Veterinary Dentistry Today January 2012

A 5-year-old castrated male giant schnauzer presented for treatment of a previously diagnosed, unerupted left mandibular canine tooth (tooth 304). Evaluate the attached photo and radiograph. The left mandibular first and second premolars were previously extracted.

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An unerupted, malformed tooth 304 is present and teeth 305, and 306 were radiographically missing with a retained tooth root in the region. Unerupted teeth may lead to dentigerous cyst formation with resulting regional bone loss.

An incision was made through the gingiva of the dorsal alveolar ridge with releasing incisions on both the buccal and lingual aspects of the mandible. The left mandibular third premolar was extracted to allow for better exposure (the left mandibular first and second premolars were previously extracted).

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After creating a mucoperiosteal flap, bone was removed with a round carbide bur on a water-cooled high speed handpiece. After removal of the dorsal cortex, a piezoelectric surgery unit was used to expose the unerupted tooth and delineate the periodontal ligament space.

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Dental elevators were used to gently elevate the tooth from the mandible. A root remnant of the previously extracted distal root of the mandibular second premolar was also identified and removed.

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Due to the presence of significant amounts of cortical bone on the buccal, lingual and ventral surfaces of the mandible, no osteoconductive or osteoinductive substances were placed. The site was closed in two layers with 4-0 poliglecaprone 25 in a simple interrupted pattern.

 

 

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TMJ Ankylosis Repair with Mandibular Asymmetry in a Cat

This kitten was presented to the surgeons at AVS in Orlando.  It could not open its mouth past a few milimeters.  CT showed TMJ ankylosis and a condylectomy was performed.  Upon healing mandibular assymetry resulted in trauma from the the mandibular canine teeth to the palate and the gingiva adjacent to the right maxillary canine.  Crown reduction sparing entry into the pulp chamber provided this kitten with a comfortable bite.  The success of the reduction will be evaluated radiographically in six months.

 

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Crown Fracture in a Dog with Periapical Lucencies on Radiographs

This patient has a very common problem that often goes undetected on routine evaluation.  There is a fracture on the crown with no pulp exposure and a probe cannot be placed into the pulp cavity.  Reparative dentin has sealed what may have once been a complicated crown fracture.  Without radiography this tooth would appear normal otherwise.

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Radiographically there are periapical lucency is seen surrounding both roots.  Root canal therapy or extraction are the options for this tooth.  Leaving it will allow the bone destruction to progress.  Pain is very likely a problem with these patients although almost none will be able to demonstrate it to the owner.

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