DENTAL DISEASES AND OTHER ORAL PATHOLOGIES OF CAPTIVE JAGUARS (PANTHERA ONCA) FROM BELIZE, CENTRAL AMERICA.

Dental and oral diseases are prevalent in many mammalian species including wild felids. Determining the dental and oral health status of captive animal populations can help establish preventive and therapeutic strategies, leading to improved welfare and conservation efforts. The aim of this study was to assess the prevalence of periodontal disease, endodontic disease, tooth resorption, and other clinically relevant dental and maxillofacial abnormalities in a population of captive jaguars (Panthera onca) using clinical, radiographic, and histopathological findings. Fifteen jaguars, ranging from young adult to geriatric, kept at a private zoo in Belize, Central America, had a detailed oral examination under general anesthesia between January 2015 and March 2019. Periodontitis was present in 3.8% (16/423) of examined teeth and 53.8% (7/13) of jaguars that underwent periodontal probing. Endodontic disease secondary to dentoalveolar trauma was found in 21.0% (89/423) of teeth in 73.3% (11/15) of animals. Tooth resorption, which has not been previously documented in jaguars, affected 1.4% (6/423) of teeth in 13.3% (2/15) of jaguars. Other abnormalities included metallic foreign material (gunshot) identified radiographically in 33.3% (5/15) of jaguars and nontraumatizing malocclusion in 9.1% (1/11) of jaguars that had occlusion evaluated. Much of the oral pathology identified in captive jaguars is suspected to arise from capture and/or captivity-associated behaviors, as suggested by gunshot around the oral cavity, fractures of rostral teeth (canine and incisor teeth), and abrasions consistent with cage-biting on canine teeth. Anesthetized oral examination-including full-mouth intraoral radiographs, periodontal probing, and charting-is recommended for jaguars with clinical signs of oral pain, as well as for routine systemic evaluation.

Dental Topics for Plastic Surgeons, Part Two: Abnormal Tooth Development, Conditions, and Treatment.

Conditions that affect dental and periodontal structures receive sparse coverage in the plastic surgery literature, yet a working knowledge of this subject matter is important in certain areas of clinical practice and a fundamental understanding is part of plastic surgery competency tested on the in-service and written board examinations. This four-part series written to provide plastic surgeons with a working knowledge of dental topics that may be relevant to their clinical practice. This section, Part II, covers abnormal tooth development and related conditions.

Effect of non-steroidal anti-inflammatory drugs on glomerular filtration rate and urinary N-acetyl-ß-D-glucosaminidase activity in cats after dental surgery.

OBJECTIVE: To compare the effects of meloxicam or carprofen on glomerular filtration rate (GFR), and to evaluate the effect of meloxicam on urinary N-acetyl-ß-D-glucosaminidase (NAG) activity, of cats after dental surgery. STUDY DESIGN: Randomized, blinded, controlled trial. ANIMALS: A total of 24 mixed breed cats. METHODS: Cats were randomly assigned to one of three groups (n = 8 per group): meloxicam (0.2 mg kg-1); carprofen (4 mg kg-1); or saline (2 mL). Acepromazine (0.04 mg kg-1) and buprenorphine (0.02 mg kg-1) were administered intramuscularly as preanaesthetic medication. Test drugs were injected subcutaneously at the time of preanaesthetic medication. Anaesthesia was induced with intravenous propofol and maintained with isoflurane in oxygen. Mean arterial blood pressure (MAP), respiratory rate (fR), heart rate (HR) and haemoglobin oxygen saturation values (SpO2) were recorded. All cats underwent ultrasonic dental scaling with polishing. Teeth extraction involved mucosal flap creation, removal of alveolar bone and flap closure. Plasma iohexol clearance (ICL), a measure of GFR, was estimated before and 24 hours after anaesthesia induction in all cats. Urinary NAG index was estimated in saline and meloxicam groups at the same time points as GFR. Between-group and -time point differences in GFR and NAG index were compared using mixed model analyses. Data are presented as mean ± standard deviation (p < 0.05). RESULTS: There was no significant difference in plasma ICL rate (range: from 1.22 ± 0.05 to 1.27 ± 0.04 mL kg minute-1) between groups or between time points. Urinary NAG index (range: from 1.0 ± 0.19 to 1.36 ± 0.29 Units gram-1) was not significantly different between meloxicam and saline groups. MAP, HR, fR and SpO2 did not differ significantly between groups. CONCLUSIONS AND CLINICAL RELEVANCE: Meloxicam and carprofen appeared to produce nonsignificant effects on GFR, and meloxicam did not affect the urinary NAG activity, of cats after dental surgery.

