Periodontal Surgery, Exodontics, and Endodontics Flashcards
(139 cards)
1
Q
Give 3 types of local anesthesia in oral surgery for dogs and cats
A
- Splash block
- Local anesthesia
- Regional anesthesia
2
Q
wound irrigation directly to an open incision which provides topical anesthesia
A
Splash Block
3
Q
infiltration of local anesthetics along planned incision lines or into the periodontal ligament of a tooth of interest
A
Local Anesthesia
4
Q
the delivery of a local anesthetic to specific nerves to block an entire section of the body
A
Regional Anesthesia
5
Q
Materials Needed for Regional Nerve Blocks in Oral Surgery
1.
2.
3.
4.
A
- 27 gauge x 0.5” hypodermic needles attached to a 1 mL syringe
- 27 gauge x 1.25” hypodermic needles attached to a 3 mL syringe
- Bupivacaine 0.5% or Lidocaine 2%
- Dental aspirating syringe (optional) > allows aspiration + injection with 1 hand
6
Q
Most commonly used local anesthetic
A
Bupivacaine 0.5%
7
Q
Bupivacaine takes effect in _____ and lasts ______
A
6-10 min
4-8 hours
8
Q
Lidocaine takes effect in _____ and lasts ______
A
2-5 min
0.5-2 hours
9
Q
Bupivacaine maximum safe dosage for dogs = _____
A
2 mg/kg
10
Q
Bupivacaine maximum safe dosage for cats = _____
A
1.5 mg/kg
11
Q
If all quadrants have to be blocked, how is the maximum safe dosage determined?
A
Calculate the maximum safe dosage for the patient > then divide by 4 > 1/4 will go into each quadrant
12
Q
provides analgesia to the incisors, canine, first 3 premolar teeth, maxillary bone, and the surrounding soft tissue
A
Infraorbital Nerve Block
13
Q
The ______ foramen is located dorsal to the maxillary 3rd premolar roots
A
infraorbital foramen
14
Q
What type of nerve block is this?
A
Infraorbital Nerve Block
15
Q
PROCEDURE - Infraorbital Nerve Block
A
- Palpate the infraorbital foramen through the oral mucosa
- Insert needle through mucosa + into foramen > to level of the mesial root of the 3rd premolar
- Advance needle caudally > to level where the caudal-most extent of oral surgery will be performed
- Aspirate before injecting to ensure needle not in blood vessel > inject anesthetic
- Remove needle > apply digital pressure over injection site > encourages caudal diffusion + decreases hematoma formation
16
Q
provides analgesia to the incisors, canine, adjacent bones and soft tissues of the ipsilateral side that was injected
A
Middle Mental Nerve Block
17
Q
The _____ foramen is located below the mesial root of the mandibular 2nd premolar
A
middle mental foramen
18
Q
PROCEDURE - Middle Mental Nerve Block
A
- Palpate the middle mental foramen
- Insert needle at foramen opening ONLY > aspirate to prevent intravascular infusion
- Place anesthetic bleb at opening of foramen
- Massage anesthetic into the foramen
19
Q
What type of nerve block is this?
A
Middle Mental Nerve Block
20
Q
prevents sensation of the soft tissue and bone of the entire ipsilateral mandible
A
Inferior Alveolar Nerve Block
21
Q
The ______ foramen is located caudal and ventral to the mandibular 3rd molar in dogs
A
inferior alveolar
22
Q
The ______ foramen is located caudal and ventral to the mandibular 1st molar in cats
A
inferior alveolar
23
Q
_______ nerve blocks can lead to self-trauma of the tongue during recovery due to numbness
A
Inferior Alveolar
24
Q
PROCEDURE - Inferior Alveolar Nerve Block Intraoral Approach
A
- Insert needle along medial surface of the mandible > just outside the inferior alveolar foramen
- Insert needle at 20º angle from the long axis of the mandible > 1 cm caudal to M3 (dogs) or 0.5 cm M1 (cats)
25
What type of nerve block is this?
Inferior Alveolar Nerve Block - Intraoral Approach
26
What type of nerve block is this?
