E2: Oral Sx, jaw fractures and Head/neck Sx

Question 1

What is a curved root tip called? What is it called when there is apical expansion of the root?

Answer 1

Dilaceration

Hypercementation

Question 2

What is the first step when extracting a single rooted tooth?

Answer 2

Severe epithelial attachment with #11 or 15c blade and enter periodontal space

Question 3

In which species should you try to always suture an extraction site?

Answer 3

Cats

Question 4

How are multi-rooted teeth simply (i.e. not surgically) extracted?

Answer 4

Section tooth at furcation of roots

Elevate and remove each root segment individually

Question 5

What is the first step in surgical tooth extraction?

Answer 5

Creating a buccal mucoperiosteal flap (either envelope or single pedicle flap)

Question 6

When making a flap for a canine root extraction, where do you begin your incision?

Answer 6

At diastema

Question 7

What is an important landmark when removing the entire lateral alveolar bone?

Answer 7

Apex of the root

Question 8

What is the most significant cause of suture failure after closing the gingiva?

Answer 8

Tension

Question 9

What part of the flap do you suture/secure first?

Answer 9

Corners

Question 10

How long should a dog not get any crunchy food after a gingival flap placement?

Answer 10

10-14 days

Question 11

What are causes of oronasal fistulas in dogs?

Answer 11

Dental disease and extractions

Pressure necrosis from foreign body

Complications (surgery, radiation therapy, hyperhermia therapy)

Trauma (electrical cord burns, bites wounds)

Question 12

Why do you need to monitor a cat for respiratory concerns after an electrical burn?

Answer 12

Pulmonary edema can occur

Question 13

What technique do you use if you cannot use a two layer technique for closing an acute oronasal fistula?

Answer 13

Single pedicle advancement flap

Question 14

What type of closure is indicated for congenital defects and chronic oronasal fistulas where the oral mucoperiosteum has healed to the nasal mucosa? From where does the flap get its blood supply?

Answer 14

Double flap technique

Nasal mucosa

Question 15

What are the salvage techniques for animals with uncorrectable palate defects?

Answer 15

Intraoral appliances: Acrylic device or Nasal Septal buttons

Question 16

What is the most common location for jaw fractures in cats?

Answer 16

Symphysis and ramus

Question 17

What is the most important consideration when repairing jaw fractures? What else is important?

Answer 17

Maintaining occlusion

Minimize soft tissue disruption

Put fixation on the tension side of the bone (the dental arcade)

Avoid placing implants through tooth roots

Question 18

What techniques can you use to avoid having to extubate and re-intubate during jaw repair?

Answer 18

Intramandibular intubation

Pharyngotracheal intubation

Temporary techeostomy

Question 19

What is indicated to maintain occlusion while a simple, minimally displaced, stable jaw fracture heals?

Answer 19

Tape muzzle

Question 20

What is the best way to repair a symphuseal separation in cats?

Answer 20

Circummandibular cerclage pass wire through skin and under oral mucosa/gingiva as much as possble

Question 21

What is the triad of injuries seen with High Rise Syndrome?

Answer 21

1. Oral/facial trauma
2. Fractures/dislocations of forelimbs
3. Thoracic trauma

Question 22

When is treatment not needed for a hard palate fracture?

Answer 22

When the fracture is closed and occlusion is ok

Question 23

What is the best technique for mandibular fracture stabilization? What does it require?

Answer 23

Composite Resin Intraoral splint

Adequate tooth surface (enough teeth) to secure material

Question 24

Why is composit resin preferred to arylic material for making intraoral splints?

Answer 24

Aryclics are exothermic

Question 25

What is the most common error made when placing external fixators?

Answer 25

Drilling through/hitting the tooth roots

Question 26

What fixation technique would be best for complex unstable fractures where occlusion has been lost? What is important to communicate to the owner adn ensure the owner is prepared for?

Answer 26

**Interarcade wiring** Must provide instructions for **emergency removal**, and tell them to remove if they suspect the dog may vomit to prevent aspiration

Question 27

What do you do to prevent stress on your suture site after a rostral partial mandibulectomy?

Answer 27

Place supportive sutures, can drill holes in jaw to help keep in place Also suture lip higher than before

Question 28

What are your differentials when the vertical ramus is stuck lateral to the zygomatic arch when the mouth is fully opened?

Answer 28

TMJ luxation Intermittent open mouth jaw locking

Question 29

What are the surgical treatment options for intermittent open mouth jaw luxation?

Answer 29

Excise portion of ventral border of zygomatic arch or Excise dorsal portion of the ramus

Question 30

Why is surture reconstruction ineffective for a lower lip avulsion? What can you do to repair this type of avulsion?

Answer 30

Heavy lower lip Place interdental stent sutures first and then suture mucogingical junction

Question 31

When performing a lip reconstruction where do you begin suturing? What type of suture pattern do you use?

Answer 31

Lip margin (to prevent step deformity) Figure-of-Eight suture (for good lip margin apposition)

Question 32

Which salivary gland is most commonly affected by adenocarcinoma in dogs? Cats?

Answer 32

Dogs: Parotid Cats: Mandibular

Question 33

What is the most common salivary gladn disorder?

Answer 33

Mucoceles

Question 34

How do you treat a dog with severe pain and systemic clinical signs associated with salivary gland enlargement?

Answer 34

Phenobarb +/- surgical removal of gland

Question 35

What is the most commonly affected salivery gland with mucoceles?

Answer 35

Sublingual (monostomatic portion)

Question 36

What lines a salivary mucocele?

Answer 36

Granulation tissue

Question 37

What breeds are most affected by salivary mucoceles?

Answer 37

GSD Poodle

Question 38

What is an accumulation of saliva below the oral mucosa along the side of the tongue called?

Answer 38

Ranula

Question 39

What is the definitive treatment for mucoceles?

Answer 39

Surgical removal of the involved gland

Question 40

What is the most common presenting sign in a dog with a pharyngeal mucocele?

Answer 40

Respiratory distress

Question 41

What approach do you take when removing the sublingual and mandibular salivery glands?

Answer 41

Along mandible or **Ventral - From mandibular space (no need to cut digastricus muscle)**

Question 42

What vessels must you ID and ligate when removing the mandibular and submandibular salivery glands?

Answer 42

Branches of the greater auricular artery and vein (which enter capsule on dorsomedial aspect)

Question 43

Why should you trace the duct to the oral mucosa near the sublingual caruncle when removing the salivery gland?

Answer 43

To make sure you got all of the salivary tissue out

Question 44

What do you do when you cannot tell which sublingual salivary gland is affected by the mucocele?

Answer 44

Remove both

Question 45

T/F: The mucocele must be removed in addition to the affected salivary gland to prevent recurrence.

Answer 45

FALSE Don't need to remove, ti will resolve if the affected gland is removed. You can drain it though.

Question 46

If there is damage to the parotid duct that has resulted in fistula formation which cannot be repaired surgically, what do you do?

Answer 46

Ligate the ductproximal to the defect that is causing the fistula (gland will eventually atrophy)