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  • Author or Editor: Frank J. M. Verstraete x
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Abstract

Objective—To evaluate factors associated with the outcome of vital pulp therapy (VPT) in dogs.

Design—Retrospective study.

Sample—190 teeth in 138 dogs.

Procedures—Medical records were reviewed; radiographs obtained before, immediately after, and during the last available follow-up examination for VPT were evaluated. Treatment was categorized as successful (with radiographic evidence of continued secondary dentin production, continued root formation in immature teeth, and absence of clinical and radiographic signs of apical periodontitis and internal or external inflammatory root resorption), having no evidence of failure (with signs for success fulfilled except the width of the apical periodontal ligament space, which could be wider than but no more than double the width of the periodontal ligament space in other areas), or failed (with radiographic evidence of pulp necrosis, apical periodontitis, or inflammatory root resorption). Associations between diagnostic or treatment-related variables and outcome were assessed with multinomial logistic regression.

Results—Overall, treatment was classified as successful for 162 of 190 (85%) teeth, including 23 (12%) teeth with no evidence of failure, and as having failed for 28 (15%) teeth. The overall success rate was 137 of 149 (92%) for teeth treated with mineral trioxide aggregate alone and 21 of 36 (58%) for teeth treated with Ca(OH)2 alone. Use of Ca(OH)2 and deep penetration of dressing material into the vital pulp were each significantly associated with increased odds of treatment failure.

Conclusions and Clinical Relevance—Results indicated that VPT with mineral trioxide aggregate was an effective option for use in crown reduction to treat malocclusion and for treatment of recent crown fractures in immature or mature permanent teeth.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To describe clinical features of oral and maxillofacial osteomas in cats.

Design—Retrospective case series.

Animals—7 cats with oral or maxillofacial osteoma or both.

Procedures—Medical records were reviewed for information on signalment, history, clinical signs, physical examination findings, diagnostic imaging findings, results of serum biochemical analyses and histologic testing, surgical procedures performed, and perioperative complications. Outcome was determined on the basis of follow-up telephone interviews of owners.

Results—Cats ranged from 1 to 23 years of age. Clinical signs were observed in 5 cats and were attributed to the presence of the mass. Diagnostic imaging (radiography and computed tomography) and histologic examination confirmed the diagnosis of osteoma. Three cats were euthanatized; 1 cat was treated by mandibulectomy, 1 was treated by maxillectomy, and 2 were treated by debulking. At the time of follow-up at least 1 year after surgery, all 4 treated cats were alive, with owners reporting an acceptable quality of life.

Conclusions and Clinical Relevance—Osteoma of the oral and maxillofacial regions is an uncommon tumor in cats. Most cats are examined during an advanced stage of the disease, when treatment options may be limited. Although osteoma is a benign tumor, the recommendation is to perform a clinical evaluation, diagnostic imaging, biopsy, and treatment early in the disease process, when less invasive surgical approaches may be feasible.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To characterize clinicopathologic features of the most common odontogenic tumors and focal fibrous hyperplasia (FFH) in dogs.

Design—Retrospective case series.

Animals—152 dogs evaluated for oral tumors of possible odontogenic origin at the William R. Pritchard Veterinary Medical Teaching Hospital of the University of California-Davis between 1995 and 2005.

Procedures—Information was collected from records, including dog breed, age, reproductive status, and location of lesion in the oral cavity. Histologic slides pertaining to each dog were reviewed by 3 investigators. Data regarding clinicopathologic features of the 3 most common lesions (canine acanthomatous ameloblastoma [CAA], peripheral odontogenic fibroma [POF], and FFH) were summarized.

Results—152 dogs with odontogenic tumors or FFH were identified. Sixty-eight (45%) dogs had CAA, 47 (31 %) had POF, 24 (16%) had FFH, and 13 (9%) had other odontogenic tumors. Canine acanthomatous ameloblastoma was present most commonly in the rostral aspect of the mandible, with POF and FFH more common in the rostral aspect of the maxilla. Males and females were equally represented among dogs with CAA and FFH. Castrated males were overrepresented among dogs with POF. Golden Retrievers, Akitas, Cocker Spaniels, and Shetland Sheepdogs were overrepresented among dogs with CAA. No breed predisposition was detected for FFH or POF. Dogs with FFH had a greater mean age at initial evaluation than did dogs with CAA or POF.

Conclusions and Clinical Relevance—CAA, POF, and FFH have distinct clinical patterns that may help clinicians and pathologists identify such lesions more readily.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To characterize clinical signs and histologic findings in dogs with odontogenic cysts and determine whether histologic findings were associated with clinical features.

Design—Retrospective case series.

Animals—41 dogs.

Procedures—Medical records were reviewed to obtain clinical data, including breed, age, sex, and lesion location. Microscopic sections and results of diagnostic imaging were reviewed.

