Treatment of Canine Tooth Fractures in the Northern Elephant Seal ( Mirounga angustirostris): Three Cases.

The Marine Mammal Center (TMMC) in Sausalito, California, rescues, rehabilitates, and releases hundreds of stranded northern elephant seals ( Mirounga angustirostris) each year. Common causes for stranding include maternal separation, malnutrition, and trauma. Causes of trauma include shark bites, conspecific interactions, and anthropogenic factors. Several cases of fractured teeth, secondary to presumed trauma, are presented to the center each year. This case series describes surgical approach and treatment of 3 young northern elephant seals that were admitted to TMMC for rehabilitation with tooth fractures with pulp exposure of maxillary or mandibular canine teeth. All 3 seals were successfully released into their natural environment.

Dental Pathology of the Iberian Lynx ( Lynx pardinus), Part I: Congenital, Developmental, and Traumatic Abnormalities.

The Iberian lynx is an endangered felid that has been subject to an intensive ongoing conservation program in an attempt to save it from extinction. Identification of dental pathologies could play an important role in the survival of this endangered species. The objective of this study is to evaluate the dental pathologies (congenital, developmental, and traumatic abnormalities) of this species of felid. Skulls of 88 adult specimens of the Iberian lynx ( Lynx pardinus) from the Doñana Biological Station [Estación Biológica de Doñana-Consejo Superior de Investigaciones Científicas] (EBD-CSIC), Seville, Spain, were examined macroscopically, and full-mouth dental radiographs of all specimens were performed. Presence, absence, form of teeth, number of roots, supernumerary teeth, and persistent deciduous teeth were evaluated. The presence of attrition/abrasion, tooth fractures, enamel hypoplasia/hypomineralization, endodontic disease, intrinsically stained teeth, and other traumatic findings were also evaluated. Abnormal grooves and dilacerations were the most common abnormalities seen in the roots of teeth. Two hundred and fifteen fractured teeth (11.3% of evaluated teeth) were detected, and mainly complicated fractures were noted in maxillary canine teeth (24.2% of fractured teeth) and mandibular canine teeth (16.7% of fractured teeth). Endodontic disease was present in 3.9% of the teeth examined. Intrinsic tooth staining was assessed in 8.5% of evaluated teeth. Of all teeth examined, 831 teeth (43.7% of evaluated teeth) exhibited some type of attrition/abrasion. Our study concluded that there is a high prevalence of dental fractures and attrition/abrasion with associated endodontic disease that could lead to impaired hunting ability as well as a threat to overall health and subsequent survival of this endangered species.

Diagnoses and Treatment of Dental Disorders in a Research Colony of Macaca fascicularis: A Case Series.

During daily routine oral examinations in a research colony of nonhuman primates (NHPs, Macaca fascicularis), a variety of oral-dental lesions were identified. A dental care program was established based on these findings. Based on the presence of dental clinical signs and their severity, 31 animals were triaged to be examined and treated by a veterinarian. Clinical examination consisted of visual inspection using a periodontal probe/explorer and full or partial mouth dental radiographs. Treatment was performed during the same procedure. Some animals had a follow-up examination including radiographs months later. Four common dental diseases were diagnosed: periodontal disease, caries, tooth fracture, and tooth attrition. Less frequent were dental abscess, enamel hypomineralization, gingival hyperplasia, hypercementosis, tooth luxation, tooth dysplasia, root resorption, abrasion. Less severe periodontal disease was treated conservatively. If severely affected, teeth were extracted. Well-circumscribed caries without endodontic involvement were treated by composite restoration. Teeth with extensive caries and pulp involvement were extracted. Teeth with exposed pulp were treated via extraction or orthograde root canal treatment. In this case series, 27 (87%) of 31 NHPs exhibited at least 1 moderate to severe dental lesion that required treatment. The presumable improvement in welfare and weight of oral/dental lesions for the overall health status in research NHPs encourages us to continue this program prospectively.

