostomy site be rostral to?
## Footnote
Ch 61
Epihyoid bone
122
What gross characteristics are specific to tonsilar lymphoma?
## Footnote
Ch 63
Malignant lymphoma may also affect the tonsils, but animals with tonsillar lymphoma tend to have uniform bilateral enlargement rather than the irregular, firm, unilateral enlargement seen with tonsillar carcinoma
123
What is the most commonly reported tonsilar tumor in dogs?
## Footnote
Ch 63
SCC
124
What are the most common sites for sialocele development in order of frequency?
## Footnote
Ch 55
1.) Cervical site
2. Ranula
3. pharyngeal site
125
Disruption to what salivary gland system most commonly results in sialocele formation?
## Footnote
Ch 55
Disruption of the small tributary ducts of the monostomatic section of the sublingual salivary gland
126
What is the most common location of sialoceles in the cat?
## Footnote
Ch 55
Sublingual sialocele/ranula
127
What size locking titanium mini plates should be used in medium/large breed and small breed dogs respectively? for internal fixation?
## Footnote
Ch 53
Medium/large dogs 2.4mm
small dogs 2.0mm
128
What is the compression resistance matrix (CRM) or scaffold for recombinant human BMPs (rhBMP) made out of?
## Footnote
Ch 53
collagen with embedded granules of hydroxyapatite (HA) and tricalcium phosphate (TCP)
## Footnote
MasterGraft Matrix
129
How much collagen matrix should be applied to a defect for BMP reconstructive surgery?
## Footnote
Ch 53
Fill defect with collagen sponge 1/2 to 3/4ths of mandibular hieght and length 2mm greater than defect span
130
How much volume of rhBMP-2 should be added to the compression resistance matrix scaffold for regeneratie surgeries?
## Footnote
Ch 53
50% of the volume of the prepared scafold
| scaffold 4cm x 1cm x 1cm, defect volume 4 cm^3 = 2ml rhBMP-2
131
What is the definition of an axial-pattern flap?
## Footnote
Ch 52
A pedicle flap of skin and subcutaneous tissue that incorporates a direct cuteaneous artery and vein into its base
132
What blood vessel is part of the caudal auricular axial-pattern flap
## Footnote
Ch 52
Sternocleidomastoid branch of the caudal auricular artery
133
This image demonstrates which axial pattern flap and corresponding artery?
## Footnote
Ch 52
Superficial temporal axial pattern flap
cutaneous branch of superficial temporal artery
## Footnote
Flap is equivalent to length of zygomatic arch
134
Which axial pattern flap is most indicated for rostral maxillofacial defects including the nasal planum? Ch 52
## Footnote
Ch 52
Angularis Oris axial-pattern flap
135
This image depicts which axial pattern flap and corresponding artery?
## Footnote
Ch 52
Angularis oris axial pattern flap
Cutaneous branch of angularis oris artery
136
What axial pattern flap is most indicated for periocular reconstruction, wound closure following orbital exenteration, and midfacial defects?
## Footnote
Ch 52
Transverse facial axial-pattern flap
137
This image depicts with axial pattern flap and corresponding artery?
## Footnote
Ch 52
Transverse facial axial pattern flap
Cutaneous branch of the transverse facial artery
138
How long after axial pattern flap surgery should revision be performed if the flap is devitalized?
## Footnote
Ch 52
4-7 days
139
What are the frequencies used for electrosurgery and radiosurgery for gingivectomies respectively?
## Footnote
Ch 20
electrosurgery 0.5 - 2.9 MHz
radiosurgery 3.0-4.0 MHz
140
Does electorsurgery or radiosurgery result in a smaller zone of thermal necrosis?
## Footnote
Ch 20
radiosurgery
141
What waveforms of electro and radiosurgical units are appropriate for gingivectomy/gingivoplasty?
## Footnote
Ch 20
Fully filtered waveform - smoothest incisions with least amount of thermal necrosis, no sig hemostasis
Fully rectified waveform - cutting and coagulation, wider zone of thermal damage
142
What is the definition of biologic width?
## Footnote
Ch 19
The physiologic dimension of the junctional epithelium and connective tissue attachment
143
Multifilament sutures have what fold higher affinity for bacterial adherence than monofilaments?
## Footnote
Ch 8
5 - 8 fold
144
What intraoperative hemostatic agents should be removed prior to closure?
## Footnote
Ch 8
Bone wax
Ferric sulfate
## Footnote
Bone wax- can cause inflammatory reaction
Ferric sulfate/VicoStat: can impede bone healing
145
How long does it take for GelFoam (absorbable gelatin sponge) to be absorbed and what part of bone formation may it impede?
