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Dentistry Outline
| Question | Answer |
|---|---|
| Diphyodont Teeth | dogs and cats- have two sets of teeth (deciduous and permanent) |
| Brachyodont Teeth | dogs and cats- long roots and true crown (stops growing when mature) |
| Hypsodont Teeth | horses and rabbits- relatively long crowns which continue to grow |
| Rodent Teeth | most have hypsodont incisors and brachyodont molars |
| Tooth Development | decidious and permanent teeth develop at same time in-utero, if decidious fails to develop, permanent will fail to develop |
| Enamel | hardest substance in body, none on root surface, only above gum line, mostly made of crystalized minerals which line up at right angels to the tooth angel, acts as a shield against trauma, protects dential tubules from pain and bacteria, non living tissue |
| Dentin | comprises majority of tooth, live tissue which can regenerate, live cells called odontoblasts |
| Dentin Tubules | microscopic tubules formed from a calcium substance secreted by odontoblasts from tooth pulp, go outward from dentin-cementum junction and the dentin-enamel junction; odontoblasts travel allowing fluid and sensory exchange- pain and bacteria if exposed |
| Primary Dentin | dentin formed in-utero |
| Odonotblasts | produce dentin throughout life, called secondary dentin |
| Secondary Dentin | pulp cavity narrows as more dentin laid down, dentin hardens and pushes in toward pulp constricting blood supply |
| Tertiary/Repairative Dentin | formed in response to trauma |
| Pulp | inner most layer, also called: root canal, pulp chamber, pulpal horn |
| Root Canal | pulp in root |
| Pulp Chamber | pulp in crown |
| Pulpal Horn | portion in crown where it curves |
| Cementum Formation | formed by cementocytes from Hertwig's Sheath, covers root below gum line, lies within periosteum and attaches to periodontal ligament, formation does not occur until tooth is almost fully grown and in position |
| Cementoenamel Junction | area where cementum and enamel meet, important landmark for signaling periodontal destruction |
| Periodontal Ligament | attaches root cementum to alveolar bone, fibers intermesh with fibers of cementum on tooth side |
| Sharpey's Fibers | attached to bone on the opposite side of tooth as periodontal ligament and cementum |
| Periodontal Ligament Functions | sensations prevent excessive pressure when biting down, separates dentin from bone |
| Alveolar Bone | comprised of ridges of jaw that support teeth |
| Alveolus | tooth socket- appears as white line on x-ray called Lamina Dura |
| Free/Marginal Gingiva | closely adhered to tooth surface |
| Gingival Sulcus | measurement with periodontal probe from sulcal base to free gingival margin, lined with highly permeable layer of junctional epithelium which allows fluid filled with antibodies and WBCs to pass and fight bacteria and flush sulcus |
| Dog Gingival Sulcus | 1-3mm normal |
| Cat Gingival Sulcus | 0-1mm normal |
| Bottom of Sulcus | formed by epithelial fibers that adhere attached gingiva to tooth at cementoenamal junction |
| Attached Gingiva | firmly attached to underlying periosteum of alveolar bone |
| Oral Mucosa | move freely over bone/connective tissue of cheeks and lips, very elastic to allow full opening of mouth |
| Muco-Gingival Line | delineates attached gingiva from oral mucosa |
| Cementum | avascular bone-like tissue that covers root surface |
| Pellicle | sticky coating of saliva and glycoproteins- covers tooth in 20 minutes |
| Plaque | 6-8 hours bacteria begin to colonize |
| Pathogenesis of Periodontal Disease | direct and indirect (inflammation) injury by plaque and bacteria |
| Gingivitis | reversible, inflammatory reaction of gingiva alone in response to plaque |
| Gingivitis Clinical Assessment | redness, swelling, bleeding, assessed using periodontal probe |
| Gingivitis Index Grading | 0- no gingival inflammation, 3- edema swelling and bleeding easily upon probing |
| Dental Calculus | mineralized plaque, always covered by a layer of plaque, does little to manifest periodontal disease |
| Horizontal Bone Loss | destruction of periodontal ligament allows disease to travel apically, usually produces gingival recession, few periodontal pockets form |
| Vertical Bone Loss | disease progression vertically along a root, also known as periodontal pocket, found with periodontal probe and/or x-ray |
| Periodontal Disease Staging Criteria | 1. gingivitis and gingival index; 2. periodontal probing depth in mm (vertical bone loss); 3. gingival recession in mm; 4. furcation exposure (horizontal bone loss); 5. tooth mobility |
| Stages of Periodontal Disease | 0-4 |
| PD 0 | clinically normal- no gingival inflammation or periodontitis |
| PD 1 | gingivitis only w/o attachment loss, height and architecture of alveolar margin normal |
| PD 2 | early periodontitis- less than 25% attachment loss, or stage 1 furcation involvement in multirooted tooth |
| PD 3 | moderate periodontitis- 25-50% attachment loss, or stage 2 furcation of multirooted tooth |
| PD 4 | advanced periodontits- more than 50% attachment loss, or stage 3 furcation of multirooted tooth |
| Canine Dental Formula | I 3/3 C 1/1 P 4/4 M 2/3 } x2 = 42 |
| Puppy Dental Formula | i 3/3 c 1/1 p 3/3 } x2 = 28 |
| Feline Dental Formula | I 3/3 C 1/1 P 3/2 M 1/1 } x2 = 30 |
| Kitten Dental Formula | i 3/3 c 1/1 p 3/2 } x2 = 26 |
| Puppy/Kitten Incisor Eruption Schedule | puppy- 4-6 wks; kitten- 3-4 wks |
| Puppy/Kitten Canine Eruption Schedule | puppy- 3-5 wks; kitten- 3-4 wks |
