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.

Association of periodontal disease with breed size, breed, weight, and age in pure-bred client-owned dogs in the United States.

Despite periodontal disease (PD) being amongst the most common diagnoses in primary-care practice, the disease is generally underdiagnosed. However, the millions of clinical records generated by pet hospitals each year provide unique opportunities to generate insights about disease risk across large numbers of dogs. The objective of this study was to undertake a retrospective analysis of medical records to ascertain which sizes and breeds of dog are most frequently diagnosed with PD. Although data collection regarding PD was not consistent, it was assumed that the same inconsistencies in recording periodontal abnormalities were present across the range of bodyweight, breed categories and breeds. Over 3 million medical records across 60 breeds of dogs visiting a chain of veterinary hospitals in the United States collected over a 5-year period were analysed. Statistical analysis of a subset of these records found that extra-small (<6.5 kg) breeds of dog were up to five times more likely to be diagnosed with PD than giant breeds (>25 kg) (P <0.0001). The majority of breeds most frequently diagnosed with PD were in the extra-small, small (6.5-9 kg) and medium-small (9-15 kg) breed size categories. Additional risk factors for PD diagnosis included age, being overweight and time since last scale and polish. Veterinarians should consider targeting client education about dental health, and diagnostic efforts, towards canine patients of the small-breed size categories and those with a higher risk of developing PD (e.g. overweight).

Tooth brushing inhibits oral bacteria in dogs.

In this study, scaling, polishing and daily tooth brushing were performed in 20 beagle dogs, and the number of oral bacteria was determined using a bacterial counter. The dogs were randomized into the scaling (S), scaling + polishing (SP), scaling + tooth daily brushing (SB) and scaling + polishing + tooth daily brushing (SPB) groups. Samples were collected from the buccal surface of the maxillary fourth premolars of the dogs immediately after scaling and every week thereafter from weeks 1 to 8. Throughout the study, the number of bacteria was significantly lower in the SB and SPB groups compared with the S group. The findings suggest that daily tooth brushing inhibited oral bacterial growth in the dogs.

Lethal septic shock after dental scaling in a healthy dog due to Ochrobactrum anthropi-contaminated propofol.

A 10-year-old, 6-kg male Yorkshire terrier dog was scheduled for routine dental cleaning. No significant problem was observed either during anaesthesia, which was induced with propofol, or during recovery. However, 2 hours after discharge, the dog's owner returned to the clinic, complaining that the animal was lethargic and had had bloody diarrhoea. On physical examination the dog was depressed, dyspnoeic, tachycardic and hypoglycaemic. Despite supportive treatment, the dog deteriorated and died within a few hours.A presumed diagnosis of sepsis was confirmed by laboratory testing. Bacteriological and molecular examinations of both premortem blood samples and the anaesthetic, highlighted the presence of Ochrobactrum anthropi, an opportunistic pathogen usually associated with immunocompromised hosts with indwelling medical devices. To the authors' knowledge, this is the first case of sepsis in a healthy dog due to contamination of an anaesthetic solution by O. anthropi, suggesting a potential role of this microorganism as an emerging pathogen.

Risk assessment of feline tooth resorption: a Portuguese clinical case control study.

Tooth resorption (TR) is one of the most common dental diseases in cats. Determination of risk factors has not yet been fully assessed and, to the best knowledge of the authors, this disease has never been studied in Portuguese cats. The objective of this case-control study was to determine type and distribution of TR lesions, evaluate risk factors, and establish relationships between variables in this disease. The study included data from 71 cats admitted for general anesthesia for various reasons. The cats were randomly selected. The inclusion criteria were availability of clinical history and owner permission. Cats with known oral disease were not excluded from the study. All cats received ultrasonic scaling and polishing of the teeth, a thorough oral examination, and full-mouth radiographs. A strong statistical relation was found between age and TR. The age group of 10 to 15-years showed an increased risk of 6.56 times for TR occurrence compared with the group 0 to 4-years of age. Presence of gingivitis in all index levels was related to an increased risk for TR. No relation was found between age or gingivitis index and lesion type. Mandibular third premolar and molar teeth were most commonly affected by TR, especially for type 1 lesions. Canine teeth were statistically more likely to have type 2 lesions. The trend for the canine teeth to be more affected with type 2 lesions needs further verification.

