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Mawad
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What is the canine dental formula?
2 (3/3 I + 1/1 C + 4/4 P + 2/3 M)
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What is the feline dental formula?
2 (3/3 I + 1/1 C + 3/2 P + 1/1 M)
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What # teeth are cats missing on the top and bottom?
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Anything lying or moving toward the apex/tip of the root.
apical
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Anything lying or moving toward the crown/
coronal
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The interproximal surface of the tooth nearest the central incisor.
Mesial surface
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The interproximal surface of the tooth farthest away from the central incisor.
Distal surface
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The outer surface of the tooth nearest the lips or cheek.
Buccal or Labial aspect
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The tongue side of the tooth.
Lingual (mandibular) or Palatal (maxillary) surface
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What are the 4 stages of periodontal disease?
- Stage 1- gingivitis
- Stage 2- early periodontitis
- Stage 3- established periodontitis
- Stage 4- advanced periodontitis
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Describe stage 1 of periodontal disease.
gingivitis- no tooth mobility or attachment loss; completely reversible with proper therapy and aftercare at home
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Describe stage 2 of periodontal disease.
early periodontitis- apical migration of the junctional epithelium, resulting in a deeper sulcus (pocket or gingival recession); up to 25% loss of attachment
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Describe stage 3 of periodontal disease.
established periodontitis- 25-50% attachment loss exists around root; slight tooth mobility in single-rooted teeth is common; +/- early furcation exposure
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Describe stage 4 of periodontal disease.
advanced peridontitis- >50% attachment loss occurs; furcation exposure, abscess formation, tooth mobility, deep pockets, and /or gingival recession
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Why is it important to clean teeth below the gumline?
periodontal disease is subgingival and supragingival plaque and calculus formation, leading to bone resorption
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What are the 11 steps to a professional teeth cleaning visit?
- 1- visual oral exam on awake animal
- 2- visual oral exam under general anesthesia
- 3- supragingival plaque an calculus removal
- 4- subgingival periodontal cleaning
- 5- charting
- 6- intraoral radiography
- 7- therapy to treat lesions found
- 8- polishing
- 9- irrigation
- 10- after treatment home care
- 11- follow-up visit
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The tooth mobility index uses the following divisions:
- 0- normal
- M1- tooth moves slightly less than 1mm
- M2- tooth moves about 1mm
- M3- tooth moves >1mm and/or may be depressed into the alveolus
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What should you do if you have an M2 mobility tooth?
radiograph +/- extraction is periodontal disease stage 4
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What should you do if you have an M3 mobility tooth?
radiograph and extraction
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What is class I furcation exposure?
explorer can just detect an entrance to the furcation (crevice b/w the 2 roots of a tooth); portion of alveolar bone and periodontal ligament is intact
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What is class II furcation exposure?
explorer can enter the furcation, but does not exit the other side; undermined furcation is occluded by gingiva or bone on one side
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What is class III furcation exposure?
periodontium is destroyed to such a degree that the furcation is open and exposed; explorer can pass from side to side
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What should you do about class FII exposure?
radiograph +/- extraction based on rads
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What should you do about class FIII exposure?
radiograph and EXTRACT
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What should you do about class F1 exposure?
monitor for progression
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Gingival recession is measured from the __________ to the __________.
cementum-enalmel junction; gingival margin
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What does gingival recession lead to?
root exposure and root sensitivity
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The periodontal pocket is measured from the __________ to __________.
gingival margin; depth of sulcus
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What is normal periodontal pocketing for dogs and cats?
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What is total attachment loss equal to?
sum of gingival recession + periodontal pocketing
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What should you do about periodontal pocketing?
- periodontal pockets >5mm in a dog and >3mm in a cat- RADS
- Stage 4 periodontal disease- extraction
- Stage 3 periodontal disease- curette pocket and apply Doxirobe (only if client agrees to homecare and frequent dental...if not, extraction)
- Stage 2 periodontal disease- curette pocket and apply Doxirobe
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What is Doxirobe?
antibiotic apply into periodontal pockets; helps seal pocket and fight infection
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Define an enamel fracture and its treatment.
no dentin exposure; do nothing or smooth rough enamel margins...monitor for signs of concussive injuries
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Define an uncomplicated crown fracture and its treatment.
