Periodontal Pocket Therapy Using a Class IV Dental Diode Laser in Dogs: A Retrospective Analysis.

Class IV dental diode lasers have been introduced as a nonsurgical therapy for periodontal pockets in veterinary and human dentistry. This retrospective case series evaluates the use of Class IV dental diode laser therapy for abnormal periodontal pockets in a specialty veterinary dental practice. A hypothesis that the Class IV diode dental laser is a useful adjuvant modality in canine periodontal pocket therapy in the reduction of clinical pocket depth was made. This article discusses and demonstrates diode laser use in periodontal pocket therapy in a specialty veterinary dental practice and reviews the current literature. Inclusion in this study was limited to client-owned dogs with noted periodontal pocketing on any tooth type between 3 and 6 mm, which were treated with closed root planing (RP/C) and laser therapy who returned in 6 to 7 months for recheck of the pockets from the years 2017 to 2020. Twelve patients met the inclusion criteria. A total of 128 periodontal pockets were included in the study. Each periodontal pocket was a case receiving therapy. The mean periodontal pocket depth before the treatment is measured as 3.35 mm. The mean pocket depth of the periodontal pockets following treatment was 0.59 mm. The mean improvement in periodontal pocket depths after diode laser therapy when considering patient and tooth number using linear mixed-effects modeling was 2.63 mm (95% confidence interval [CI]: 1.81-3.46, P < .0001). No statistically significant results were observed for pocket type, as P values were greater than .05.

Submucosal Injection of Activated Platelet-Rich Plasma for Treatment of Periodontal Disease in Dogs.

Periodontal disease is the most common oral disease seen in dogs, and its routine treatment usually involves dental scaling. Platelet-rich plasma (PRP) therapy may enhance the effectiveness of treatment of periodontal disease, delay the progression of the disease and decrease the time under anesthesia. However, its application in dogs is rarely discussed. The objective of this study was to evaluate the benefits of activated PRP for treatment of periodontal disease in dogs. 43 mL of whole blood was collected from six adult dogs and PRP extracted using the double centrifugation tube method. Subsequently, the PRP was activated using calcium chloride (A-PRP). Significantly elevated concentrations of PDGF-BB (7000.28 pg/mL), TGF-ß (378.98 pg/mL), and VEGF (7.14 pg/mL) were detected in the A-PRP. Additionally, three of the dogs with stage 2-3 periodontal disease were enrolled in the clinical trial. Periodontal pocket depth, stage of periodontal disease, gingival index, horizontal bone loss, and alveolar bone density involving the maxillary third and fourth premolar and first molar teeth (107, 108, 109, 207, 208, and 209) were evaluated. Teeth were treated by dental scaling alone (control group) or by dental scaling followed by submucosal injection of 0.1 mL A-PRP per site. After 56 days, significant improvement in periodontal pocket depth, stage of periodontal disease, gingival index, and horizontal bone loss was observed in dogs injected with A-PRP. The high concentrations of growth factors in A-PRP likely contributed to this effect. The use of submucosal injections of A-PRP to treat canine stage 2-3 periodontal disease appears safe and effective for clinical practice.

Estimation of periodontal pocket surface area in small to medium dogs: a proof-of-concept study.

BACKGROUND: Periodontal disease is the most common dental disease in dogs. Although the systemic effects of periodontal disease have not been clarified in veterinary science, it is necessary to evaluate the effects of periodontal disease in clinical trials in the future. There have been a few clinical attempts made, however, to assess the severity of periodontal inflammation and its impact on the systemic health of dogs. Meanwhile, in the field of dentistry for humans, the periodontal inflamed surface area (PISA) and periodontal epithelial surface area (PESA) have been used to quantitatively assess the degree of periodontal disease affecting a single tooth as well as the overall extent of periodontitis. Recent studies have also suggested the use of these assessments to examine the relationship between periodontal inflammation and systemic health. RESULTS: The estimation formula for a dog's periodontal pocket surface area (PPSA), an alternative to PISA and PESA in humans, was established using body weight and periodontal pocket depth. Actual values were measured using extracted teeth from various dog breeds and sizes (2.3-25.0 kg of body weight) to obtain universal regression equations for PPSA. Altogether, 625 teeth from 73 dogs of 16 breeds were extracted and subsequently analyzed for morphological information. PPSA was measured in 61 dogs of 10 breeds with periodontal disease using the established estimation formulas, and the correlation between PPSA and preoperative blood chemistry data was analyzed accordingly. A strong correlation was found between PPSA and serum globulin (r = 0.71) while moderate correlations were found for C-reactive protein (r = 0.54) and serum albumin (r = -0.51). CONCLUSIONS: Estimation formulas using body weight and the 6-point probing depth were established for determining PPSA. Direct correlations between PPSA and several blood test results were observed in the study sample. Taken together, these results suggest that PPSA could be useful for evaluating the effects of periodontitis on systemic conditions in dogs.

