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Phase 1 Boards Prep - SA > Verstraete > Flashcards

Verstraete Flashcards

1
Q

What is the primary directional force of the following muscles of mastication: temporalis, pterygoid, masseter?

Ch 27

A

Rostrodorsal

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2
Q

What surface of the mandible undergoes the maximal tensile force?

Ch 27

A

Oral/tooth surface

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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

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4
Q

What are the key mediators of wound healing?

Ch 1

A

Platelet derived growth factors (PDGFs)
Transforming growth factor beta (TGF-Beta)

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5
Q

What cell type regulates formation of granulation tissue?

Ch 1

A

Macrophages

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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

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7
Q

Alveolar osteitis occurs when…

Ch 1

A

The extraction site blood clot fails to form or disintegrates

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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

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9
Q

Does the canine/feline mandible contain hematopoietic cells?

Ch 2

A

No

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10
Q

How much osteoid may be produced per day?

Ch 2

A

1 µm

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11
Q

Which forms first in fracture healing, woven or lamellar bone?

Ch 2

A

Woven bone

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12
Q

How much bone can osteoclasts resorb per day?

Ch 2

A

50-100µm

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13
Q

What is the fracture gap cutoff (µm) for direct vs indirect bone healing?

Ch 2

A

800µm

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14
Q

True or false - the term antibiotic refers only to natural compounds of microbial origin?

Ch 3

A

True

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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%

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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

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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.”

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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)

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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

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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

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21
Q

What is the only cardiac disease statistically shown to predispose dogs to infective endocarditis?

Ch 3

A

subaortic stenosis

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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

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23
Q

Examples of clean contaminated oral surgeries

Ch 3

A

Noninfected dental extraction
Bone grafting
Orthognathic surgery

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24
Q

Infection rate of contaminated surgeries when antibiotics not used

Ch 3

A

20-30%

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25
Q

Infection rate of dirty surgeries when antibiotics not used

Ch 3

A

50%

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26
Q

Mandibular or maxillary fractures have a higher rate of infection?

Ch 3

A

Mandibular

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27
Q

Review of 547 human patients with major contaminated oncologic head and neck surgery concluded (Johnson 1988 Ann Surg)

Ch 3

A

Perioperative antibiotic administration should be performed
No evidence exists to support prolonged antibiotic administration beyond first 24 hours

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28
Q

What are the 2012 guidelines of the International Association of Dental Traumatology’s recommendations for antibiotic usage following reimplantation of luxated/avulsed teeth?

Ch 3

A

Recommend antibiotics for 7 days following tooth reimplantation
First choice is tetracycline followed by penicillin or amoxicillin

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29
Q

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.)

Ch 3

A

True

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30
Q

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.)

Ch 3

A

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

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31
Q

Doxirobe (subgingivally delivered, sustained release doxycycline polymer) is registered for veterinary patients for treatment of…

Ch 3

A

periodontal pockets with probing depths 4mm or deeper after periodontal debridement

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32
Q

What is the subantimicrobial dose of doxycycline according to Verstraete?

Ch 3

A

20mg PO q12h for 9 months or 2mg/kg PO q24h for 8 weeks

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33
Q

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?

Ch 3

A

250-1000

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34
Q

What is primary hyperalgesia?

Ch 4

A

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

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35
Q

What is secondary hyperalgesia?

Ch 4

A

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

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36
Q

What is the definition of allodynia?

Ch 4

A

Pain due to a stimulus which does not normally provoke pain

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37
Q

What is the volume of collagen scaffold recommended to fill a critical size bone defect for regeneration?

Ch 53

A

Volume of collagen scaffold = 1/2 to 3/4 of the mandibular height and a length 2 mm greater than the defect span

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38
Q

What % volume should a collagen scaffold be infused with rhBMP-2 for regeneration of critical size bone defect?

Ch 53

A

50%

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39
Q

How does light cure composite become solid?

Ch 31

A

Polymerization reaction by the induction of free radical formation through a specific wavelength of blue light (400-500 (470) nm)

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40
Q

What concentration of light source is needed for light-curing composites?

Ch 31

A

400-500 nm → 470 nm

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41
Q

Name that wiring technique

Ch 31

A

Ivy loop

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42
Q

Name that wiring technique

Ch 31

A

Risdon

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43
Q

Name that wiring technique

Ch 31

A

Essig

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44
Q

Name that wiring technique

Ch 31

A

Stout

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45
Q

What is the definition of hypotension in mmHg?

