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| The branch of dentistry dealing with the study and treatment of diseases of the periodontium - tissues investing and supporting the teeth, including the periodontal ligament, alveolar bone and gingiva. |
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| The branch of dentistry concerned with irregularities of teeth and malocclusion |
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| The branch of dentistry concerned with the aetiology, prevention, diagnosis and treatment of conditions that affect the tooth pulp, root and periapical tissues |
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| Portion of the tooth above the gum (gingiva) line...and covered in enamel |
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| the constriction of the tooth at the gumline...where enamel ends and dentin, covered by cementum begins |
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| Most terminal portion of the root |
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| Small openings in the root tip allowing tiny nerves and vessels to penetrate the substance of the tooth |
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| How does the presence of plaque damage the gingival? |
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Definition
Often periodontal disease evolves as a sequelae to plaque, tartar and calculus buildup. When saliva contacts a tooth, a glycoprotein layer is laid down permitting certain oral bacteria to adhere to the surface of the tooth. These bacteria synthesize other polysaccharides that permit other bacterial species to also adhere to the surface of the tooth, forming "plaque. The entrapment of bacteria and bacterial toxins in plaque, facilitated by the presence of food, as well as the physical interaction of developing calculus (hard/irritating) stimulates an inflammatory response by the juxtapositioned gums (gingiva) including the tooth's surrounding gingival "pocket". Plaque extends under gums causing inflammation there, and this, in turn loosens the periodontal ligaments' attachment to alveolar bone, resulting in deeping of the pocket and recession of gingival tissue, which results in partial root exposure, and invites furthur advancement of tartar and calculus to these areas. As periodontal ligaments are damaged, and gingiva recede, affected teeth loosen and are painful. The animal may drool, gag, wretch and cough. Halitosis is common. Abscessation of surrounding pocket or root apices involving adjacent bone can lead to bone infection (osteomyelitis),oronasal fistula and systemic infection
Periodontal disease may arise from primary metabolic, neoplastic and infectious diseases and gingival hyperplasia, as well. Examples of metabolic diseases causing periodontal disease are Hypothyroidism and Cushings Disease, Diabetes .There may be others |
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Definition
| Viral, chemical or other causes of defective tooth development or trauma may result in the absence of adequate enamel over the crown. The underlying dentin is easily stained and and affected teeth are easily broken or worn. The problem may be focal ("Enamel Defect"...one area) or generalized (more or less everywhere). Focal lesions/defects (as apposed to generalized ) can often be repaired |
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Gingival Hyperplasia:
This problem is believed to be genetic in origin, though it is plausible that chronic gingivitis may give rise to it.It is described as exhuberant accumulation of gingival tissue, sometimes covering the crowns of adjacent teeth. In the presence of gingival hyperplasia, periodonal disease may ensue, due to the presence of "pseudopockets" formed by gingiva surrounding teeth. Breeds most commonly affected are Collies and Boxers. Treatment is repeated surgical reduction. |
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An abscess is a focal accumulation of prurulent material (aka "pus"). The most common cause is advances periodontal disease. The large periodontal pocket permits accumulation of bacteria and food to collect. Growth of bacteria and inflammation from calculus and tartar forces the accumulation of purulent material. The resulting loosening of periodonal ligament leads to advancing inflammation and movement of teeth which are no longer firmly anchored in place. Affected animals are painful, reluctant to eat, may rub the face with paws and may drool with blood tinged material visible. Sneezing may occur if there is sufficient drainage into the nasal cavity. Diagnosis is made via presence of advanced periodontal disease, loose teeth and radiographic confirmation (increased lucency around root, and recession/loss of alveolar bone from the neck of the tooth).
Trauma is another potential cause of tooth abscess via infection of and extension from exposed pulp. A tooth root abscess of the upper canine tooth can lead to drainage of the prurulent exudate into a nasal sinus and nasal cavity. Typically, a swelling is present below the eye on the affected side. Sometimes, there is rupture from here back into the oral cavity, creating an oronasal fistula.Sneezing is common.
