Intraosseous maxillary hemangioma in an immature Bassett Hound

A 6-month-old Bassett Hound dog presented for evaluation of recurrent oral bleeding and a right maxillary swelling. Oral examination revealed right maxillary enlargement extending from the level of the right maxillary canine tooth to the area of the second and third premolar teeth. A discolored persistent right maxillary deciduous canine tooth and gingival inflammation was noted. Biopsies taken at the time of extraction of the persistent deciduous canine tooth resulted in significant hemorrhage and a biopsy report of reactive bone. The right maxillary enlargement did not resolve following the extraction procedure and empirical antimicrobial therapy. The owner elected euthanasia and post-mortem evaluation. Histopathologic assessment provided a diagnosis of maxillary hemangioma.     

Nasal displacement of a tooth root in a dog

A ten-year-old miniature Dachshund dog was presented for chronic paroxysmal sneezing and unilateral nasal discharge. Extraction of the maxillary right fourth premolar tooth had been performed 2-weeks prior to the onset of clinical signs. Multiple diagnostic modalities were used to confirm the diagnosis and determine that the etiology was a nasally displaced mesiopalatal tooth root. A limited lateral rhinotomy was performed to remove the root. Postoperative examination 1-month following surgery indicated resolution of the clinical signs and uncomplicated healing of the surgery site. Oral examination indicated normal healing of the surgery site with continued absence of clinical signs 6-months after treatment.     

A CONGENITAL MALFORMATION OF THE MAXILLA OF A HORSE

A 1-month-old male American Paint Horse was evaluated for a hard swelling on the right side of the maxillary region. On radiographs there was a large, expansile outpouching of the right maxillary bone between the second and third premolar teeth. Computed tomography further characterized the expansile lesion to have a soft tissue component and to originate in the region of a caudal maxillary tooth. Surgical reconstruction of the defect was unsuccessful and the animal was euthanetized. Based on failure to find histopathologic evidence of a neoplasm or cyst, the diagnosis was a congenital malformation.     

Morphologic features of the root canal system of the maxillary fourth premolar and the mandibular first molar in dogs

Root canal morphology was evaluated in 72 maxillary fourth premolar and 59 mandibular first molar teeth. An apical delta was present in all roots (n = 334). The apical delta represented approximately 12-18% of the total root length for all roots. Non-apical ramifications from the main canal were observed in 25.1% of roots. Secondary canal(s) were present in 20.6% of roots, while lateral canal(s) were present in 6.9% of roots. The distal root of the maxillary fourth premolar had the highest incidence (47.2%) of non-apical ramifications. Overall, 68.0 and 20.4% of maxillary fourth premolar and mandibular first molar teeth had non-apical ramifications, respectively. The prevalence and location of non-apical ramifications may influence clinical decision making when performing endodontic therapy.     

Management of a complicated maxillary fourth premolar crown-root fracture in a dog

A five-year-old spayed/female Border Collie was presented with a crown-root fracture of the maxillary left fourth premolar. Surgical endodontic, and restorative techniques were performed to maintain the tooth. Re-examination 18-months following therapy indicated a successful outcome with no radiographic signs of periapical pathology.     

Surgical repair of a chronic,oronasal fistula in a horse using an alveolar bone flap

An 8‐year‐old Andalusian stallion was presented to the Equine Hospital with a 1.5 year history of an oronasal fistula measuring approximately 2 cm long (caudal to rostral) by 1.5 cm wide following an oral extraction of the right second maxillary premolar (106). An alveolar bone flap was created adjacent to the oronasal fistula and rotated axially and ventrally to close the oral aspect of the fistula. At 3 days after surgery, clinical signs of the fistula, such as green‐tinged purulent nasal discharge and malodorous breath, were no longer evident. At 10 days after surgery, the oral opening of the fistula filled with granulation tissue and mucosa and decreased in size to less than 2 ml. The horse was fed a pelleted mash and grass diet and the small fistula was flushed orally twice daily until it completely healed. At 6 months following surgery, the fistula had completely healed. Few options are available for repairing an oroantral or an oronasal fistula in horses. This case report suggests that a large, chronic oronasal fistula involving the alveolus of a maxillary second premolar can be repaired successfully with an alveolar bone flap.     

Furcation canals of the maxillary fourth premolar and the mandibular first molar teeth in cats

The furcation region morphology was evaluated in 103 mature feline carnassial teeth (54 maxillary fourth premolar and 49 mandibular first molar teeth). Patent furcation canals were present in 27.2% of teeth. No significant difference (p = 0.88) in distribution of this anatomical variation was found between maxillary fourth premolar and mandibular first molar teeth. The mean width of these furcation canals was 104.0 microns with two-thirds of the canals having a buccal orientation. The presence of furcation canals could be a factor in the etiopathogenesis of feline dental resorptive lesions, as well as a characteristic to be considered in the diagnosis, prognosis, and treatment of endodontic or periodontic-endodontic lesions in cat teeth.     

