Dentistry

Question 1

Name the 4 nerve blocks

Answer 1

Infra-orbital
Caudal maxillary
Middle mental
Caudal mandibular

Question 2

What needle size do you use for nerve blocks?

Answer 2

25G

Question 3

How long does lidocaine last as a LA?

Answer 3

60-120mins

Question 4

What is the onset time of lidocaine for LA?

Answer 4

5minutes

Question 5

Name the 3 types of mucoperiosteal flaps

Answer 5

Envelope
Triangle
Pedicle

Question 6

What suture size/type and needle would you use to suture closed the mucoperiosteal flap?

Answer 6

Monosyn 4/0 (5/0 in cats) w/ a reverse cutting needle

Question 7

When is a crown amputation indicated?

Answer 7

In type 2 tooth resorption in cats (tooth and surrounding bone are same opacity)

Question 8

How much of the tooth root should you expose in a surgical extraction

Answer 8

1/3-2/3

Question 9

List 4 complications of nerve blocks

Answer 9

1. Nerve damage
2. Desensitisation of tongue and lips and self-mutilation on waking
3. Paralysis
4. Damage to eye

Question 10

Anatomical structures to beware of when raising flaps

Answer 10

i. Parotid duct above/slight distal to carnassials
ii. Infraorbital neurovascular bundle prox to carnassial
iii. Nasal cavity

Question 11

What type of bur is used to section a tooth

Answer 11

taper-fissure bur

Question 12

What size scalpel blade is used to incise the gingival attachment?

Answer 12

15

Question 13

What is the onset and duration of bupivacaine (0.5%)/ropivacaine (0.75%) as LA

Answer 13

onset 15min, duration 4-8hrs

Question 14

What is the purpose of polishing?

Answer 14

Smooths the enamel surface as scaling results in surface defects. Removes any remaining plaque and calculus

Question 15

Rad signs of periodontitis

Answer 15

1. Alveolar bone loss, may be vertical or horizontal
2. Widening of periodontal ligament space
3. Blunting of sharp angle of alveolar marginal bone
4. Loss of fuzziness of lamina dura (white line around tooth – is inner surface of alveolus)

Question 16

Explain the Gingivitis index

Answer 16

1: line of red along gingival margin
2: more extensive redness, gingiva swollen, bleeds on probing
3: bleeding spontaneously

Question 17

Explain the Calculus index

Answer 17

1 = 1/3 crown covered
2 = 2/3 crown coverd
3 = over 2/3 crown covered in calculus

Question 18

What is the healthy sulcus depth of a cat/dog?

Answer 18

healthy is <0.5-1mm in cats, <3mm in dogs

Question 19

What bacterial sp are assoc. w/ development of periodontitis?

Answer 19

1. Bacteroides
2. Prevotella spp.
3. Porphyromonas spp
4. Fusobacterium spp.

Question 20

Why do Maltese and greyhounds tend to have more severe periodontal disease?

Answer 20

Thought to be genetic – possible increased IL1 levels increases inflm. Response (to the bacterial toxins)

Question 21

Top Ddx for Rough cauliflower-like, ulcerated surface mass at maxillary PM4?

Answer 21

Acanthomatous ameloblastoma (previously called acanthomatous epulis)

Question 22

Top DDx for Pink, smooth, may be pedunculated, Slow growing oral mass?

Answer 22

Peripheral odontogenic fibroma (previously ossifying epulis and fibromatous epulis).

Question 23

Explains type 1-3 of Tooth resorption (TR) – prev. feline odontoclastic resorptive lesions (FORLS)

Answer 23

Type 1 – normal root radiodensity and periodontal ligament intact
Type 2 – roots more radiolucent, lack PL space
Type 3 – combination of above ie. One root may have signs of type 1 and other root signs of type 2

Question 24

What viruses may be associated with Feline chronic gingivostomatitis?

Answer 24

calicivirus, herpes, FIV, FeLV

Question 25

Top DDx for a cat with Bilateral, erythematous ulcerative and proliferative lesions of gingiva, buccal mucosa, lips, lateral palatoglossal folds and lateral edges of tongue

Answer 25

Feline chronic gingivostomatitis

Question 26

Define Class IV (MAL4)

Answer 26

mesiodistocclusion (maxillomandibular asymmetry) = special type of wry bite where one jaw class II and one class III

Question 27

Define Class III (MAL3)

Answer 27

mesiocclusion (mandib mesioccluson) = long mandible and/or short maxilla, or wry mouth.

Question 28

Define Class II (MAL2)

Answer 28

mandibular distocclusion = when short mandible and/or long maxilla or wry bite

Question 29

Define Class I (MAL1)

Answer 29

neutrocclusion = both jaws align but individal teeth misaligned

Question 30

When is permanent eruption finished in cats?

Answer 30

Permanent: eruption complete at 6-7mo (30teeth)

Question 31

When is permanent eruption finished in dogs?

Answer 31

Permanent dentition: order of eruption – PM1 then incisors (3-4mo), canines, PM2-PM4, then molars (4-6mo), mandibular M3 (6-7mo)

Question 32

Explain a potential progression of a complicated tooth fracture

Answer 32

Ingress of bacteria into pulp, pulpitis, necrosis, leakage of material periapically --> acute apical periodontitis. Painful, no rad. Signs

Question 33

When is a vital pulpotomy an option?

Answer 33

If fresh fracture (,48hrs) – vital pulpotomy (involved removal of only small portion of pulp near tip of crown and filling w/ appropriate sealant)

Question 34

What are some ABs indicated for severe periodontitis?

Answer 34

Choose for bacterial flora – ie gram negative anaerobes. Most commonly used antibiotics are amoxicillin +/- clavulanic acid, metronidazole, clindamycin and doxycycline.

Question 35

Indications for antimicrobial therapy

Answer 35

1. Severe periodontitis 2. Acute periodontal or endodontic disease with swelling or bone involvement 3. Systemically unwell (pyrexic) 4. Oral trauma involving tissue destruction 5. Have impaired host defences or who are immuno-compromised 6. Surgical extractions and bone removal.