Classification and Epidemiology of Traumatic Dentoalveolar Injuries in Dogs and Cats: 959 Injuries in 660 Patient Visits (2004-2012).

The objective of this study was to determine the epidemiology of traumatic dentoalveolar injuries (TDI) in dogs and cats and to evaluate the applicability of a human classification system for TDI in dogs and cats. All patients diagnosed with a TDI were identified from the University of Wisconsin-Madison School of Veterinary Medicine Dentistry and Oral Surgery Service case log and the hospital patient processing software. The study population consisted of 621 dogs and cats, in a total of 660 patient visits from 2004 to 2012, admitted for oral treatment and subsequently diagnosed with at least one TDI Medical records including diagnostic imaging studies were reviewed to group the injury according to a classification system used in humans for TDI. Patient signalment, tooth injured, and number of injuries per patient were recorded and tabulated. The overall prevalence of TDI was 26.2%. The mean +/- SD number of TDI per patient was 1.45 +/- 0.85. All 14 classes of TDI recognized by the classification system utilized in humans were identified, and all (100%) TDI identified in this study were classifiable using this system. Enamel-dentin-pulp fracture was the most common TDI (49.6%). The most commonly injured teeth were the mandibular or maxillary canine teeth (35.5%). The most common age for dogs and cats with TDI were 3-6 years (33.0%) and 7-10 years (31.3%). With a frequency of 1 in 4 animals, TDI are common and represent a significant pet health concern. Most TDI are considered severe and require timely, and sometimes immediate, treatment. The adoption and utilization of a complete classification system, such as the one used in this study, is recommended in order to improve future epidemiological study of TDI in animals.

Prevalencia de enfermedades dentales en gatos (feliz catus) de los distritos del cono corte de Lima / Prevalence of dental disease in cats (feliz catus) in the northern districts of lima

Determinar la prevalencia de las patologías dentales de los gatos (Felis catus) del Cono Norte de Lima atendidos en la Clínica Veterinaria de la Universidad Peruana Cayetano Heredia. Material y métodos: Se evaluaron 200 felinos de 1 a 16 años de edad, sin distinción de raza y sexo. Las variables evaluadas fueron: edad (≥1 a <5, ≥5 a <9, ≥9 años), tipo de alimentación (balanceada, mixta sin hueso y mixta con hueso) y localización de la patología dental. Resultados: Se determinó que el 95,5% de los felinos presentaron algún grado de enfermedad periodontal, y los dientes más afectados por la enfermedad periodontal fueron los dientes caninos y el cuarto premolar superior. Los felinos que consumieron el alimento mixto con hueso tuvieron una mayor frecuencia de enfermedad periodontal avanzada. La fractura dental fue la única patología que mostró una asociación con la edad. El 31% de los felinos presentaron fractura dental (caninos), siendo los animales más afectados los que consumieron alimento mixto con hueso. Otras patologías observadas fueron el Síndrome Gingivitis-Estomatitis y masas orales. El tipo de alimentación y el sexo no estuvo estadísticamente asociado a la presentación de las enfermedades dentales. Conclusiones: Los resultados permiten sustentar que la enfermedad periodontal y la fractura dental son patologías comunes en los gatos del Cono Norte de Lima...

The study aimed to determine the prevalence of dental diseases in cats (Felis catus) of the northern districts of Lima that were patients of the Clínica Veterinaria of the Universidad Peruana Cayetano Heredia. Material and methods: Two hundred cats, from 1 to 16 years of age, and without distinction of breed and sex were evaluated. The variables under evaluation were: age (≥1 to <5, ≥5 to <9, ≥9 years), type of diet (balanced, mixed without bone, mixed with bone), and location of the dental pathology. Results: The results showed that 95,5% of examined cats presented periodontal disease, where the canine teeth and the fourth upper premolar were the most affected. Those that consumed mixed feed with bone had higher frequency of advanced periodontal disease. Dental fracture (canine teeth) was found in 31% of the cats, being most affected those that consumed mixed food with bone. Also, dental fracture was the only dental pathology that showed an association with age. Other pathologies were the Gingivitis-Stomatitis Syndrome and oral masses. The type of food and sex were not statistically associated with the presentation of dental diseases. Conclusions: The results allow to sustain that periodontal disease and dental fractures are common pathologies in cats in the northern districts of Lima...