Ch 4

A

systolic pressure <90mmHg or mean pressure < 70mmHg

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46
Q

What percent of crystalloids administered will remain in the vascular space?

Ch 4

A

50%

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47
Q

What is the standard for determining efficiency of ventilation in the anesthetized patient?

Ch 4

A

Blood gas analysis

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48
Q

What nerve provides sensory innervation to the hard palate?

A

Major palatine nerve

branch of the pterygopalatine n

Ch 4

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49
Q

Which branches of the infraorbital nerve primarily supply the maxillary fourth premolar tooth?

Ch 4

A

Middle superior alveolar branches

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50
Q

Which branches of the infraorbital nerve supply the rostral premolar, canine and incisor teeth?

Ch 4

A

Rostral superior alveolar branches

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51
Q

Which opioids can take up to 30 minutes to achieve maximal effect?

Ch 4

A

Morphine and buprenorphine

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52
Q

How long does it take for fentanyl patches to reach peak plasma concentrations?

Ch 4

A

6-24 hours

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53
Q

What is the mechanism of action of grapiprant?

Ch 4

A

Prostaglandin EP4 Receptor Antagonist

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54
Q

What are these instruments used for?

Ch 4

A

Percutaneous needle catheter technique for esophagostomy tube placement

esophagostomy tube set: esophagostomy introduction tube, 10G 50mm needle with Peel-away sheath needle, 10 F silicone catheter

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55
Q

What is the allometric RER formula?

Ch 5

A

RER (kcal/day) = 70( BW (kg) ^ 0.75)

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56
Q

Why does cone beam CT have poorer contrast resolution than conventional CT?

Ch 6

A

More scatter

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57
Q

What does increasing pitch do to signal:noise ratio for CT?

Ch 6

A

Increasing pitch reduces signal:noise ratio
An increase in pitch negatively impacts image quality for pitch >1.5

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58
Q

What is the dose for iodonated contrast?

Ch 6

A

600-800 mg/kg

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59
Q

What force does an elevator apply to the Sharpey fibers?

Ch 13

A

Rotational (lever)

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60
Q

What are the three requirements for acceptable retained tooth root?

Ch 13

A

<3-4 mm in size, deeply embedded in bone, no periapical lucency

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61
Q

How frequently are dichotomous roots of cats MaxP2s seen?

Ch 14

A

Greater than 50%

27.7% single root, dichotomous root 55.1%, two roots 9.2%

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62
Q

Which two arteries are located near the maxillary canine tooth alveolus in a dog?

Ch 15

A

Lateral nasal artery and branch of major palatine artery

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63
Q

What is the definition of asepsis?

Ch 7

A

Complete absence of any bacteria, viruses, fungi, molds or parasites capable of causing infection

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64
Q

What is the most common needle holder grip in oral surgery?

Ch 7

A

Wide-based tripod grip

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65
Q

What is the maximum speed of a high speed handpiece?

Ch 7

A

40,000rpm

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66
Q

Have emphysematous complications from using a high speed hand piece been documented in animals?

Ch 7

A

No

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67
Q

Why is deionized water used in dental machines?

Ch 7

A

Tap water is harmful to canine fibroblasts
Microorganisms may be present in tap water and biofilm may form in waterline

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68
Q

What does low level disinfection achieve?

Ch 7

A

least effective - does not kill bacterial endospores or Mycobacterium tuberculosis. Can kill most bacteria, some viruses and some fungi

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69
Q

What is intermediate level disinfection?

Ch 7

A

kills M. tuberculosis bu not bacterial endospores. kills vegetative bacteria, most viruses, most fungi

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70
Q

What is high level disinfection?

Ch 7

A

kills some but not all bacterial endospores, M. tuberculosis

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71
Q

Monocryl loses what percent of its tensile strength after 2 weeks?

Ch 8

A

20-30%

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72
Q

What is the most commonly used suture needle in oral surgery?

Ch 8

A

3/8 circle needle

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73
Q

What are the most recommended sutures for intraoral use?

Ch 8

A

Monocryl and Vicryl-Rapide sizes 4-0, 5-0, 6-0

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74
Q

What is the frequency needed to cut mineralized tissue with a piezotome?

Ch 9

A

25-35 kHz

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75
Q

What is the cutting rate of the piezotome?

