Tooth shortening and endodontics, then extraction

28 Tooth shortening and endodontics, then extraction




INITIAL PRESENTATION


Malocclusion – lower canine teeth erupting into palatal mucosa, causing teeth indentations and ulceration.



PATIENT DETAILS


A 6-month-old, female, Great Dane.



CASE HISTORY


The owner was concerned about the indentations and ulcerations caused by the maloccluding lower canine teeth. The dog was showing signs of discomfort from the malocclusion (not playing with toys, selecting soft food in preference to hard, not eating very well, etc.). The dog had been examined by its own veterinarian, who referred the case to us for evaluation and treatment.



ORAL EXAMINATION – CONSCIOUS


The dog was nice tempered but anxious when the head and face were examined. Oral malodour was obvious. Cursory oral examination revealed that the upper jaw was of normal length and width for the breed, but the mandible was much too short and narrow. The lower canines occluded with the palatal mucosa, causing deep ulcerated indentations, which were filled with debris.



ORAL EXAMINATION – UNDER GENERAL ANAESTHETIC


A thorough oral and dental examination, including investigating periodontal parameters, was performed. All findings were noted on the dental record sheet. In summary, examination under general anaesthesia identified the following:


1. Skeletal malocclusion. Upper jaw of normal length and width, with short and narrow lower jaw, i.e. mandibular brachygnathism. The lower incisors were occluding with the palatal mucosa, but not causing any soft tissue lesions. The lower canines occluded with the palatal mucosa, distal to the upper canines, causing deep ulcerated indentations (12 mm), which were filled with debris. There were also non-ulcerated indentations in the palatal mucosa where the lower carnassials occluded.

2. Generalized mild gingivitis.


FURTHER INVESTIGATIONS


Radiographs of 304 and 404 were taken to determine the developmental stage.



RADIOGRAPHIC FINDINGS


Teeth 304 and 404 were immature (as expected in a 6-month-old dog) with open apices and only a thin layer of secondary dentine formed.



THEORY REFRESHER


Malocclusion can result from jaw length and/or width discrepancy (skeletal malocclusion), from tooth malpositioning (dental malocclusion), or a combination of both. This case is a skeletal malocclusion and is thus inheritable. Malocclusion causing discomfort and pathology always needs treating.


The treatment options available are orthodontics, tooth shortening or extraction. The aim of any treatment is primarily to make the animal comfortable; aesthetics are a secondary consideration.




CLINICAL TIPS



• Malocclusion can result from jaw length and/or width discrepancy (skeletal malocclusion), from tooth malpositioning (dental malocclusion), or a combination of both.

• Skeletal malocclusion is inheritable. Affected dogs should not be used for breeding.

• The aim of any treatment is primarily to make the animal comfortable; aesthetics are a secondary consideration.

Related posts:

  1. The tooth and its periodontium
  2. Multiple tooth and jaw fracture
  3. Natural progression of disease
  4. Enamel dysplasia

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Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on Tooth shortening and endodontics, then extraction

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