Bonded sealants for fractured teeth

Dental fractures in veterinary patients are relatively common. Historically, very little treatment has been provided for these fractures. Because of the relatively thin layer of enamel present in canine and feline dentition, most fractures result in exposure of dentin and/or pulp. This article discusses the rationale and procedure for treatment of exposed dentin in vital (live) teeth. Correct case selection and treatment improve patient comfort and help decrease the chance of future endodontic involvement in these teeth. This procedure may be considered an entry-level restorative procedure. Once mastered, the materials and principles will allow the practitioner to branch into more sophisticated restorative procedures, such as composite restorations, auto-incline planes, and restoration of endodontic access sites.     

Restorative dentistry

The author considers materials, methods, and techniques used in restorative dentistry. Information about components of cavity preparation, common equipment for restorative work, restorative materials, enamel bonding technique, pin retention, and indirect and direct pulp capping is presented.     

Restorative procedures after root canal therapy

One of the most common indications for veterinary dental restoration involves replacing tooth structure after a root canal procedure. Special considerations are necessary due to the interaction of the restorative material with materials used to obturate the root canal. The restoration must provide a hermetic seal of the pulp chamber, as well as restore function. Combining several different restorative materials provides the best overall performance. In certain instances, full crown coverage is required to restore functional length or cervical anatomy.     

Restorative dentistry. Clinical applications

Restorative techniques for human teeth have been used and refined for centuries. Most of these techniques can be applied with few modifications to restore diseased or damaged teeth in animals. The results can be both functionally sound and cosmetically pleasing.     

Scanning electron microscopic study of the dentinal tubules in dog canine teeth

Dentin adhesive restorative techniques are regularly used in veterinary dentistry. Knowledge of the microanatomic structure and properties of dentin is essential to ensure success in restorative procedures. The aim of this study was to describe the density and diameter of dentinal tubules in dog canine teeth using recently described standardized scanning electron microscopy techniques. The results showed dentin of dog canine teeth to be more oval-shaped with a higher tubular density and slightly larger tubular diameters compared with human teeth. These features suggest dog canine teeth have less intertubular dentin compared with human teeth, which may theoretically result in lower resin-dentin shear bond strengths.     

Commissurotomy for improving access to the oral cavity of the wombat

Wombats are a grazing marsupial with a diet rich in silicates, which is highly abrasive and results in a higher rate of tooth attrition than in other grazing marsupials such as kangaroos. Any interference in the natural wear process, such as malocclusion or loss of teeth, causes overgrowth of teeth. The small mouth opening of the wombat makes access to the caudal mouth difficult and overgrowth of cheek teeth can be difficult to treat effectively. This case report describes a technique that greatly improves access to allow dental treatment of all overgrown teeth with minimal complications.     

Oral surgery. Basic techniques

Some of the clinical problems most frequently seen in veterinary dentistry and their surgical solutions are discussed. Extraction of teeth, surgical repositioning of teeth, tooth transplant, oral abscesses of tooth origin, impaction of teeth, repair of maxillary canine oronasal fistula, and simple techniques for oral wiring are among the issues considered.     

Recent developments in equine dentistry

ABSTRACT

Equine dentistry is a rapidly developing clinical specialty. It has benefitted from key advances in anatomical and physiological research, development of equipment and instrumentation, utilisation of standing sedation and anaesthesia protocols, a change towards minimally invasive surgical techniques, and the introduction of restorative and endodontic techniques translated from techniques used in human and canine dentistry. Anatomical research has provided further insight into the endodontic system of incisors and cheek teeth and how it changes throughout development with age. Studies of the periodontium have demonstrated a rich vascular supply and repair capacity. Routine dental visits are increasingly being performed utilising sedation and clinical instruments for routine examinations. Equipment has become more efficient, battery-operated and miniaturised giving benefits to both equine dental maintenance work and advanced techniques, assisting the transition to minimally invasive techniques, and the development of endodontic and restorative dentistry. Diagnosis has also benefitted from advances in equipment such as patient-side digital radiography systems, high definition oroscopy, and small diameter flexible fibrescopes that are capable of visualising inside a pulp canal. Dental units combining endodontic high- and low-speed drills, suction and air or water flush are becoming increasingly used and adapted for equine use. Sedative combinations and standing anaesthesia protocols have meant that revisions of traditional techniques, as well as novel techniques, can be performed with almost no requirement for general anaesthesia. Equine dentistry can only continue to advance in this way if there is early identification of dental disease through clinical oral examinations, leading to a system based on prophylaxis, as in human dentistry. This necessitates a change in attitude of the public and industry in general to a proactive approach, with early intervention based on examination and diagnostic findings of practitioners and not necessarily based on the clinical signs displayed by the patient.     

