Auer Ch 30 Oral Cavity

Front 1

Define “coronal”:

Back 1

refers to the crown

Front 2

Define clinical crown:

Back 2

portion of the erupted tooth

Front 3

Define reserve crown:

Back 3

portion of the tooth that is yet to be erupted

Front 4

Define “apical”:

Back 4

refers to the portion of the tooth furthers from the occlusal surface

Front 5

Define mesial:

Back 5

surface of incisors closest to midline

Front 6

Define distal:

Back 6

surface of the incisors furthest from midline

Front 7

Rate of eruption of CT:

Back 7

2-3mm/yr

Front 8

Cells that produce enamel:

Back 8

ameloblasts

Front 9

Composition of enamel:

Back 9

impure hydroxyapatite (98%) and keratin-type proteins

Front 10

Composition of dentin:

Back 10

impure hydroxyapatite (70%) and collagenous tissues

Front 11

Cells that produce dentin:

Back 11

odontoblasts

Front 12

Benefit of secondary dentin production at the periphery of the pulp cavity:

Back 12

secondary dentin production occludes the size of the pulp cavity to prevent pulpar exposure for normal attrition of the occlusal surface

Front 13

Define pulp:

Back 13

soft tissues (nerves, vessels, connective tissue) within pulp cavities that is contiguous with periodontal connective tissue in the apical foramen

Front 14

How many pulp cavities are in cheek teeth?

Back 14

06 have 6, 07-10 have 5, 11 have 6 or 7

Front 15

Define apical foramen:

Back 15

opening in the apex of the tooth through which dental vasculature passes to the pulp

Front 16

Composition of cement:

Back 16

impure hydroxyapatite (65%) and collagenous tissues

Front 17

Cells that produce cement:

Back 17

cementoblasts

Front 18

What are sharpey’s fibers?

Back 18

Cement-origin fibers that cross the periodontal space to anchor cement to the alveolar bone

Front 19

Difference between cement of the reserve and clinical crowns:

Back 19

reserve crown cement is supported by vasculature of the periodontal ligament but cementoblasts of the clinical crown lose this blood supply

Front 20

Functions of cement:

Back 20

provide anchorage fibers of the periodontal ligament, protect underlying dentin at dental apex, increase bulk of clinical crown, protect coronal enamel from cracking, help form protruding enamel ridges on the occusal surface

Front 21

Define cement hypoplasia:

Back 21

incomplete filling of the infundibula with cement

Front 22

Dental formula for deciduous teeth:

Back 22

2(Di 3/3, Dc 0/0, Dpm 3/3) = 24

Front 23

Dental formula for permanent teeth:

Back 23

2(I 3/3, C 0-1/0-1, PM 3-4/3-4, M 3/3) = 36-44

Front 24

When do canines erupt?

Back 24

4-6 yrs

Front 25

When do permanent 05 (wolf teeth) erupt?

Back 25

6-12 mo

Front 26

When do the permanent premolar 06, 07, 08 erupt?

Back 26

2.5, 3, 4 yrs

Front 27

When do the permanent molars erupt?

Back 27

09 at 1, 10 at 2 and 11 at 3.5 yrs

Front 28

# of roots in upper cheek teeth:

Back 28

3 (2 smaller lateral, 1 larger medial)

Front 29

# of roots in lower cheek teeth:

Back 29

2 for 6-10 (rostral & caudal), 3 for 11

Front 30

Average length of erupted cheek tooth:

Back 30

6-8cm

Front 31

Relation of upper cheek teeth to sinuses:

Back 31

caudal 08, all 09 in rostral maxillary, all 10-11 in caudal maxillary (much variability)

Front 32

Plane of occlusal surface:

Back 32

10-15 degrees

Front 33

Define cusp:

Back 33

pronounced elevation of the occlusal surface in an area with thicker enamel

Front 34

Define ridge:

Back 34

linear elevation on the peripheral or occlusal surface

Front 35

Source of pulpar nerves:

Back 35

sensory nerves from the trigeminal and sympathetic nerves from cervical ganglion

Front 36

Define tooth growth:

Back 36

lengthening of the tooth in the apical portion due to deposition of dentin and cement

Front 37

Define tooth eruption:

Back 37

progressive protrusion of the tooth out of the alveolus

Front 38

What causes tooth eruption?