Adjunct Extraction Techniques in Equine Dentistry.

Adjunct extraction techniques are used when the shape or integrity of the tooth, the shape or size of the patient's oral cavity, the location of the tooth, or the location of the proximal teeth prevents or complicates standard oral extraction. Techniques described and discussed include partial coronectomy, tooth sectioning, minimally invasive buccotomy, transbuccal screw extraction, and commissurotomy.

Equine Oral Extraction Techniques.

This article serves as a template for equine veterinarians to become proficient in basic intraoral premolar and molar extraction techniques of Equidae. Indications, equipment, and methodology are described. Numerous photos and videos are included to achieve a more immersive learning experience than can be accomplished with the written word alone. Clinicians performing these techniques will continue to improve their skillsets to achieve positive outcomes as case specifics become more challenging.

Equine Standing Surgical Extraction Techniques.

Dental repulsion techniques reported in the past decades have a high incidence of complications. Although the practice of surgical extractions in horses is limited because of the training, instrumentation, and experience required to perform these techniques, veterinarians should be aware these procedures are available, general anesthesia is not required, and when performed by skilled veterinary dentists they have low complication rates. Surgical techniques are often used after failure of other extraction techniques to remove retained tooth root and fragments or to debride chronically contaminated orofacial lesions. However, surgical extractions should be considered during initial treatment planning of all complicated cases.

Minimizing Equine Tooth Extraction Complications.

Oral extraction has become the most popular extraction technique owing to its high rate of success with minimal major complication. Repulsion continues to produce unacceptably high iatrogenic complication rates. To avoid tooth repulsion, veterinary dentists have introduced procedures to facilitate difficult intraoral extractions and surgical extraction techniques. Minimizing complications is best achieved preoperatively. A comprehensive preoperative evaluation and treatment plan allows the dentist to predict intraoperative complication and prepare for procedures to produce the best outcome. With proper case selection and adherence to extraction principles, the primary veterinarian and the veterinary dentist can perform equine tooth extractions with minimal complications.

The medically compromised patient: Are dental implants a feasible option?

In healthy subjects, dental implants have evolved to be a common therapy to solve problems related to stability and retention of dentures as well as to replace failing teeth. Although dental implants are applied in medically compromised patients, it is often not well known whether this therapy is also feasible in these patients, whether the risk of implant failure and developing peri-implantitis is increased, and what specific preventive measures, if any, have to be taken when applying dental implants in these patients. Generally speaking, as was the conclusion by the leading review of Diz, Scully, and Sanz on placement of dental implants in medically compromised patients (J Dent, 41, 2013, 195), in a few disorders implant survival may be lower, and the risk of a compromised peri-implant health and its related complications be greater, but the degree of systemic disease control outweighs the nature of the disorder rather than the risk accompanying dental implant treatment. So, as dental implant treatment is accompanied by significant functional benefits and improved oral health-related quality of life, dental implant therapy is a feasible treatment in almost any medically compromised patient when the required preventive measures are taken and follow-up care is at a high level.

Decompression for Unerupted Primary Mandibular Second Molars Associated with Physical Barriers: Case Reports.

Primary impaction of primary teeth might be due to genetic predisposition or physical disturbance including odontoma, supernumerary tooth, and crowded tooth. Among them, calcific deposit or odontoma is commonly associated with primary dentition. Early diagnosis and treatment is the key to prevent complications. However, results of treatment may vary depending on the condition of unerupted tooth. Here we report two clinical cases of unerupted primary mandibular second molars with physical barriers such as compound odontoma and calcific deposit focusing on diagnostic means and the importance of early treatment of these lesions.

[Analysis of the prevalence of dental diseases requiring prosthodontic treatment among the rural population of the Omsk region]. / Analiz rasprostranennosti stomatologicheskikh zabolevanii, trebuiushchikh ortopedicheskogo lecheniia, sredi sel'skogo naseleniia Omskoi oblasti.

