Endodontic Treatment of a Maxillary Incisor Tooth in a Chimpanzee (Pan troglodytes).

Chimpanzees (Pan troglodytes) with teeth severely damaged by dental caries and/or periodontal disease are often managed with medication and/or tooth extraction. A common endodontic treatment for severely decayed teeth in a 26-year-old female chimpanzee is reported. The left maxillary central incisor tooth had lost its crown, probably due to trauma that was not recent, and it had a fistula most likely due to chronic apical periodontitis. The diagnosis was confirmed radiographically before treatment. To treat the infected root canal, endodontic treatment used in humans was adapted for a chimpanzee. After the treatment, the tooth was sealed using an adhesive resin composite. At 11-years post-treatment, there were no signs of recurrence of the lesion or of failure of the tooth seal. The results of this case report suggest that common endodontic treatments used in humans are also effective in chimpanzees.

Endodontic Treatment Outcome of 45 Incisor Teeth in Dogs Determined by Intraoral Radiography.

A retrospective study was conducted to determine the outcome of endodontic treatment of incisor teeth in dogs. Medical and dental records from four private veterinary specialty practices over an 8-year period (2013-2021) were reviewed. Forty-five incisor teeth from 41 dogs with ages from 1 to 11-years-old were included in the study. The indications for endodontic treatment were complicated crown fracture in 23 incisors (51.1%), non-vital tooth in 15 incisors (33.3%) and complicated crown-root fracture in seven incisors (15.5%). Evaluation criteria included availability of complete medical and dental records, patient demographics, and at least one follow-up visit as recent as 6 months after the initial root canal therapy. Endodontic treatment outcome was defined as successful, no evidence of failure, or failure. Root canal therapy was successful in 42 teeth (93.3%), no evidence of failure was found in three teeth (6.6%), and none of the cases showed failure of the treatment. Duration of follow-up ranged from 6 to 64 months. Only three variables appeared to have statistical significance: presence of preoperative periapical lucency (PAL) (P = .01), postoperative PAL (P < .001) and postoperative external inflammatory root resorption (P = .014). Based on this study, following "loose criteria" (success and no evidence of failure combined), 100% of the treatments were successful, making this option an excellent therapy choice in a veterinary specialty dentistry practice.

Radiographic Outcome of the Endodontic Treatment of 55 Fractured Canine Teeth in 43 Dogs (2013-2018).

Medical records from 4 private practice veterinary dentistry specialty clinics were reviewed for a 5-year period (2013-2018) to identify dogs that had a fractured canine tooth treated by root canal therapy and returned for subsequent follow-up evaluation. Evaluation criteria included the presence of complete medical records with diagnostic quality intraoral radiographs for each procedure visit with a minimum of 6 months between visits. Forty-three dogs with a total of 55 endodontically treated canine teeth were identified and evaluated. Root canal treatment outcome was defined as successful, no evidence of failure (NEF), or failure based on radiographic findings. Patient age, time from initial treatment to follow-up, obturation material used, radiographic quality of obturation (including voids, overfill, and retention of fractured endodontic files), radiographic evidence of periapical disease and/or presence of external inflammatory root resorption (EIRR), and the presence or absence of a full coverage metal crown were evaluated. Treatment was classified as successful in 51 (92.73%) teeth, NEF in 3 (5.45%) teeth, and failure in 1 (1.82%) tooth. The results suggest that endodontic treatment of fractured canine teeth in dogs is a successful treatment option that allows for retention of this functionally important tooth.

Radiographic outcome of root canal treatment in dogs: 281 teeth in 204 dogs (2001-2018).

OBJECTIVE: To evaluate the radiographic outcome of root canal treatment (RCT) in dogs and compare outcomes with those reported for a previous study performed at the same institution in 2002. ANIMALS: 204 dogs representing 281 teeth that underwent RCT. PROCEDURES: The medical record database of a veterinary teaching hospital was searched to identify dogs that underwent RCT between 2001 and 2018. Only dogs that had undergone at least 1 radiographic recheck appointment a minimum of 50 days after RCT were included in the study. Dental radiographs were reviewed. Treatment was considered successful if the periapical periodontal ligament space was within reference limits and preexisting external inflammatory root resorption (EIRR), if present, had stabilized. Treatment was considered to show no evidence of failure (NEF) if preoperative EIRR had stabilized and any preoperative periapical lucency (PAL) remained the same or had decreased in size but had not completely resolved. Treatment was considered to have failed if EIRR or a PAL developed after RCT, if a preoperative PAL increased in size, or if preexisting EIRR progressed. RESULTS: Follow-up time ranged from 52 to 3,245 days (mean, 437 days). RCT was classified as successful for 199 (71%) teeth, NEF for 71 (25%) teeth, and failed for 11 (4%) teeth. CONCLUSIONS AND CLINICAL RELEVANCE: Results showed that almost 2 decades after RCT outcome in dogs was first evaluated, during which time numerous advances in dental materials and techniques had been made, the success rate of RCT was virtually unchanged.

