Porphyromonas spp., Fusobacterium spp., and Bacteroides spp. dominate microbiota in the course of macropod progressive periodontal disease.

Macropod progressive periodontal disease (MPPD) is a necrotizing, polymicrobial, inflammatory disease commonly diagnosed in captive macropods. MPPD is characterized by gingivitis associated with dental plaque formation, which progresses to periodontitis and then to osteomyelitis of the mandible or maxilla. However, the underlying microbial causes of this disease remain poorly understood. In this study, we collected 27 oral plaque samples and associated clinical records from 22 captive Macropodidae and Potoroidae individuals that were undergoing clinical examination at Adelaide and Monarto Zoos in South Australia (15 healthy, 7 gingivitis and 5 periodontitis-osteomyelitis samples). The V3-V4 region of the 16S ribosomal RNA gene was sequenced using an Illumina Miseq to explore links between MPPD and oral bacteria in these animals. Compositional differences were detected between the microbiota of periodontitis-osteomyelitis cases compared to healthy samples (p-value with Bonferroni correction < 0.01), as well as gingivitis cases compared to healthy samples (p-value with Bonferroni correction < 0.05) using Permutational Multivariate Analysis of Variance (PERMANOVA). An overabundance of Porphyromonas, Fusobacterium, and Bacteroides taxa was also identified in animals with MPPD compared to healthy individuals using linear discriminant analysis effect size (LEfSe; p = < 0.05). An increased abundance of Desulfomicrobium also was detected in MPPD samples (LEfSe; p < 0.05), which could potentially reflect differences in disease progression. This is the first microbiota analysis of MPPD in captive macropods, and these results support a polymicrobial pathogenesis of MPPD, suggesting that the microbial interactions underpinning MPPD may be more complex than previously documented.

[Practical experience in treating mandibular osteomyelitis ("lumpy jaw") with gamithromycin in a muntjac]. / Praktische Erfahrungen zur Behandlung einer mandibulären Osteomyelitis ("lumpy jaw") mit Gamithromycin bei einem Muntjak.

Mandibular osteomyelitis is common in domestic and wild ruminants. Inflammation of the mandible is not only caused by Actinomyces ssp., but numerous additional bacteria may also lead to this disease. A privately owned muntjac was presented to the clinic due to reluctant food intake and a solid mass on the corpus of the right mandible. Cranial radiography led to the diagnosis mandibular osteomyelitis. The muntjac was treated with gamithromycin (Zactran®) for 50 days, which led to an improvement of food intake as well as a size reduction of the mandibular mass. Radiographic imaging 18 and 28 months after treatment revealed a satisfactory mandibular remodeling, however complete loss of the molar teeth occured. Solitary long-term treatment with gamithromycin may represent a successful method for treating mandibular osteomyelitis in ruminants.

miRNA-21 promotes osteogenesis via the PTEN/PI3K/Akt/HIF-1α pathway and enhances bone regeneration in critical size defects.

BACKGROUND: Functional reconstruction of maxillofacial bone defects is a considerable clinical challenge. Many studies have emphasized the osteogenic and angiopoietic abilities of stem cells for tissue regeneration. We previously showed that microRNA-21 (miRNA-21) can promote angiogenesis in human umbilical cord blood-derived mesenchymal stem cells (UCBMSCs). In the present study, the role of miRNA-21 in osteogenic differentiation of bone marrow-derived stem cells (BMSCs) was investigated. METHODS: Western blotting and qPCR were performed to investigate the influences of miRNA-21 on osteogenic differentiation of BMSCs. The effects of miRNA-21 on PTEN/PI3K/Akt/HIF-1α pathway were also assessed using western blotting. To further evaluate the roles of miRNA-21 in osteogenesis in vivo, we conducted animal experiments in rat and canine. New bone formation was assessed using micro-CT and histological methods. RESULTS: In the present study, we found that miRNA-21 promotes the migration and osteogenic differentiation of bone marrow-derived stem cells (BMSCs) in vitro. Using gain- and loss-of-function studies, we found that miRNA-21 promoted the osteogenic ability of BMSCs by increasing P-Akt and HIF-1α activation. Finally, we verified the essential role of miRNA-21 in osteogenesis by implanting a miRNA-21-modified BMSCs/ß-tricalcium phosphate (ß-TCP) composite into critical size defects. Radiography, micro-CT, and histology revealed significantly greater volume of new bone formation in the miRNA-21 group than in the control group. CONCLUSION: In conclusion, our study demonstrated an essential role of miRNA-21 in promoting maxillofacial bone regeneration via the PTEN/PI3K/Akt/HIF-1α pathway.

Treatment of mandibular osteomyelitis in two red-necked wallabies (Macropus rufogriseus) by means of intensive long-term parenteral drug administration and serial computed tomographic monitoring.

