A Retrospective Evaluation of Secondary Wound Healing for Extraction of the Maxillary First Molar in Dogs

Oral surgery and exodontia can present challenges in veterinary patients, with a particular area of challenge being extraction and closure of the maxillary first molar (M1) in dogs. This retrospective assessment evaluated patients that had the maxillary first molar extracted with placement of a cruciate suture across the alveolus to achieve partial closure and secure the blood clot. Patients that had teeth extracted adjacent to M1 (maxillary fourth premolar [PM4] or second molar [M2]) were excluded from the study. Three groups of patients were assessed: Group A - at the time of extraction of M1, both the maxillary PM4 and M2 were still present in the oral cavity. Group B - at the time of M1extraction only PM4 or M2 was present, but not both. The tissue was completely intact at the location of the missing tooth. Group C - at the time of M1 extraction neither PM4 or M2 were present, but tissue in these locations was intact. In a three-and-a half-year time period (2015-2018), 179 dogs with 213 solitary M1 extractions were performed. Of these 213 extraction sites, 127 sites (60%) had follow up examination within a two-week postoperative period. Of these 127 sites, 126 (99.2%) appeared appropriately healed without complication. The results of this retrospective evaluation demonstrate that primary closure of a maxillary first molar extraction site may not be required for appropriate soft tissue wound healing in canine patients.

The bacteriome of the oral cavity in healthy dogs and dogs with periodontal disease

OBJECTIVE

To compare the bacteriome of the oral cavity in healthy dogs and dogs with various stages of periodontal disease.

ANIMALS

Dogs without periodontal disease (n = 12) or with mild (10), moderate (19), or severe (10) periodontal disease.

PROCEDURES

The maxillary arcade of each dog was sampled with a sterile swab, and swabs were submitted for next-generation DNA sequencing targeting the V1-V3 region of the 16S rRNA gene.

RESULTS

714 bacterial species from 177 families were identified. The 3 most frequently found bacterial species were Actinomyces sp (48/51 samples), Porphyromonas cangingivalis (47/51 samples), and a Campylobacter sp (48/51 samples). The most abundant species were P cangingivalis, Porphyromonas gulae, and an undefined Porphyromonas sp. Porphyromonas cangingivalis and Campylobacter sp were part of the core microbiome shared among the 4 groups, and P gulae, which was significantly enriched in dogs with severe periodontal disease, was part of the core microbiome shared between all groups except dogs without periodontal disease. Christensenellaceae sp, Bacteroidales sp, Family XIII sp, Methanobrevibacter oralis, Peptostreptococcus canis, and Tannerella sp formed a unique core microbiome in dogs with severe periodontal disease.

CONCLUSIONS AND CLINICAL RELEVANCE

Results highlighted that in dogs, potential pathogens can be common members of the oral cavity bacteriome in the absence of disease, and changes in the relative abundance of certain members of the bacteriome can be associated with severity of periodontal disease. Future studies may aim to determine whether these changes are the cause or result of periodontal disease or the host immune response.

The mycobiome of the oral cavity in healthy dogs and dogs with periodontal disease

OBJECTIVE

To investigate the mycobiome of the oral cavity in healthy dogs and dogs with various stages of periodontal disease.

ANIMALS

51 dogs without periodontal disease (n = 12) or with mild (10), moderate (19), or severe (10) periodontal disease.

PROCEDURES

The whole maxillary arcade of each dog was sampled with a sterile swab, and swabs were submitted for next-generation DNA sequencing targeting the internal transcribed spacer 2 region with a commercial sequencing platform.

RESULTS

Fungi were detected in all samples, with a total of 320 fungal species from 135 families detected in the data set. No single fungal species was found in all samples. The 3 most frequently found fungal species were Cladosporium sp (46/51 samples), Malassezia restricta (44/51 samples), and Malassezia arunalokei (36/51 samples). Certain fungi, specifically those of the family Didymellaceae, the family Irpicaceae, and the order Pleosporales, were significantly associated with different stages of periodontitis. Mycobial analysis indicated that Cladosporium sp could be considered part of the core oral cavity mycobiome.

CONCLUSIONS AND CLINICAL RELEVANCE

Results highlighted that fungi are present in the oral cavity of dogs and are characterized by substantial species diversity, with different fungal communities associated with various stages of periodontal disease. The next-generation DNA sequencing used in the present study revealed substantially more species of fungi than previous culture-based studies.

