PATIENT DETAILS

A 7-year-old, neutered female, domestic short-haired cat.

CASE HISTORY

The cat had received three episodes of periodontal treatment in the last 4 years. These had consisted of scaling, polishing and extraction (no record of which teeth or reason for extraction). Six months prior to the referral it was noted that the left upper canine extraction socket had not healed. The cat had received several courses of antibiotics with no improvement. Also, the left lower canine was catching the upper lip and causing ulceration.

The cat was referred to us for management of the non-healing extraction socket and the lip lesion.

ORAL EXAMINATION – CONSCIOUS

The cat was relatively amenable to quick conscious oral examination, which revealed the following:

ORAL EXAMINATION – UNDER GENERAL ANAESTHETIC

See the front page of the dental record (Fig. 7.1) for details of findings.

Figure 7.1 Dental record. All clinical findings are reported on the front page of the dental record. Remember that periodontitis is a site-specific disease. PPD is recorded on the occlusal view of the tooth on the dental record so that you can easily identify the precise site of disease. Normal periodontal probing depth (PPD) is not noted on the dental record to avoid clutter. However, when gingival recession is present, then PPDs are always recorded so that periodontal attachment loss (PAL) can be calculated (GR + PPD) and entered on the record at its precise site in green ink. PAL is a more accurate assessment of attachment loss.

In summary, examination under general anaesthesia identified the following:

Figure 7.2 Occlusal view of the non-healed extraction socket of 204.

Figure 7.3 Lateral photo of the non-healed extraction socket of 409.

Figure 7.4 Advanced periodontitis.

(a) Bone loss and gingival recession have resulted in exposure of the furcation on the palatal aspect of 107.

(b) Tooth 107 has a grade III furcation lesion, i.e. the probe can be passed through the furcation.

FURTHER INVESTIGATIONS

Full-mouth radiographs (10 views) were taken.

RADIOGRAPHIC FINDINGS

The radiographs revealed a generalized horizontal alveolar bone loss, which was more severe in the upper jaw (Fig. 7.5). There was extensive bone loss at the furcation of 107 (Fig. 7.5), 309 (Fig. 7.6) and 408 (Fig. 7.7). The bone loss at 408 had a vertical (as well as horizontal) component and there was a pathological fracture of the mesial root (Fig. 7.7). In addition, the root of the extracted 204 (Fig. 7.8) and the distal root of the extracted 409 were retained.

Figure 7.5 Advanced periodontitis. Radiograph reveals generalized horizontal bone loss and extensive loss of furcation bone of 107.

Figure 7.6 Advanced periodontitis. Radiograph demonstrates horizontal bone loss and furcation involvement of 309.

Figure 7.7 Advanced periodontitis, pathological root fracture and retained root from previous extraction. Radiograph demonstrates horizontal bone loss and external root resorption of 408. Remember that inflammatory root resorption is a feature of periodontitis and needs to be differentiated from idiopathic root resorption. The bone loss at the furcation of 408 is severe. Note the pathological fracture of the mesial root of 408, which explains the grade II mobility recorded for this tooth. Note also the retained distal root from extraction of 409, which prevented healing of the socket.

Stay updated, free articles. Join our Telegram channel

Join