Results—Odontogenic cysts were identified in 41 dogs between 1995 and 2010. There were 29 dogs with dentigerous cysts, 1 with a radicular cyst, 1 with a lateral periodontal cyst, and 1 with a gingival inclusion cyst. In addition, 9 dogs with odontogenic cysts that had clinical and histologic features suggestive of, but not diagnostic for, odontogenic keratocysts seen in people were identified. In all 9 dogs, these cysts were located in the maxilla and surrounded the roots of normally erupted teeth. Of the 29 dogs with dentigerous cysts, 23 had a single cyst, 5 had 2 cysts, and 1 had 3 cysts. Six cysts were associated with an unerupted canine tooth, and 30 were associated with an unerupted first premolar tooth (1 cyst was associated both with an unerupted canine tooth and with an unerupted first premolar tooth). Dentigerous cysts were identified in a variety of breeds, but several brachycephalic breeds were overrepresented, compared with the hospital population during the study period.

Conclusions and Clinical Relevance—Results suggested that a variety of odontogenic cysts can occur in dogs. In addition, cysts that resembled odontogenic keratocysts reported in people were identified. We propose the term canine odontogenic parakeratinized cyst for this condition.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To describe CT findings in dogs and cats with temporomandibular joint (TMJ) disorders.

Design—Retrospective case series.

Animals—41 dogs and 17 cats.

Procedures—Medical records and CT images of the skull were reviewed for dogs and cats that were examined at a dentistry and oral surgery specialty practice between 2006 and 2011.

Results—Of 142 dogs and 42 cats evaluated, 41 dogs and 17 cats had CT findings consistent with a TMJ disorder. In dogs, the most common TMJ disorder was osteoarthritis; however, in most cases, there were other TMJ disorders present in addition to osteoarthritis. Osteoarthritis was more frequently identified at the medial aspect rather than the lateral aspect of the TMJ, whereas the frequency of osteoarthritic involvement of the dorsal and ventral compartments did not differ significantly. In cats, fractures were the most common TMJ disorder, followed by osteoarthritis. Clinical signs were observed in all dogs and cats with TMJ fractures, dysplasia, ankylosis, luxation, and tumors; however, only 4 of 15 dogs and 2 of 4 cats with osteoarthritis alone had clinical signs.

Conclusions and Clinical Relevance—Results indicated that TMJ disorders were frequently present in combination. Osteoarthritis was the most common TMJ disorder in dogs and the second most common TMJ disorder in cats. Computed tomography should be considered as a tool for the diagnosis of TMJ disorders in dogs and cats with suspected orofacial disorders and signs of pain. (J Am Vet Med Assoc 2013;242:69–75)

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To determine and identify variables associated with outcomes of surgical repair of congenital palatal defects in dogs.

DESIGN Retrospective case series with nested observational study.

ANIMALS 26 dogs that underwent surgical repair of congenital palatal defects at 2 veterinary teaching hospitals from 2007 to 2016.

PROCEDURES Data were collected from medical records regarding dog age and body weight at the time of surgical defect repair, prior surgical history, skull type (brachycephalic, mesocephalic, or dolichocephalic), surgical technique used for defect repair, and defect severity. Functional outcome as well as frequency and location of oronasal fistula (ONF) formation were recorded. These outcomes were compared among various groups.

RESULTS Surgical defect repair achieved functional success in 22 of the 26 (85%) dogs. An ONF formed after initial repair in 13 (50%) dogs, and the most common location was the hard palate. Hard palate ONF formation was more common in dogs > 8 months of age at the time of initial repair; ONF at the junction between the hard and soft palates was more common in dogs > 8 months of age at the time of initial repair and in dogs with a history of failed surgical repair. An unsuccessful functional outcome was more common in dogs weighing < 1 kg (2.2 lb) at the time of initial repair.

CONCLUSIONS AND CLINICAL RELEVANCE Patient age, patient size, and defect characteristics should be taken into consideration when planning and assessing prognoses for surgical repair of congenital palatal defects in dogs.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To evaluate the radiographic outcome of root canal treatment (RCT) in dogs and compare outcomes with those reported for a previous study performed at the same institution in 2002.

ANIMALS

204 dogs representing 281 teeth that underwent RCT.

PROCEDURES

The medical record database of a veterinary teaching hospital was searched to identify dogs that underwent RCT between 2001 and 2018. Only dogs that had undergone at least 1 radiographic recheck appointment a minimum of 50 days after RCT were included in the study. Dental radiographs were reviewed. Treatment was considered successful if the periapical periodontal ligament space was within reference limits and preexisting external inflammatory root resorption (EIRR), if present, had stabilized. Treatment was considered to show no evidence of failure (NEF) if preoperative EIRR had stabilized and any preoperative periapical lucency (PAL) remained the same or had decreased in size but had not completely resolved. Treatment was considered to have failed if EIRR or a PAL developed after RCT, if a preoperative PAL increased in size, or if preexisting EIRR progressed.

