APRIL 2007: ROCKY

Rocky is a 6-month-old, 9.7-pound neutered male Miniature Poodle presented for a routine dental prophylaxis based on the owner's perception of excessive tartar buildup on the puppy's tooth surfaces. Upon oral examination, it was determined that Rocky had enamel hypoplasia (a condition where the enamel is thin or reduced, affecting the crowns of his entire dentition). Due to the rough coronal surfaces, plaque and tartar had formed along the buccal and lingual crowns. There was also a persistent deciduous upper left canine tooth (#604) affecting the positioning of the permanent canine (#204) and the first premolar (#205). The mandibular incisors were crowded ,with the second incisors (# 302, #402) lingually displaced along with a deciduous crown cap (#808) blocking the path of eruption for the mandibular right fourth premolar (#408). The photograph shows the extent of enamel hypoplasia and the radiographs depict the deciduous canine, crown cap, and displaced incisors. Observe that many of the developing permanent teeth have open apices and apexogenesis (maturation of the tooth, with its full root length) has occurred with others.

A full mouth radiographic series was done and a complete prophylaxis was performed. An injection of buprenorphine was given 15 minutes prior to beginning the extraction process. The second incisors (302 and 402) were extracted with simple elevation; the deciduous 808 crown was removed to allow an unobstructed eruption path for 408. A mucoperiosteal flap was created for removal of 604. A small amount of buccal bone was removed with a small round tip bur to further expose the tooth to ensure a safe extraction procedure and eliminate any trauma to the developing teeth. The tooth was carefully elevated to remove. Followup radiographs showed successful extraction of all teeth. Splash blocks with Marcaine were applied to each site to decrease any discomfort incurred and the gingival flap was closed with 5.0 Monocryl.

Rocky was to be sent home with an oral antibiotic along with Tramadol tablets and Metacam for pain relief. Since the owner resided in Las Vegas, she would be referred to a doctor in her area for further consultation and advice on which avenues of treatment would be appropriate for her dog's long-term oral health and comfort. Tooth restoration, surface bonding, and a conservative approach of cleaning and fluoride application were among the possibilities.