Update on Endodontic, Restorative, and Prosthodontic Therapy.

Endodontic therapy is intended to preserve the function of mature teeth with irreversible pulpitis or pulp necrosis or to maintain the vitality of endodontically compromised immature teeth. Standard root canal therapy and vital pulp therapy are 2 mainstays of endodontic treatment. Recent knowledge has improved the outcomes of endodontic treatment with newer materials, such as mineral trioxide aggregate. Composite or prosthodontic crown restoration is also a critical key to success.

Successful Use of MTA Fillapex as a Sealant for Feline Root Canal Therapy of 50 Canines in 37 Cats.

Intentional or unintentional pulp exposure of cat canines can lead to periapical disease, osteomyelitis, and oral pain. Root canal therapy (RCT) allows the retention of cat canines with pulp exposure by removing the infected pulp and replacing it with an inert material. This study used MTA Fillapex™ as a root canal sealant with gutta percha single cone obturation in 37 cats (50 canine teeth). Roots were classified as "successful," "no evidence of failure (NEF)," or "failed" at 6-month radiographic reviews. Therapy was considered "successful" if a preoperative periapical lucency had healed or not formed after treatment and any preoperative external inflammatory root resorption (EIRR) had stabilized without progression. Therapy was categorized as "NEF" if a periapical lucency had remained the same or decreased in size but not completely resolved and any preoperative EIRR had stabilized without progression. "Failed" if a periapical lucency had occurred or increased in size posttreatment or if EIRR had developed or progressed posttreatment. Thirty-two canine teeth (64%) were classified as "successful," 14 canine teeth (28%) were classified as "NEF," and 4 canine teeth (8%) were classified as "failed". The study concluded that RCT using MTA Fillapex as a root canal sealant is a suitable endodontic treatment for fractured cat canines, especially those that are periodontally or endodontically challenged.

Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry.

Pulp debridement and disinfection in the pulp cavity is a critical step in achieving a successful root canal therapy. Microorganisms remaining in the root canal system after endodontic treatment are a main cause of root canal failure. The challenges faced in endodontic disinfection include the complex anatomy of the root canal system, the existence of a biofilm within the root canal, and the creation of a problematic smear layer during instrumentation of the canal. Historically, sodium hypochlorite and ethylenediaminetetraacetic acid have been utilized as irrigants and still remain as the most effective disinfectants due to their synergistic abilities to eradicate microorganisms, dissolve necrotic debris, and remove the smear layer and biofilm. This article addresses challenges in endodontic disinfection, objectives of endodontic irrigants, properties of an ideal irrigant, currently used irrigants, and irrigant delivery systems utilized in veterinary dentistry.

Microbiological Aspects of Naturally Occurring Primary Endodontic Infections in Dogs.

Dental fractures are common in dogs, but data on microbiology of naturally occurring primary endodontic infections, and their relation to clinical and radiographic signs, are lacking. Samples were obtained from root canals of 32 periodontally healthy fractured teeth under aseptic conditions and immediately cultured for aerobic and anaerobic bacteria. Cultures were further identified by matrix-assisted laser desorption/ionization, time of flight technology. Sixty-one bacteria (30 bacterial species) were isolated from root canals; 54% were Gram-negative bacteria, 53% were facultative anaerobic, and 42% were anaerobic bacteria. Number of bacterial species in the root canals declined with the duration of fractures over 12 months. No statistically significant association was found between the number of bacterial species involved in the root canal infection and any of the clinical or radiographic signs of endodontic disease. Naturally occurring primary endodontic infections in dogs appear to be polymicrobial and involve only a selected number of opportunistic pathogen species.

Radiographic outcome of root canal treatment of canine teeth in cats: 32 cases (1998-2016).

OBJECTIVE To describe the radiographic outcome of root canal treatment (RCT) of canine teeth of cats. DESIGN Retrospective case series. ANIMALS 32 cats with 37 canine teeth with complicated crown fractures that underwent RCT. PROCEDURES Medical record databases of 5 referral veterinary hospitals were searched to identify cats that underwent RCT between 1998 and 2016. Only cats that had at least 1 follow-up examination during which radiographs were obtained of the treated canine tooth or teeth were included in the study. Dental radiographs obtained before and immediately after RCT and during all follow-up examinations were reviewed. Treatment was considered successful if the periodontal ligament space was within reference limits and preoperative external inflammatory root resorption (EIRR), if present, had stabilized. Treatment was considered to have no evidence of failure if preoperative EIRR had stabilized and preexisting periapical lucency was stable or decreased in size but had not resolved. Treatment was considered to have failed if periapical lucency or EIRR developed subsequent to RCT or preexisting periapical lucency increased in size or preoperative EIRR progressed following RCT. RESULTS Follow-up time after RCT ranged from 3 to 72 months. The RCT was successful for 18 (49%) of the 37 treated teeth, had no evidence of failure for 12 (32%), and failed for 7 (19%). Preexisting EIRR and patient age ≥ 5 years significantly increased the rate of RCT failure. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that RCT was a viable treatment option to salvage endodontically diseased canine teeth in cats.

Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst.

Dentigerous cysts are uncommon, yet are being reported with increasing frequency in the veterinary literature. Dentigerous cysts are a type of benign odontogenic cyst associated with impacted teeth, most commonly the mandibular first premolar tooth. Significant bone destruction can occur secondary to the expansion of a dentigerous cyst. The expanding cyst can lead to pathology of neighboring teeth, which can include external root resorption or pulpitis. Intraoral dental radiographs are imperative to properly assess the presence and extent of a dentigerous cyst, as well as the status of the neighboring teeth. This case report describes treatment for dentigerous cyst including cyst lining curettage, mandibular bone regeneration, and endodontic therapy for a canine tooth with irreversible pulpitis.

Outcome of surgical endodontic treatment in dogs: 15 cases (1995-2011).

OBJECTIVE: To document the short- and long-term outcomes of surgical endodontic treatment in dogs in a clinical setting. DESIGN: Retrospective case series. ANIMALS: 15 dogs that underwent surgical endodontic treatment. PROCEDURES: Medical records of dogs that underwent surgical endodontic treatment at 3 institutions from January 1995 to December 2011 were reviewed. Information extracted included signalment, history, initial clinical signs, physical and radiographic examination findings, treatment, and outcome. Outcome was determined through evaluation of the pre- and postoperative radiographs as well as clinical and radiographic findings at follow-up evaluations. On the basis of radiographic findings, treatment was considered successful if the periapical lesion and bone defect created by surgery had completely healed and no new root resorption was detected; a treatment was considered to have no evidence of failure if the periapical lesion remained the same or had not completely resolved and root resorption was static. RESULTS: 15 dogs were treated by means of apicoectomy and retrograde filling following a failed or complicated orthograde root canal treatment. The mean long-term follow-up time was 15.2 months (range, 3 to 50 months). On radiographic evaluation, 10 of 15 dogs had successful resolution of the periapical disease; 5 dogs had no radiographic evidence of failure of endodontic treatment. All dogs were considered to have a successful clinical outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Surgical endodontic treatment was an effective option for salvaging endodontically diseased but periodontally healthy teeth of dogs in which orthograde treatment was unsuccessful and nonsurgical retreatment was unlikely to succeed.

Restoration of fractured canines in ferrets after one-step root canal treatment.

This article describes a one-step root canal treatment and restoration of canine teeth in ferrets. Standard brass posts were used for the reconstruction of the teeth. The procedures were performed by dentists according to all rules and procedures used in root canal treatment in humans. The teeth were immediately restored anatomically. The procedures were successfully performed in four ferrets aged between 6 and 20 months of age, in three upper and one lower canines.

Root surface temperature rise of mandibular first molar during root canal filling with high-temperature thermoplasticized Gutta-Percha in the dog.

This in vitro study evaluated the temperature rise on the outer root surface of the mandibular first molar following root canal filling using the high-temperature, thermoplasticized, Gutta-Percha technique (HTTG) (BeeFill) in the dog. Twelve extracted dog mandibular first molars were used. After root canal preparation, the teeth were filled with thermoplasticized Gutta-Percha and root canal sealer. Temperature changes on the vestibular surfaces of the mesial and distal roots of mandibular first molars were measured using a thermal imaging camera. The results of this in vitro study showed that using HTTG to fill mandibular first molars in dogs produces a safe temperature rise on the root surface and, therefore, should not damage the periodontal ligament and/or surrounding tissues.

A clinical evaluation of glass-fibre posts and restorative materials used for the reconstruction of fractured canines after one-step root canal treatment in cats.

This article describes a procedure for a one-step root canal treatment and the subsequent restoration of fractured canine teeth in cats. Standard glass fibre posts were used in the reconstruction of the teeth which were then divided into two groups and restored anatomically using two different composite materials. The procedures were successfully performed on six cats. The subject teeth were four upper and two lower canines.

Endodontic treatment of dens invaginatus in a dog.

Dens invaginatus or dens in dente is a developmental dental malformation that has the radiographic appearance of a separate tooth inside the pulp chamber or canal of another tooth. This report describes endodontic treatment of a variation of dens invaginatus in the maxillary canine tooth of a dog.

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.