The aim of the study was to evaluate the prevalence of dental diseases requiring prosthetic treatment among rural population of Omsk region. The study involved 1247 residents from 12 rural areas of the Omsk region at the age of 18 to 87 years. Partial absence of teeth was found in 69.4±1.30%, 7.5±0.75% had a complete absence of teeth on one jaw and 3.8±0.54% on both jaws. Malocclusion is present in 29.5±1.29% of rural residents, the pathology of dental hard tissues, clinical symptoms of TMJ dysfunction, increased dental abrasion were revealed in 63.8±1.36%, 12.0±0.92% and 8.7±0.80%, respectively. Thus the study showed high prevalence of dental pathology that require prosthetic dental rehabilitation in rural areas of the Omsk region.

Dentoalveolar oral surgery in children and adolescents: organization and surgical treatment in a large, Danish municipal dental service.

OBJECTIVE: To describe a population-based organization of dentoalveolar surgical service for 0 to 18-year old subjects in a Danish municipal dental service, and analyze the type of dentoalveolar surgical interventions needed. MATERIAL AND METHODS: The study was conducted in the Municipality of Aarhus, Denmark during five consecutive school-years. An internal referral system was established within the municipality where patients could be referred to colleagues with a higher level of competencies and more experiences with paediatric dentoalveolar surgery. The analysis includes a total of 1812 children and a total of 2854 surgical interventions. RESULTS: Almost 80% of the patients, representing more than 80% of the dentoalveolar surgical interventions needed, were referred internally. Denudations were the most frequent treatment type (40.3%) carried out, followed by removal of third molars (18.0%). Furthermore, 22 odontomas and 100 supernumerary teeth were removed. CONCLUSIONS: The need of dentoalveolar surgery in children and adolescents is relatively low, but includes a wide range of interventions. An organizational system, where dentists can refer to colleagues who have developed special competencies in this field, results in most of these surgical patients being referred and treated internally.

Extraoral cutaneous sinus tracts of dental origin in the paediatric patient. A report of three cases and a review of the literature.

BACKGROUND: An extraoral sinus of odontogenic origin within the face and neck region is normally the consequence of long-standing chronic infection due to caries, trauma or periodontal infection. There is little reported literature on the prevalence of extraoral cutaneous sinus lesions in the paediatric dental patient as presentation is often delayed resulting in misdiagnosis and consequential mismanagement. CASE REPORT: The cases discussed concentrate on the aetiology, history, presentation and diagnosis of extraoral sinus lesions that presented in children referred to the Child Dental Health Department at the University Dental Hospital of Manchester over a six-month period. CONCLUSIONS: The importance of correct diagnosis and treatment management of an extra oral cutaneous sinus in the paediatric patient only occurred when the child attended a specialist led paediatric dental clinic for consultation.

The Prosthetic Management of an Infra-Occluded First Permanent Molar: Case Report.

This report describes the prosthetic management of a 15-year-old patient with an infra-occluded first permanent molar due to primary failure of eruption (secondary retention). An indirect composite onlay restoration was used to stimulate the periodontal fibres, improve function and restore occlusal stability. This paper describes the clinical technique involved. CPD/Clinical Relevance: Early detection, diagnosis and management of infra-occluded permanent molar teeth is important to avoid occlusal complications, in addition to improving function and stimulating the periodontal fibres.

A Retrospective Study of the Effectiveness of Four Different Treatments of Periodontal Disease in Equine Cheek Teeth.

Periodontal disease of equine cheek teeth is common and may lead to tooth loss if left untreated. Limited information is available comparing the effectiveness of treatment methods. The objective of this study was to retrospectively compare the effectiveness of 4 commonly used treatments in reducing periodontal pocket depth (in addition to routine dental treatment and occlusal equilibration). The 4 treatments compared were (1) removal of feed material, lavaging the pocket with dilute chlorhexidine, and then rinsing the mouth with chlorhexidine-containing mouthwash (CL); (2) CL plus placement of metronidazole into the pocket (M); (3) M plus the addition of polyvinyl siloxane temporary filling over the diastema (PVS); and (4) diastema widening to increase the interdental space, then PVS (DW). Pocket measurements were compared before and 2 to 6 months after treatment. Treatment groups CL, M, and PVS showed statistically significant reductions in pocket depth following treatment. The mean pocket depth reduction was the greatest in the DW group (and this was the only group with no cases having an increase in pocket depth), but this was not significant due to the small sample size. Additional analysis to compare effectiveness revealed a confounding effect of initial pocket depth. After accounting for this, DW was associated with smaller improvements than the other treatments, however, this was also based on a small sample size. After accounting for confounders, differences between treatments CL, M and PVS were not found to be significant, although all were associated with statistically significant reductions in pocket depth.

