GI1- SA Dentistry

2 (3/3 I + 1/1 C + 4/4 P + 2/3 M)

2 (3/3 I + 1/1 C + 3/2 P + 1/1 M)

• top: 05
• bottom: 05, 06

apical

coronal

Mesial surface

Distal surface

Buccal or Labial aspect

Lingual (mandibular) or Palatal (maxillary) surface

• Stage 1- gingivitis
• Stage 2- early periodontitis
• Stage 3- established periodontitis
• Stage 4- advanced periodontitis

gingivitis- no tooth mobility or attachment loss; completely reversible with proper therapy and aftercare at home

early periodontitis-  apical migration of the junctional epithelium, resulting in a deeper sulcus (pocket or gingival recession); up to 25% loss of attachment

established periodontitis- 25-50% attachment loss exists around root; slight tooth mobility in single-rooted teeth is common; +/- early furcation exposure

advanced peridontitis- >50% attachment loss occurs; furcation exposure, abscess formation, tooth mobility, deep pockets, and /or gingival recession

periodontal disease is subgingival and supragingival plaque and calculus formation, leading to bone resorption

• 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

• 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

radiograph +/- extraction is periodontal disease stage 4

radiograph and extraction

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

explorer can enter the furcation, but does not exit the other side; undermined furcation is occluded by gingiva or bone on one side

periodontium is destroyed to such a degree that the furcation is open and exposed; explorer can pass from side to side

radiograph +/- extraction based on rads

radiograph and EXTRACT

monitor for progression

cementum-enalmel junction; gingival margin

root exposure and root sensitivity

gingival margin; depth of sulcus

• dogs <3mm
• cats <0.5mm

sum of gingival recession + 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

antibiotic apply into periodontal pockets; helps seal pocket and fight infection

no dentin exposure; do nothing or smooth rough enamel margins...monitor for signs of concussive injuries

No pulp exposure; smooth rough enamel margins...monitor for signs of concussive injury

pulp involvement that always leads to bacterial contamination and pulpitis, incredibly painful; endodontic treatment or extraction

fracture that involved the crown and root, can be complicated or uncomplicated; endodontic treatment or extraction if complcated

apical, middle, and cervical third

• apical third: little to no mobility; immobilize with splint
• middle third: increasing mobility; extraction or splint
• cervical third: significant mobility; extraction

1mm or more of missing canine tooth tip missing results in pulp exposure in cats

extrinsic staining is superficial and purely cosmetic; intrinsic staining usually occurs when the tooth is dead and need treatment

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)

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

to reflect the gingiva apically when creating a surgical gingival flap

tooth's root; alveolar bone

insertion into the sulcular space, used to severe the gingival attachment

for use only by the experienced dental surgeon; should not be used as a level because this might cause bending or blade breakage

to remove mobile teeth from the alveolus

where teeth are markedly mobile due to support loss from advanced periodontal disease or trauma; NOT FOR MULTI-ROOTED TEETH

entails incisions for flap exposure, allowing access to the root to remove the buccal and/or lingual alveolar plate to ease extraction of teeth

for teeth with large roots, such as canine teeth and those teeth that are well anchored within the alveolus

to prevent orthodontic displacement of the erupting permanent tooth and subsequent malocclusion

vertical incision for canines; elevate all areas except near the secondary tooth

section each root so that each root can be extracted as if it were a single-rooted tooth

dental cleaning, radiographs, and extraction of all teeth with FRLs (if affecting crown), pain control

mandibular third premolars, molars, and maxillary third and fourth premolars

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

outgrowths of bone secondary to chronic inflammation; extraction

ALWAYS extract; do NOT leave them or attempt to bur away the tip

full mouth extractions