## Footnote
Ch 8
Absorbed in 4-6 weeks
Can impede cancellous bone replacement
146
Fibrillar (oxidized regenerated cellulose) is absorbed in how many days and may swell up to what percent?
Absorbed in 7-14 days
May swell up to 135% of size
147
What are the advantages of oxidized regenerated cellulose for intraoperative hemostasis?
## Footnote
Surgicel, Fibrillar
Absorbable glucose polymer based sterile knitted fabric that acts as matrix for clot formation and clot stabilization
Does not impeded epithelialization, is bactericidal, and scaffold function
148
What is the hemostatic MOA of CollaPlug/hemostatic collagen?
## Footnote
Ch 8
Causes hemostasis via compression and is held in place for 5 minutes
## Footnote
made from bovine deep flexor tendons
Resorbs in 7 weeks
149
Polysaccharide hemostatic agents like Arista AH degrade in how many days?
## Footnote
Ch 8
1-2
150
What mechanical principle is utilized for extraction when luxators are employed?
## Footnote
Ch 13
Wedge
151
What mechanical principle is utilized for extraction when elevators are inserted perpendicular to and between two roots and turned to lift the root from the alveolus?
## Footnote
Ch 13
Wheel-and-axle motion
152
What mechanical principle is utilized for extraction when elevators are used with the blade along the root and directing the handle downward to lift out the root?
## Footnote
Ch 13
Leverage
153
Rotational forces are used to tooth roots during extraction using what instrument?
Extraction forceps
## Footnote
root rotated slightly to fatigue apical PDL fibers
154
What force is used with extraction forceps to deliver the tooth from the alveolus?
## Footnote
Ch 13
Tractional force
155
What are the 3 fundamental requirements for satisfactory surgical or simple extractions?
## Footnote
Ch 13
1.) Adequate visualization of the tooth to be extracted
2.) Unimpeded pathway for removal of the tooth
3.) Use of controlled force to luxate or elevate and remove the tooth
156
What length of root fragment requires surgical removal?
## Footnote
Ch 13
> 4mm
157
When is it appropriate for clients to resume teeth brushing following extractions?
## Footnote
Ch 13
3-4 days postop
158
What is the crown:root ratio of incisor teeth in a dog?
## Footnote
Ch 14
1:3
159
What permanent teeth are appropriate to extract in closed fashion?
## Footnote
ch 14
Incisors (often minus maxillary I3)
First premolar teeth
Second premolar teeth in cats
Maxillary first molar teeth in cats
Mandibular third molar teeth
160
What tooth is shown below?
Feline maxillary first molar
161
What concentration of chlorhexidine gluconate should the mouth be rinsed with prior to extraction to decrease oral bacterial contamination and reduce incidence of postoperative infection?
0.05-0.12%
162
What vessels may result in major hemorrhage during extraction of the dog maxillary canine?
## Footnote
Ch 15
The lateral nasal branches of the infraorbital artery and its anastomosis with the branches of the major palatine artery
163
What is the name of the groove present on roots of large premolar and molar teeth?
## Footnote
Ch 16
radicular sulcus
164
The white arrowhead corresponds to what structure?
## Footnote
Ch 16
Interradicular septum
165
How much buccal bone removal is recommended for the maxillary second and third premolars and mandibular second, third and fourth premolars?
## Footnote
Ch 16
Only 1-3mm to expose the furcation for sectioning if needed
166
According to Verstraete is it acceptable to leave the maxillary first molar extraction site open to heal by second intention?
## Footnote
Ch 16
Yes
167
Dorsal slippage of a luxator when extracting the maxillary second molar can lead to traumatization of whate vessel?
## Footnote
Ch 16
Minor palatine branch of the maxillary artery
168
What is the definition of TR1?
## Footnote
Ch 17
TR1: mild dental hard tissue loss (cementum or cementum and enamel)
169
What is the definition of TR2?
## Footnote
Ch 17
Loss of cementum or cementum and enamel with loss of dentin that does not extend into pulp cavity
170
What is the definition of TR3?
## Footnote
Ch 17
Deep dental hard tissue loss with loss of dentin that extends into pulp cavity
Most of tooth retains its integrity
171
What is the definition of TR4 including, a, b and c?
Extensive dental hard tissue loss that extends into pulp and most of tooth has lost its integrity
TR4a: crown and root equally affected
TR4b: crown severely more affected than root
TR4c: Root more severely affected than crown
172
What is the definition of TR5?