Black-pigmented anaerobic bacteria associated with ovine periodontitis.

Periodontitis is a polymicrobial infectious disease that causes occlusion change, tooth loss, difficulty in rumination, and premature culling of animals. This study aimed to detect species of the genera Porphyromonas and Prevotella present in the periodontal pocket of sheep with lesions deeper than 5mm (n=14) and in the gingival sulcus of animals considered periodontally healthy (n=20). The presence of microorganisms was evaluated by polymerase chain reaction (PCR) using specific primers for Porphyromonas asaccharolytica, Porphyromonas endodontalis, Porphyromonas gingivalis, Porphyromonas gulae, Prevotella buccae, Prevotella intermedia, Prevotella loescheii, Prevotella melaninogenica, Prevotella nigrescens, Prevotella oralis, and Prevotella tannerae. Prevalence and risk analysis were performed using Student's t-test and Spearman's correlation. Among the Prevotella and Porphyromonas species detected in the periodontal lesions of sheep, P. melaninogenica (85.7%), P. buccae (64.3%), P. gingivalis (50%), and P. endodontalis (50%) were most prevalent. P. gingivalis (15%) and P. oralis (10%) prevailed in the gingival sulcus. P. gulae and P. tannerae were not detected in the 34 samples studied. Data evaluation by t-test verified that occurrence of P. asaccharolytica, P. endodontalis, P. gingivalis, P. buccae, P. intermedia, P. melalinogenica, and P. nigrescens correlated with sheep periodontitis. The findings of this study will be an important contribution to research on pathogenesis of sheep periodontitis and development of its control measures.

An abattoir survey of equine dental abnormalities in Queensland, Australia.

OBJECTIVE: A cadaver study to estimate the prevalence of dental disorders in horses presented at an abattoir in Queensland, Australia. METHODS: Cadaver heads at a Queensland abattoir were examined for the presence of dental abnormalities and categorised into age groups. The prevalence of abnormalities was analysed by binomial observation of observed proportion, Pearson's Chi-square test or Fisher's exact correlation test. Strength of association was evaluated using Cramer's V test. RESULTS: Heads from horses (n=400) estimated to be between 1 and 30 years of age were placed into four age groups. The most common abnormalities were sharp enamel points (55.3%) and hooks (43%). The highest frequency of dental diseases and abnormalities were in horses 11-15 years old (97.5%). CONCLUSIONS: Common abnormalities were found in all groups and the prevalence increased with age. This study suggests that all horses should have regular complete dental examinations to detect and treat dental disorders in order to limit more severe dental pathologies later in life.

Treponema denticola in microflora of bovine periodontitis / Treponema denticola na microbiota da periodontite bovina

Periodontitis in cattle is an infectious purulent progressive disease associated with strict anaerobic subgingival biofilm and is epidemiologically related to soil management at several locations of Brazil. This study aimed to detect Treponema species in periodontal pockets of cattle with lesions deeper than 5mm in the gingival sulcus of 6 to 24-month-old animals considered periodontally healthy. We used paper cones to collect the materials, after removal of supragingival plaques, and kept frozen (at -80°C) up to DNA extraction and polymerase chain reaction (PCR) using T. amylovorum, T. denticola, T. maltophilum, T. medium and T. vincentii primers. In periodontal pocket, it was possible to identify by PCR directly, the presence of Treponema amylovorum in 73% of animals (19/26), T. denticola in 42.3% (11/26) and T. maltophilum in 54% (14/26). Among the 25 healthy sites, it was possible to identify T. amylovorum in 18 (72%), T. denticola in two (8%) and T. maltophilum in eight (32%). Treponema medium and T. vincentii were not detected over all 51 evaluated samples. The presence of Treponema amylovorum, T. maltophilum and, in particular, the widely recognized T. denticola in subgingival microflora brings an original and potencially important contribution in studies of the bovine periodontitis.