[Computed tomography diagnosis of a retrobulbar abscess in a white tiger]. / Computertomographische Diagnostik eines retrobulbären Abszesses bei einem weißen Königstiger.

SUBJECT: Etiologic diagnosis of a retrobulbar process is essential for the initiation of a causative therapy. Penetrating foreign bodies and tooth root abscesses, but also neoplastic processes have to be considered as a differential diagnosis for a retrobulbar swelling. The objective of this case report of a tiger with a retrobulbar process was to demonstrate the diagnostic value of computed tomography for making a causative diagnosis. MATERIAL AND METHODS: General examination of the tiger as well as subsequent computed tomography and surgical extraction of a fractured fourth premolar tooth of the left upper jaw was carried out under general anaesthesia. Collected alveolar tissue samples underwent cytological, histopathological and microbiological analyses. RESULTS AND CLINICAL RELEVANCE: Computed tomography was able to allocate the origin of the retrobulbar abscess to the left 4th premolar tooth of the upper jaw. The cytological, histopathological and microbiological examination of the recovered alveolar material confirmed the diagnosis of purulent-necrotic abscess-forming inflammation as a result of a mixed bacterial infection. The present case report demonstrates the diagnostic accuracy of computed tomography for the diagnosis of a retrobulbar process of unknown origin.

Oral examination results in rescued ferrets: clinical findings.

Ferrets have increased in popularity as pets, and a growing number are seen in companion animal practice. Domestic ferrets are commonly used as animal models for research of human oral conditions. The present study evaluated the prevalence of oral pathology in rescued ferrets which - to the authors' knowledge - has not yet been described in the scientific literature. Conscious oral examination was performed on 63 ferrets, of which 49 underwent general anesthesia for further examination. The most common clinical findings included malocclusion of mandibular second incisor teeth (95.2%); extrusion of canine teeth (93.7%); and abrasion and attrition of teeth (76.2%). Tooth fractures were exclusively associated with canine teeth and found in 31.7% of ferrets. Pulp exposure was confirmed in 60.0% of fractured teeth. The normal gingival sulcus depth measured < 0.5-mm in 87.8% of anesthetized ferrets. Clinical evidence of periodontal disease was present in 65.3% of anesthetized ferrets (gingivitis or probing depths > 0.5-mm), however advanced periodontal disease (i.e. periodontal pockets > 2-mm or stage 3 furcation exposure) was not found upon clinical examination. There was no evidence of tooth resorption, dental caries, stomatitis, or oral tumors in the examined group of ferrets.

Repulsion of maxillary and mandibular cheek teeth in standing horses.

OBJECTIVE: To report the technique and results of cheek teeth repulsion in standing, sedated horses. STUDY DESIGN: Case series. ANIMALS: Horses (n = 12), ponies (6). METHODS: Medical records (2006-2009) of horses that had cheek tooth repulsion while standing were reviewed. Inclusion criteria included: maxillary or mandibular cheek tooth disease diagnosed by clinical and radiographic examination where attempted oral extraction failed necessitating repulsion. Horses were sedated and a local nerve block performed. Intraoperative radiographs facilitated instrument positioning and ensured repulsion of all dental remnants. Alveolar cavities were packed postoperatively and secondary dental sinusitis treated with lavage. RESULTS: Median horse age was 7 years (range, 1-30 years). Maxillary (n = 15) and mandibular (5) cheek teeth were removed successfully. One horse was euthanatized 1 week after tooth removal because of concurrent liver disease and 10 horses (59%) had resolution of discharge after the 1st treatment; 41% of extractions required follow-up medical or surgical treatment to resolve signs [6/12 maxillary sinusitis and 1/5 persistent mandibular drainage]. CONCLUSIONS: Standing repulsion of diseased and fractured cheek teeth is an effective means of resolving clinical signs of dental disease when oral extraction fails. Chronic sinus involvement increased the risk of postextraction surgical treatment for sinusitis.