Effect of Causative Tooth Extraction on Clinical and Biological Parameters of Odontogenic Infection: A Prospective Clinical Trial.

PURPOSE: To prospectively compare changes of body temperature, white blood cell count, fibrinogen, and C-reactive protein between odontogenic infections in which the responsible tooth was removed and odontogenic infections in which the treatment included no extraction. MATERIALS AND METHODS: The sample was composed of patients admitted to the authors' maxillofacial unit for odontogenic infection from 2010 through 2013. One hundred seventy-nine patients were categorized into an extraction or a non-extraction group based on whether the causative tooth was non-restorable or restorable, respectively. Non-restorable teeth were extracted at admission of the patient. Otherwise, the treatment protocol, including incision of the involved space in conjunction with intravenous antibiotics, was the same for the 2 groups. The parameters were measured and recorded at admission and 2 days later. Data records were statistically analyzed by comparing the change of the parameters studied between the extraction and non-extraction groups. P values less than .05 were regarded as statistically significant. RESULTS: One hundred seventy-nine patients fulfilled the inclusion criteria and were enrolled in the study. The mean age of the patients was 39.1 years (minimum, 14 yr; maximum, 81 yr; standard deviation, 15.4 yr). One hundred nine patients (60.9%) were male, and 70 (39.1%) were female. Differences in the mean decrease of axillary temperature, white blood cell count, fibrinogven, and C-reactive protein between the 2 groups were 0.178, 2,300, 1.01, and 0.64, respectively. All these differences were statistically significant (P =.02, .001, .001, and .001, respectively). Also, the mean hospital stay in the extraction group was 1.05 days shorter than in the non-extraction group, with the difference being statistically significant (P = .006). CONCLUSIONS: In odontogenic maxillofacial infections, extraction of the causative tooth is associated with a faster clinical and biological resolution of the infection.

Determinants of length of hospitalization due to acute odontogenic maxillofacial infections: a 2009-2013 retrospective analysis.

OBJECTIVES: To investigate the determinants of the length of hospitalization (LOH) due to acute odontogenic maxillofacial infections (AOMIs) from 2009 to 2013. MATERIALS AND METHODS: Dental records of adult patients with AOMIs and related data were retrieved from the Vilnius University's dental hospital. The LOH was related to several determinants in each of the following domains: outpatient primary care, severity of AOMIs, lifestyle and disease domains. Determinants were also associated with the LOH using multivariate analysis. RESULTS: A total of 285 patients were hospitalized with AOMIs, of which 166 (58.2%) were males and 119 (41.8%) were females. The mean LOH was 8.3 ± 4.9 days. The bivariate analysis did not reveal any statistically significant differences in LOH between patients with AOMIs who received urgent outpatient primary care and those who did not receive such care prior to hospitalization. All AOMI severity-related determinants were associated with the LOH. The LOH was related to coexisting systemic conditions but not to the higher severity of dental or periodontal diseases. Both bivariate and multivariate analyses revealed similar trends, where the most significant determinants of a longer LOH were related to the severity of AOMIs. CONCLUSION: The most important determinants regarding longer hospitalization were indicators of infection severity such as an extension of the odontogenic infection and the need for an extraoral incision to drain the infection.

Clinical crown lengthening - a case report.

Maintaining healthy parodontium during teeth restoration procedures is an indispensable condition for obtain- ing regular functionning and esthetics. Thus, the knowledge of correct anatomy and the influence of filling and complement on paradontium tissue is vital. Difficulty in maintaining appropriate gingival biological width (GBW) is a frequent problem encountered in this type of reconstruction. Preservation of unchanged biological width conditions predictible treatment result and, what is more, lack of inflammatory lesions in marginal parodontium. The ideal situation for parodontium is localizing the filling/complement border supragingivaly, which is at least 3 mm from alveolar process edge. In the case, when the above conditions are impossible to fulfil, elongation of clinical crown is a metod of choice. The effect is possible to achieve by surgical treatment or combined orthodontic - surgical treatment. Surgical treatment is faster and preferred procedure for indirect reconstruction, where achieving high clinical crown is necessary. Three clinical cases of performing method of surgical clinical crown elongation were presented in the article. Performing the described procedure enables correct tooth crown reconstruction and, what is most important, keeping individual toothing.