Back 38

Continuous remodeling of the periodontal ligament

Front 39

What are caries?

Back 39

Disease of calcified dental tissues resulting from the action of microorganisms on CHO, characterized by demineralization and destruction of organic portions of tooth

Front 40

Define periodontium:

Back 40

gingiva, periodontal ligament, cemuntum, and alveolar bone

Front 41

Define periodontal disease:

Back 41

altered state of periodontal tissues

Front 42

Define periodontitis:

Back 42

active state of periodontal disease with inflammation of periodontal tissues

Front 43

Define gingivitis:

Back 43

inflammation of gingiva only

Front 44

Examples of incisors disorders:

Back 44

overjet, underbite, retained deciduous incisors, supernumerary incisors, fracture, abnormal wear

Front 45

Define incisor overjet:

Back 45

rostral projection of the upper incisors beyond the lower incisors

Front 46

Other terms for incisor overjet:

Back 46

mandibular brachygnathism, maxillary prognathism, parrot mouth, overshot jaw

Front 47

Sequella of incisor overjet:

Back 47

overgrowth of rostral 106, 206, caudal aspect of 311, 411; reduced wear/ overgrowth of 101, 201 leading to convex incisor occlusal surface

Front 48

How is incisor overjet corrected in foals?

Back 48

Incisor orthodontic brace +/- bite plate

Front 49

Ideal age for incisor orthodontic brace placement:

Back 49

3 months (can be up to 8 mo)

Front 50

Describe incisor orthodontic brace placement:

Back 50

1) 1cm stab incision into oral cavity at level of interdental space of 06-07 or 07-08 2) Steinman pin with jacob’s chuck or drill used to reach the palatal aspect of the interproximal interdental space 3) place 14 ga needle in created tract 4) pass 1.25mm wire through needle 5) pull wire from palatal surface to exit oral cavity 6) remove needle 7) external end of wire is passed through incision to buccal aspect of teeth 8) wire is pulled buccally to exit the oral cavity 9) wires are twisted on each other toward rostral surface of 06 10) free ends are wrapped around labial surface of incisors 11) wire free ends from both sides are twisted on the labial surface of the incisors or interwoven between some of the incisors 12) wires are covered with PMMA

Front 51

When is a bite plate used?

Back 51

In foals that with overbite that may result in caudoventral deviation of the upper incisors with application of incisor orthodontic brace only

Front 52

What is the function of the bite plate?

Back 52

Promotes indirect occlusion between the upper and lower incisors

Front 53

How is the bite plate placed?

Back 53

1) aluminum plate is constructed that would cover occlusal surface of upper incisors and extend 4-5 caudally from the incisors 2) acrylic is formed over the labial and occlusal surface of the upper incisors and hard palate, covering the aluminum plate, and incorporating the wires from the orthodontic brace

Front 54

Complications of bite plate placement:

Back 54

difficulty nursing or pain to the mare during nursing

Front 55

Complications of incisor orthodontic brace placement:

Back 55

wire breakage, incomplete reduction

Front 56

When is the incisor orthodontic brace removed?

Back 56

When nearly aligned

Front 57

How is incisor overjet addressed in adults?

Back 57

Reduction of overgrowth in 5mm increments every 6 mo

Front 58

Define incisor underbite:

Back 58

prognathism, undershot jaw, sow mouth

Front 59

What is the relationship of the deciduous incisors to the permanent incisors?

Back 59

Deciduous incisors are rostral to permanent incisors

Front 60

Sequella of retained deciduous incisors:

Back 60

caudal displacement of the permanent incisor leading to changes in the occlusal surface

Front 61

What occurs if the permanent incisor does not erupt?

Back 61

The deciduous reserve crown is not resorbed leaving a length of reserve crown in the alveolus

Front 62

How are retained deciduous incisors removed?