Ch 9

A

0.25-0.3mm per second

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76
Q

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

Ch 24

A

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.”

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77
Q

Which teeth are most commonly affected by TDI?

Ch 24

A

Incisors and canines

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78
Q

How long does the clinician have before necrosis of the PDL starts to occur for an avulsed tooth without storage in an appropriate solution?

Ch 24

A

60 minutes

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79
Q

What properties are important to preserve an avulsed tooth?

ch 24

A

Osmolarity
pH
Temperature

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80
Q

How long does the clinician have before necrosis of the PDL starts to occur for an avulsed tooth WITH storage in an appropriate solution?

Ch 24

A

3 hours

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81
Q

What are complications of TDI replantation?

ch 24

A

Coronal discoloration
Marginal bone loss
Pulp necrosis
Ankylosis and resorption

The removal of the blood clot prior to replantation of experimentally avulsed dog teeth resulted in less ankylosis and resorption

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82
Q

Where do the efferent lymphatics of palatine tonsils drain to?

Ch 63

A

Medial retropharyngeal lymph nodes

No afferent lymphatics

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83
Q

What is the arterial and venous anatomy of the palatine tonsils?

Ch 63

A

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

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84
Q

What are the indications for tonsillectomy?

Ch 63

A

Chronic recurrent tonsillitis, adjunct therapy to radiation for canine tonsillar SCC, removal of benign tonsillar polyps and cysts, less commonly to treat brachycephalic syndrome

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85
Q

The tonsillar pathology in images A and B are most consistent with what neoplasms?

Ch 63

A

A. Malignant lymphoma
B. Unilateral tonsillar SCC

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86
Q

For what tonsillar neoplasia is tonsillectomy not indicated?

Ch 63

A

Malignant lymphoma

Chemotherapy treatment of choice

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87
Q

What is the most commonly reported tonsillar tumor in dogs? Ch 63

Ch 63

A

SCC

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88
Q

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

A

B. CO2 laser

commonly performed in people but not described in dogs. A and C most recommended

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89
Q

What suture pattern is demonstrated in this image?

Ch 63

A

Parker-Kerr suture pattern

90
Q

What is the arterial blood supply of the hard palate?

Ch 62

A

Major palatine arteries, lesser extent from minor palatine arteries caudally, sphenopalatine arteries dorsally

Venous drainage via diffus venous plexus to maxillary vein

91
Q

Bilateral carotid artery ligation may result in death in what species?

Ch 62

A

Cats

92
Q

The image below demonstrates which procedure and technique?

Ch 62

A

Temporary carotid ligation using a Rummel tourniquet

93
Q

What surgical techniques for control of hemorrhage during nasopharyngeal surgeries are recommended?

Ch 62

A

Temporary carotid artery ligation, lavage with cold saline, suction, epinephrine 1:100,000, bipolar electrocautery for individual vessels

94
Q

What oral approach is recommended for acess to the caudal nasal passages and nasopharynx?

Ch 62

A

Ventral approach through hard palate

95
Q

What is the difference between a pharyngostomy and a pharyngotomy?

Ch 61

A

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
Q

What are the names of the labeled neurovascular structures?

A

A. Hypoglossal nerve
B. External carotid artery
C. External jugular vein
D. Linguofacial vein
E. Lingual artery
F. Linguofacial vein
G. Epihyoid bone

97
Q

During a staphylectomy what tissue layer is not included in the closure?

Ch 60

A

The palatine muscles are not included. Nasopharyngeal mucosa and oropharyngeal mucosa are sutured together with a simple continuous pattern.

98
Q

What are the two types of unerupted teeth?

Ch 59

A

Embedded teeth - do not erupt due to lack of eruptive force
Impacted tooth - failure to erupt due to physical obstruction

99
Q

What is pericoronitis?

Ch 59

A

Inflammation around the operculum (mucosa over an unerupted tooth) or inflammation around a partially erupted tooth

100
Q

What is the defintion of osteonecrosis of the jaws?

Ch 58

A

Exposed nonvital bone in the maxillofacial region that fails to heal after 6-8 weeks in patients with no history of maxillofacial radiation

101
Q

What breed may be prone to osteonecrosis of the jaws?

Ch 58

A

Scottish Terriers

102
Q

The following images demonstrate which disease process and etiology?

Ch 58

A

Osteonecrosis caused by blastomycosis

103
Q

Tight-lip syndrome is seen exclusively in what breed?