No pulp exposure; smooth rough enamel margins...monitor for signs of concussive injury
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Define a complicated crown fracture and its treatment.
pulp involvement that always leads to bacterial contamination and pulpitis, incredibly painful; endodontic treatment or extraction
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Define a crown root fracture and its treatment.
fracture that involved the crown and root, can be complicated or uncomplicated; endodontic treatment or extraction if complcated
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What are the types of horizontal root fractures?
apical, middle, and cervical third
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Describe the 3 types of horizontal root fractures and their treatments.
- apical third: little to no mobility; immobilize with splint
- middle third: increasing mobility; extraction or splint
- cervical third: significant mobility; extraction
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What is the cat tooth fracture rule of thumb?
1mm or more of missing canine tooth tip missing results in pulp exposure in cats
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What is the difference b/w extrinsic and extrinsic staining?
extrinsic staining is superficial and purely cosmetic; intrinsic staining usually occurs when the tooth is dead and need treatment
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What are indications for dental radiographs? (7)
pre- and post-extraction, missing tooth with no history of prior extraction, feline resorptive lesions, complicated crown fracture, periodontal pockets >5mm (dog) or >3mm (cat), FE2 and FE3 (FE= furcation exposure), M2 or M3 (mobility index)
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What are indications for extraction? (11)
stage IV periodontal disease, Stage III furcation, fractured teeth (tooth cannot be save or owner does not agree to endodontic care), persistent deciduous teeth, abnormal location of teeth that cause trauma to opposing teeth or soft tissues, dental overcrowing (predisposes to periodontal disease), retained or fractured root fragments, impacted and unerupted teeth, feline resorptive lesions affecting crown, nonresponsive feline lymphocytic plasmacytic stomatitis, extensive internal or external root resorptions resulting in nonrestorable tooth
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What are periosteal elevators used for?
to reflect the gingiva apically when creating a surgical gingival flap
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Dental elevators are placed between the ________ and ________ to wedge the tooth from the alveolus.
tooth's root; alveolar bone
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What are luxators used for?
insertion into the sulcular space, used to severe the gingival attachment
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What caution should be taken when using a luxator?
for use only by the experienced dental surgeon; should not be used as a level because this might cause bending or blade breakage
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What are extraction forceps used for?
to remove mobile teeth from the alveolus
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When is a simple (closed) extraction indicated?
where teeth are markedly mobile due to support loss from advanced periodontal disease or trauma; NOT FOR MULTI-ROOTED TEETH
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Describe a surgical extraction.
entails incisions for flap exposure, allowing access to the root to remove the buccal and/or lingual alveolar plate to ease extraction of teeth
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When is surgical extraction indicated?
for teeth with large roots, such as canine teeth and those teeth that are well anchored within the alveolus
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Why should extraction of persistent primary teeth be done as soon as possible?
to prevent orthodontic displacement of the erupting permanent tooth and subsequent malocclusion
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Describe the extraction technique for persistent primary teeth.
vertical incision for canines; elevate all areas except near the secondary tooth
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Describe the extraction technique for a multi-rooted tooth.
section each root so that each root can be extracted as if it were a single-rooted tooth
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What is the treatment for feline resorptive lesions?
dental cleaning, radiographs, and extraction of all teeth with FRLs (if affecting crown), pain control
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What teeth are most commonly affected by feline resorptive lesions?
mandibular third premolars, molars, and maxillary third and fourth premolars
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How do you treat lymphocytic plasmacytic gingivostomatitis syndrome in cats?
dental cleaning with full mouth dental radiographs, incisional biopsy of gingival tissue, (ideally) extraction of all teeth distal to the canines (if canines/incisors affected, take them out too), Clindamycin, Bupenorphine for pain management
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What causes peripheral buttressing/alveolar osteitis? What is the treatment?
outgrowths of bone secondary to chronic inflammation; extraction
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How do you treat a fractured root tip?
ALWAYS extract; do NOT leave them or attempt to bur away the tip
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How do you treat chronic ulcerative paradental stomatitis (CUPS)?
full mouth extractions
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