Back 62

If loose, extract with extraction forceps. If failure of permanent eruption, remove rostral alveolar wall to extract

Front 63

Define supranumerary incisor:

Back 63

permanent incisors additional to the 6 normal permanent incisors

Front 64

How are supranumerary incisors treated:

Back 64

if grossly displaced rostrally, perform rostral alveolar wall to extract otherwise do not extract

Front 65

Why should supranumerary incisors not be extracted?

Back 65

Long reserve crown with close association with crowns and roots of normal incisors, removal could negatively affect root and crown of adjacent (normal) incisors

Front 66

Management options for incisor fractures with pulp exposure:

Back 66

debridement followed by either no treatment (allow pulp cavity to fill in with dentin) or endodontic filling of the pulp cavity

Front 67

Describe vital pulpotomy:

Back 67

1) pulp cavity debrided 2) control hemorrhage from cavity 3) seal cavity with Ca hydroxide 4) acid etch with phosphoric acid gel 5) flush acid 6) air dry cavity 7) apply bonding agent 8) seal in layers with restorative composite material

Front 68

Describe canine extraction:

Back 68

1) remove vertical aspect of lateral alveolar wall 2) use elevator to loosen canine in horizontal direction 3) extract tooth

Front 69

Why type of elevators can be used for wolf tooth extraction?

Back 69

Burgess, Musgrave

Front 70

Examples of developmental disorders of cheek teeth:

Back 70

retained deciduous cheek teeth, diastemata, rostral positioning of the maxillary cheek teeth row, cheek tooth displacements, supranumerary cheek teeth

Front 71

When do retained deciduous cheek teeth occur?

Back 71

2-5 yrs

Front 72

Sequella of retained deciduous cheek teeth:

Back 72

Pain, delayed eruption of permanent cheek teeth

Front 73

Sequella of early (planned) removal of deciduous cheek teeth:

Back 73

exposure of underdeveloped permanent occlusal surface, loss of blood supply to infundibular cementum resulting in predisposition to infundibular caries and apical infections

Front 74

Define diastema:

Back 74

space between occlusal aspect of adjacent teeth

Front 75

Define valve diastema:

Back 75

space is narrower at occlusal surface than at gingival margin

Front 76

Causes of diastema:

Back 76

lack of sufficient angulation of rostal or caudal cheek teeth to provide compression of cheek teeth row, development of dental buds far apart, displaced cheek teeth, supranumerary cheek teeth, overgrowth cheek teeth

Front 77

Sequella of diastema:

Back 77

pocketing of food leading to periodontal infection

Front 78

Treatment of diastema:

Back 78

young horses- clean diastema, fill periodontal defect with antibiotics & impression material until sufficient angulation eruption occurs older horses – diastemal widening, or if widening fails, extraction

Front 79

Describe diastemal widening:

Back 79

widen diastema to 4-6mm with a burr to allow prevent food packing

Front 80

What portion of the tooth is preferentially removed during diastemal widening?

Back 80

Rostral aspect of the adjacent tooth because pulp cavitys are closer to caudal edge of tooth and could be inadvertently penetrated during widening

Front 81

Treatment of rostral positioning of the maxillary cheek teeth row:

Back 81

removal of overgrowth on rostral 106, 206 and caudal 311, 411

Front 82

Causes of displaced cheek teeth:

Back 82

overcrowding of the teeth during eruption

Front 83

Teeth most commonly affected by displacement:

Back 83

09, 10

Front 84

Types of cheek tooth displacements:

Back 84

medial, lateral, rotary

Front 85

Sequella of cheek tooth displacement:

Back 85

overgrowth of displaced and opposite tooth, diastema both leading to periodontal disease

Front 86

Treatment of displaced cheek teeth:

Back 86

remove overgrowths, widen diastema; very displaced teeth should be extracted

Front 87

Common location for supranumerary cheek teeth:

Back 87

caudal maxilla

Front 88

Sequella of supranumerary cheek teeth:

Back 88

diastema, overgrowths both which can result in periodontal disease

Front 89

Treatment of supranumerary teeth:

Back 89

remove overgrowths, widen diastema, or extract

Front 90

Examples of acquired disorders of cheek teeth:

Back 90

overgrowths, trauma, fractures, carious infundibula, odontogenic tumors, periapical infection

Front 91

Causes of overgrown cheek teeth:

Back 91

restricted lateral mandibular movement due to decreased forage intake and decreased eating/chewing time

Front 92

Sequella of overgrown cheek teeth:

Back 92

change in agulation of the occlusal surface, restricted mandibular mastication motion, food stagnation, periodontal disease, undulating irregularities of the occlusal surface

Front 93

Define shear mouth/ scissor mouth:

Back 93

change from 10-30 degree occlusal angle to a sharp angulation of 45 or greater

Front 94

Define slope or slant mouth:

Back 94

changing in occlusal angle on 1 side of the mouth only due to chewing only on 1 side

Front 95

Where do slab fractures of cheek teeth usually occur?

Back 95

Lateral 2 pulp cavities of upper 09s

Front 96

Sequella of cheek tooth slab fracture:

Back 96

lateral displacement of lateral fragment and food pocketing, sealing of pulp affected pulp horns with dentin, continued normal eruption OR pulpar exposure leads to apical infection, secondary sinusitis

Front 97

Treatment of cheek tooth slab fractures:

Back 97

none if normal eruption occurs, extraction if apical infection occurs

Front 98

Where do cheek tooth sagittal fractures occur?

Back 98

Upper 09

Front 99

Cause of cheek tooth sagittal fractures:

Back 99

carious infundibula resulting in sagittal weakening

Front 100

Sequella of cheek tooth sagittal fractures:

Back 100

pulp exposure, apical infection, secondary sinusitis

Front 101

Treatment of cheek tooth sagittal fractures:

Back 101

if infection exists, extraction

Front 102

What is the advantage of leaving the stable (medial) fragment of a fractured cheek tooth?

Back 102

Prevents drifting of adjacent teeth, decreases the development of overgrowth on opposite tooth

Front 103

Advantages of endodontic therapy for carious infundibula:

Back 103

improve mechanical soundness of tooth to prevent sagittal fractures

Front 104

Disadvantage of endodontic therapy for carious infundibula:

Back 104

difficult to access so not always possible to remove all carious cement and debris, deep defects may not be accessible at all

Front 105

Examples of dental tumors:

Back 105

ameloblastoma, ameloblastic odontoma, odontoma, cementoma, compound odontoma

Front 106

Radiographic projections recommended for detecting apical infections:

Back 106

45 degree ventrolateral oblique for mandibular teeth and 30 degree dorsolateral oblique for maxillary teeth

Front 107

Define anachoresis:

Back 107

bloodborne infection of the apex

Front 108

Treatment of apical infections:

Back 108

early stages of anachorectic infection- systemic antibiotics, +/- apical curettage later stages – extraction; if involves sinuses, treat/ explore sinusitis

Front 109

Methods of cheek tooth extraction:

Back 109

oral, repulsion, lateral buccotomy

Front 110

Describe infraorbital nerve anesthesia:

Back 110

5cm 21ga needle passed caudally within the infraorbital canal, injecting 3-5 mL lidocaine

Front 111

What structures are desensitized with infraorbital anesthesia?

Back 111

Upper 06-07

Front 112

How is mandibular nerve anesthesia performed?

Back 112

15cm 18 gauge needle walked up the medial aspect of the mandible at a line drawn from the caudal aspect of the orbit and aiming to intersect this line with a line drawn parallel to the occlusal surface of the cheek teeth, 20-30 mL lidocaine

Front 113

What structures are desensitized with the mandibular anesthesia?

Back 113

All mandibular teeth

Front 114

What are methods to anesthetize the maxillary nerve?