Ch 57

A

Shar-Peis

104
Q

What are the indications for frenuloplasty?

Ch 57. frenuloplasty: repositioning the frenulum

A

Dermatologic infection of the lower lip, chronic periodontal disease of the distal mandibular canine teeth, Shar-Pei’s with tight-lip syndrome

105
Q

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

Ch 45

A

d. Odontogenic myxoma → malignant

106
Q

What % of ameloblastomas are located at the rostral mandible?

Ch 45

A

41%

6% at caudal maxilla

107
Q

What breeds have predispositions to gingival hyperplasia?

Ch 46

A

Collie, Great Dane, Boxer, Doberman, Dalmation

108
Q

Oral eosinophilic granuloma in siberian huskies involves lesions typically of what anatomy?

Ch 46

A

Tongue

ALSO! Oral eosinophilic granuloma in siberian huskies often presents with a peripheral eosinophilia → 80% of cases

109
Q

What breed is associate with Craniomandibular osteopathy (CMO)?

Ch 46

A

West Highland white terriers

disease is inherited as an autosomal recessive trait
Ddx: Idiopathic calvarial hyperostosis

110
Q

What is the typical presentation of Mandibular periostitis ossificans?

Ch 46

A

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.

Characteristic radiographic finding of a double cortex at the ventral aspect of the mandible. (Stanley et al, JVD 2010)

111
Q

What is the most prevalent odontogenic cyst in the dog?

Ch 47

A

dentigerous cyst

112
Q

What is the most common presentation of a dentigerous cyst?

Ch 47

A

Age 2-3yo, brachycephalic, 1st premolar impacted tooth

113
Q

What type of odontogenic cyst is depicted?

Ch 47

A

Perapical/radicular cyst

Note the RCT – non-vital tooth prereq for this cyst, most commonly secondary to failed RCT in humans

114
Q

What histopatholgic feature distinguishes an Odontogenic keratocyst form other odontogenic cysts?

Ch 47

A

parakeratotic keratinization of the cyst lining

115
Q

What is the typical location of a OKC in a dog?

Ch 47

A

Maxilla - may go unnoticed until facial deformity/exopthalmos/bone erosion?

116
Q

Define a lateral periodontal cyst?

Ch 47

A

developmental, noninflammatory cysts that occur on the lateral aspect or between the roots of vital erupted teeth

typically incidental finding

117
Q

What are the two most common sites of sialoceles in dogs?

Ch 55

A

Cervical, sublingual

118
Q

What veins does the mandibular salivary glad lay between anatomically?

Ch 55

A

Jugular and linguofacial veins

119
Q

Define embedded tooth and impacted tooth

Ch 59

A

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
Q

In shallow unerupted teeth, what % of crown is sufficient to expose via operculectomy?

Ch 59

A

1/2 - 2/3 of crown

121
Q

What laryngeal structure should the pharyngostomy site be rostral to?

Ch 61

A

Epihyoid bone

122
Q

What gross characteristics are specific to tonsilar lymphoma?

Ch 63

A

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
Q

What is the most commonly reported tonsilar tumor in dogs?

Ch 63

A

SCC

124
Q

What are the most common sites for sialocele development in order of frequency?

Ch 55

A

1.) Cervical site
2. Ranula
3. pharyngeal site

125
Q

Disruption to what salivary gland system most commonly results in sialocele formation?

Ch 55

A

Disruption of the small tributary ducts of the monostomatic section of the sublingual salivary gland

126
Q

What is the most common location of sialoceles in the cat?

Ch 55

A

Sublingual sialocele/ranula

127
Q

What size locking titanium mini plates should be used in medium/large breed and small breed dogs respectively? for internal fixation?

Ch 53

A

Medium/large dogs 2.4mm
small dogs 2.0mm

128
Q

What is the compression resistance matrix (CRM) or scaffold for recombinant human BMPs (rhBMP) made out of?

Ch 53

A

collagen with embedded granules of hydroxyapatite (HA) and tricalcium phosphate (TCP)

MasterGraft Matrix

129
Q

How much collagen matrix should be applied to a defect for BMP reconstructive surgery?

Ch 53

A

Fill defect with collagen sponge 1/2 to 3/4ths of mandibular hieght and length 2mm greater than defect span

130
Q

How much volume of rhBMP-2 should be added to the compression resistance matrix scaffold for regeneratie surgeries?