CASE DESCRIPTION 2 female red-necked wallabies (Macropus rufogriseus) were evaluated because of sudden-onset mandibular swelling, ptyalism, and hyporexia. CLINICAL FINDINGS Physical examination revealed a mandibular swelling with a fluctuant center in both wallabies. Hematologic analysis revealed leukocytosis with a mature neutrophilia and monocytosis in one wallaby (case 1) and a slight neutrophilia, hyperglobulinemia, and high serum alanine aminotransferase activity in the other (case 2). Cytologic examination of the swelling revealed a uniform population of gram-negative rods in case 1 and neutrophilic inflammation in case 2. Radiography revealed a soft tissue mandibular swelling with osteolucency around mandibular incisor roots in both wallabies. Computed tomography revealed changes consistent with chronic active mandibular osteomyelitis and reactive bone formation, but also sequestra formation not appreciable via radiography. TREATMENT AND OUTCOME Long-term antimicrobial treatment was initiated with clindamycin (17 to 21 mg/kg [7.7 to 9.5 mg/lb], IV, q 12 h for 40 to 55 days) and high-dose benzathine penicillin G (80,000 U/kg [36,364 U/lb], SC, q 12 h for 150 days). Serial CT was performed to evaluate response to treatment and resolution of disease. A CT scan 18 months after the initial evaluation revealed complete resolution of osteomyelitis and sequestra. CLINICAL RELEVANCE Advanced imaging and long-term treatment and management were integral to the successful outcome for these wallabies, given that the osseous changes visible on CT images were not visible on standard radiographs, guiding therapeutic decision-making. This report provides new therapeutic and diagnostic monitoring information to assist clinicians with similar cases.

Successful Treatment of Mandibular Nonunion With Cortical Allograft, Cancellous Autograft, and Locking Titanium Miniplates in a Dog.

Discontinuities of the mandible can occur for a variety of reasons including primary pathology of bone, pathologic fracture secondary to periodontal disease, and segmental resection for the treatment of neoplasia. Surgical intervention is necessary in many cases to establish normal occlusion and normal mandibular function. Rigid stabilization and treatment of these defects can be challenging due to the limited availability of bone for fixation as well as limited soft tissue coverage. This case report describes successful treatment of a nonunion fracture using cortical allograft and locking titanium miniplates. Complete osseointegration and bone healing were achieved, allowing for complete return to normal occlusion and function.

Enhanced bone healing using collagen-hydroxyapatite scaffold implantation in the treatment of a large multiloculated mandibular aneurysmal bone cyst in a thoroughbred filly.

An unmet need remains for a bone graft substitute material that is biocompatible, biodegradable and capable of promoting osteogenesis safely in vivo. The aim of this study was to investigate the use of a novel collagen-hydroxyapatite (CHA) bone graft substitute in the clinical treatment of a mandibular bone cyst in a young horse and to assess its potential to enhance repair of the affected bone. A 2 year-old thoroughbred filly, presenting with a multilobulated aneurysmal bone cyst, was treated using the CHA scaffold. Post-operative clinical follow-up was carried out at 2 weeks and 3, 6 and 14 months. Cortical thickening in the affected area was observed from computed tomography (CT) examination as early as 3 months post-surgery. At 14 months, reduced enlargement of the operated mandible was observed, with no fluid-filled area. The expansile cavity was occupied by moderately dense mineralized tissue and fat and the compact bone was remodelled, with a clearer definition between cortex and medulla observed. This report demonstrates the promotion of enhanced bone repair following application of the CHA scaffold material in this craniomaxillofacial indication, and thus the potential of this material for translation to human applications.

Advanced diagnostic imaging and surgical treatment of an odontogenic retromasseteric abscess in a guinea pig.

A two-year-old guinea pig presented for difficulty chewing. Examination and diagnostic imaging, including computed tomography and magnetic resonance, revealed an odontogenic retromasseteric abscess associated with a mandibular cheek tooth. Treatment included removal of the abscess and marsupialisation of the surgical site for repeated debridement and healing by second intention. Unique features of this case included the use of advanced diagnostic imaging and utilisation of marsupialisation for surgical correction.

Regenerating Mandibular Bone Using rhBMP-2: Part 1-Immediate Reconstruction of Segmental Mandibulectomies.

