Oral Pathology

Question 1

Which teeth are most commonly affected by supernumerary teeth?

Answer 1

1st premolars, incisors

Question 2

Answer 2

Dentigerous cysts
Most commonly associated with imbedded mandibular 1st premolar
Tx: extraction, enucleation

Question 3

Compare imbedded vs retained teeth

Answer 3

Retained: persistent deciduous tooth
Imbedded: two few teeth, one or more imbedded in bone - should always be extracted

Question 4

Pathogenesis: Canine Chronic Ulcerative Stomatitis

Answer 4

Lymphocytic-plasmacytic inflammation of tissue contacting plaque retentive surfaces including the vestibular mucosa and lateral tongue margins

Question 5

Answer 5

Canine Chronic Ulcerative Stomatitis

Question 6

Clinical Signs: Canine Chronic Ulcerative Stomatitis

Answer 6

Very painful, severe halitosis
Kissing lesions (contact mucositis)
+/- weight loss, difficulty eating, masticatory muscle wasting

Question 7

Treatment: Canine Chronic Ulcerative Stomatitis

Answer 7

Immaculate oral care
Analgesia
Immunosuppression
Extractions (usually lots, sometimes all)
Symptoms will improve with dental cleaning, but then return quickly

Question 8

Answer 8

Canine Chronic Ulcerative Stomatitis

Question 9

Answer 9

Periodontal disease

Question 10

Answer 10

Question 11

Feline Dentition

Answer 11

Question 12

Unlike many dental problems, ______________ lesions are often the presenting complaint

Answer 12

Ulcerative lesions
Severe oral pain

Question 13

Treatment: Chemical Exposure

Answer 13

Systemic tx
Supportive care
Magic mouthwash
No sx needed
May have chronic scarring

Question 14

Answer 14

Chemical exposure

Question 15

Answer 15

Chemical exposure

Question 16

Presentation: Electrical Cord Injury

Answer 16

Red or blanched ares of tissue around the lips and gums
Sores that aren’t bleeding

Question 17

Treatment: Electrical Cord Injury

Answer 17

Stabilize, tx systemically first
Can take up to 6 months to see full extent of damage (osteonecrosis)
Surgical tx must be delayed
Magic mouthwash and analgesia for oral sores

Question 18

Answer 18

Electrical cord injury

Question 19

Answer 19

Electrical cord injury - osteonecrosis

Question 20

Answer 20

Osteonecrosis

Question 21

Answer 21

Osteonecrosis

Question 22

Treatment: Osteonecrosis

Answer 22

Large surgeries to remove devitalized bone
Poor prognosis

Question 23

Answer 23

Sublingual/buccal granuloma

Question 24

Answer 24

Sublingual/buccal granuloma

Question 25

Answer 25

Sublingual/buccal granuloma

Question 26

Sublingual/buccal granuloma

Answer 26

Associated with physical trauma from mastication Often bilateral

Question 27

Treatment: sublingual/buccal granuloma

Answer 27

Excise only if it becomes ulcerated

Question 28

Answer 28

Gingival enlargement

Question 29

Causes: Gingival Enlargement

Answer 29

Idiopathic, PD, breed Cyclosporine Ca channel blockers Anti-seizure meds *Causes pseudopocketing underneath the gum tissue*

Question 30

Treatment: Gingival Enlargement

Answer 30

Excise, change medications, Azithromycin toothpaste

Question 31

Treatment: Severe Papillomatosis

Answer 31

Medical management - vaccine, immunomodulatory therapy Laser

Question 32

Answer 32

Focal fibrous hyperplasia

Question 33

Focal fibrous hyperplasia

Answer 33

Mass-like lesion associated with periodontal disease Must be dx with biopsy May appear to be malignant (especially SCC)

Question 34

Treatment: Focal fibrous hyperplasia

Answer 34

Sx excision and treatment of underlying periodontal disease

Question 35

Which masticatory disorders result in trouble or painful opening?

Answer 35

MMM TMJ ankylosis Retrobulbar dz

Question 36

Which masticatory disorders cause trouble or painful closing?

Answer 36

Fracture/trauma Dental disease TMJ luxation Trigeminal neuropathy

Question 37

Which muscles are affected by MMM?

Answer 37

Temporalis, masseterm pterygoids NOT digastricus

Question 38

Acute Phase MMM

Answer 38

Muscle inflammation Pain (extreme) on opening of mouth Swelling of mm of mastication Good prognosis

Question 39

Chronic Phase MMM

Answer 39

Muscle fibrosis Reduced ability to open mouth *Often nonpainful* Atrophy of muscles of mastication Guarded prognosis

Question 40

Diagnosis: MMM

Answer 40

Measure CK 2M Ab test (before pred) CT bx 2 mg/kg pred until aperture opening is normal

Question 41

Treatment: TMJ Ankylosis

Answer 41

Condylectomy or mandibulectomy Analgesia/anti-inflammatories

Question 42

Treatment: Bilateral mandibular fracture

Answer 42

Rigid fixation Mandibulectomy Conservative therapy

Question 43

Presentation: bilateral mandibular fracture

Answer 43

Animal cannot close mouth, but is very painful if you try to close

Question 44

Treatment: TMJ Luxation

Answer 44

Closed reduction Support in tape muzzle Open sx reduction Condylectomy

Question 45

Trigeminal Neuropathy

Answer 45

**Nonpainful inability to close mouth**

Question 46

Treatment: Trigeminal neuropathy

Answer 46

Supportive care Anti-inflammatories