Ch 53

A

50% of the volume of the prepared scafold

scaffold 4cm x 1cm x 1cm, defect volume 4 cm^3 = 2ml rhBMP-2

131
Q

What is the definition of an axial-pattern flap?

Ch 52

A

A pedicle flap of skin and subcutaneous tissue that incorporates a direct cuteaneous artery and vein into its base

132
Q

What blood vessel is part of the caudal auricular axial-pattern flap

Ch 52

A

Sternocleidomastoid branch of the caudal auricular artery

133
Q

This image demonstrates which axial pattern flap and corresponding artery?

Ch 52

A

Superficial temporal axial pattern flap
cutaneous branch of superficial temporal artery

Flap is equivalent to length of zygomatic arch

134
Q

Which axial pattern flap is most indicated for rostral maxillofacial defects including the nasal planum? Ch 52

Ch 52

A

Angularis Oris axial-pattern flap

135
Q

This image depicts which axial pattern flap and corresponding artery?

Ch 52

A

Angularis oris axial pattern flap
Cutaneous branch of angularis oris artery

136
Q

What axial pattern flap is most indicated for periocular reconstruction, wound closure following orbital exenteration, and midfacial defects?

Ch 52

A

Transverse facial axial-pattern flap

137
Q

This image depicts with axial pattern flap and corresponding artery?

Ch 52

A

Transverse facial axial pattern flap
Cutaneous branch of the transverse facial artery

138
Q

How long after axial pattern flap surgery should revision be performed if the flap is devitalized?

Ch 52

A

4-7 days

139
Q

What are the frequencies used for electrosurgery and radiosurgery for gingivectomies respectively?

Ch 20

A

electrosurgery 0.5 - 2.9 MHz
radiosurgery 3.0-4.0 MHz

140
Q

Does electorsurgery or radiosurgery result in a smaller zone of thermal necrosis?

Ch 20

A

radiosurgery

141
Q

What waveforms of electro and radiosurgical units are appropriate for gingivectomy/gingivoplasty?

Ch 20

A

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
Q

What is the definition of biologic width?

Ch 19

A

The physiologic dimension of the junctional epithelium and connective tissue attachment

143
Q

Multifilament sutures have what fold higher affinity for bacterial adherence than monofilaments?

Ch 8

A

5 - 8 fold

144
Q

What intraoperative hemostatic agents should be removed prior to closure?

Ch 8

A

Bone wax
Ferric sulfate

Bone wax- can cause inflammatory reaction
Ferric sulfate/VicoStat: can impede bone healing

145
Q

How long does it take for GelFoam (absorbable gelatin sponge) to be absorbed and what part of bone formation may it impede?

Ch 8

A

Absorbed in 4-6 weeks
Can impede cancellous bone replacement

146
Q

Fibrillar (oxidized regenerated cellulose) is absorbed in how many days and may swell up to what percent?

A

Absorbed in 7-14 days
May swell up to 135% of size

147
Q

What are the advantages of oxidized regenerated cellulose for intraoperative hemostasis?

Surgicel, Fibrillar

A

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
Q

What is the hemostatic MOA of CollaPlug/hemostatic collagen?

Ch 8

A

Causes hemostasis via compression and is held in place for 5 minutes

made from bovine deep flexor tendons
Resorbs in 7 weeks

149
Q

Polysaccharide hemostatic agents like Arista AH degrade in how many days?

Ch 8

A

1-2

150
Q

What mechanical principle is utilized for extraction when luxators are employed?

Ch 13

A

Wedge

151
Q

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?

Ch 13

A

Wheel-and-axle motion

152
Q

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?

Ch 13

A

Leverage

153
Q

Rotational forces are used to tooth roots during extraction using what instrument?

A

Extraction forceps

root rotated slightly to fatigue apical PDL fibers

154
Q

What force is used with extraction forceps to deliver the tooth from the alveolus?

Ch 13

A

Tractional force

155
Q

What are the 3 fundamental requirements for satisfactory surgical or simple extractions?

Ch 13

A

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
Q

What length of root fragment requires surgical removal?

Ch 13

A

> 4mm

157
Q

When is it appropriate for clients to resume teeth brushing following extractions?

Ch 13

A

3-4 days postop

158
Q

What is the crown:root ratio of incisor teeth in a dog?

Ch 14

A

1:3

159
Q

What permanent teeth are appropriate to extract in closed fashion?

ch 14

A

Incisors (often minus maxillary I3)
First premolar teeth
Second premolar teeth in cats
Maxillary first molar teeth in cats
Mandibular third molar teeth

160
Q

What tooth is shown below?