OBJECTIVE: To describe a surgical technique using a regenerative approach and internal fixation for immediate reconstruction of critical size bone defects after segmental mandibulectomy in dogs. STUDY DESIGN: Prospective case series. ANIMALS: Dogs (n = 4) that had reconstruction after segmental mandibulectomy for treatment of malignant or benign tumors. METHODS: Using a combination of extraoral and intraoral approaches, a locking titanium plate was contoured to match the native mandible. After segmental mandibulectomy, the plate was secured and a compression resistant matrix (CRM) infused with rhBMP-2, implanted in the defect. The implant was then covered with a soft tissue envelope followed by intraoral and extraoral closure. RESULTS: All dogs that had mandibular reconstruction healed with intact gingival covering over the mandibular defect and had immediate return to normal function and occlusion. Mineralized tissue formation was observed clinically within 2 weeks and solid cortical bone formation within 3 months. CT findings at 3 months showed that the newly regenerated mandibular bone had ∼50% of the bone density and porosity compared to the contralateral side. No significant complications occurred. CONCLUSION: Mandibular reconstruction using internal fixation and CRM infused with rhBMP-2 is an excellent solution for immediate reconstruction of segmental mandibulectomy defects in dogs.

Nocardia cyriacigeorgica as the causative agent of mandibular osteomyelitis (lumpy jaw) in a cat.

An unusual case of osteomyelitis caused by Nocardia cyriacigeorgica infection and resulting in mandibular osteomyelitis and cellulitis (lumpy jaw) is described in a young cat. A 1-cm hard nodular mass was an incidental finding in the right mandible of a 14-month-old cat during routine physical examination. The lesion was fast growing, reaching up to 6 cm in its largest dimension over a 5-week period. A core biopsy of the affected mandible revealed foci of osteolysis, woven bone formation, and a few large clusters of filamentous bacteria surrounded by fine eosinophilic amorphous material bordered by neutrophils, plasma cells, macrophages, and occasional multinucleated giant cells. Pure cultures of acid-fast variable, Gram-positive filamentous bacteria were recovered on blood and chocolate agar plates at 48-hr postinoculation. On amplification and sequencing of the 16S ribosomal RNA and 65-kDa heat shock protein genes, the microorganisms were identified as N. cyriacigeorgica, within the actinomycetes.

Swellings of the angle of the mandible in 32 horses (1997-2011).

Disorders of the horizontal ramus (body) of the equine mandible are well reported, but there is minimal documentation of disorders of the angle of mandible. A retrospective examination of the records of Edinburgh University Equine Hospital (1997-2011) showed that 32 horses were referred due to swellings of the angle of the mandible. The aetiology of these swellings was identified in just 13/32 cases (41%) including fractures (n=2), traumatic, localised periosteal/cortical lesions (n=4), traumatic soft tissue lesions (n=2), neoplasia (n=3), and inflammation of the adjacent salivary gland (n=1) and masseter muscle (n=1). The remaining 19 (59%) cases without a definitive diagnosis showed two patterns of lesions. Twelve cases had localised periosteal/cortical lesions of the ventral aspect of the angle of mandible that were most likely traumatic in origin. The remaining seven undiagnosed cases without mandibular bony changes all had sinus tracts/chronic soft tissue infections on the medial aspect of the angle of the mandible which were believed to be caused by a draining retro-pharyngeal lesion in five cases. Surgical excision of abnormal soft tissues (if present) and bone curettage was the most successful treatment. It was concluded that the aetiology of swellings of the angle of the equine mandible are often obscure; most appear to be traumatic in origin, yet horses seldom develop gross fractures at this site due to the support of the dense surrounding musculo-tendinous structures. A smaller proportion are caused by draining retropharyngeal lesions that respond poorly to medical therapy, but respond well to surgical treatment.

Comparison of destructive periodontal disease in blue iris mink to PCB 126-induced mandibular and maxillary squamous epithelial proliferation in natural dark mink.

Mink (Mustela vison) exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-like chemicals have been reported to develop mandibular and maxillary squamous cell proliferation that results in the destruction of alveolar bone and eventual tooth loss. This jaw lesion has been reported in wild mink collected from areas contaminated with TCDD-like compounds and is a potential biomarker for exposure to these chemicals. The blue iris strain of domestic mink is prone to develop severe periodontal disease, which results in destruction of bone and tooth loss that is grossly similar to the lesion induced by exposure to TCDD-like chemicals. A histological assessment of jaws from blue iris mink and natural dark mink exposed to 3,3',4,4',5-pentachlorobiphenyl (PCB 126) was done to determine whether the oral lesions are similar. The jaw tissue from the blue iris mink had lesions indicative of lymphoplasmacytic gingivitis and osteomyelitis, caused by inflammation entering the dental sulcus, while the jaw tissue from the mink exposed to PCB 126 exhibited squamous epithelial proliferation. Therefore, it was determined that the tooth loss and bone destruction seen in these mink are of different origin despite the similarity of the gross clinical signs.

Uncommon mandibular osteomyelitis in a cat caused by Nocardia africana.