## Footnote
Ch 17
Remnants of dental hard tissue visible only as irregular radiopacities with complete gingival covering
173
What stage of tooth resorption is acceptable to perform crown amputations/coronectomy in cats with gingivostomatitis?
## Footnote
Ch 17
TR4c
## Footnote
root more severely affected than crown
174
What 4 variables influence both the mechanism of laser-tissue interaction and the resulting effect on tissue?
## Footnote
Ch 10
Wavelength
beam intensity
time domain of energy delivery
tissue handling
175
In laser surgery what is the temperature cut off above which tissues can no longer be viable and below which they experience thermal injury but remain viable?
## Footnote
Ch 10
60 degrees Celsius
176
What is the definition of the dentogingival complex?
## Footnote
Ch 23
The sum widths of the gingival sulcus, junctional epithelium and connective tissue attachments
177
What is Type III crown-lengthening?
## Footnote
Ch 23
Forced eruption with an orthodontic device to expose more of the tooth
178
When performing Type II crown-lengthening when a fracture or caries extends below the gingival margin or to increase the crown length for prosthodontic work, the new alveolar margin should be placed how many millimeters apically?
Fracture or caries: 2mm or more apical to apical most extent of lesions
Prosthodontics: minimum of 3mm apical to planned new free gingival margin
179
What is healing by third intention?
## Footnote
Ch 1
Staged procedure where wound is allowed to granulate and heal by second intention before a delayed primary closure is carried out by bringing together the two surfaces of granulation tissue
180
What are the key mediators of wound healing/chemoattractants?
## Footnote
Ch 1
Platelet-derived growth factors (PDGFs)
Transforming growth factor beta (TGF-Beta)
## Footnote
Recruit inflammatory cells that begin to remove damaged tissue and bacteria from injured area
181
What is the predominant inflammatory cell during the first 2-3 days following injury and what what cell(s) are they replaced by?
## Footnote
Ch 1
Neutrophils: first 2-3 days
Then outnumbered by macrophages derived from mobilized monocytes
182
Macrophages regulate the formation of granulation tissue through release of what modulating cytokines?
## Footnote
Ch 1
Platelet derived growth factor (PDGF)
Vascular endothelial growth factor (VEGF)
183
In general --> the maximum strength of a healed wound is reached in how long?
## Footnote
Ch 1
6-12 months
## Footnote
Never reaches the strength of unwounded tissue
184
Organization of the clot within the extraction site begins how soon after extraction?
## Footnote
Ch 1
within the first 24 to 48 hours
185
What occurs in the first week of extraction site healing?
## Footnote
Ch 1
Clot forms forms a temporary scaffold for inflammatory cells to migrate upon
Epithelium at wound periphery grows over surface of organzing clot
Osteoclasts accumulate along the alveolar bone margin (crest in humans)
Angiogenesis begins in remanents of PDL
186
What occurs in the second week of extraction site healing?
## Footnote
Ch 1
Continued clot organization through fibroplasia and neoangiogenesis penetrating toward center of clot
Trabeculae of osteoid extend into clot from alveolus, osteoclastic resorption of cortical margins more distinct
187
What occurs in the third week of extraction site healing?
## Footnote
Ch 1
Extraction socket filled with granulation tissue
Poorly calcified bone formed around periphery of wound
Surface of wound completely reepithelialized with minimal or no scar formation
188
At what time frame after extraction is the alveolus completely epithelialized when left to heal by second intention?
## Footnote
Ch 1
3 weeks
189
When does radiographic evidence of bone formation at an extraction site become apparent?
## Footnote
Ch 1
6 - 8 weeks following extraction
190
When does the extraction site become radiographically inconspicuous?
## Footnote
Ch 1
6 to 8 months
191
Collagen deposition and wound tensile strength are limited by what factors?
## Footnote
Ch 1
Tissue perfusion and oxygen tension
192
What condition is primarily responsible for poor wound healing in diabetic patients?
## Footnote
Ch 1
Diabetic microangiopathy
## Footnote
Local ischemia, secondary to poor oxygen delivery at the tissue level, and small vessel occlusion play an essential role in the pathogenesis and delayed healing of diabetes
193
What is the key amino acid of wound healing?
## Footnote
Ch 1
Methionine
## Footnote
Metabolized to cysteine which plays a vital role in the inflammatory, proliferative and remodeling phases of wound healing
194
What are the three most important conditions necessary for bone formation and mineralization?
## Footnote
Ch 2
Pluripotent precursor cells
ample blood supply
mechanical stability
195
What are Volkmann canals?
