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Dentistry Outline

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
Created by: cheshirecat



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