Jason W. Soukup

Prevalence and nature of dentoalveolar injuries among patients with maxillofacial fractures

OBJECTIVE Although not previously reported, experience suggests that dentoalveolar injury is -common among patients with maxillofacial fractures. The objective of this study was to evaluate and describe the prevalence and nature of dentoalveolar injuries in patients identified with maxillofacial fractures. METHODS Medical records of 43 dogs and cats diagnosed with maxillofacial fractures between 2005 and 2012 were reviewed to identify patients with concurrent dentoalveolar injury. Medical records of patients with dentoalveolar injury were abstracted for the following information: signalment (including sex, age and skull type), mechanism of maxillofacial trauma, location and number of maxillofacial fractures, dentoalveolar injury type and location and the number of dentoalveolar injury per patient. Statistical evaluation was performed to determine associations between signalment, mechanism of trauma, location and number of maxillofacial fractures and the prevalence and nature of concurrent dentoalveolar injury. RESULTS Dentoalveolar injuries are common among patients with maxillofacial trauma. Age and mechanism of trauma are significant predictors of the presence of dentoalveolar injuries in patients with maxillofacial trauma. CONCLUSIONS AND CLINICAL RELEVANCE The findings of this study serve to encourage veterinarians to fully assess the oral cavity in patients with maxillofacial fractures as dentoalveolar injuries are common and can be predicted by age and mechanism of trauma.

Clinical, Histologic, and Computed Tomographic Features of Oral Papillary Squamous Cell Carcinoma in Dogs: 9 Cases (2008–2011)

Medical records of dogs diagnosed with oral papillary squamous cell carcinoma between December 2008 and April 2011 were reviewed. Information abstracted included signalment, tumor location, tumor size, computed tomographic (CT) features, evidence of metastatic disease based on cytologic examination of lymph node aspirates and thoracic radiography, treatment, surgical margins, histologic features, and treatment outcome. Dogs included in the study were all sexually altered, predominantly large breed dogs with a mean age of 3.9-years (range, 0.5 to 9.0-years). The most common location was the rostral maxilla. Invasion of underlying bone and lymphadenopathy were evident on CT imaging in most dogs. No evidence of metastasis was found on mandibular lymph node cytology and thoracic radiography. Histologic analysis revealed similar morphologic findings for all surgically resected tumors. Surgical excision with 1–2 cm margins was complete in all cases, with a mean tumor-free interval of 12.1-months.

Comparing the Degree of Exothermic Polymerization in Commonly Used Acrylic and Provisional Composite Resins for Intraoral Appliances

The use of dental acrylics and composite resins in veterinary dentistry has become widespread. However, their use is not without potential complications. All acrylics and composite resins produce an exothermic reaction during the polymerization process. The aim of the current study was to evaluate thermal conduction during the polymerization reaction of each material to offer clinical guidelines when choosing a material with particular consideration for the significant volumes typically used. Results showed that methylmethacrylate based resins generated a significantly higher degree of heat during polymerization. Bis-acryl based composite resins generated a significantly lower degree of heat during polymerization, making them the material of choice to potentially minimize thermal injury to the dentin-pulp complex. It is the responsibility of the clinician to become aware of all materials available, and to have an understanding of their properties to guide them in making sound clinical judgments.

Imaging and management of a caudal mandibular fracture in an immature dog.

Interfragmentary wire surgical technique was used to repair a caudal mandibular fracture in a 15-week-old Labrador Retriever dog. Computed tomographic imaging aided the diagnosis and treatment planning for the application of this method. Abnormal tooth development of caudal molar teeth was related to the traumatic event and/or surgical technique. The strategically important mandibular first molar tooth was maintained. The fracture fixation method used in this case provided early return to function and radiographic evidence of expected fracture healing during a 10-month period despite wire displacement secondary to tooth eruption.

Caudal Mandibular Bone Height and Buccal Cortical Bone Thickness Measured by Computed Tomography in Healthy Dogs

