7 Periodontitis in a cat
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.
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.
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 7.7 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.