Ectodermal dysplasia: an 11-year follow-up of siblings with 2 implant treatment approaches.

PURPOSE: To describe 2 different treatment approaches for a 20-year-old Caucasian man and his 22-year-old sister who were affected by ectodermal dysplasia (ED) and compromised maxillary bone. MATERIALS AND METHODS: The sister had a history of an iliac crest transplant with 6 implants placed in the maxillary and mandibular arches, 6 years before complications. It was necessary to debride the right sinus, remove the failing infected bone graft and 2 implants. Her brother presented with missing teeth, few remaining deciduous teeth, and wearing all-acrylic resin temporary partials in both the maxillary and mandibular arches. RESULTS: Zygomatic and pterygomaxillary implants were used to rehabilitate the brother with a screw-retained fixed prostheses. His sister had 6 new maxillary implants. Both siblings' mandibular arches were restored with screw-retained implant-supported prostheses. CONCLUSION: Although these siblings affected with ED had different treatment approaches, they both eventually obtained successful outcomes. The brother's treatment was expedited. Both siblings have been followed for a period of 11 years, and all postoperative evaluations have been uneventful.

Evaluation of a romifidine constant rate infusion protocol with or without butorphanol for dentistry and ophthalmologic procedures in standing horses.

OBJECTIVE: To compare the clinical usefulness of constant rate infusion (CRI) protocols of romifidine with or without butorphanol for sedation of horses. STUDY DESIGN: Prospective 'blinded' controlled trial using block randomization. ANIMALS: Forty healthy Freiberger stallions. METHODS: The horses received either intravenous (IV) romifidine (loading dose: 80 µg kg(-1) ; infusion: 30 µg kg(-1)  hour(-1) ) (treatment R, n = 20) or romifidine combined with butorphanol (romifidine loading: 80 µg kg(-1) ; infusion: 29 µg kg(-1)  hour(-1) , and butorphanol loading: 18 µg kg(-1) ; infusion: 25 µg kg(-1)  hour(-1) ) (treatment RB, n = 20). Twenty-one horses underwent dentistry and ophthalmic procedures, while 19 horses underwent only ophthalmologic procedure and buccal examination. During the procedure, physiologic parameters and occurrence of head/muzzle shaking or twitching and forward movement were recorded. Whenever sedation was insufficient, additional romifidine (20 µg kg(-1) ) was administered IV. Recovery time was evaluated by assessing head height above ground. At the end of the procedure, overall quality of sedation for the procedure was scored by the dentist and anaesthetist using a visual analogue scale. Statistical analyses used two-way anova or linear mixed models as relevant. RESULTS: Sedation quality scores as assessed by the anaesthetist were R: median 7.55, range: 4.9-9.0 cm, RB: 8.8, 4.7-10.0 cm, and by the dentist R: 6.6, 3.0-8.2 cm, RB: 7.9, 6.6-8.8 cm. Horses receiving RB showed clinically more effective sedation as demonstrated by fewer poor scores and a tendency to reduced additional drug requirements. More horses showed forward movement and head shaking in treatment RB than treatment R. Three horses (two RB, one R) had symptoms of colic following sedation. CONCLUSIONS AND CLINICAL RELEVANCE: The described protocols provide effective sedation under clinical conditions but for dentistry procedures, the addition of butorphanol is advantageous.

Standing equine dental surgery.

Dental surgeries refer to procedures that affect the dental tissues or their supporting structures. With the development of specific, efficacious, and conservative treatments, morbidity risks have been lowered and chances of benefiting the health of equids improved. Advances in quality of sedation, analgesia, and locoregional anesthesia allow a majority of dental surgeries to be performed in the standing patient. This update focuses on an orthograde endodontic technique, a minimally invasive buccotomy technique, with the potential to combine it with a transbuccal screw extraction technique, and revisits the AO pinless external fixator for fractures of the body of the mandible.