Efficacy of cyclosporine for chronic, refractory stomatitis in cats: A randomized, placebo-controlled, double-blinded clinical study.

Sixteen cats with chronic stomatitis, that had previously undergone premolar-molar or full-mouth extractions, were randomly assigned a group to receive 2.5 mg/kg cyclosporine or placebo orally twice daily Neither the clinician nor the clients were aware of the group assignments. Cats were evaluated prior to treatment and every 2 weeks for 6 weeks using a 30 point Stomatitis Disease Activity Index (SDAI) score. Mean improvement in SDAI scores among cats in the treatment group after 6 weeks was 52.7 %. This was significantty diffrent fom the mean improvement (12.2 %) of cats in the placebo group. During the 6 week study period, 7 of the 9 cats in the treatment group (77.8 %) showed a > 40 % improvement in SDAI score, while 1 of 7 cats in placebo group (14.3 %) showed a > 40 % improvement in SDAI score. This difference was statistically significant. Individual variability in the absorption of orally-administered cyclosporine was high. Trough whole-blood cyclosporine levels ranged firm 32.1 ng/ml to 1,576.2 ng/ml. At the end of the 6 week observation period, there was a statistically significant diference among cats with trough whole-blood cyclosporine levels >300 ng/ml (72.3 % improvement) compared with cats with cyclosporine levels < 300 ng/ml (28.2 % improvement). Whole-blood cyclosporine levels > 300 ng/ml were associated with significant improvement in oral inflammation in cats with chronic stomatitis that had previously undergone premolar-molar or fuill-mouth extraction.

Veterinary dentistry in senior canines and felines.

When you have completed this article, you will be able to (1) understand and grade patients with periodontal disease and prescribe proper treatment for them; (2) describe the AVDC Stages of Tooth resorption and the treatment; (3) describe the non-clinically aggressive and aggressive oral tumors; (4) be knowledgeable of the American Animal Hospital Association Guidelines on Veterinary Dental Procedures and how to obtain them; and (5) understand the disadvantage of Non-Professional Dental Scaling (NPDS) and why it should not be performed.

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.

Effect of a mucoadhesive gel and dental scaling on gingivitis in dogs.

Twenty client-owned dogs diagnosed with gingivitis were studied over a 45-day period in order to investigate the effect of professional dental prophylaxis combined with the use of a topical mucoadhesive gel containing adelmidrol, an aliamide. A non-intrusive papillary-marginal-gingival index (PMGI) was measured at each assessment, while the gingivitis index (GI) was measured only at the beginning and end of the study. Compared to the control group, the treated dogs had a significant decrease (P < 0.005) in the average GI index during the course of the study. A significant reduction (P < 0.002) in the average PMGI index was observed in both groups 15-days following dental prophylaxis. However at 30 and 45-days following dental prophylaxis, the PMGI index values were significantly different (P < 0.005) from baseline only in treated dogs. These results suggest that the combined use of a mucoadhesive gel with dental scaling was able to improve the regression of gingival inflammation and lengthen the therapeutic benefits of dental scaling and polishing during a limited study period.

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.

Observations on the effects of scaling and polishing methods on enamel.

This study compared several techniques of manual and power instrument supragingival scaling and subsequent polishing with different methods. Observations were made to determine if there was an optimal method of enamel surface treatment based on the efficacy of the polishing and damage to the enamel. The maxillary fourth premolar and canine teeth were used as experimental teeth. These teeth were extracted after treatment and immersed in 10% buffered formalin solution for further processing and evaluation using electron microscopy. Our observations indicated that the most effective method for scaling and enamel protection during periodontal treatment was provided by power instrumentation followed by polishing using a soft polishing wheel with pumice paste.

Repair of experimental plaque-induced periodontal disease in dogs.