Extraction of fractured cheek teeth under oral endoscopic guidance in standing horses.

OBJECTIVE: To evaluate a technique for oral extraction of fractured cheek teeth (CT) under oral endoscopic guidance. STUDY DESIGN: Case series. ANIMALS: Horses (n = 30) with fractured CT. METHODS: Medical records (April 2007-August 2010) of horses that had standing oral extraction of fractured CT under endoscopic guidance were reviewed. RESULTS: Thirty horses (median age, 11.5 years; range, 5-23 years) had 31 fractured CT (21 maxillary, 10 mandibular) removed. Midline sagittal fractures of maxillary teeth (n = 13; 42%) were the most common type, followed by buccal or palatal (10; 32%), and transverse or multiple (5; 16%) fractures. Extraction under endoscopic guidance was successful for 27 (87%) teeth. Median age of the surgical failure group was 7 years (range, 5-8 years), significantly lower than that of the surgical success group (P = .0135, Mann-Whitney U-test). CONCLUSIONS: Endoscopic viewing facilitates instrument use and removal of fractured CT in standing horses.

Lip avulsion and mandibular symphyseal separation repair in an immature cat.

A 12-week-old kitten was presented for symphyseal separation, comminuted rostral fractures of the mandibles, avulsion of the mandibular lip, andfractured teeth. Oral examination and intraoral dental radiographs demonstrated a mandibular symphyseal separation and the presence of developing tooth buds. Cerclage wire was placed circumferentially around the mandibles for 2-weeks to provide stabilization of the mandibular symphyseal separation. Clinical examination 9.5-months following surgery demonstrated normal occlusion with enamel hypoplasia affecting the mandibular canine teeth. Intraoral dental radiographs showed a partial bony union of the mandibular symphysis and vital, developing mandibular canine teeth.

Oral examination and radiographic evaluation of the dentition in wild cats from Namibia.

Feline tooth resorption has been widely reported in domestic cats and sporadically described in other felidae. The goal of the present study was to determine the prevalence of tooth resorption and to report other dental problems in a population of wild felidae. Observations of dental disorders and anomalies were made in skulls from 73 wild felidae (cheetahs, leopards, caracals, African wildcats, and lions) originating from Namibia. In addition, radiographs were taken in 43 cases to determine signs of bone and root pathology. Radiographs showed varying stages of tooth resorption in 16.0% of the specimens. Other dental anomalies found included fused teeth, supernumerary roots, or missing teeth. The prevalence of dental resorption in wild felidae was lower than reported in the domestic cat.

Prevalence of occlusal pulpar exposure in 110 equine cheek teeth with apical infections and idiopathic fractures.

Examination of 110 cheek teeth (CT) that were clinically extracted (between 2004 and 2008) because of apical infection (n=79; mean dental age 3.5 years) or idiopathic CT fractures (n=31; median dental age 8.5 years), including examinations of transverse and longitudinal sections, showed the apical infections to be mainly (68%) due to anachoresis, with the residual cases caused by periodontal spread, infundibular caries spread, fissure fractures and dysplasia. The idiopathic fracture patterns were similar to previously described patterns. Occlusal pulpar exposure was found in 32% of apically infected CT, including multiple pulps in 27% and a single pulp in 5%. However, 10% of apically infected CT had changes to the occlusal secondary dentine, termed occlusal pitting, but did not have exposure of the underlying pulp. Multiple pulpar exposures occurred in some CT with apical infections, and the combination of pulp involvement reflects the anatomical relationships of these pulps. A higher proportion (42%) of CT extracted because idiopathic fractures had pulpar exposure (26% multiple, 16% single pulps), especially with midline sagittal maxillary and miscellaneous pattern mandibular CT fractures, but only (3%) had occlusal pitting.