| Puppy/Kitten Premolar Eruption Schedule | puppy- 5-6 wks; kitten- 5-6 wks |
| Dog/Cat Incisor Eruption Schedule | dog- 12-16 wks; cat- 11-16 wks |
| Dog/Cat Canine Eruption Schedule | dog- 12-16 wks; cat- 12-20 wks |
| Dog/Cat Premolar Eruption Schedule | dog- 16-20 wks; cat- 16-20 wks |
| Dog/Cat Molar Eruption Schedule | dog- 16-24 wks; cat- 20-24 wks |
| Triadan Tooth Numbering System | upper right quadrant- 100, upper left- 200, lower left- 300, lower right- 400; teeth numbered from central incisor back (01-03), canines (04), premolars (05-08), molars (09-11) |
| Rule of 4s and 9s | canines are always 04 and molars are always 09 |
| Triadan Deciduous Teeth Numbering | 500-800 |
| Scissor Bite | normal occlusion |
| Mandibular Mesiocculsion | class 3 malocculsion of jaw where mandible is longer than maxilla |
| Mandibular Distocclusion | class 2 malocculsion of jaw where mandible is shorter than maxilla |
| Anterior Crossbite | most common type, malocculsion of incisors |
| Posterior Crossbite | malocculsion of premolar and molars where lower molar crown is buccal to opposing maxillary premolar |
| Wry Bite | class 4 malocclusion of skeletal asymmetry |
| Malocclusion Associated with Persistent Deciduous Teeth | most common are maxillary canines |
| Dolicocephalic Breeds | longer than normal jaws- large interdental space |
| Mesocephalic Breeds | medium sized jaw- least likely to form malocclusions from jaw type |
| Brachycephalic Breeds | shorter than normal maxilla- decreased interdental space resulting in rotation/overlapping teeth |
| Pharyngeal Pack | two way- air/water syringe, extraction forceps, power scaler, hand scalers, low speed hand-piece with prophy angle and cup, periodontal probe, explorer |
| Two-Way Air/Water Syringe | rinse mouth, deliver chlorhexadine |
| Extraction Forceps | remove heavy deposits of tarter, grasp crown during extractions |
| Power Scaler | ultrasonic scaler- magnetostrivtive vs air driven, sonic- rarely used; subpar to ultrasonic, peizo-electric- uses pulsing voltage on ceramic crystals that move tip in reciprocating pattern; causes tissues to heat requiring fluid cooling |
| Hand Scalers (Fine and Coarse) | sickle- angled blade with straigh, flat face and two cutting edges that come to a point; hoe- used to loosen heavy supragingival tartar, used with a pulling motion; always use modified pen-grasp with hand tools |
| Modified Pen Grasp | enhance control and sensitivity- thumb, index and middle hold, ring stabilizes |
| Low Speed Hand-Piece with Prophy Angel and Cup | used with pumice to polish, autocaveable, pre-sterilized, with or without prophy cup |
| Explorer | delicate, tactile instrument used in examining oral cavity, detects coronal defects/pulp exposure, detects subgingival tartar and root defects, examines tooth mobility |
| Dental PPE | gloves, goggles, mask/face shield, instruments, pharyngeal pack, warming device, blankets |
| Instruments | ultrasonic scaler supra or perio tip or both, probe, explorer, curette, hand scaler, dental mirror, extraction forceps, low speed hand-piece with prophy angle, cup, and pumice, chlorhexadine, dental elevator |
| SE of Hypothermia | prolonged recovery, bradycardia, respiratory depression, apnea, ileus, hypotension, impaired clot function, impaired immune function |
| Hypodontia | common- only a few teeth missing, should x-ray to r/o unerrupted teeth |
| Supernumerary | extra adult tooth |
| Adult Tooth Impaction | persistent deciduous teeth, impacted tooth crown can develop into dentigerous cyst, may cause occlusion and/or oral soft tissue trauma |
| Dentigerous Cyst | can undergo neoplastic metaplasia, cause destruction of underlying alveolar bone, histopath on cyst when extracted |
| Epulis/Gingival Hyperplasia | benign growth of gums that may be invasive, often causes enlargement of gingival tissue, histopath at removal but not normally neoplastic, can cause abnormal pocket depth causing periodontal disease |
| Attrition | wear of enamel over time, pulp will stimulate odontoblasts to make dentin, if rate of wear slower than dentin production- pulp will be protected by tertiary dentin |
| Tooth Fracture | if dentin involved- bacteria can enter through tubules and enter pulp, entire pulp removed and inert substance placed in root canal, tooth no longer viable but maintains function |
| Gutta Percha | substance placed in root canal in tooth fracture |
| Pulpotomy | may be performed on fractured/injured tooth if < 48 hrs or 2 wks if open apex |
| Tooth Resorption | common in cats- 75% of cats > 6 yrs, cause unknown, progressive odontoclastic reaction causing root/crown destruction, usually not clinical until pulp above gum line affected, usually need extraction or crown amputation |
| Type I Tooth Resorption | x-rays w/ areas of radiolucency with intact periodontal ligament space- extracted |
| Type II Tooth Resorption | x-rays w/ aread of radiopacity and no intact periodontal ligament space- crown amputation |
| Caries | rare- teeth extracted or treated endodonitcally |
| Stomatitis | common in adult cats, characterized by chronic inflammation of oral and pharyngeal area, can include severe ulceration and gingivitis, thought to be saliva allergy, sometimes treated with steroids or full mouth extractions |
| Home Care | daily brushing, water additives, dental diets, oral rinses, barrier treatments |
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cheshirecat
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