Treatment of abscessed teeth requires extraction |
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| CUPS (Chronic Ulcerative Paradental Stomatitis) |
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Definition
CUPS (Chronic Ulcerative Paradental Stomatitis)
This disease is also known as idiopathic stomatitis, ulcerative stomatitis or lymphocytic-plasmacytic stomatitis and occurs in any breed though Maltese and King Charles Cavalier Spaniels seem predisposed. This is an immune-mediated disease in which the animal develops an allergic reaction to bacterial plaque on the teeth. Buccal (i.e. cheek) and lingual (i.e. tongue) tissue resting against affected teeth develop red, raised and often ulcerated lesions that are painful. Affected animals are often inappetant, develop severe, fetid halitosis, drool (with resulting secondary dermatitis of the lips); enlarged submandibular lymph nodes are sometimes seen. Diagnosis is via tissue biopsy and treatments vary depending on the severity of the signs. Fastidious, long-term oral care, anti-inflammatory or immuno-suppressive therapy and antibiotics are commonly employed. In many animals, the disease is never resolved and teeth...even relatively healthy teeth...must be extracted. |
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| Undue wear from chewing abrasive material (e.g. tennis balls, rope, stones, constant chewing of fur) may result in exposure of tooth pulp. When the process occurs gradually, reparative dentin in created which protects the pulp from environmental contacts and infection. A brown spot is seen at the area of wear, but a dental probe is unable to penetrate into pulp due to overlying dentin. If, on the other hand, the process occurs rapidly, exceeding the rate of dentin formation, there is communication between pulp and environment and endodontic intervention is required to protect the integrity of the tooth. |
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Oronasal Fistula:
This is a hole allowing direct communication of the oral and nasal cavities. Foodstuff may pass directly into the fistulous orifice, dwelling in the nasal cavity, causing sneezing and representing a basis for an additional infection nidus. Often the cause is a tooth abscess with secondary drainage of prurulent material into the nasal cavity. |
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| Ondontoclastic Resorptive Lesions (ORL) |
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Definition
| a type of 'idiopathic' external root resorption, where the hard tissues of the root surface are destroyed by the activity of multinucleated cells called ondontoclasts. The destroyed root surface is replaced by cementum- or bone-like tissue. The process starts in cementum and progresses to involve the dentine, where it spreads along the dentine tubules and eventually comes to involve the dentine of the crown as well as the root. The peri-pulpal dentine is relatively resistant to resorption and the pulp thus only becomes involved late in the dz. The process extends through the crown dentine, eventually reaching the enamel. The enamel is either resorbed or it fractures off and a cavity becines clinically evident. In the absence of routine rad, the lesions are first noted clinically when they become evident at the crown, often as cavities at the cemento-enamel junction (CEJ) |
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| What is the periodontium composed of? |
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Definition
| Periodontal tissues. Tissues adjacent to , surrounding and supporting the tooth and its roots. Alveolar bone, periodontal ligament, cementum and gingiva |
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| What can cause enamel hypoplasia? |
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Definition
| Viral, chemical or other causes of defective tooth development or trauma may result in the absence of adequate enamel over the crown. The underlying dentin is easily stained and affected teeth are easily broken or worn. The problem may be focal ("Enamel Defect"...one area) or generalized (more or less everywhere). Focal lesions/defects (as opposed to generalized ) can often be repaired. |
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| If a tooth is missing can you assume that the root is gone as well? |
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Definition
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| What can cause enamel hypoplasia? |
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Definition
| Viral, chemical or other causes of defective tooth development or trauma may result in the absence of adequate enamel over the crown. The underlying dentin is easily stained and affected teeth are easily broken or worn. The problem may be focal ("Enamel Defect"...one area) or generalized (more or less everywhere). Focal lesions/defects (as opposed to generalized ) can often be repaired. |
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| In what tooth does is a slab fracture commonly seen? What can cause slab fractures? |
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| Upper 4th premolars (carnassial teeth). Chewing on hard items |
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| What teeth are oro-nasal fistulas commonly associated with? |
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Definition
| The upper 4th premolar and molars |
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| Define periodontal disease. |
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Definition
| Plaque-induced inflammation of periodontium. Includes gingivitis and periodontitis |
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Definition
| overall normal occlusion, however one or more teeth are out of occlusion. One or more of the maxillary incisors are displaced palatally or one or more of the mandibular incisors are displaced labially. Otherwise, there is a normal occlusion. Base narrowed canines may be due to a structural narrowing of the mandible, or failure of the primary teeth to exfoliate prior to the eruption of the adult canine teeth. Spearing or lancing canines are maxillary canine teeth that are tipped in a rostral position by the mandibular canines. They occur most often in Shelties and Persian cats. Often times the problem starts out with spearing primary canine teeth which direct the adult teeth into mal-occlusion. Extraction of the primary teeth may prevent the problem in the adult teeth. Extraction or orthodontic correction is the treatment options. The lateral incisors may erupt in a buccal direction. Most of the time, the incisors will re-direct downward. |
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Definition
| In mandibular brachygnathism (Class II Occlusion), the mandible is shorter than the maxilla. The mandibular incisor teeth occlude palatal or caudal to their normal position on the cingulum of the maxillary incisor teeth. Often times these incisors may occlude against and irritate the hard palate or nasal bulbar gland. The canine teeth may indent or perforate the hard palate. The occluding mandibular teeth may cause wear of the palatal surface of the maxillary canine teeth at a later age. The premolar teeth may occlude caudal to their normal position. |
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| The patient with mandibular prognathism (Class III) has maxillary incisors occluding lingual or caudal to the mandibular incisors. The mandibular canine may occlude anterior to the maxillary incisors. |
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Term
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Definition
a mass of bacteria that are adherent to the enamel surface of the tooth.
PLAQUE INDEX (PI #)
• PI 0 no observable plaque
• PI 1 scattered plaque covering less than one third of the buccal tooth surface
• PI 2 plaque covering between one and two thirds of the buccal tooth surface
• PI 3 plaque covering >two thirds of the buccal tooth surface |
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Term
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Definition
mineralized material on the tooth surface.
CALCULUS INDEX (CI#) refers to the amount of calculus on a tooth.