Endodontic treatment and metal crown restoration of a fractured maxillary right fourth premolar tooth: a case report

A 2 year-old, spayed female Shetland sheepdog presented with a fractured maxillary right fourth premolar tooth during oral examination for a dental prophylaxis. Seven months after conventional root canal therapy was performed, the tooth was prepared for non-precious metal, full crown restoration, which was cemented in place 1 month after crown margin preparation. During re-examination for an unrelated problem 6 months later, the metal crown was in place and there was no evidence of further fracture of the tooth.     

True cementomas (cementoblastomas) associated with a nonvital left maxillary second premolar in an 11‐year‐old miniature horse

An 11‐year‐old miniature horse gelding presented for a left maxillary facial swelling and surgical removal of 2 ovoid mineralised masses located near the tooth roots of the left maxillary second and third premolars. Preoperative radiographs were performed to triangulate the location of the calcified masses for removal, and an oral examination revealed that the left maxillary second premolar was nonvital with multiple feed‐packed pulp exposures. Both the radiographs and oral examination indicated that the mineralised masses were associated with the nonvital second premolar. Therefore, the tooth was extracted intraorally, and the masses were removed via a maxillary trephine dorsal to the extracted tooth. Both masses were submitted for histopathology, which diagnosed the masses as true cementomas (cementoblastomas) with adenomatous hyperplasia of the surrounding nasal glandular tissue.     

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.     

Hemangiomatosis associated with osteolysis of the mandible in a dog resembling Gorham-Stout disease in humans

A 6-month-old female German Shepherd Dog died as a result of profuse oral bleeding. At postmortem examination, the oral cavity showed visible roots of the right mandibular fourth premolar and first molar teeth and, in addition, they were very mobile and compressible. Radiographs showed a generalized radiolucency in the body of the right mandible, with evidence of resorption of the affected alveolar bone. Histologically, the lesion of the right mandible was characterized by the lysis of bony structures and a non-malignant proliferation of blood-filled vascular spaces lined by a single layer of well-differentiated endothelial cells. The clinical, radiographic, and histologic presentation of this dog is consistent with that associated with Gorham-Stout disease, a rare bone disorder in humans.     

Mapping of the radiographic central point of feline dental resorptive lesions

Intraoral dental radiographs of 217 cats presented for dental treatment were examined. Radiographic signs of dental resorptive lesions were identified in 107 cats, and the apparent central point of each lesion was mapped on a diagram of the tooth. Mapping was only possible on maxillary and mandibular canine teeth and on mandibular third premolar, fourth premolar, and first molar teeth. Resorptive lesions were most common on the molar teeth (n = 103) and maxillary canine teeth (n = 96), and least common on fourth premolar teeth (n = 56). Resorptive lesions on premolar and molar teeth were widely scattered, noted more commonly in the coronal portions of the root. Resorptive lesions in canine teeth had a tendency to be located more apically on the roots.     

Dental bulge restoration and gingival collar expansion after endodontic treatment of a complicated maxillary fourth premolar crown-root fracture in a dog

This case report describes endodontic, restorative, and periodontal treatment of a complicated crown-root fracture of the right maxillary fourth premolar tooth in a dog. A buccal portion ('slab') had separated from the tooth, which extended subgingivally into root structure. Following completion of standard root canal therapy, a periodontal flap was elevated. Alveolectomy and alveoloplasty were performed, and inflamed soft tissues were debrided. The fracture site was prepared, restored, and shaped to receive a dental bulge contour. A gingival collar expansion technique was utilized to allow for apical positioning of gingiva at the distobuccal crown-root segment. Clinical and radiographic examination 15-months following treatment showed no evidence of endodontic failure. The restorations were intact, and periodontal probing depths were slightly increased probably due to gingival enlargement from concurrent cyclosporine therapy. The importance of biologic width maintenance in periodontal surgery and need for owner compliance with home oral hygiene are discussed.     

Repair of a gingival cleft associated with a maxillary canine tooth in a dog

This case report describes repair of a gingival cleft located on the labial aspect of the maxillary left canine tooth in a client-owned dog. Multiple procedures were performed including elevation of a pedicle flap, granulation tissue removal, alveoloplasty and root planing, and placement of an osteoconductive bone graft material. The surgical site was closed with a laterally repositioned flap. Postoperative examinations were performed at 2 and 3-weeks without chemical restraint and at 3 and 10-months postoperatively under general anesthesia. At the 10-month postoperative examination, a broad band of gingiva surrounded the maxillary left canine tooth, and probing revealed absence of periodontal pockets. Intraoral dental radiographs indicated maintenance of alveolar bone height and incorporation of the bone graft material into alveolar bone.     