Dental bulge restoration and gingival collar expansion after endodontic treatment of a complicated maxillary fourth premolar crown-root fracture in a dog.

This case report describes endodontic, restorative, and periodontal treatment of a complicated crown-root fracture of the right maxillary fourth premolar tooth in a dog. A buccal portion ('slab') had separated from the tooth, which extended subgingivally into root structure. Following completion of standard root canal therapy, a periodontal flap was elevated. Alveolectomy and alveoloplasty were performed, and inflamed soft tissues were debrided. The fracture site was prepared, restored, and shaped to receive a dental bulge contour. A gingival collar expansion technique was utilized to allow for apical positioning of gingiva at the distobuccal crown-root segment. Clinical and radiographic examination 15-months following treatment showed no evidence of endodontic failure. The restorations were intact, and periodontal probing depths were slightly increased probably due to gingival enlargement from concurrent cyclosporine therapy. The importance of biologic width maintenance in periodontal surgery and need for owner compliance with home oral hygiene are discussed.

Complications of equine oral surgery.

The vast majority of equine oral procedures are dental-related and, unless great care is taken, almost all such procedures have the potential to cause marked short- or long-term damage to other oral structures. This review of the more common complications of oral surgery begins at the rostral oral cavity with procedures of the incisors, and then moves caudally to deal with complications related to procedures of wolf teeth and cheek teeth, including salivary duct disruption and dental sinusitis. Finally, complications associated with maxillary and mandibular fractures are discussed.

A review of equine dental disorders.

Equine dentistry is a very important but until recently rather neglected area of equine practice, with many horses suffering from undiagnosed, painful dental disorders. A thorough clinical examination using a full mouth speculum is a pre-requisite to performing any equine dental procedure. Common incisor disorders include: prolonged retention of deciduous incisors, supernumerary incisors and overjet--the latter usually accompanied by cheek teeth (CT) overgrowths. Overjet can be surgically corrected, but perhaps should not be in breeding animals. In younger horses, traumatically fractured incisors with pulpar exposure may survive by laying down tertiary dentine. Loss or maleruption of incisors can cause uneven occlusal wear that can affect mastication. Idiopathic fractures and apical infection of incisors are rare. The main disorder of canine teeth is the development of calculus of the lower canines, and occasionally, developmental displacements and traumatic fractures. The main indications for extraction of "wolf teeth" (Triadan 05s) are the presence of displaced or enlarged wolf teeth, or their presence in the mandible. Developmental abnormalities of the CT include; rostral positioning of the upper CT rows in relation to the lower CT rows--with resultant development of focal overgrowths on the upper 06s and the lower 11s. Displaced CT develop overgrowths on unopposed aspects of the teeth and also develop periodontal disease in the inevitable abnormal spaces (diastemata) that are present between displaced and normal teeth. Diastemata of the CT due to excessive developmental spacing between the CT or to inadequate compression of the CT rows is a common but under diagnosed problem in many horses and causes very painful periodontal disease and quidding. Supernumerary CT mainly occur at the caudal aspect of the CT rows and periodontal disease commonly occurs around these teeth. Eruption disorders of CT include prolonged retention of remnants of deciduous CT ("caps") and vertical impaction of erupting CT that may lead to large eruption cysts and possibly then to apical infections. Disorders of wear, especially enamel overgrowths ("enamel points"), are the main equine dental disorder and are believed to be largely due to the dietary alterations associated with domestication. If untreated, such disorders will eventually lead to more severe CT disorders such as shearmouth and also to widespread periodontal disease. More focal dental overgrowths will develop opposite any CT not in full opposition to their counterpart, e.g., following maleruption of or loss of a CT. Because of the great length of reserve crown in young (hypsodont) CT, apical infections usually cause infection of the supporting bones and depending on the CT involved, cause facial swellings and fistulae and possibly sinusitis. Diagnosis of apical infection requires radiography, and possibly scintigraphy and other advanced imaging techniques in some early cases. When possible, oral extraction of affected CT is advocated, because it reduces the costs and risks of general anaesthesia and has much less post-extraction sequelae than CT repulsion or buccotomy.