Inferior Alveolar Nerve Block - Extraoral Approach
27
PROCEDURE - Inferior Alveolar Nerve Block Extraoral Approach
1. Palpate midpoint of zygomatic arch between rostral + caudal > move ventrally to the mandible > now at approx. location of the facial vascular notch on the ventral cortex of the mandible
2. Insert needle through skin here > stay as close as possible to medial surface of mandible
3. Gloved index finger of opposite hand > feel for the foramen > assess whether the needle top is in the correct position
28
prevents sensation of the soft tissue and bone of the entire ipsilateral maxilla
Maxillary Nerve Block
29
The ______ foramen is located in the soft palate caudal to the maxillary 2nd molar in dogs
maxillary
30
The ______ foramen is located in the soft palate caudal to the maxillary 1st molar in cats
maxillary
31
The maxillary foramen is ___ cm deep in dogs
1 cm
32
The maxillary foramen is ___ cm deep in cats
0.5 cm
33
Do NOT use ______ nerve blocks in brachycephalic dogs or cats
maxillary
34
______ nerve blocks will affect the entire ipsilateral maxilla in brachycephalic patients
Infraorbital
35
PROCEDURE - Maxillary Nerve Block
1. Bend needle 1 cm from tip
2. Identify most caudal aspect of hard palate > just caudal to M2 (dogs) or M1 (cats)
3. Insert needle here perpendicular to soft palate > aspirate to confirm not in a vessel
4. Advance needle 1 cm deep (dogs) or 0.5 cm (cats) > inject anesthetic
36
What type of nerve block is this?
Maxillary Nerve Block
37
Periodontal Disease Classification:
Clinically normal
Grade 0 (PD0)
38
Periodontal Disease Classification:
No attachment loss
Gingivitis
Grade I (PD1)
39
Periodontal Disease Classification:
< 25% attachment loss
Grade II (PD2)
40
Periodontal Disease Classification:
25-50% attachment loss
Grade III (PD3)
41
Periodontal Disease Classification:
> 50% attachment loss
Grade IV (PD4)
42
an antimicrobial with a good spectrum of action against various periodontal pathogens and also has anti-inflammatory effects that decrease damage to periodontal tissues by these pathogens
Doxycycline
43
______ or ______ prevents treated periodontal pockets 4mm or deeper from filling with food and debris right after a procedure
doxycycline gel or clindamycin gel
44
dental bone loss along the long axis of the tooth root
Vertical Bone Loss
45
dental bone loss in which multiple furcations are exposed
Horizontal Bone Loss
46
Which type of bone loss is harder to treat?
horizontal
47
materials that act as scaffolding for new bone cells to traverse a defect
Osteoconductive Materials
48
materials that stimulate progenitor cells of osteoblasts to differentiate and form new bone in an area
Osteoinductive Materials
49
Consil is a _____ material
osteoconductive
50
Osteoallograft is a _____ material
osteoinductive
51
The Bass Technique aims the bristles ____ and _____
toward the gingival margin and into the sulcus
52
In which order are the following surfaces brushed? Why?
lingual, palatal, buccal
Buccal > lingual > palatal
always focus on areas that collect the heaviest debris first in case the patient won't let you finish
53
PROCEDURE - Bass Tooth Brushing Technique
1. Cover bristles with veterinary toothpaste
2. Direct bristles at 45º angle toward gingival margin > some bristles enter the sulcus + other bristles rest on tooth adjacent to the margin
3. Press lightly + maintain 45º angle > short back and forth strokes > 5-10 seconds
4. Reposition brush along next group of teeth
5. Prioritize areas that collect heaviest debris first - buccal surfaces of caudal teeth > lingual surfaces > palatal surfaces
54
If the patient won't keep their mouth open while brushing:
1.
2.
3.
1. Don't add toothpaste > just rinse tooth brush with water
2. Lift lips to access teeth
3. Apply dentifrice to mouth after as a treat
55
toothpaste
Dentifrice
56
What brushing technique is this?
Bass Technique
57
What brushing technique is this?