Multifocal odontoblastic dysplasia in a dog

A two-year-old Boerboel dog presented for a discolored left maxillary canine tooth. Dental radiographs revealed abnormally mineralized pulp within the discolored tooth. Similar radiographic findings were also seen in both maxillary third incisor teeth and in the remaining canine teeth to varying degrees. The discolored tooth was treated by surgical extraction and histopathology revealed abnormal dentin deposition within the canal indicative of dentin dysplasia. Although not previously documented in the dog, the pulpal changes in multiple teeth of the dog reported here were similar to those described for odontoblastic dysplasia in humans. This case report includes a review of developmental abnormalities of dentin in humans and pulpal response to inflammation and injury.     

Development, growth and eruption of permanent incisor teeth in Romney sheep

The development of permanent incisor teeth of sheep was followed from the age of six weeks to 116 weeks. The teeth were observed through the bud, cap and bell stages, and the development of enamel and dentine. At the same time that amelogenesis started, the papillary layer developed from the intermediate layer and the outer dental epithelium began to form the cell rests of Malassez. The ameloblasts went through secretory, transitional and maturational phases, and in due course disappeared, after which cementum was laid down over the enamel surface. Initially the connective tissue of the follicle surrounding the growing tooth was very loose, but was replaced from the crown end as the tooth developed, by more dense connective tissue. Around the time of eruption, melanocytes were found on the lingual surface of the coronal end of the follicle. The root was formed under the influence of Hertwig's epithelium, and the cell rests of Malassez appeared to continue to develop from the outer enamel epithelium. Odontoblasts, which arose from the pulp connective tissue, were initially cuboidal but became fusiform as the tooth matured. At the time of eruption, amelogenesis was almost complete and cementum covered the majority of the tooth surface. The cell rests and melanocytes of the tootth follicle appeared to migrate with the tooth as it erupted. The deciduous tooth was resorbed from the lingual surface. The junctional epithelium of the erupted permanent tooth may have arisen from the cell rests, remnants of the dental lamina or gingival epithelium, depending on the presence or absence of inflammation.     

An Epidemiological Study on Orodental Disorders in 3,791 Working Donkeys in Egypt: Prevalence and Risk Factors

Orodental disorders are common in equidae and can lead to serious clinical complications. This study determines the prevalence rate (PR) of orodental disorders in working donkeys in Egypt and their potential risk factors. During 4 years, 3,791 donkeys were examined in six Egyptian governorates. Full case history and thorough clinical and oral examinations were performed. Radiography and oroendoscopy were undertaken whenever possible. All data were statistically analyzed using Poisson generalized linear models to compare PR among governorates, sex, years, body condition score, and age groups and to determine the potential risk factors. Of 3,791 examined donkeys, 954 donkeys (25.17%) had orodental disorders. The PRs of acquired disorders were 9.81% sharp enamel points, 5.86% buccal ulcers, 4.88% hook, 4.70% overgrown teeth, 4.19% periodontal disease, 3.11% ramp, 2.60% dental caries, 2.37% dental calculus, 2.30% diastema, 2.06% step mouth, 2.00% soft tissue injuries other than buccal ulcers, 1.77% worn tooth, 1.37% loose tooth, 1.29% exaggerated transverse ridge, 1.24% fractured teeth, 0.82% missing teeth, 0.69% wave mouth, 0.50% molar table angle change, and 0.45% wolf tooth overgrowth. The PRs of the congenital disorders were 1.90% displaced teeth, 1.37% deviated teeth, 0.58% retained teeth, 0.16% overbite, 0.16% underbite, 0.11% supernumerary teeth, and 0.11% premolar cap. The risk factors significantly associated (P < .05) with the orodental disorders were age and sex of the animal, geographic location, and year of examination. This study provides a database for future studies on orodental disorders and for designing effective preventive and therapeutic strategies for these disorders in donkeys.     

A scanning electron microscopic study on surface lesions in fluorosed enamel of roe deer (Capreolus capreolus L.)

Scanning electron microscopy of surface enamel lesions in fluorosed permanent premolars and molars of free-ranging Roe deer revealed two types of pits. Post-eruptive lesions that resulted from mechanical stress on hypomineralized enamel during mastication were characterized by steep walls and a typical honeycomb structure on their bottom, a result of fracture of enamel rods; holes left by fractured rods were surrounded by interrod enamel. Pits of developmental origin (hypoplasias), either as shallow depressions of enamel surfaces or narrow holes running deep into the enamel, were characterized by convex, rounded walls covered by numerous Tomes' process pits. Pits of hypoplastic and post-eruptive origin were often found in the same tooth. Intact enamel surfaces of fluorosed teeth resembled that of controls.     

