32 Uncomplicated crown fracture with periapical complications
This case was seen as a new client when I was in first opinion practice.
The owner was interested in oral care, and the dog had received an annual scale and polish since she was 2 years old (seven episodes of periodontal therapy under general anaesthesia). She was fed a dental diet and given daily dental hygiene chews. The owner reported that the dog was worried about having her face touched. The dog had previously allowed toothbrushing, but had not allowed it for the last year.
ORAL EXAMINATION – CONSCIOUS
The dog was aggressive when the head was approached and conscious oral examination was not possible.
ORAL EXAMINATION – UNDER GENERAL ANAESTHETIC
A thorough oral examination, including investigating periodontal parameters, was performed and all findings were entered on the dental record sheet.
In summary, examination under general anaesthesia identified the following:
The diameter of the pulp system of 108 was wide and the apices of the roots were open, indicating that the injury occurred during tooth development in the first year of life. There was also periapical inflammation with bone destruction and external root resorption (see Fig. 32.2 for details of the radiographic findings for 108).
Figure 32.2 Radiograph of the right upper caudal mandible. Note the wide diameter of the pulp chamber and the distal root canal of 108, indicating pulp necrosis and cessation of dentine production. Periapical pathology is evident. There is a significant periapical destruction of the distal root of 108 and the apical segment is rough and uneven, indicating inflammatory external root resorption. A second view was taken to visualize the mesial roots, which were also found to have external root resorption and periapical bone destruction.
The diameter of the pulp system of 208 was narrow and the apices were closed, i.e. it was a mature tooth, as expected in a 9-year-old dog. There was periapical inflammation with bone destruction. The drainage tract was shown to originate from the mesiopalatal root (see Fig. 32.3a, b for details of the radiographic findings for 208).
Figure 32.3 Radiographs centring on 208.