Equine dental disease. Part 3: A long-term study of 400 cases: disorders of wear, traumatic damage and idiopathic fractures, tumours and miscellaneous disorders of the cheek teeth.

Of 400 horses referred because of dental disorders, 349 cases were diagnosed as suffering from primary disorders of their cheek teeth. Details of 104 of these cases are presented, including 44 cases with abnormalities of wear, 26 cases with traumatic damage, 24 cases with idiopathic fractures and 10 cases with miscellaneous cheek teeth disorders including oral tumours. The long-term response to treatment was excellent in most cases, even in cases with residual secondary periodontal disease.

Fractures of the rostral portion of the mandible and maxilla in horses: 89 cases (1979-1997).

OBJECTIVE: To compare fracture locations, repair methods, complications, and outcomes of horses with fractures of the rostral portions of the mandible and maxilla. DESIGN: Retrospective study. ANIMALS: 89 horses with fractures of the rostral portions of the mandible and maxilla. PROCEDURE: Medical records and radiographs were reviewed. Fractures were categorized by fracture location and stability. Postoperative complications and long-term outcome were determined by clinical examination and telephone interviews with horse owners. RESULTS: 4 fracture types were recognized. Fractures involving just the alveolar plate (33%) and those involving the alveolar plate and the body of the bone (32%) were most common and were often repaired by interdental wiring. Unilateral fractures of the mandible (11%) were managed without surgery if stable. Unstable fractures were repaired with wires, a U-shaped bar (U-bar), or a bone plate. Bilateral fractures (24%) were often repaired with orthopedic wires in foals or with a U-bar, acrylic splint, wires, or bone plate in adult horses. In 2 horses, bilateral fractures were managed conservatively. Short-term complications developed in 24 of 89 (27%) horses. Soft tissue infections and wire loosening or failure were the most common short-term and long-term complications. Wire replacement was not required in any horses after release from hospital. Persistent draining tracts were most often associated with bone sequestration. Long-term functional and cosmetic outcomes were favorable for all fracture types and repair methods. CLINICAL IMPLICATIONS: Although complications in horses with fractures of the mandible and maxilla are common, long-term prognoses for functional and cosmetic outcome are favorable.

The dental pathology of feral cats on Marion Island, part I: congenital, developmental and traumatic abnormalities.

Skulls (n = 301) of adult feral cats from Marion Island, a sub-Antarctic island, were examined macroscopically. Congenital anomalies, which were rare, included a few supernumerary premolars, located mesially to those normally present. Supernumerary roots, mainly of the maxillary third premolar, were found in just over 10% of cases. The maxillary second premolar was absent in 16.8% of skulls; dichotomous and double-formed roots of this tooth were present in 20.1% and 1.9% of cases, respectively. Enamel hypoplasia, which is most unusual in this species, was noted in 24.6% of cases, and persistent deciduous teeth in 2.0%. Dental abrasion, which was noted in 19.3% of cats, affected only 2.3% of teeth, most commonly the lower fourth and upper third premolars. Dental fractures, mainly complicated crown fractures and root fractures, were noted in 54.8% of cats and 7.0% of teeth. Fractures were found most commonly in the canine and carnassial teeth, as also were periapical lesions, which were often severe. Mandibular fractures in various stages of healing were found in 11 cats (3.7%); such fractures most frequently affected the body of the mandible and resulted in malunion. It was concluded that the high prevalence of dental fractures and associated periapical lesions probably exerted a significant adverse effect on health and survival in this population of feral cats.