A periodontite bovina é um processo infeccioso purulento e progressivo associado à presença de biofilme subgengival anaeróbio estrito e epidemiologicamente relacionada ao manejo do solo em amplas áreas geográficas do Brasil. O trabalho teve por objetivo detectar espécies de Treponema presentes na bolsa periodontal de bovinos com lesões de profundidade maior que 5mm e do sulco gengival de animais com idade de 6 a 24 meses e considerados periodontalmente sadios. Os materiais foram colhidos por meio de cones de papel, após a remoção do biofilme supragengival, e mantidos sob congelamento (-80°C) até a extração do DNA e realização da reação em cadeia da polimerase (PCR) com o emprego de iniciadores de T. amylovorum, T. denticola, T. maltophilum, T. medium e T. vincentii. Na bolsa periodontal de 73% (19/26) dos animais foi possível detectar diretamente, pela PCR, a presença de Treponema amylovorum, de 42,3% (11/26) T. denticola e de 54% (14/26) T. maltophilum. Dos 25 sítios sadios, em 18 (72%) foi possível identificar T. amylovorum, em dois (8%) T. denticola e em oito (32%) T. maltophilum. Treponema medium e T. vincentii não foram detectados nas 51 amostras avaliadas. A presença de Treponema amylovorum, T. maltophilum na microbiota subgengival, e em especial do amplamente reconhecido periodontopatógeno T. denticola, traz uma contribuição original de importância potencial nos estudos da periodontite bovina.

Evaluation of an Osseous Allograft Membrane for Guided Tissue Regeneration in the Dog.

Clinical application of a demineralized freeze-dried cortical bone membrane allograft (DFBMA) for treatment of intra(infra)bony periodontal pockets in dogs was evaluated. The mean pre-treatment periodontal probing depth equaled 7.2-mm. Post-treatment probing depths in all 11 cases were normal, with a mean periodontal probing gain of 5.4-mm. Guided tissue regeneration using a commercially available veterinary canine DFBMA and canine demineralized freeze-dried bone allograft (DFDBA) resulted in clinically significant periodontal attachment gains. The gain of new periodontal tissue attachment was statistically significant (P < 0.0001). The commercially available veterinary allograft products predictably increased new periodontal attachment without any identified membrane sequelae in these 11 cases.

Periodontal disease as a potential factor for systemic inflammatory response in the dog.

Periodontal disease is an inflammatory disease that has numerous consequences both locally and systemically The aim of this study was to assess whether periodontal disease causes systemic inflammatory response in otherwise healthy, adult dogs. We estimated the total mouth periodontal score (TMPS), measured the concentration of C-reactive protein (CRP), hematocrit, and albumin, and determined the white blood cell (WBC) and polymorphonuclear cell (PMN) counts in client-owned dogs. There was a statistically significant relationship between the gingival bleeding index (TMPS-G) and CRP concentration, and WBC and PMN counts, possibly during the active periods of periodontal tissue destruction. No correlation was found between the periodontal destruction index (TMPS-P) and the measured blood parameters. We conclude that chronic periodontal disease does not cause anemia or a reduction in serum albumin. However, active periods of periodontal inflammation may be associated with laboratory values suggestive of a systemic inflammatory response.

Isolation and identification of Porphyromonas spp. and other putative pathogens from cats with periodontal disease.

The purpose of this study was to evaluate the subgingival microbiota and determine the most prevalent periodontal pathogens implicated in feline periodontal disease and to correlate these findings with the clinical periodontal status. Subgingival microbiological samples were taken under sedation from 50 cats with clinical signs of periodontal disease. Pooled paper point samples from 4 selected subgingival sites were cultured on blood agar and on Dentaid-1 medium. Suspected pathogens were identified, subcultured, and preserved. The association between the microbiological findings and the clinical status was studied using correlation coefficients (CC). In addition, cats were stratified in subgroups according to presence of putative pathogens, and comparisons were carried out using unpaired t-test. Three bacterial species were frequently detected including Porphyromonas gulae (86%), Porphyromonas circumdentaria (70%) and Fusobacterium nucleatum (90%). The mean proportion of total flora was high for P. gulae (32.54%), moderate for P. circundentaria (8.82%), and low for F. nucleatum (3.96%). Among the clinical variables, tooth mobility was correlated (CC > 0.50, p < 0.001) with recession, pocket depth, attachment level, gingival index, and calculus index (CC = 0.29, p = 0.04) as well as with total bacterial counts (CC = 0.38, p = 0.006). Cats with more than 10% of P. gulae showed significantly more mobility (p = 0.014) and recession (p = 0.038), and a tendency for deeper probing pocket depths (p = 0.084) and attachment loss (p = 0.087). The results from this cross-sectional study confirmed that P. gulae is the most relevant pathogen in periodontal disease in cats.