Modified Stillman
58
The Modified Stillman Technique aims the bristles ____ and _____
apical to the gingival margin and NOT into the sulcus
59
_____ brushing technique is sometimes used in areas of periodontal surgery
Modified Stillman
60
VOHC
Veterinary Oral Health Council
61
group that recognizes products that have been shown to meet predetermined standards for plaque and calculus retardation
Veterinary Oral Health Council (VOHC)
62
The Dental Diet reduces calculus accumulation by ______ and ______ means
mechanical and chemical
63
_____ binds to the calcium in plaque fluids and prevents the mineralization of plaque, thus reducing calculus formation
Hexametaphosphate
64
Safe toys and chews are _____, _____, and _____.
flexible, easily bent with your hands, and soft enough to indent with a fingernail
65
the treatment of dental pathology via tooth extraction
Exodontics
66
an exodontic procedure used for single-rooted teeth that have severe periodontal disease, in which soft tissue attachments are severed and a dental elevator is used
Closed Extraction
67
tool used to apply pressure to loosen a tooth for removal with a larger instrument
Dental Elevators
68
Do not _____ dental elevators because it breaks down alveolar bone and there is a loss of leverage
wiggle
69
PROCEDURE - Closed Tooth Extraction
1. Place regional nerve block
2. Separate gingival attachments around the tooth with periosteal elevator, dental luxator, or scalpel blade
3. Place appropriate size + shape in periodontal space on mesial or distal surface of the crown
4. Place gentle pressure to seat the elevator within the tooth + alveolar bone > rotate elevator handle slightly > stretches periodontal ligament fibers
5. Hold pressure for 10 seconds > advance elevator apically + rotate against the root in opposite direction > creates pressure > hold pressure again
6. Appose gingival tissue with 4-0 or 5-0 monofilament absorbable suture > simple interrupted pattern > closes extraction site
70
an exodontic procedure in which the soft tissue attachments are severed, a mucoperiosteal flap is made, and roots of multirooted teeth are sectioned
Surgical Extraction
71
PROCEDURE - Surgical Tooth Extractions
1. Place regional nerve block
2. Separate gingival attachments around the tooth with periosteal elevator, dental luxator, or scalpel blade
3. Create a flap > raise flap > create a window in the buccal bone of roots to be extracted with a round carbide burr in a water-cooled high-speed handpiece
4. Section roots > gently pry roots + attached crown segments from their sockets > remove roots
5. Smooth rough edges with diamond butt
6. Curette + lavage the alveolus of each root with sterile isotonic solution or 0.12% chlorhexidine
7. Close flap with 4-0 or 5-0 absorbable monofilament
72
Do NOT blow air from an air or water syringe into the socket while treating root fractures. Why?
May cause fatal air embolism
73
the treatment of the tooth pulp and periapical tissues
Endodontics
74
tissue located around the tip of the tooth root
Periapical Tissue
75
small openings in the apex of the tooth root that contain pulp
Apical delta
76
Root apex should be closed by ______
10-18 months
77
These are ______ permanent teeth of a dog. How can you tell?
immature permanent teeth - root apex is still open
78
These are ______ permanent teeth of a dog. How can you tell?
mature permanent teeth - root apices have closed
79
______ protect already fractured teeth and minimize repeat fractures
Metal crowns
80
the restoration or maintenance of the structure and function of a tooth
Restorative Dentistry
81
The most common placement of metal crowns in dogs is on the _____ and _____
canines and 4th maxillary premolars
82
the erosion and irreversible destruction of dentin and eventually all areas of an affected tooth
Tooth Resorption
83
Tooth resorption is common in _____
cats
84
What condition is seen in this radiograph? How do you know?
Tooth resorption - decreased root density, loss of periodontal ligament space, tooth root incorporated into adjacent alveolar bone
85
occlusion in which the maxillary and mandibular jaw lengths are normal but one or more teeth are in an abnormal position
Class I Malocclusion (Neutrocclusion)
86
Class I Malocclusion is also called ______
neutrocclusion
87
_____ is the most common type of malocclusion
Class I (Neutroclusion)
88
abnormally long maxilla
Maxillary Prognathism
88
occlusion in which the mandible is relatively shorter than the maxilla, due to either maxillary prognathism or mandibular brachygnathism
Class II Malocclusion (Mandibular Distoclusion)
89
abnormally short mandible
Mandibular Brachygnathism
90
What type of malocclusion is this?
Class II Malocclusion (Mandibular Distoclusion)
91
occlusion in which the maxilla is relatively shorter than the mandible due to mandibular prognathism or maxillary brachygnathism
Class III Malocclusion (Mandibular Mesioclusion)
92
Class III Malocclusion is also called _____
Mandibular Mesioclusion
93
abnormally long mandible
Mandibular Prognathism
94
abnormally short maxilla
Maxillary Brachygnathism
95
Mandibular malocclusion in brachycephalic breeds is a normal class _____ occlusion
class III
96
What type of malocclusion is this?