Forty mongrel dogs were used in this study for induction of periodontal disease by placing subgingival silk ligatures affecting maxillary and mandibular premolar teeth during a 12-month period. Experimental premolar teeth received monthly clinical, radiographic, and histometric/pathologic assessments. The results demonstrated significant increases in scores and values of periodontal disease parameters associated with variable degrees of alveolar bone loss. The experimental maxillary premolar teeth exhibited more severe and rapid rates of periodontal disease compared with mandibular premolar teeth. Histometric analysis showed significant reduction in free and attached gingiva of the experimental teeth. Histopathological examination of buccolingual sections from experimental premolar teeth showed the presence of rete pegs within the sulcular epithelium with acanthosis and erosive changes, widening of the periodontal ligament, and alveolar bone resorption. Various methods for periodontal repair were studied in 194 experimental premolar teeth exhibiting different degrees of periodontal disease. The treatment plan comprised non-surgical (teeth scaling, root planing, and oral hygiene) and surgical methods (closed gingival curettage, modified Widman flap, and reconstructive surgery using autogenous bone marrow graft and canine amniotic membrane). The initial non-surgical treatment resulted in a periodontal recovery rate of 37.6% and was found effective for treatment of early periodontal disease based on resolution of gingivitis and reduction of periodontal probing depths. Surgical treatment by closed gingival curettage to eliminate the diseased pocket lining resulted in a recovery rate of 48.8% and proved effective in substantially reducing deep periodontal pockets. Open root planing following flap elevation resulted in a recovery rate of 85.4% and was effective for deep and refractory periodontal pockets. Autogenous bone graft implantation combined with canine amniotic membrane as a biodegradable membrane was used in 18 premolar teeth and failed to improve advanced furcation defects in most teeth.

Cerebral state monitoring in Beagle dogs sedated with medetomidine.

OBJECTIVE: To provide experience of monitoring the level of hypnosis with the Cerebral State Monitor (CSM), a device extracting a single numerical variable between 0 and 100 from the electroencephalogram in dogs sedated with medetomidine during dental scale removal. STUDY DESIGN: Prospective observational study. Animals Nine female Beagle dogs weighing 13.3 +/- 1.3 kg. METHODS: Cerebral state index (CSI) and burst suppression ratio (BSR) were recorded from sub-dermal needle electrodes in dogs sedated after subcutaneous injection of 114 +/- 11 microg kg(-1) medetomidine. Ten minutes after injection CSI monitoring began, and after 5 minutes, dental scale removal with an ultrasonic probe was started. After approximately 30 minutes, the effects of medetomidine were antagonized with atipamezole. RESULTS: The CSI had a median value of 43 (range 40-56) in undisturbed sedated dogs. During dental scale removal, CSI increased to a median value of 99 (range 92-100). The BSR in undisturbed sedated dogs ranged from 2 to 15, but fell to zero during dental scale removal. CONCLUSIONS: Stimulation during dental scale removal might be expected to reduce the level of sedation and hypnosis in dogs to which medetomidine had been administered. The concurrent increase in CSI and decrease in BSR suggested that a higher CSI was associated with arousal from sedation and a reduction in the depth of hypnosis. More studies are needed to validate CSI in order to better understand the functioning of this monitor. CLINICAL RELEVANCE: The CSM shows promise for monitoring the degree of sedation and hypnosis during anaesthesia, and after adequate validation, could contribute to the refinement of anaesthetic techniques in animals.

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.

Measurement of peptidase activity and evaluation of effectiveness of administration of minocycline for treatment of dogs with periodontitis.

OBJECTIVE: To determine clinical, enzymatic, and microbiologic effects of controlled-release localized administration of minocycline on dogs with periodontitis. ANIMALS: Five adult Beagles with periodontitis. PROCEDURE: After tooth scaling and root planing, 2 treatment, 1 placebo, and 1 control site were selected for each dog. Treatment sites (n = 10) received a periodontal formulation of minocycline hydrochloride, placebo sites (5) received ointment without minocycline, and control sites (5) did not receive ointment. Treatments were administered 4 times at weekly intervals. Peptidase activity and clinical and microbiologic effects were evaluated and compared among sites for 17 weeks. RESULTS: Bleeding of the gums on probing (BOP) and pocket depth (PD) improved at the treatment site and were maintained for 13 weeks after treatment. However, BOP and PD in placebo and control sites increased from weeks 9 to 17 Peptidase activity in the periodontal pocket decreased noticeably from week 1 to 17, compared with baseline values for the treatment site. However, peptidase activity for placebo and control sites increased and were above baseline values on week 9 and week 13, respectively. Total bacterial counts decreased by 90% for treatment sites and remained at that value for 13 weeks. However, for placebo and control sites, bacterial counts increased and reached the baseline value on week 17. CONCLUSIONS AND CLINICAL RELEVANCE: Increased peptidase activity is correlated with the progression of periodontitis in dogs. Treatment with minocycline, using a localized delivery system, was effective in dogs for at least 13 weeks after cessation of drug administration.

