Idiopathic canine root resorption

21 Idiopathic canine root resorption




INITIAL PRESENTATION


Complicated crown fracture of 404.



PATIENT DETAILS


A 9-year-old, neutered male, cross-breed.



CASE HISTORY


The dog was referred to us for endodontic treatment of a complicated crown fracture of 404. The fractured tooth had been noted by the referring veterinarian at the time of vaccination. There was no history of any previous dental treatment. The owner had not been aware of the fractured tooth and did not feel that it was causing any discomfort.



ORAL EXAMINATION – CONSCIOUS


He was a nice-tempered dog that allowed conscious examination of the head and mouth. The following were identified:


1. Normal occlusion

2. Generalized moderate gingivitis

3. Teeth 101, 102, 201, 202, all lower incisors and 304 were missing

4. Complicated crown fracture of 404.


ORAL EXAMINATION – UNDER GENERAL ANAESTHESIA


A thorough oral examination, including investigating periodontal parameters, was performed and all findings were noted on the dental record.


In summary, examination under general anaesthesia identified the following:


1. Teeth 101, 102, 201, 202, 110, 210, all lower incisors, 304, 305, 310, 311, 405, 410 and 411 were missing

2. Generalized moderate gingivitis

3. Complicated crown fracture of 404

4. Cavity (filled with soft tissue) at the lingual cervical aspect just above the gingival margin of 404

5. Cavity (filled with soft tissue) at the buccal cervical aspect just above the gingival margin affecting 104, 109 (Fig. 21.1), 208, 306, 307, 308, 309, 406, 407, 408 and 409

6. Teeth 108, 109, 208 and 209 (Fig. 21.1) were discoloured pink.

image

Figure 21.1 Oblique lateral photograph of 108 and 109. Both 108 and 109 are discoloured pink. This is a consequence of the destruction of the dental hard tissue extending into the crown and involving the pulp, which ‘shines through’ the thin enamel. Note the soft tissue-filled cavity on the buccal aspect of 109.



FURTHER INVESTIGATIONS


A series of full-mouth radiographs (14 views) was taken.



RADIOGRAPHIC FINDINGS


The series of full-mouth radiographs showed replacement resorption of all remaining teeth. See Figs 21.2, 21.3, 21.4, 21.5, 21.6, 21.7, 21.8 and 21.9 for details of findings.


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Figure 21.2 Rostrocaudal radiograph of the rostral upper jaw. Clinically, there was no evidence of 101, 102, 201 and 202, and the edentulous area was covered by healthy gingiva. The radiograph shows that these teeth have undergone resorption and been replaced by bone.


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Figure 21.3 Lateral radiograph of the right upper jaw. Tooth 103 has a clear periodontal ligament space and a smooth root outline, i.e. there is no radiographic evidence of external root resorption. A clear periodontal ligament space separating the tooth from the alveolar bone can be identified for 104, but note the vertical radiolucent lines in the root, indicating ongoing resorption of dentine. The roots of 105, 106, 107 and 108 all show extensive replacement resorption. It is difficult to identify a clear periodontal ligament and the roots have the appearance of bone rather than dentine.


image

Figure 21.4 Lateral radiograph of 108 and 109. The crowns of these teeth have lost their roots and have only soft tissue attachment to the jaw. Clinically, there was a soft tissue-filled cavity at the buccal aspect of 109 just above the gingival margin and both teeth were discoloured pink as a consequence of the resorptive process spreading into the crowns of these teeth.

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Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on Idiopathic canine root resorption
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