Class III Malocclusion (Mandibular Mesioclusion)
97
occlusion in which there is asymmetry in a rostrocaudal, side-to-side, or dorsoventral direction
Class IV Malocclusion (Maxillomandibular Asymmetry)
98
Class IV Malocclusion is also called _______
Maxillomandibular Asymmetry
99
______ is a malocclusion common in foals
Class IV Malocclusion (Maxillomandibular Asymmetry)
100
Wry bite is a class _____ malocclusion
class IV
101
skull shape with a wide skull and a short maxilla
Brachycephalic
102
Boxers, Bulldogs, Persian cats have a _____ skull shape
brachycephalic
103
skull shape with a well-proportioned skull and maxillary length
Mesocephalic (Mesaticephalic)
104
Beagles, Labs, Shepherds have a ______ skull shape
mesocephalic
105
skull shape with a narrow skull and long maxilla
Dolichocephalic
106
Sighthounds (Greyhounds, Whippets), Siamese cats have a _____ skull shape
Dolichocephalic
107
the extraction of persistent deciduous or adult teeth that are causing or will cause problems associated with malocclusion
Interceptive Orthodontics
108
baby teeth that should have been shed before their permanent counterpart erupted, but did not
Persistent Deciduous Teeth
109
Persistent deciduous teeth are most common in ______ such as ______, ______, and ______
small dogs > yorkies, poodles, dachshunds
110
What is the goal of persistent deciduous tooth extraction?
remove entire tooth root to provide space for permanent tooth to move into
111
Persistent Deciduous Teeth
112
lingually displaced mandibular canines due to deciduous teeth that do not exfoliate properly
Base-Narrow or In-Standing Mandibular Canine Teeth
113
How are base-narrow or in-standing mandibular canine teeth treated?
shorten tooth to remove interference with another tooth or surrounding soft tissue
114
An uncomplicated tooth fracture has ______ exposure
no pulp
115
A complicated tooth fracture has ______ exposure
pulp
116
Attrition/abrasion is most common on ______ and ______ (teeth)
incisors and canines
117
Fractures are most common in _______ and ________ (teeth)
maxillary 4th premolars and canines
118
Acute fractures with pulp exposure must be treated with ______ or ______
endodontic treatment or extraction
119
inflammation and discoloration of a tooth often as a result of blunt trauma
Pulpitis
120
92% of discolored teeth are likely _______
partial/complete pulp necrosis
121
Pulpitis
122
_____ are the most common oral neoplasia in cats
Squamous Cell Carcinoma (SCC)
123
_____ are the most common benign oral neoplasia in dogs
Gingival Tumors
124
gingival tumors that do not typically invade bone and usually do not recur if the tooth of origin and its periodontal ligament are removed
Peripheral Odontogenic Fibromas
125
gingival tumors that require removal of the mass within a minimum of 1 cm of normal tissue in all directions to prevent recurrence
Acanthomatous ameloblastoma
126
_____, _____, _____, and _____ are the most common malignant oral neoplasia in dogs
Malignant melanoma
Fibrosarcoma
Osteosarcoma
Squamous Cell Carcinoma
127
inflammation that extends beyond the mucogingival junction
Stomatitis
128
Stomatitis is common in _____
cats
129
inflammation of the gingiva, alveolar mucosa, buccal mucosa, sublingual mucosa, and/or mucosa of the caudal oral cavity lateral to palatoglossal folds
Gingivostomatitis
130
______ get inappropriate inflammation from even small amounts of plaque and thus frequent cleaning and home care should be performed
Cats
131
an immune-mediated disease in which the immune system forms antibodies toward a specific component of myosin found only in the chewing muscles
Masticatory Myositis
132
Pain upon mouth opening, dropping food, decreased appetite, and swelling of facial muscles are signs of _______
masticatory myelitis
133
abnormal protrusion of one or both eyeballs
Exophthalmos
134
jaw trauma in which the right and left mandibles separate at their rostral fibrous union
Symphyseal Separation
135
the rostral fibrous union between the right and left mandibles
Symphysis
136
______ is the most common type of jaw trauma
Symphyseal Separation
137
Symphyseal Separation
138
Why can tape muzzles be definitive treatment choices in puppies?
Rigid fixation may have adverse growth effects on the mandible
