Archive for January, 2010
Gingival Hyperplasia, Ossifying Epulis and a Jaw Cyst in a Boxer Dog
by Brett on Jan.31, 2010, under Veterinary Dental Cases
This 4 ½ year old boxer was referred for excision of gingival hyperplasia. Both mandibular canines had gingival enlargement as did the maxillary premolars. Treatment pending biopsy was excision with a scalpel and contouring with a #12 fluted finishing bur. Biospy revealed an ossifying epulides on the right canine definitive therapy would be removing the mass and extracting the canine. Closure will be a problem due to the involvement of the entire attached gingiva adjacent to the canine.
Unfortunately the left mandible has a large cyst forming. See caption below for details.
Intially this ossifying epulis was treated with bulk excision with a blade and contour with a #12 fluted bur pending histopath.
Immediate postop. The bur decreases hemorrhage to a minimum.
The left mandible had similare changes
Postoperative view
A large cyst is present in the left mandible. This will eventually destroy the jaw if not treated. Note the supernumery first premolars with resorption on them and the mesial root of the second premolar.
Jaw Fracture Repair in a Dog Utilizing Titanium Mesh
by Brett on Jan.30, 2010, under Veterinary Dental Cases
This dog had a right mandibular fracture secondary to chronic periodontal disease. The jaw fractured spontaneously. It was repaired utilizing a titanium mesh material and an osteoconductive bone putty. http://www.securos.com/downloads/SI%20VelosityPuttyBrochure5.pdf
The fracture line can be seen overshadowed by the first molar mesial root. The site of the mesial root of the 4th premolar was near fracture. The veterinarian did a great job avoiding fracture when extracting these teeth.
Post extraction the fracture line becomes visible. This was a chronic fracture that had the body had attempted to heal. Fibrous tissue was present around the site and provided minor stability.
View of the right mandible after fitting the titanium mesh. The ventral mandible had considerable fibrous tissue present. Disrupting this would have created more instability. The plate was placed over the fibrous tissue. This gives the appearance on the final radiography that the plate doesn't conform well to the mandible. On the contrary this material is very compliant and fits tightly to the bone with minimal anchorage.
The vestibular aspect of the right mandible, screw placement
You can appreciate the delicate structure in relation to my fingers. The plate placed was about 5 times the size of this peice that was clipped off of the portion utilized in this case.
The final repair preclosure
Postop radiograph showing screw placement. Accomodation of the mesh was excellent. Consequently a lingual screw was not needed
Sliding Pedicle Flap for Repair of V-shaped Gingival Recession in a Dog
by Brett on Jan.27, 2010, under Veterinary Dental Cases
This is a (very sweet) middle aged miniature schnauzer with v-shaped gingival defects. Surgery is required to regenerate attachment and slow or prevent further compromise of the periodontal tissue associated with this canine (both were affected) and the 4th premolar. Rostral and caudal sliding pedicle flaps were utilized to repair the canine defect. Donor tissue was taken rostral for the 4th premolar.
For a link to the article describing this procedure Step By Step from the Journal of Veterinary Dentistry please follow this link:
http://veterinarydentistry.net/blog/wp-content/uploads/2010/01/Sliding-Pedicle1.pdf
Stomatitis in a dog responds to home care avoiding full mouth extractions.
by Brett on Jan.26, 2010, under Veterinary Dental Cases
This middle aged dog presented with severe oral pain and halitosis. Visual examination could only be done with sedation. Note the attached gingival is severely inflamed. Biopsy showed changes consisitent with stomatitis. Prednisone ½ mg/kg BID was initiated following a thorough prophy in the hospital. The results can be seen in the recheck picture one week post initiation of predisone. The dog allowed the owner to brush once the inflammation resolved. Prednisone was then tapered to discontinue.
Daily brushing with adjunctive care such as wax sealants, water additives, dental diets and chews, chlorhexidine and sub antimicrobial doses of doxycycline aid in home care efforts. Unfortunately most of these cases must have all full mouth extractions eventually or are euthanized. Full mouth extractions is curative. Most patients get 3 months at best before prophy in the hospital is needed.
Malocclusion In a Dog Causing Trauma to Canine Tooth
by Brett on Jan.23, 2010, under Veterinary Dental Cases