Back 114

9 cm needle insert caudal to the highest point of the zygomatic arch, walked ventrorostromedially down the orbital aspect of the frontal bone to caudoventral aspect of orbit, 20-30 mL lidocaine OR insert needle at right angle ventral to sygomatic process between middle and caudal third of orbit for 4.5-5.5 cm, 20mL lidocaine

Front 115

Describe oral extraction:

Back 115

1) detech gingiva around tooth 2) sequentially increasing size molar spreaders placed for 5 min 3) attach cheek tooth extractors 4) slow movement of extractors in horizontal plane until squelching heard and foamy hemorrhage at gingival margin 5) place fulcrum on tooth rostral to extracted tooth 6) place vertical pressure on extractors

Front 116

Effect of molar spreaders:

Back 116

stretch and damage periodontal ligaments

Front 117

When are molar spreaders not used?

Back 117

Between 06-07 because not support rostrally for 06

Front 118

When should a fulcrum not be utilized during extraction?

Back 118

Caudal mandibular teeth because vertical force is oblique to the tooth and may cause fracture

Front 119

Complications or oral extraction:

Back 119

nonhealing alveoli due to alveolar fragments, localized osteitis

Front 120

How is repulsion performed?

Back 120

1) surgical window is created in bone using a saw, trephine, or chisel adjacent to infected apex 2) place repulsion punch on tooth 3) confirm placement with radiographs 4) repulse tooth with mallet 5) plug oral aspect of alveolus

Front 121

Location for repulsion punches:

Back 121

ventral mandible for mandibular 06-11; dorsorostral aspect of rostral maxillary bone for maxillary 06-07, possibly 08

Front 122

Visual appearance of infected apices:

Back 122

sharp edges of exposed epical enamel, sharp edges of alveolar bone, granulation tissue, mucosal inflammation

Front 123

Why do complications occur with repulsion?

Back 123

In younger horses there is damage to supporting alveolar, mandibular or maxillary bone

Front 124

Complications of repulsion:

Back 124

nonhealing alveoli due to alveolar fragments, osteomyelitis, oronasal, orofacial or oromaxillary fistula, chronic draining tracts, damage to adjacent teeth, chronic sinusitis

Front 125

Indications for lateral buccotomy:

Back 125

chronic apical infection with progressive dense cement deposition around the apex makes the apex larger than the occlusal aspect of the alveolus

Front 126

Describe lateral buccotomy:

Back 126

1) horizontal skin incision over affected tooth 2) buccal nerve & parotid duct identified and retracted 3) vertical periosteal incision over affected tooth 4) reflect periosteum 5) removal of lateral alveolar wall with a saw or burr 6) section tooth longitudinally with diamond wheel or carbide burr 7) extract in segments 8) pack occlusal aspect of alveolus 9) pack apical aspect of alveolus with gauze with draw through skin incision adjacent to surgical incision

Front 127

Complications of lateral buccotomy:

Back 127

parotid duct rupture, buccal nerve damage resulting in nasal paralysis

Front 128

Advantages of endodontic pulp canal therapy:

Back 128

preservation of tooth, prevention of overgrowths

Front 129

Approaches to endodontic pulp canal therapy:

Back 129

apical and occlusal

Front 130

Disadvantages of endodontic pulp canal therapy:

Back 130

specialized training and equipment, variable results, surgical approach to apex

Front 131

When is partial glossectomy indicated?

Back 131

Rostral tongue is devitalized with minimal attachment to body of tongue

Front 132

Describe partial glossectomy:

Back 132

1) amputate stump 2) remove wedge of muscle between dorsal and ventral edges 3) close space with multiple rows of simple interrupted sutures 4) close edge with buried interrupted suture

Front 133

How can tension be countered when closing tongue lacerations?

Back 133

Pre-placement of vertical mattress sutures in the deep muscular body of the tongue

Front 134

What reduces tension on the suture line in primary lip laceration closure?

Back 134

Undermine edges of skin for 1-1.5 cm, pre-place vertical mattress sutures with soft stents

Front 135

How is commissure repair supported?

Back 135

Placement of additional vertical mattress sutures rostral to the primary repair

Front 136

How are avulsions of the lower lip supported?

