Virtually edentulous, no clinical signs of root resorption

19 Virtually edentulous, no clinical signs of root resorption




INITIAL PRESENTATION


Inappetance and dysphagia.



PATIENT DETAILS


A 14-year-old, female, domestic short-haired cat.



CASE HISTORY


The cat had always had an extremely good appetite until roughly a month ago, when she started having trouble eating. She seemed to want to eat but had trouble swallowing and would stop eating after a few mouthfuls. In the last 2 weeks she had not been eating at all and barely drinking. She was drooling continuously. She was referred to us for evaluation and management.


The cat had never had any oral or dental problems. In fact, she had never had her teeth scaled and polished. The owner was very clear that they had restricted finances and would only want treatment if I could guarantee successful outcome at minimal cost.



ORAL EXAMINATION – CONSCIOUS


The cat was distressed and would only allow a cursory conscious examination of the face and oral cavity. She was virtually edentulous, with only the right upper canine tooth evident. All edentulous areas were covered by clinically healthy gingivae. She strongly resented attempts to open the mouth, so this was abandoned.


The owner declined pre-anaesthetic blood work-up.



ORAL EXAMINATION – UNDER GENERAL ANAESTHETIC


Examination under general anaesthesia confirmed that 104 was the only remaining tooth. There was no evidence of any pathology affecting 104 based on inspection and tactile exploration with a dental explorer. There was no inflammation of the gingivae and oral mucous membranes. However, a large, right-sided tonsillar mass was identified. The owner did not want any further treatment (likelihood of squamous cell carcinoma and poor prognosis) and the cat was euthanized.



FURTHER INVESTIGATIONS


I was given permission to take a series of full-mouth radiographs and submit a section of the tonsillar mass for histopathology. This was for my own interest and the client was not charged. I wanted to confirm that the mass really was a squamous cell carcinoma and I was interested in the dental findings.



RADIOGRAPHIC FINDINGS


The series of full-mouth radiographs (eight views) identified numerous teeth in different stages of replacement resorption. See Figs 19.1, 19.2, 19.3, 19.4 and 19.5 for details of radiographic findings.


image

Figure 19.1 Rostrocaudal radiograph (a) and right lateral radiograph (b) of the rostral upper jaw.


(a) The upper incisors and canines are in different stages of replacement resorption. The roots of the incisors are still identifiable as ‘tooth’, but the absence of a clear periodontal ligament space indicates active external root resorption and replacement of lost tissue by bone. These roots are ankylosed, i.e. there is fusion between root and bone. The crown of 104 is still in place, but most of the root has been resorbed and replaced by bone. Tooth 204 has been almost completely resorbed and replaced by bone-like material. It is impossible to clearly differentiate between remaining root tissue and bone.

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Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on Virtually edentulous, no clinical signs of root resorption
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