Development of the Permanent Mandibular Cheek Teeth in Fallow Deer (Dama dama)

The study describes crown and root formation of the permanent mandibular cheek teeth of fallow deer from a gestational age of 22–23 weeks up to a post‐natal age of 33 months. Tooth development was recorded using a scoring scheme based on morphological criteria ranging from crypt formation to completion of root growth. The morphological appearance of the enamel surface during three different stages (secretory‐stage enamel, maturation‐stage enamel and mature enamel) was described, and the approximate age at termination of the secretory stage of amelogenesis in the deciduous and permanent mandibular cheek teeth was determined. The data enable an age estimation of fallow deer up to 3 years of age and provide a basis for assessing the timing of stress episodes that affect tooth crown formation. This information is useful for the management of the species as well as in bioarchaeological and bioindication studies.     

Anterior crossbite correction in a dog using a lingual bar, a labial bow, lingual buttons, and elastic threads.

Anterior crossbite occurs as a result of several conditions. These conditions include retained deciduous teeth, over-crowding, trauma to developing permanent tooth buds, and trauma to erupted teeth. Treatment includes the use of orthodontic appliances and materials to correct the occlusal relationship. This case illustrates the use of a maxillary labial bow, a mandibular lingual bar and lingual buttons to correct an anterior crossbite in a dog.     

Donkey dental anatomy. Part 2: Histological and scanning electron microscopic examinations

Ten normal cheek teeth (CT) were extracted at post mortem from donkeys that died or were euthanased for humane reasons. Decalcified histology was performed on three sections (sub-occlusal, mid-tooth and pre-apical) of each tooth, and undecalcified histology undertaken on sub-occlusal sections of the same teeth. The normal histological anatomy of primary, regular and irregular secondary dentine was found to be similar to that of the horse, with no tertiary dentine present. Undecalcified histology demonstrated the normal enamel histology, including the presence of enamel spindles. Scanning electron microscopy was performed on mid-tooth sections of five maxillary CT, five mandibular CT and two incisors. The ultrastructural anatomy of primary and secondary dentine, and equine enamel types-1, -2 and -3 (as described in horses) were identified in donkey teeth. Histological and ultrastructural donkey dental anatomy was found to be very similar to equine dental anatomy with only a few quantitative differences observed.     

Dens invaginatus of the mandibular first molars in a dog

A 6-year-old dog was presented for draining tracts associated with both mandibular first molar teeth. Radiographs of the affected teeth showed periapical bone lysis. Surgical tooth extractions were performed and the tooth segments were submitted for histopathologic examination. Microscopic evaluation of the teeth showed in folding of the enamel and dentin consistent with a diagnosis of dens invaginatus. Examination performed 13-months following the extraction procedures indicated uncomplicated healing at the extraction sites and no other visible evidence of endodontic disease.     

Purulent dacryocystitis (nasolacrimal duct drainage) secondary to periapical tooth root infection in a donkey

Periapical tooth disease in the equid has been extensively described. Rostral cheek tooth abscessation usually leads to external facial swelling, and in some cases, nasal drainage. Periapical infection of the caudal cheek teeth usually results in maxillary empyema and sinusitis. This case report describes a donkey with periapical tooth root infection of the left 3rd maxillary premolar (207) diagnosed with computed tomography, which drained exclusively into the adjacent/collateral nasolacrimal duct.     

Dental fluorosis in bovine temporary teeth

Deciduous incisors from calves born to dams fed an average of 40 mg of fluoride/kg of forage ration (40 ppm) were compared with incisors from calves born to dams fed a normal dairy ration. Skeletal fluoride concentration in the calves born to fluoride-fed dams was increased 5 to 8 fold, but enamel mottling and hypoplasia, typical of permanent bovine incisor dental fluorosis were not seen by gross, histologic, or radiologic examination. Decreases in the amount of enamel on the tooth or hardness of the enamel were not observed. These data do not support recent reports of widespread dental fluorosis of deciduous bovine teeth as a clinical sign of fluoride toxicity.     

Endodontic decisions based on radiographic appearance

Endodontic disease or disease that affects the internal portion of the tooth is a frequently encountered oral problem of the cat and dog. There are many etiologies that can cause the tooth's health and longevity to be adversely affected. Trauma, tooth malformations of either congenital or acquired origin, and bacterial periodontal ascending infections all can lead to pulpal inflammation, necrosis, and tooth death. One must correlate history, physical exam and radiographic impressions of the tooth, and its supporting structures and adjacent teeth in determining proper treatment options and aftercare. Based on extent, timing, and involvement of adjacent structures, resulting pathology of the tooth may be endodontically treated with either a vital pulpectomy, standard root-canal therapy, surgical root-canal therapy, or when the disease is too extensive by extraction. Through a case presentation, we will discuss some of the decisions that enter into the therapy used to treat presenting pathology. It is the authors' intent to present a thought process for deriving a treatment plan to promote healing. There are many ways to achieve this healing, and therefore, there is no right or wrong plan, but rather one that is based on all the presenting factors.