Back 136

Large mattress sutures passed through the mandibular symphysis

Front 137

Term for persistant lingual frenulum:

Back 137

ventral ankyloglossia

Front 138

Major salivary glands:

Back 138

parotid, mandibular, sublingual

Front 139

Minor salivary glands:

Back 139

buccal, labial, lingual, palatine

Front 140

Anatomic location of parotid gland:

Back 140

generally in retromandibular fossa between vertical ramus or mandible and wing of atlas; rostral border- TMJ & masseter muscle on caudal border of mandible caudal border- wing of atlas dorsal border – base of ear ventral border – intermandibular space

Front 141

Course of parotid duct:

Back 141

from medial surface of mandible (with facial artery and vein) to rostrolateral mandible, along rostral edge of masseter to open in oral cavity opposite 108, 208

Front 142

Anatomic location of mandibular salivary gland:

Back 142

extends from atlantal fossa to basihyoid bone, bordered laterally by the parotid gland and medially by the larynx, common carotid & vasosympathetic trunk

Front 143

Where does the mandibular salivary gland exit?

Back 143

Few centimeters rostrolateral to the lingual frenulum

Front 144

Name for parotid duct opening?

Back 144

Buccal ostium

Front 145

Name for mandibular salivary gland opening?

Back 145

Sublingual caruncle

Front 146

Examples of disorders of salivary glands:

Back 146

trauma, sialolith, atresia, salivary mucocele, heterotrophic salivary tissue, idiopathic parotiditis, neoplasia

Front 147

Goal of management of salivary gland or duct trauma:

Back 147

repair of damaged structure or elimination of saliva secretion

Front 148

Describe primary closure of duct laceration:

Back 148

1) incision created into the oral cavity just rostral to buccal ostium 2) pass suture material normograde down distal end of duct 3) pass tubing through incision and over suture to be pulled retrograde out the distal aspect of the laceration 4) pass tubing retrograde up the proximal aspect of the duct to the ventral aspect of the gland 5) anatomose duct with 4-0 to 7-0 suture in simple interrupted pattern

Front 149

Options for elimination of saliva secretion:

Back 149

surgical removal of gland, duct ligation, chemical ablation of gland

Front 150

Disadvantages of chemical ablation of parotid gland:

Back 150

severe periocular or facial swelling and pain, nasopharyngeal collapse, facial nerve paralysis, anorexia, dyspnea

Front 151

Agents used for chemical ablation of parotid gland:

Back 151

Lugol’s iodine, 10% formalin, 2% chlorhexadine, 2-3% silver nitrate

Front 152

Describe chemical ablation of the parotid gland:

Back 152

1) duct is cannulated to level of gland 2) ligature tied to prevent leakage 3) 35mL of agent injected 4) agent left for 90 seconds then allowed to drain 5) cannula maintained for 36 hrs

Front 153

Composition of sialolith:

Back 153

calcium carbonate, organic matter, usually plant material nidus

Front 154

Sequella of sialolith:

Back 154

inflammation and infection of the duct

Front 155

Preferred treatment of sialolith:

Back 155

oral removal of sialolith either through buccal ostium/ parotid papilla or intraoral incision over the sialolith and removal

Front 156

How is atresia of salivary ducts diagnosed?

Back 156

Clinical appearance, positive contrast sialography, cytology of aspirated duct fluid

Front 157

Sequella of centesis of salivary duct:

Back 157

leakage of saliva from needle tract causing severe local inflammation

Front 158

Treatment options for atresia of the salivary duct:

Back 158

surgical creation of a buccal ostium, duct excision and proximal ligation, gland extirpation, chemical ablation of the gland

Front 159

Define mucocele/ sialocele:

Back 159

accumulation of salivary secretions adjacent to local gland, not lined b epithelium

Front 160

Define ranula/ honey cyst:

Back 160

mucocele of one of the sublingual salivary glands

Front 161

Define heterotrophic salivary tissue:

Back 161

salivary tissue found in an abnormal location