RESULTS

Follow-up time ranged from 52 to 3,245 days (mean, 437 days). RCT was classified as successful for 199 (71%) teeth, NEF for 71 (25%) teeth, and failed for 11 (4%) teeth.

CONCLUSIONS AND CLINICAL RELEVANCE

Results showed that almost 2 decades after RCT outcome in dogs was first evaluated, during which time numerous advances in dental materials and techniques had been made, the success rate of RCT was virtually unchanged.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the prevalence and types of tooth resorption in dogs with oral tumors and to compare findings with those for control dogs.

Animals—101 dogs with oral tumors and 128 control dogs that did not have oral tumors and for which dental radiographs were available.

Procedures—Exclusion criteria for dogs included systemic disease, long-term administration of anti-inflammatory drugs, traumatic occlusion, severe semigeneralized or generalized periodontitis, and endodontic disease. For each dog with an oral tumor, histologic sections of biopsy specimens of tumors were examined. Dental radiographic images of dogs were examined, and the presence and type of tooth resorption were determined for each tooth. Statistical analyses were performed to compare data regarding prevalence of tooth resorption.

Results—Teeth at tumor sites in dogs with nonodontogenic tumors were significantly more frequently affected with external inflammatory resorption, compared with teeth at tumor sites in dogs with odontogenic tumors. Teeth at sites distant from tumors in dogs with oral tumors were 3.2 times as likely to have external surface resorption (OR, 3.2; 95% confidence interval, 1.3 to 7.9) and 83.4 times as likely to have external inflammatory resorption (OR, 83.4; 95% confidence interval, 9.7 to 719.6) as teeth in control dogs.

Conclusions and Clinical Relevance—Resorption of teeth at tumor sites and at sites distant from tumors was common in dogs with oral tumors. Results of the present study will contribute to an understanding of the complex effects of oral tumors on local and distant hard tissues.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To evaluate the diagnostic yield of dental radiography (Rad method) and 3 cone-beam CT (CBCT) methods for the identification of predefined anatomic landmarks in brachycephalic dogs.

ANIMALS 19 client-owned brachycephalic dogs admitted for evaluation and treatment of dental disease.

PROCEDURES 26 predefined anatomic landmarks were evaluated separately by use of the RAD method and 3 CBCT software modules (serial CBCT slices and custom cross sections, tridimensional rendering, and reconstructed panoramic views). A semiquantitative scoring system was used, and mean scores were calculated for each anatomic landmark and imaging method. The Friedman test was used to evaluate values for significant differences in diagnostic yield. For values that were significant, the Wilcoxon signed rank test was used with the Bonferroni-Holm multiple comparison adjustment to determine significant differences among each of the 6 possible pairs of diagnostic methods.

RESULTS Differences of diagnostic yield among the Rad and 3 CBCT methods were significant for 19 of 26 anatomic landmarks. For these landmarks, Rad scores were significantly higher than scores for reconstructed panoramic views for 4 of 19 anatomic landmarks, but Rad scores were significantly lower than scores for reconstructed panoramic views for 8 anatomic landmarks, tridimensional rendering for 18 anatomic landmarks, and serial CBCT slices and custom cross sections for all 19 anatomic landmarks.

CONCLUSIONS AND CLINICAL RELEVANCE CBCT methods were better suited than dental radiography for the identification of anatomic landmarks in brachycephalic dogs. Results of this study can serve as a basis for CBCT evaluation of dental disorders in brachycephalic dogs.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To evaluate the diagnostic yield of dental radiography (Rad method) and cone-beam CT (CBCT) methods for the identification of 31 predefined dental disorders in brachycephalic dogs.

ANIMALS 19 client-owned brachycephalic dogs admitted for evaluation and treatment of dental disease.

PROCEDURES 31 predefined dental disorders were evaluated separately and scored by use of dental radiography and 3 CBCT software modules (serial CBCT slices and custom cross sections, tridimensional rendering, and reconstructed panoramic views). A qualitative scoring system was used. Dental disorders were grouped into 10 categories for statistical analysis. Point of reference for presence or absence of a dental disorder was determined as the method that could be used to clearly identify the disorder as being present. Accuracy, sensitivity, specificity, and positive and negative predictive values were calculated with the McNemar χ2 test of marginal homogeneity of paired data.

RESULTS When all 3 CBCT methods were used in combination, the diagnostic yield of CBCT was significantly higher than that of dental radiography for 4 of 10 categories (abnormal eruption, abnormally shaped roots, periodontitis, and tooth resorption) and higher, although not significantly so, for all categories, except for 1 (loss of tooth integrity).

CONCLUSIONS AND CLINICAL RELEVANCE CBCT provided more detailed information than did dental radiography. Therefore, CBCT would be better suited for use in diagnosing dental disorders in brachycephalic dogs.

Full access
in American Journal of Veterinary Research