Success of Feather Margin Preparation for Full Metal Prosthodontic Crowns in the Canine Teeth in 84 Pet and Working Dogs (2005-2017)

Medical and dental records of Veterinary Dental Specialties and Oral Surgery were searched to identify dogs that received full metal prosthodontic crowns on canine teeth, using a feather or knife edge preparation between 2005 and 2017. A total of 160 teeth in 84 dogs were included in the study. Current follow-up by telephone, electronic mail, or electronic messaging was conducted, in addition to thorough record review for in-person recheck examinations. Treatment was considered successful if the prosthodontic crown was in place and no further or additional injury to the tooth had occurred at the time of reexamination, owner contact, or patient death. Tooth fracture apical to the prosthodontic crown occurred in 2 (1.25%) cases, bond failure between the tooth and the cement or the cement and the crown occurred in a single case (0.625%), and one metal crown required replacement after 3 years due to wear (0.625%), for an overall failure rate of 2.5%. These results suggest that feather preparation of the margin is at least as, if not more, successful as the more commonly accepted and performed chamfer margin, and thus is a successful, practical and durable option for prosthodontic crown treatment in dog canine teeth.

The Incidence of Radiographic Lesions of Endodontic Origin Associated With Uncomplicated Crown Fractures of the Maxillary Fourth Premolar in Canine Patients

Fractured maxillary fourth premolar teeth are commonly diagnosed in canine patients. These fractures are subdivided into uncomplicated and complicated, depending on absence or presence of pulp exposure, respectively. Pulp injury associated with fractures can lead to pulpitis, pulp necrosis, and "lesions of endodontic origin" (LEO) on intraoral radiographs. The incidence of LEO associated with uncomplicated crown fractures (UCFs) of the maxillary fourth premolar in canine patients is currently unknown. We hypothesized that a significant number of UCFs of the maxillary fourth premolar would have LEO evident on intraoral radiographs. The purpose of this article was to identify this incidence and to illustrate the importance of radiographing these teeth. This was a retrospective study of 111 UCFs and 500 nonfractured (control) maxillary fourth premolars in domestic canine patients. The frequency of LEO was 24.3% (27/111) in the UCF population and 0% (0/500) in the control population (P < .0001). These findings are important because UCFs are sometimes ignored or considered insignificant, when in fact a large proportion of them have LEO, indicating periapical pathology. These results suggest that all UCFs be radiographed, even if there are no other abnormalities noted on clinical oral examination.

Feline dental radiography and radiology: A primer

PRACTICAL RELEVANCE

Information crucial to the diagnosis and treatment of feline oral diseases can be ascertained using dental radiography and the inclusion of this technology has been shown to be the best way to improve a dental practice. Becoming familar with the techniques required for dental radiology and radiography can, therefore, be greatly beneficial.

CLINICAL CHALLENGES

Novices to dental radiography may need some time to adjust and become comfortable with the techniques. If using dental radiographic film, the generally recommended 'E' or 'F' speeds may be frustrating at first, due to their more specific exposure and image development requirements. Although interpreting dental radiographs is similar to interpreting a standard bony radiograph, there are pathologic states that are unique to the oral cavity and several normal anatomic structures that may mimic pathologic changes. Determining which teeth have been imaged also requires a firm knowledge of oral anatomy as well as the architecture of dental films/digital systems.

EVIDENCE BASE

This article draws on a range of dental radiography and radiology resources, and the benefit of the author's own experience, to review the basics of taking and interpreting intraoral dental radiographs. A simplified method for positioning the tubehead is explained and classic examples of some common oral pathologies are provided.

2013 AAHA dental care guidelines for dogs and cats

Veterinary dentistry is constantly progressing. The purpose of this document is to provide guidelines for the practice of companion animal dentistry for the veterinary profession. Dental care is necessary to provide optimum health and optimize quality of life. Untreated diseases of the oral cavity are painful and can contribute to local and systemic diseases. This article includes guidelines for preventive oral health care, client communication, evaluation, dental cleaning, and treatment. In addition, materials and equipment necessary to perform a medically appropriate procedure are described.

Case based dental radiology

Dental radiology is quickly becoming integral to the standard of care in veterinary dentistry. This is not only because it is critical for proper patient care, but also because client expectations have increased. Furthermore, providing dental radiographs as a routine service can create significant practice income. This article details numerous conditions that are indications for dental radiographs. As you will see, dental radiographs are often critical for proper diagnosis and treatment. These conditions should not be viewed as unusual; they are present within all of our practices. When you choose not to radiograph these teeth, you leave behind painful pathology. Utilizing the knowledge gained from dental radiographs will both improve patient care and increase acceptance of treatment recommendations. Consequently, this leads to increased numbers of dental procedures performed at your practice.

