DEFINITION/OVERVIEW

Response to chronic periodontitis seen most commonly in the alveolar bone of the maxillary canine teeth of older cats characterized by thickening or bulging of the alveolar bone (peripheral buttressing or expansile osteitis), periodontal pocketing with or without extrusion, or supereruption of the teeth

ETIOLOGY/PATHOPHYSIOLOGY

Most often found in cats
- Chronic periodontitis
  - Constant bacterial stimulation
  - Alveolar osseous changes leading to thickening of bulging of the alveolar bone (Fig. 51-1)
  - Loss of healthy periodontal support can lead to pocket formation and tooth mobility
  - Supereruption of one or more teeth with apical bone deposition (Fig. 51-2)
- Often bilateral, but one side can be more advanced
Mild form sometimes seen in the alveolar bone of the maxillary and mandibular canine teeth of brachycephalic dogs

Figure 51-1 Bilateral maxillary canine teeth: chronic osteitis with bulging of the alveolar bone.

Figure 51-2 Supereruption of left maxillary canine with additional gingival recession.

SIGNALMENT/HISTORY

Older cats, any breed or gender
Thickening or bulging of alveolar bone of the maxillary canine teeth
Uncommonly, oral pain is present
- Discomfort with mobile teeth
- Discomfort when supererupted maxillary canine contact lower lip

Bulging of buccal alvolar bone
- Gingiva stretched thin over bone
- Variable gingival inflammation, but usually minor
May have periodontal pockets
- Often exhibit vertical bone loss with infrabony pockets
May exhibit extrusion or supereruption of one or more teeth
- Extended tooth length may cause trauma to lower lip
May progress to tooth mobility
Oronasal fistulation is possible

Oral mass: squamous cell carcinoma common in older cats
- Typically, neoplasia is not bilateral

Complete oral examination with periodontal probing
- Record any periodontal pockets, gingival bleeding, or tooth mobility
- Pay particular attention to probing depth of palatal side of maxillary canine teeth
Intraoral radiographs (Fig. 51-3)
- Assess extent of osseous involvement
- Assess root stability and attachment loss
Biopsy
- If unilateral or aggressive osseous changes
- If unresponsive to therapy
Appropriate preoperative diagnostics when indicated prior to procedure

Figure 51-3 Radiograph of right maxillary canine with osseous bulging of alveolar bone with apparent infrabony pocket.

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May 22, 2017 | Posted by admin in GENERAL | Comments Off