Histopathological lesions associated with equine periodontal disease.

Equine periodontal disease (EPD) is a common and painful condition, the aetiology and pathology of which are poorly understood. To characterise the histopathological lesions associated with EPD, the skulls of 22 horses were assessed grossly for the presence of periodontal disease, and a standard set of interdental tissues taken from each for histopathological examination. Histological features of EPD included ulceration and neutrophilic inflammation of the gingival epithelium. Mononuclear and eosinophilic inflammation of the gingival lamina propria and submucosa was commonly present irrespective of the presence or degree of periodontal disease. Gingival hyperplasia was present to some degree in all horses, and was only weakly associated with the degree of periodontal disease. In all horses dental plaque was present at the majority of sites examined and was often associated with histological evidence of peripheral cemental erosion. Bacteria (including spirochaetes in four horses) were identified in gingival samples by Gram and silver impregnation techniques and were significantly associated with the presence of periodontal disease. This is the first study to describe histological features of EPD, and the first to identify associated spirochaetes in some cases. Histological features were variable, and there was considerable overlap of some features between the normal and diseased gingiva. Further investigation into the potential role of bacteria in the pathogenesis and progression of EPD is warranted.

Validation of use of subsets of teeth when applying the total mouth periodontal score (TMPS) system in dogs.

A total mouth periodontal score (TMPS) system in dogs has been described previously. Use of buccal and palatal/lingual surfaces of all teeth requires observation and recording of 120 gingivitis scores and 120 periodontitis scores. Although the result is a reliable, repeatable assessment of the extent of periodontal disease in the mouth, observing and recording 240 data points is time-consuming. Using data from a previously reported study of periodontal disease in dogs, correlation analysis was used to determine whether use of any of seven different subsets of teeth can generate TMPS subset gingivitis and periodontitis scores that are highly correlated with TMPS all-site, all-teeth scores. Overall, gingivitis scores were less highly correlated than periodontitis scores. The minimal tooth set with a significant intra-class correlation (> or = 0.9 of means of right and left sides) for both gingivitis scores and attachment loss measurements consisted of the buccal surface of the maxillary third incisor canine, third premolar fourth premolar; and first molar teeth; and, the mandibular canine, third premolar, fourth premolar and first molar teeth on one side (9 teeth, 15 root sites). Use of this subset of teeth, which reduces the number of data points per dog from 240 to 30 for gingivitis and periodontitis at each scoring episode, is recommended when calculating the gingivitis and periodontitis scores using the TMPS system.

A survey of equine oral pathology.

Dental abnormalities in horses can lead to weight-loss, poor performance, pain, behavioral abnormalities, and illness. Despite this impact, the occurrence and type of dental disease in horse populations is infrequently reported in veterinary medicine. The purpose of this cross-sectional survey of horses presented for slaughter at a processing plant in Western Canada was to measure the prevalence of equine oral abnormalities, examine associations between the most common abnormalities, and consider the relationship between the age of horse and types of abnormalities observed. The horses used in this research consisted of a variety of ages, breeds, body conditions, and origins. Horses ranged in age from 18-months to 30-years (median = 11-years). The most common oral pathologies included sharp edges, buccal abrasions, calculus, lingual ulcers, gingival recession, periodontal pockets, ramps, and waves. Several types of pathology were strongly associated with other dental disorders. The prevalence of periodontal pockets, gingival recession, and waves was highest in older horses.

Modified distal wedge excision for access and treatment of an infrabony pocket in a dog.

A six-year-old male neutered Dachshund dog presented with generalized moderate gingivitis and calculus formation. A comprehensive oral examination performed under general anesthesia revealed infrabony pockets and horizontal bone loss associated with the left mandibular first and second molar teeth. The left mandibular second molar tooth was extracted, while the left mandibular first molar tooth was treated by staged periodontal therapy, including a modified distal wedge excision for open root planning and bone augmentation. Preoperative probing depths of 9-mm associated with the distal root of the left mandibular first molar tooth were reduced to 2-mm following treatment. The patient continued to maintain normal periodontal probing depths, with no gingival recession at 3, 6, 16, and 33-months following periodontal treatment.