Periodontal therapy

Periodontal disease is the most common disease in small animal patients. It not only creates severe localized infection, but it has been linked to numerous severe systemic maladies. Proper therapy of this disease process results in a significant increase in the overall health of the patient. The treatment of periodontal disease is currently evolving due to the acceptance of the specific plaque hypothesis of periodontal disease. These findings have led to the development of the "one-stage full-mouth disinfection" treatment as well as a vaccine against these organisms. However, the cornerstone of therapy is still meticulous plaque control. This control is achieved via a combination of regular dental prophylaxis and home care. With progressive disease, advanced periodontal surgery or extraction becomes necessary.

Establishing a standardized dental record-keeping system for a small investigational colony of rhesus monkeys (Macaca mulatta)

BACKGROUND

Dental hygiene is becoming an increasingly important component of quality health care for laboratory animals, especially non-human primates (NHPs). One key to a successful health care program is an effective and efficient record-keeping system.

METHODS

To standardize a dental hygiene program for a small colony of NHPs, we developed a dental recording chart specific for rhesus monkeys. This dental chart was developed using the modified Triadan system. This system numbers teeth across species according to location.

RESULTS

An illustrative case report was presented to demonstrate the accurate record keeping and spatial relationship generated from this Old World NHP dental chart design.

CONCLUSION

The development and implementation of a standardized dental chart, as part of a dental hygiene program will help minimize variables that may affect research data.

Fundamentals of Endodontics

Endodontic disease is a highly prevalent (>10% of all dogs) and insidiously painful process that can have significant local and systemic effects. The root canal system is a delicate organ and is prone to inflammation, infection, and partial and complete necrosis. Vital pulp therapy must be performed quickly, gently, and meticulously if it is to be effective. The relatively high rate of failure in direct pulp capping makes regular follow-up radiographs of critical importance to ensure patient health. Once a tooth is dead, there are often no obvious clinical signs; therefore, clinicians must be educated in the diagnosis of the disease processes. Once properly educated, the practitioner must remain vigilant for subtle signs of the disease process. Standard root canal therapy is an effective method of removing the inflammation, infection, and associated discomfort of the endodontically diseased tooth while maintaining its function. Endodontic failure most likely remains hidden unless dental radiology is used. Follow-up radiographs at regular intervals throughout the patient's life are critical for ensuring the long-term success of any endodontic therapy.

Vital Pulp Therapy

Indications for vital pulp therapy include: crown reduction for orthodontic abnormalities; canine tooth disarming; crown fractures of immature permanent teeth; pulp exposure during debridement of deep carious lesions; and, recent crown fractures of mature permanent teeth. Vital pulp therapy for these conditions or procedures includes direct pulp capping after partial coronal pulpectomy is performed to excise inflamed pulp, if present, and provide space for the restoration. Appropriate tissue handling and a meticulous restoration providing a bacteria-tight marginal seal are critical components of vital pulp therapy1, which is described step-by-step.

Assessment of vital pulp therapy for nine complicated crown fractures and fifty-four crown reductions in dogs and cats

Subjective owner assessment of the success of vital pulp therapy was performed for complicated crown fracture (n = 9) and crown reduction (n = 54) of canine teeth in dogs and cats. Our results documented that owners are not able to accurately determine the outcome of vital pulp therapy. Objective assessment of vital pulp therapy for teeth receiving crown reduction indicated maintenance of vitality in 28 of 28 (100%) teeth. Subjective and objective assessments of vital pulp therapy performed > 7-days following complicated crown fracture indicated 9 of 9 (100%) teeth were non-vital. A poor prognosis for maintenance of tooth vitality is warranted for vital pulp therapy of complicated crown fractures with prolonged pulp exposure regardless of the age of the patient. Whereas, an excellent prognosis can be provided for vital pulp therapy following crown reduction. Semiannual, postoperative oral and radiographic examinations are recommended for a minimum of 2-years to assess vitality in all teeth receiving vital pulp therapy.

Treatment of mandibular first molar teeth with endodontic-periodontal lesions in a dog

A two-year-old spayed/female Miniature Pinscher was treated for mobility of the left and right mandibular first molar teeth. Periodontal probing and intraoral dental radiographs indicated severe periodontal attachment loss. It was determined that both teeth had endodontic-periodontal lesions based on restoration of periodontal attachment and partial resolution of radiolucent periapical lesions following treatment which emphasized endodontic therapy.

Management of a complicated maxillary fourth premolar crown-root fracture in a dog

A five-year-old spayed/female Border Collie was presented with a crown-root fracture of the maxillary left fourth premolar. Surgical endodontic, and restorative techniques were performed to maintain the tooth. Re-examination 18-months following therapy indicated a successful outcome with no radiographic signs of periapical pathology.