NOVEMBER/DECEMBER 2007: JACK

"The importance of dental radiology can be seen in this case, presented recently as a dental “cleaning” with radiographs only as needed. Due to the mobility of tooth #207 and the accidental inclusion of #206, this procedure became a multiple oral surgery case along with the initial concern for the multiple mass removals.

Jack is a 12 year old, neutered male Labrador retriever that was admitted to the hospital for several lipoma type mass removals and a dental prophylaxis. Dental radiographs would be taken as needed. Upon oral examination, tooth #207 appeared to be malpositioned and on probing was mobile. A radiograph was taken, which showed mesial root resorption causing a separation of the root from the crown. Distal resorption was also evident along with the process occurring in tooth # 206 as well. At this point, full mouth radiographs were recommended and approved by the client. Teeth #105,106,107,205,206,207, 305, 307,308, 405,406 and 407 were all involved in the resorption process. Tooth #306 was visually missing but radiographically showed retained root tips. There was no pathology noted on the radiograph. The remaining teeth showed normal alveolar bone and tooth structure.

Regional blocks were given with a combination of Lidocaine and Marcaine. Injections of Buprenorphine and Rimadyl had been given prior to the anesthesia episode and an injection of antibiotics was also given. All the affected teeth were surgically extracted or had the crowns amputated due to replacement resorption. The mucoperiosteal flaps were closed with 4.0 Monocryl. Antibiotics and a multimodal pain approach were used to keep the dog comfortable. A recheck of the surgical sites was scheduled for 1 week.

Photograph #1 shows the malpositionong of tooth 207; 2nd photograph shows closure of the surgical extraction sites. Radiographs #1 and 2 shows the resorption process taking place in the premolars; radiograph #3 shows the site post crown amputation and alveoloplasty (smoothing of bony structures).