A

Feline maxillary first molar

161
Q

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?

A

0.05-0.12%

162
Q

What vessels may result in major hemorrhage during extraction of the dog maxillary canine?

Ch 15

A

The lateral nasal branches of the infraorbital artery and its anastomosis with the branches of the major palatine artery

163
Q

What is the name of the groove present on roots of large premolar and molar teeth?

Ch 16

A

radicular sulcus

164
Q

The white arrowhead corresponds to what structure?

Ch 16

A

Interradicular septum

165
Q

How much buccal bone removal is recommended for the maxillary second and third premolars and mandibular second, third and fourth premolars?

Ch 16

A

Only 1-3mm to expose the furcation for sectioning if needed

166
Q

According to Verstraete is it acceptable to leave the maxillary first molar extraction site open to heal by second intention?

Ch 16

A

Yes

167
Q

Dorsal slippage of a luxator when extracting the maxillary second molar can lead to traumatization of whate vessel?

Ch 16

A

Minor palatine branch of the maxillary artery

168
Q

What is the definition of TR1?

Ch 17

A

TR1: mild dental hard tissue loss (cementum or cementum and enamel)

169
Q

What is the definition of TR2?

Ch 17

A

Loss of cementum or cementum and enamel with loss of dentin that does not extend into pulp cavity

170
Q

What is the definition of TR3?

Ch 17

A

Deep dental hard tissue loss with loss of dentin that extends into pulp cavity
Most of tooth retains its integrity

171
Q

What is the definition of TR4 including, a, b and c?

A

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
Q

What is the definition of TR5?

Ch 17

A

Remnants of dental hard tissue visible only as irregular radiopacities with complete gingival covering

173
Q

What stage of tooth resorption is acceptable to perform crown amputations/coronectomy in cats with gingivostomatitis?

Ch 17

A

TR4c

root more severely affected than crown

174
Q

What 4 variables influence both the mechanism of laser-tissue interaction and the resulting effect on tissue?

Ch 10

A

Wavelength
beam intensity
time domain of energy delivery
tissue handling

175
Q

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?

Ch 10

A

60 degrees Celsius

176
Q

What is the definition of the dentogingival complex?

Ch 23

A

The sum widths of the gingival sulcus, junctional epithelium and connective tissue attachments

177
Q

What is Type III crown-lengthening?

Ch 23

A

Forced eruption with an orthodontic device to expose more of the tooth

178
Q

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?

A

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
Q

What is healing by third intention?

Ch 1

A

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
Q

What are the key mediators of wound healing/chemoattractants?

Ch 1

A

Platelet-derived growth factors (PDGFs)
Transforming growth factor beta (TGF-Beta)

Recruit inflammatory cells that begin to remove damaged tissue and bacteria from injured area

181
Q

What is the predominant inflammatory cell during the first 2-3 days following injury and what what cell(s) are they replaced by?

Ch 1

A

Neutrophils: first 2-3 days
Then outnumbered by macrophages derived from mobilized monocytes

182
Q

Macrophages regulate the formation of granulation tissue through release of what modulating cytokines?

Ch 1

A

Platelet derived growth factor (PDGF)
Vascular endothelial growth factor (VEGF)

183
Q

In general –> the maximum strength of a healed wound is reached in how long?

Ch 1

A

6-12 months

Never reaches the strength of unwounded tissue

184
Q

Organization of the clot within the extraction site begins how soon after extraction?

Ch 1

A

within the first 24 to 48 hours

185
Q

What occurs in the first week of extraction site healing?

Ch 1

A

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
Q

What occurs in the second week of extraction site healing?

Ch 1

A

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
Q

What occurs in the third week of extraction site healing?

Ch 1

A

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
Q

At what time frame after extraction is the alveolus completely epithelialized when left to heal by second intention?

Ch 1

A

3 weeks

189
Q

When does radiographic evidence of bone formation at an extraction site become apparent?

Ch 1

A

6 - 8 weeks following extraction

190
Q

When does the extraction site become radiographically inconspicuous?

Ch 1

A

6 to 8 months

191
Q

Collagen deposition and wound tensile strength are limited by what factors?

Ch 1

A

Tissue perfusion and oxygen tension

192
Q

What condition is primarily responsible for poor wound healing in diabetic patients?