Dimensions of diastemata and associated periodontal food pockets in donkey cheek teeth.

Equine cheek teeth (CT) diastemata often cause deep periodontal food pocketing and are therefore regarded as a painful dental disorder of equidae. However there appears to be no information available on the size or shape of these diastemata. This post mortem study examined 16 donkey skulls (mean age = 32-years) containing 45 CT diastemata to define the anatomical shape and dimensions of these diastemata, and of the associated periodontal food pockets that occur with this disorder. Diastemata were found to more commonly involve mandibular (56.0%) compared with maxillary CT (44.0%), and 71.0% of these diastemata had adjacent intercurrent dental disorders that may have predisposed donkeys to the diastemata. The median widths of all diastemata were 2.0-mm at the occlusal surface and 3.1-mm at the gingival margin, with no diferences in widths between the lateral or medial aspects of diastemata. Diastemata were defined as open (60.00%) or valve (40.00%) based on their gross appearance. This classification was confirmed to be accurate by measurements that showed valve diastemata to have an occlusal to gingival width ratio of 0.4, in contrast to open diastemata where this ratio was 1.07. Food was impacted in 89.0% of diastemata, but all diastemata had adjacent periodontal disease. Periodontal food pocketing was present adjacent to 76.0% of diastemata, more commonly on the lateral aspect (73.0% prevalence; mean pocket depth = 4.1-mm) than the medial aspect (47.0% prevalence; mean pocket depth = 2.4-mm). The depth of periodontal pockets of diastemata was not associated with the height of the erupted crowns of adjacent CT.

Scoring the full extent of periodontal disease in the dog: development of a total mouth periodontal score (TMPS) system.

The development of a total mouth periodontal scoring system is described. This system uses methods to score the full extent of gingivitis and periodontitis of all tooth surfaces, weighted by size of teeth, and adjusted by size of dog.

Treatment of an infrabony pocket in an American Eskimo dog.

This case report describes the use synthetic bone graft particulate and 24% EDTA gel to treat an infrabony defect adjacent to the mandibular right first molar tooth in an American Eskimo dog. Postoperative examination 33-months following surgery showed osseous integration at the infrabony defect and restoration of the periodontal ligament space with a small refractory periodontal pocket.

Treatment of periodontal pockets with doxycycline in beagles.

Following pretreatment with clindamycin, cleaning, scaling, polishing, and curettage, six beagles that were patients at the Dental Department of the Clinic for Surgery and Ophthalmology of the University of Veterinary Medicine of Vienna received a doxycycline polymer filling (Doxirobe, Pharmacia Animal Health) in periodontal pockets of teeth 204, 208, 304, and 309. Gingivitis index, gingival crevicular fluid, probing depth, and attachment loss were determined before and 6 and 12 weeks after treatment. Teeth 104, 108, 404, and 409 did not receive antibiotic therapy but were pretreated in the same manner as the doxycycline-treated teeth. Pocket depth for teeth treated with doxycycline was significantly reduced (improved) by 39% after 6 weeks (P =.001) and by 35% after 12 weeks (P =.001). Pockets around control teeth were improved after cleaning and curettage but were still significantly deeper than around teeth treated with doxycycline. Compared with control teeth, teeth treated with doxycycline had significantly less gingival crevicular fluid after treatment (P =.001). Teeth treated with doxycycline gained significant attachment after 6 (42%) and 12 (38%) weeks. Significantly fewer bacteria were harvested from doxycycline-treated teeth than from control teeth. The gingival index was significantly lower in the doxycycline-treated teeth than in the control teeth 6 (P =.002) and 12 (P =.007) weeks after treatment. Local application of doxycycline complements traditional subgingival curettage therapy in a reasonable and effective way and can significantly improve treatment success, especially with regard to pocket depth reduction and attachment gain.

Evaluation of Bioglass/PerioGlas (Consil) synthetic bone graft particulate in the dog and cat.

This paper describes the use of Bioglass synthetic bone graft particulate (PerioGlas/Consil) in the treatment of osseous periodontal defects, and in post-extraction sites to maintain the vertical height and width of the alveolar ridge. The material is easy to use, inhibits epithelial down-growth, and acts as a mechanical hemostatic agent. Radiographic follow up in 36 dogs and 5 cats demonstrated significant bone fill. In the osseous periodontal defect treatment group, clinical probing depths decreased significantly, and there was an apparent gain in attachment level.