Relationship between diet, dental calculus and periodontal disease in domestic and feral cats in Australia

Objective To compare the dental calculus scores and prevalence of periodontal disease in domestic cats eating commercially available canned and dry foods with those in feral cats consuming a diet consisting of small mammals, birds, reptiles and insects.
Animals Twenty-nine feral cats and 20 domestic cats were included in the study.
Procedure A dental chart and dental calculus scores were recorded using the maxillary canine, maxillary third and fourth premolar, mandibular canine, mandibular fourth premolar and first molar teeth on both sides. Periodontal disease was recorded using gingival recession, increased periodontal pocket formation, radiographic alveolar bone loss, osteomyelitis, furcation and root exposure, and the presence of calculus as indicators.
Results Dental calculus scores were significantly higher in domestic cats than in feral cats. There was no statistical difference in the prevalence of periodontal disease between the two groups.
Conclusion It can be inferred that diet may play a role in the accumulation of calculus, but a diet based on live prey does not protect cats against periodontal disease.     

Hemisection and partial retention of carnassial teeth in client-owned dogs

Nine client-owned dogs presented with periodontally and/or endodontically involved mandibular or maxillary carnassial teeth that were either individually affected or adjacent to a jaw fracture. A total of 10 teeth were hemisected (8 mandibular first molar teeth and 2 maxillary fourth premolar teeth), and one crown-root segment was extracted for each tooth. Gingival tissues were approximated and sutured over the extraction sites, and the retained tooth portions were treated by means of standard root canal therapy or vital pulp therapy followed by standard root canal therapy. Retained crown-root segments of 2 of the 10 hemisected teeth were extracted following short- and long-term postoperative examinations due to continued periodontal complications. It was concluded that resection of a portion of a tooth can be a useful treatment for periodontally and/or endodontically involved carnassial teeth that are affected individually or located adjacent to a jaw fracture in dogs.     

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.     

Feline dental resorptive lesions. Prevalence patterns.

Surveys were carried out in cats presented for dental examination in the Netherlands (432 cats) and in the United States (78 cats). In 62% of the Dutch cats and 67% of the US cats, resorptive lesions were present. In the Dutch study, Asian Short-hair (principally Siamese) cats were most commonly involved, and male cats were more commonly affected than females. The most commonly affected teeth were the fourth maxillary premolar and the mandibular premolar and molar teeth.     

Maxillary bone epithelial cyst in a dog

A swelling ventromedial to the left eye of a one-year-old, neutered male Labrador failed to respond to antibiotic and anti-inflammatory therapy. Plain and contrast radiography revealed a spherical, radiolucent area, 1.5 cm in diameter, dorsomedial to the fourth maxillary premolar and rostral to the ethmoid region. The lesion was thin-walled, with a smooth radiopaque margin, and was clearly demarcated from the surrounding structures. Dacryocystography demonstrated no apparent physical association between the lesion and the nasolacrimal duct, the latter appearing normal. Ultrasonography of the lesion showed a round, anechoic structure consistent with the appearance of a cyst. Prior to surgical excision of the lesion, intralesional fluid was aspirated. Bacteriology of the fluid was negative for both aerobic and anaerobic organisms. Cytological examination of the fluid showed a few macrophages and small lymphocytes; neither significant inflammatory component nor neoplastic cells were found. Histology showed the lesion to be a benign epithelial cyst. The dog recovered uneventfully and there was no clinical evidence of recurrence within a two-year follow-up period.     

Furcation entrance anatomy of the fourth maxillary premolar in dogs

Tooth surface and interradicular area (furcation) measurements were determined for 20 fourth maxillary premolar teeth obtained randomly from canine cadavers. The palatal furcation entrance had a mean width of 1.2 +/- 0.1 mm. The coronal roof of the palatal furcation was located at the cementoenamal junction (CEJ). The buccal furcation entrance had a mean width of 0.9 +/- 0.2 mm. The horizontal attachment area between the CEJ and the coronal roof of the buccal furcation was 1.3 +/- 0.3 mm. The mesial furcation entrance had a mean width of 0.4 +/- 0.1 mm. The horizontal attachment area between the CEJ and the coronal roof of the mesial furcation entrance was 1.7 +/- 0.3 mm. The mean coefficient of variation for variables measured was 10.3%. Tooth size did not have a significant effect on furcation entrance measurement. All teeth had a fluted area between the CEJ and mesial furcation, a concavity coronal to the furcation area, a distal concavity of the mesial root trunk between the mesiopalatal and mesiobuccal roots, and a mesial furcation concavity of the distal root extending apically for a mean distance of 60% of the distal root length. The complexity of furcation entrance anatomy may be a factor in the manifestation of periodontal disease involving the furcation of the fourth maxillary premolar in dogs.