OBJECTIVE To characterize bone height and buccal cortical bone thickness of the caudal mandible of healthy dogs. STUDY DESIGN Prospective original study. SAMPLE POPULATION Client-owned dogs (n = 36). METHODS Dogs were distributed by weight into 3 groups (<10, 10-20, >20 kg). Thirteen transverse plane computed tomography images were selected for each dog based on anatomic landmarks from the 4th premolar (PM4) through the 2nd molar. On each image, bone thickness was measured along the buccal surface of both mandibles from the alveolar margin to the ventral border in 3 mm increments. The number of 3 mm increments were recorded as an estimation of mandibular height. RESULTS Buccal bone was generally thicker ventrally in the area studied with decreasing bone thickness over both roots of PM4 and the mesial root of the 1st molar (M1). Cortical bone thickness of <2.0 mm was measured across all groups at most locations 3 mm ventral from the alveolar margin. Mandibular bone height demonstrated significantly fewer (P < .05) 3 mm increments over the distal root of M1 in dogs >10 kg compared with the number of observations at the immediately mesial and distal locations. CONCLUSION Thin cortical bone overlying the mesial and distal roots of PM4 and the mesial root of M1 limits use of these areas for application of monocortical anchorage devices. Decreased mandibular bone height at mandibular M1 may create a stress riser at this location, which along with thin cortical bone may explain why this is a common area for mandibular fracture.

Classification and Epidemiology of Traumatic Dentoalveolar Injuries in Dogs and Cats: 959 Injuries in 660 Patient Visits (2004–2012)

The objective of this study was to determine the epidemiology of traumatic dentoalveolar injuries (TDI) in dogs and cats and to evaluate the applicability of a human classification system for TDI in dogs and cats. All patients diagnosed with a TDI were identified from the University of Wisconsin-Madison School of Veterinary Medicine Dentistry and Oral Surgery Service case log and the hospital patient processing software. The study population consisted of 621 dogs and cats, in a total of 660 patient visits from 2004 to 2012, admitted for oral treatment and subsequently diagnosed with at least one TDI. Medical records including diagnostic imaging studies were reviewed to group the injury according to a classification system used in humans for TDI. Patient signalment, tooth injured, and number of injuries per patient were recorded and tabulated. The overall prevalence of TDI was 26.2%. The mean +/− SD number of TDI per patient was 1.45 +/− 0.85. All 14 classes of TDI recognized by the classification system utilized in humans were identified, and all (100%) TDI identified in this study were classifiable using this system. Enamel-dentin-pulp fracture was the most common TDI (49.6%). The most commonly injured teeth were the mandibular or maxillary canine teeth (35.5%). The most common age for dogs and cats with TDI were 3–6 years (33.0%) and 7–10 years (31.3%). With a frequency of 1 in 4 animals, TDI are common and represent a significant pet health concern. Most TDI are considered severe and require timely, and sometimes immediate, treatment. The adoption and utilization of a complete classification system, such as the one used in this study, is recommended in order to improve future epidemiological study of TDI in animals.

Effect of Preparation Surface Area on the Clinical Outcome of Full Veneer Crowns in Dogs

Crown therapy is commonly used in veterinary medicine to provide support to teeth which have previously fractured, received root canal therapy, have significant wear, or experienced other detrimental removal of tooth substance. As with several aspects of veterinary medicine, many of the recommendations or guidelines for crown therapy originate from human dentistry, which are then transferred to veterinary patients. Due to the significant difference in the anatomy of teeth and function of the oral cavity between humans and dogs, these guidelines need to be studied to determine the appropriateness of their use in veterinary patients. This article evaluates the relationship between surface area of the preparation and clinical outcome of full veneer crown therapy of the canine tooth in dogs. Although there appeared to be a positive relationship between preparations with greater surface area and successful clinical outcome, it was not found to be statistically significant.

Nomenclature and Classification of Odontogenic Tumors — Part II: Clarification of Specific Nomenclature

Accurate identification of odontogenic tumors is critical for productive communication and an important foundation for useful comparative epidemiologic studies of odontogenic tumors in both domestic animals and humans. This manuscript illuminates the subject of veterinary odontogenic tumor nomenclature and will serve as a foundation for future updates in nomenclature and classification of odontogenic tumors.

Crown preparation design: an evidence-based review.

Evidence-based clinical guidelines for full metal crown preparation design are seldom encountered in the veterinary literature. The veterinary literature regarding prosthodontic treatment in companion animals is sparse and consists primarily of case reports and expert opinion based primarily on clinical experience. The goal of this manuscript is to present concepts of evidence-based practice, review common recommendations on crown preparation design from the veterinary literature, and to provide an assessment of the evidence for or against those recommendations.

Use of an autogenous cortical graft in combination with guided tissue regeneration for treatment of an infrabony defect.

Infrabony periodontal defects are common findings encountered during complete oral examinations. Treatment options for infrabony lesions are aimed at meeting client demands as well as patient needs. Deciding on how to treat these lesions depends on the nature and degree of disease present as well as having the materials available to improve the chances of achieving the greatest clinical success. Bone grafting of an infrabony defect of the left mandibular first molar tooth of a dog using an autogenous cortical graft harvested with a reusable bone grafter in combination with guided tissue regeneration is described.