Ch 1

A

Diabetic microangiopathy

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
Q

What is the key amino acid of wound healing?

Ch 1

A

Methionine

Metabolized to cysteine which plays a vital role in the inflammatory, proliferative and remodeling phases of wound healing

194
Q

What are the three most important conditions necessary for bone formation and mineralization?

Ch 2

A

Pluripotent precursor cells
ample blood supply
mechanical stability

195
Q

What are Volkmann canals?

Ch 2

A

contain nutritional vessels that arise from the periosteal and endosteal bone surface
connect with Haversian vessels within osteons

196
Q

What is extraosseous circulation?

Ch 2

A

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

Health of surrounding soft tissues crucial for fracture repair

197
Q

Direct bone healing is a synergism between what types of healing?

ch 2

A

Contact and gap healing

198
Q

Why do maxillary fractures tend to heal faster with fewer complications than mandibular fractures?

Ch 2

A

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
Q

What is the term for replacement of cartilage by bone in fracture healing?

Ch 2

A

Endochondral ossification

200
Q

Direct bone healing occurs when only what type of connective tissue forms between the fracture fragments?

Ch 2

A

Bone

201
Q

What criteria are necessary for contact healing to occur?

Ch 2

A

No gap and direct cortical contact
Bone union and Haversian remodeling occur simultaneously

202
Q

What conditions need to be present for gap healing to occur?

Ch 2

A

Gap in fragments > 200 micrometers < 800 micrometers
Bony union and Haversian remodeling are separate sequential processes

gaps filled in with transversely oriented lamellar bone that is parallel with fracture orientation
Then Haversian remodeling occurs across fracture line

203
Q

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?

Ch 2

A

Lamellar bone: 4-6 weeks
Haversian remodeling and cortical bone: 10 weeks

204
Q

What craniofacial fracture repair technique provides the optimum environment for direct bone healing?

Ch 2

A

Miniplates

205
Q

What are major and minor contacts of screws with tooth roots?

Ch 2

A

Major > 50% screw diameter penetrating tooth root
Minor < 50% screw diameter penetrating tooth root

Minimal morbidity for human patients with major or minor contact

206
Q

Is interfragmentary compression necessary for direct bone healing in the craniomaxillofacial skeleton? (not the mandible)

ch 2

A

No!

207
Q

Administration of what types of medications can cause osteonecrosis in people?

Ch 58

A

Bisphosphonates
Denosumab
Antiangiogenic medications

208
Q

What are the potential causes of osteonecrosis?

Ch 58

A

Administration of certain systemic medications
Iatrogenic drauma –> extractions
Radiation therapy
Dental infections
Idiopathic

209
Q

What factors are commonly reported in dogs with ONJ?

Ch 58

A

Recent dental extractions
Oral Antibiotic use to treat oral/dental disease

209
Q

Maximal compressive stresses exit the mandible at what surface?

Ch 27

A

Aboral

210
Q

What are the anatomic names of the rostral/medial, lateral and caudal buttresses of the maxilla/face?

Ch 27

A

Rostral/medial: Nasomaxillary buttress
Lateral: zygomaticomaxillary buttress
Caudal: Pterygomaxillary buttress

211
Q

What interdental wiring technique is shown?

Ch 31

A

Ivy Loop

212
Q

What interdental wiring technique is shown?

Ch 31

A

Stout loop

213
Q

What interdental wiring technique is shown?

Ch 31

A

Risdon wiring with secondary wires anchoring around individual teeth

214
Q

What interdental wiring technique is shown and what type of fractures is it best used for?

Ch 31

A

Essig interdental wiring
Reduction and stabilization of luxated canine teeth with alveolar bone fracture

215
Q

Intraoral splints are best applied in what types of fractures?

Ch 31

A

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
Q

What is the name of this instrument used to fracture the splint into segments for removal?

Ch 31

A

Bond removing forceps

217
Q

What is the defintion of a malunion?

Ch 35

A

Healed fracture in which anatomic bone alignment was not achieved or maintained during healing

218
Q

What is the definiton of a nonunion?

Ch 35

A

A fracture that has failed to heal and does not show any further signs of progression towards consolidation

219
Q

What is the difference between a viable and nonviable nonunion?

Ch 35

A

Viable nonunions are hypervascular
Nonviable nonunions are avascular

220
Q
A

Phase 1 Boards Prep - SA (22 decks)

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