April 2008: Lady

The use of a flowable polymer, such as Doxirobe^™ Gel, a slow release doxycycline product has been utilized in the reduction of periodontal pocket formation. The theory is to assist in preserving the alveolar structures by healing the gingival tissues. This in turn will hopefully reduce the periodontal pocket depth and increase reattachment, preserving the health of the surrounding tissues and therefore the integrity of the tooth. Another product in use today is a synthetic bioglass bone grafting particulate called Consil^®. It is applied to the extraction site to help promote new bone growth and periodontal ligament formation.

In this case, Lady, a 12 year old, female, shepherd mix was presented with a fractured upper right 4th premolar (tooth # 108) for surgical extraction. Facial swelling was apparent just below the right eye and she was eliciting discomfort when eating. A full mouth radiographic series would be recommended along with the prophylaxis and surgery. Since Lady had been a patient at this hospital approximately a year and a half ago, a comparison was done between the procedure done then and any teeth being monitored for possible disease progression. At that time, Doxirobe^™ was used at the mesial aspects of both lower #2 molars (teeth # 310 and 410) and applied to the 5-6 mm periodontal pockets that were probed during the oral examination. The original radiographs showed significant mesial vertical bone loss. Also the upper right canine (tooth #104) had been extracted and Consil^® applied to the surgery site.

Reviewing the radiographs from the previous procedure to the radiographs taken for the current procedure, remarkable results were seen from both products. The periodontal pockets treated with Doxirobe^™ were reduced to less then 1 mm and the healing process was significant on radiographic examination. The canine extraction site was nicely filled in with new bone and no empty space was seen. The ability to see the results post treatment was a positive affirmation that the products had shown their worth by preserving the surrounding structures of the mandibular molars and providing new bone growth at the site of the maxillary canine extraction. This had given an acceptable contour to the site and added some strength to the space left by the loss of a very large tooth.

Radiograph #1 and 2 show the bone loss associated with the disease process going on in the periodontal pockets of teeth # 310 and 410.

Radiographs # 3 and 4 show the healing process that resulted from the application of the Doxirobe^™ Gel 1½ yrs previously

Radiograph # 5 shows the new bone growth seen after the application of Consil^® that replaced the large empty space from the extraction of tooth #104.