Effects of ultrasonic dental scaling on pulp vitality in dogs: an experimental study.

We investigated whether dental pulpal damage is produced as a result of the application of an ultrasonic scaler commonly used in clinical veterinary dentistry. Using methods developed in preliminary studies, we examined six dogs. The radiographic thickness of the dentin and pulp cavity was measured. The ultrasonic scaler was applied to maxillary and mandibular premolar teeth for 30, 60, or 90 seconds, without the use of water as a coolant. The temperatures of the room, the pulp canal on untreated incisor teeth, the cheek, the gingival sulcus, and the dentin of the affected teeth were recorded using a probe with a thermistor attached to a resistivity meter and inserted in the dentin to a depth of 1 mm. Two weeks following scaling, the teeth were extracted for microscopic examination. In another dog serving as a control, the temperature of the dentin was increased to between 45 degrees C (113 degrees F) and 47 degrees C (117 degrees F) and the premolar teeth were removed for microscopic examination 15 days later. We concluded that the application of an uncooled ultrasonic scaler for 90 seconds did not increase the temperature of the dentin. However, damage comparable with acute pulpitis resulted as a consequence of the ultrasonic effect, similar to the effects produced by the 45-47 degrees C heat applied in the control animal.

Prevention of bacteremia in dogs undergoing dental scaling by prior administration of oral clindamycin or chlorhexidine oral rinse.

Dogs with periodontitis were used to determine the efficacy of an oral regimen of clindamycin versus chlorhexidine acetate oral rinse in reducing the total number of bacteria and the incidence of bacteremia before and after dental scaling. Aerobic and anaerobic bacteria, isolated from blood and gingival swab cultures, were identified to genus using an automated system.

Comparison of the effects of four different power scalers on enamel tooth surface in the dog.

The surface roughness of tooth enamel was quantitatively evaluated following scaling with four power scalers at three different tip forces. Ceramic and tooth samples were evaluated for surface roughness using surface profilometry. Applied tip forces were produced with a horizontal balanced arm holding the scaler handpiece and load weight, and were measured using a load cell. The power scalers evaluated were the ultrasonic piezoelectric, ultrasonic magnetostrictive (ferromagnetic stack), sonic, and rotosonic. For the tooth samples, at 50 grams of force, the piezoelectric, magnetostrictive, and sonic scaler roughnesses were similar and the rotosonic scaler outcome was statistically higher. Increasing the applied force significantly increased the roughness produced by the rotosonic and piezoelectric scalers. The results of this study indicate that the type of power scaler and applied tip force used determines the post-scaling surface roughness of ceramic and tooth enamel surfaces.

Effects of treatment with clindamycin hydrochloride on progression of canine periodontal disease after ultrasonic scaling.

This study was conducted to determine the benefit, if any, of combining antibiotic therapy with ultrasonic scaling, root planing, and polishing (USRP) over USRP alone as determined by improvements in plaque index, gingival index, and pocket depth measurements. Thirty dogs with signs of periodontal disease were randomly assigned to the USRP-only treatment group or to the USRP-antibiotic treatment group. USRP was performed on all dogs on study day 0. In addition, dogs in the USRP-antibiotic treatment group received clindamycin hydrochloride (Antirobe, Pharmacia & Upjohn, Kalamazoo, MI) dosed at 2.5 mg/lb body weight (BW) twice a day beginning on day 0 and continuing 8 days. Followup visits occurred 2, 6, 13, and 25 weeks after the start of the study. Treatment differences were compared using a mixed model analysis for repeated measures. This analysis indicated that the clindamycin regimen, after USRP, had a significant effect on plaque and pocket depth measures of periodontal disease but not on gingivitis. For plaque, average index scores for the treatment group were lower at all follow-up visits with significant differences at 2 and 6 weeks after cleaning. The antibiotic treatment group also maintained a significantly smaller average pocket depth, representing a 15% postcleaning reduction for the clindamycin group versus a 3% reduction in the control group.