• CI 0 no observable calculus
• CI 1 scattered calculus covering less than one third of the buccal tooth surface.
• CI 2 calculus covering between one and two thirds of the buccal tooth surface with minimal subgingival deposition.
• CI 3 calculus covering greater than two thirds of the buccal tooth surface and extending subgingivally |
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Definition
| the mucosal tissue that lies over the mandible and maxilla inside the mouth. |
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Definition
Reversible plaque-induced inflammation limited to the gingival (ie no loss of periodontal attachment.
GINGIVITIS INDEX (GI#) is the number assigned to designate the degree of gingival inflammation.
• GI 0 normal healthy gingiva with sharp non inflamed margins.
• GI 1 marginal gingivitis with minimal inflammation and edema at the free gingiva. No bleeding on probing.
• GI 2 moderate gingivitis with a wider band of inflammation and bleeding upon probing.
• GI 3 advanced gingivitis with inflammation clinically reaching the mucogingival junction usually with ulceration. Periodontitis will usually be present. |
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Definition
| a form of hardened dental plaque. It is caused by the continual accumulation of minerals from saliva on plaque on the teeth |
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| Inflammation of the tissue around the teeth, often causing shrinkage of the gums and loosening of the teeth. |
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| the proliferation of the attached gingiva. Gingival hyperplasia is measured from the cementoenamel junction to the gingival margin. |
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| a gingival sulcus that has experienced an apical extension of the epithelial attachment. |
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Definition
| the result of a chronic, localized infection located at the tip, or apex, of the root of a tooth. |
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| How common is periodontal disease? |
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Definition
| Probably the most common dz seen in sm animal practice, with the great majority of dogs and cats over the age of 3 yrs having a degree of dz that warrants intervention |
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| List the 4 periodontal structures. |
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Definition
| Gingiva, periodontal ligament, cementum, and alveolar bone |
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| What two hypotheses have been proposed to explain how plaque incites inflammatory rxns in the periodontium? |
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Definition
- non-specific plaque hypothesis – a direct relationship is assumed to exist between the total # of bacteria that accumulate on a tooth surface and the amplitude of the pathogenic effect.
- Specific plaque hypothesis – the view is that periodontitis is caised by specific pathogens. This hypothesis is supported by the fact that not all gingivitis lesions invariably develop into periodontitis lesions |
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Definition
| involves only a chip of the enamel |
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| Define and describe FORL. |
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Definition
A common feline oral malady is feline ondoclastic resorptive lesion (FORL). A majority of the cats affected are older than five years. In fact, in a recent study, 72% of all cats older than five years have t least one painful FORL. These tooth defects have also been called cavities, neck lesions, external or internal root resorptions, and cervical line erosions. The location of FORL is usually at the labial or buccal surface of the cemento-enamel junction (CEJ), where the free gingiva meets the tooth surface. The most common teeth affected are the maxillary third and fourth premolars and the mandibular third premolar and first molars, however FORLs can be found on any tooth. The etiology is unknown, however, theories supporting an autoimmune response mediating cellular and humoral factors, calici virus, and metabolic imbalances relating to calcium regulation have been proposed.
Patients affected with FORLs may show hypersalivation, oral bleeding, or have difficulty apprehending food. A majority of effected cats do not show clinical signs. Most times it is up to the clinician to diagnose the lesions on oral examination. Diagnostic aids include a periodontal probe or cotton tipped applicator, applied to the suspected FORL. The lesion often erodes into the sensitive dentin, causing the cat to show pain with jaw spasms when the FORL is touched. Intraoral radiology is helpful in making definitive diagnosis and treatment planning.
Stage 2 FORL
The FORL can present in many stages. Initially (Stage 1), an enamel defect is noted. The lesion is usually minimally sensitive because it has not entered the dentin. Therapy of this defect usually involves thorough cleaning, polishing, and use of fluoride-containing toothpaste. In Stage 2, lesions penetrate the enamel and dentin. These teeth may be treated with self-cured or light-cured glass ionomer restoratives, which release fluoride ions to desensitize the exposed dentin, strengthen the enamel, and chemically bind to tooth surfaces. The long term (greater than two years) studies on the effectiveness of restoration of Stage 2 show 20% success rates. Glass ionomer application to the FORL does not automatically stop the progression or the disease.
Stage 3 FORL
Intraoral radiography is essential to determine if the lesions have entered the pulp chamber (Stage 3), requiring either endodontics or extraction. These teeth should not be filled and left alone.
Radiographic appearance of FORLs vary from minute radiolucent defects of the tooth at the cemento-enamel junction, to internal resorption and ankylosis of the apex to the supporting bone.
Stage 4 FORL
In Stage 4 FORL, the crown has been eroded or fractured.
Gingiva grows over the root fragments, leaving a sometimes painful bleeding lesion upon probing. Treatment of choice is flap surgery and extraction of the root fragments if they appear inflamed or painful to the patient |
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Definition
| involves a chip of enamel and includes dentin but has not exposed the pulp chamber. |
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| involve the enamel and dentin and have involved the pulp as well |
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