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WSV18-0252
WSAVA DENTAL GUIDELINES
ADVANCED EXTRACTION TECHNIQUES AND DEALING WITH COMPLICATIONS
B. Niemiec1
1Veterinary Dental Specialties and Oral Surgery, Dentistry, San Diego, USA
SURGICAL EXTRACTIONS and COMPLICATIONS Brook A. Niemiec, DVM, DAVDC, DEVDC, FAVD
Veterinary Dental Specialties and Oral Surgery
SanDiego, CA, USA
Challenging extractions are best performed via a surgical approach. Canine and carnassial (maxillary fourth premolar and mandibular first molar) teeth are typically considered “difficult”. However, it is also beneficial
for teeth with root malformations or pathology (ie.e ankyloses) and retained roots. A surgical approach allows the practitioner to remove buccal cortical bone, promoting an easier extraction process.
A surgical extraction is initiated by creating a gingival flap. This can be a horizontal flap along the arcade (an envelope flap) or a flap with vertical releasing incisions.
Envelope flaps are created by incising the interdental gingiva and then releasing the gingival attachment with a periosteal elevator along the arcade including one to several teeth
on either side of the tooth or teeth to be extracted. The flap is created by incising the gingiva in the interdental spaces gingiva along the arcade and then releasing the tissue to
or below the level of the mucogingival junction (MGJ). The advantages to this flap are
· Decreased surgical time
· Blood supply is not interrupted · Less suturing.
· Less chance of dehiscence
The more commonly used flap includes one or two vertical releasing incisions. This method allows for
a much larger flap to be created, which (if handled properly) will increase the defects which can be covered. Classically, the vertical incisions are created at the line angle of the target tooth, or one tooth mesial and distal to the target tooth. Line angles are theoretic edges of teeth. However, if there is space between the teeth, either a naturally occurring diastema or from previous extraction, the incision can be made in the space rather than carrying to a healthy tooth.
The incisions should be made slightly apically divergent. It is important that the incisions be created full thickness and in one motion. A full thickness incision is created by incising all the way to the bone, and the periosteum is
43RD WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND 9TH FASAVA CONGRESS
25-28 September, 2018 | Singapore
Hypocapnia
A state of reduced carbon dioxide in the blood and often results from hyperventilation – deep or rapid breathing.
The Electrocardiogram
The ECG, or electrocardiogram, measures the electrical activity of the heart. In a normal animal, electrical impulses pass through the cardiac tissue in an orderly and regular manner and cause the heart muscle (myocardium) to contract. If this electrical activity is abnormal, then this will result in abnormal muscular contractions.
There are two main types of ECG machines. More modern machines will display the image obtained on
a video screen, while the type of ECG machines found more commonly in veterinary practice, record the electrical activity on heat sensitive paper. In both cases, the resulting image is referred to as a trace.
The use of ECG can be a useful aid in the diagnosis of heart conditions when used in conjunction with other diagnostic tools, such as ultrasound (echocardiography) or radiography.
In addition, ECG is also commonly used to monitor the heart rate and rhythm of patients undergoing general anaesthesia and also to monitor ‘at risk’ patients (i.e. those patients who may have an increased risk of developing cardiac arrhythmias such as post GDV surgery patients).
The P wave corresponds to atrial depolarisation (i.e. electrical activity), which results in the atrial myocardium contracting (i.e. muscular activity).
The QRS waves are usually considered together and are referred to as the QRS complex. This complex relates
to ventricular depolarisation (i.e. electrical activity), which results in ventricular myocardium contraction (i.e. muscular activity).
The final component of the trace is the T wave, which relates to repolarisation of the ventricles (electrical activity) and resultant relaxation of the myocardium (muscular activity).
































































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