## Footnote
Ch 2
contain nutritional vessels that arise from the periosteal and endosteal bone surface
connect with Haversian vessels within osteons
196
What is extraosseous circulation?
## Footnote
Ch 2
Development of a temporary blood supply external to the bone when normal blood supply interrupted by a fracture
Arises from surrounding soft tissue/buccal mucosa
## Footnote
Health of surrounding soft tissues crucial for fracture repair
197
Direct bone healing is a synergism between what types of healing?
## Footnote
ch 2
Contact and gap healing
198
Why do maxillary fractures tend to heal faster with fewer complications than mandibular fractures?
## Footnote
Ch 2
Bones of maxilla consistent of relatively thin lamina and so have a much greater bone surface area per unit volume that is exposed to soft tissue
Greater proximitity to vascular supply of soft tissues --> greater healing potential
199
What is the term for replacement of cartilage by bone in fracture healing?
## Footnote
Ch 2
Endochondral ossification
200
Direct bone healing occurs when only what type of connective tissue forms between the fracture fragments?
## Footnote
Ch 2
Bone
201
What criteria are necessary for contact healing to occur?
## Footnote
Ch 2
No gap and direct cortical contact
Bone union and Haversian remodeling occur simultaneously
202
What conditions need to be present for gap healing to occur?
## Footnote
Ch 2
Gap in fragments > 200 micrometers < 800 micrometers
Bony union and Haversian remodeling are separate sequential processes
## Footnote
gaps filled in with transversely oriented lamellar bone that is parallel with fracture orientation
Then Haversian remodeling occurs across fracture line
203
In gap healing, replacement with lamellar, transversely oriented bone is completed within how many weeks, and Haversian remodeling to replace the lamellar bone with cortical bone occurs after how many weeks?
## Footnote
Ch 2
Lamellar bone: 4-6 weeks
Haversian remodeling and cortical bone: 10 weeks
204
What craniofacial fracture repair technique provides the optimum environment for direct bone healing?
## Footnote
Ch 2
Miniplates
205
What are major and minor contacts of screws with tooth roots?
## Footnote
Ch 2
Major > 50% screw diameter penetrating tooth root
Minor < 50% screw diameter penetrating tooth root
## Footnote
Minimal morbidity for human patients with major or minor contact
206
Is interfragmentary compression necessary for direct bone healing in the craniomaxillofacial skeleton? (not the mandible)
## Footnote
ch 2
No!
207
Administration of what types of medications can cause osteonecrosis in people?
## Footnote
Ch 58
Bisphosphonates
Denosumab
Antiangiogenic medications
208
What are the potential causes of osteonecrosis?
## Footnote
Ch 58
Administration of certain systemic medications
Iatrogenic drauma --> extractions
Radiation therapy
Dental infections
Idiopathic
209
What factors are commonly reported in dogs with ONJ?
## Footnote
Ch 58
Recent dental extractions
Oral Antibiotic use to treat oral/dental disease
209
Maximal compressive stresses exit the mandible at what surface?
## Footnote
Ch 27
Aboral
210
What are the anatomic names of the rostral/medial, lateral and caudal buttresses of the maxilla/face?
## Footnote
Ch 27
Rostral/medial: Nasomaxillary buttress
Lateral: zygomaticomaxillary buttress
Caudal: Pterygomaxillary buttress
211
What interdental wiring technique is shown?
## Footnote
Ch 31
Ivy Loop
212
What interdental wiring technique is shown?
## Footnote
Ch 31
Stout loop
213
What interdental wiring technique is shown?
## Footnote
Ch 31
Risdon wiring with secondary wires anchoring around individual teeth
214
What interdental wiring technique is shown and what type of fractures is it best used for?
## Footnote
Ch 31
Essig interdental wiring
Reduction and stabilization of luxated canine teeth with alveolar bone fracture
215
Intraoral splints are best applied in what types of fractures?
## Footnote
Ch 31
Transverse or favorable fractures in the mid body or rostral mandible
At least two teeth should be available on either side of fracture to stablize
216
What is the name of this instrument used to fracture the splint into segments for removal?
## Footnote
Ch 31
Bond removing forceps
217
What is the defintion of a malunion?
## Footnote
Ch 35
Healed fracture in which anatomic bone alignment was not achieved or maintained during healing
218
What is the definiton of a nonunion?
## Footnote
Ch 35
A fracture that has failed to heal and does not show any further signs of progression towards consolidation
219
What is the difference between a viable and nonviable nonunion?
## Footnote
Ch 35
Viable nonunions are hypervascular
Nonviable nonunions are avascular
220