BACKGROUND: Nocardiosis is an unusual infection in companion animals characterized by suppurative to pyogranulomatous lesions, localized or disseminated. Cutaneous-subcutaneous, pulmonary and systemic signs are observed in feline nocardiosis. However, osteomyelitis is a rare clinical manifestation in cats. Nocardia cyriacigeorgica (formerly N. asteroides sensu stricto), Nocardia brasiliensis, Nocardia otitidiscaviarum, and Nocardia nova are the most common pathogenic species identified in cats, based on recent molecular classification (16S rRNA gene). The present report is, to our knowledge, the first case of mandibular osteomyelitis in a cat caused by Nocardia africana, diagnosed based upon a combination of methods, including molecular techniques. CASE PRESENTATION: A one-year-old non-neutered female cat, raised in a rural area, was admitted to the Companion Animal Hospital-PUCPR, São José dos Pinhais, State of Paraná, Brazil, with a history a progressive facial lesion, difficulty apprehending food, loss of appetite, apathy and emaciation. Clinical examination showed fever, submandibular lymphadenitis, and a painless, 8 cm diameter mass, which was irregularly-shaped, of firm consistency, and located in the region of the left mandible. The skin around the lesion was friable, with diffuse inflammation (cellulitis), multiple draining sinuses, and exudation of serosanguinous material containing whitish "sulfur" granules.Diagnosis was based initially in clinical signs, microbiological culture, cytological, and histopathological findings, and radiographic images. Molecular sequencing of 16S rRNA of isolate allowed diagnosis of Nocardia africana. Despite supportive care and antimicrobial therapy based on in vitro susceptibility testing the animal died. CONCLUSION: The present report describes a rare clinical case of feline osteomyelitis caused by Nocardia africana, diagnosed based upon a combination of clinical signs, microbiological culture, cytological and histopathological findings, radiographic images, and molecular methods. The use of modern molecular techniques constitutes a quick and reliable method for Nocardia species identification, and may contribute to identification to new species of Nocardia that are virulent in cats.

Mandibular osteomyelitis in red deer (Cervus elaphus hispanicus) and fallow deer (Dama dama): occurrence and associated factors in free-living populations in southern Spain.

The prevalence of mandibular osteomyelitis, which results in a condition called lumpy jaw, and factors associated with its occurrence were investigated in syntopic free-living populations of red deer (Cervus elaphus hispanicus) and fallow deer (Dama dama) in Spain. The study material consisted of 3,586 mandibles from 2,548 red deer and 1,038 fallow deer shot during sport hunting, herd management culls, and programs for population control between 1988 and 1997 (period 1) and 2002 and 2009 (period 2) in eastern Sierra Morena, southern Spain. Disease prevalence ranged from 0.36% to 10.91% among age groups. Older animals were significantly more likely to be affected than younger ones. Red deer stags had higher prevalence than other groups. There was a significantly higher prevalence in period 1, probably associated with differences in climatic and population conditions. High population densities of female red deer contributed significantly to occurrence of disease. Intensive herd management and poor environmental conditions were considered risk factors that increased susceptibility to disease. The study of this affliction could be useful for monitoring general herd welfare and ecologic changes in Mediterranean ecosystems.

Bilateral dentigerous cysts in a dog.

Dentigerous cysts are infrequently seen in veterinary medicine, but the consequences of an undiagnosed dentigerous cyst can be severe. Dentigerous cysts, that can be sub-classified as eruption or follicular, are a type of benign odontogenic cyst. They can cause significant bony and dental destruction associated with expansion if they remain undiagnosed for a period of time. Dentigerous cysts are secondary to embedded or impacted teeth, however not every impacted tooth subsequently forms a dentigerous cyst. Intraoral dental radiographs are necessary to differentiate a missing tooth from an impacted tooth. This case demonstrates the successful surgical management of a dog with bilateral impacted mandibular canine teeth, with secondary dentigerous cyst formation.

Treatment of a periradicular lesion in an alpaca (Vicugna pacos).

This case report describes the diagnosis and surgical treatment of a cyst-like periradicular lesion in an alpaca.

First reported isolation of Neisseria canis from a deep facial wound infection in a dog.

Neisseria canis was isolated in pure culture from a mandibular abscess in a dog. Ultrasound-guided fine-needle aspiration was used to obtain a sample from the abscess. Conventional bacteriological examination techniques followed by 16S rRNA gene sequencing from pure subculture and construction of a phylogenetic tree verified the isolate as N. canis. 16S rRNA sequence analysis revealed that a broader phylogenetic platform is needed in the part of the phylogenetic tree where the canine pathogenic N. canis isolate is located. The canine pathogenic isolate was found to be resistant to cephalexin and trimethoprim.