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- Author or Editor: Dr. Frank J. M. Verstraete x
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Abstract
OBJECTIVE To systematically characterize the morphology of cleft lip, cleft palate, and cleft lip and palate in dogs.
ANIMALS 32 client-owned dogs with clefts of the lip (n = 5), palate (23), or both (4) that had undergone a CT or cone-beam CT scan of the head prior to any surgical procedures involving the oral cavity or face.
PROCEDURES Dog signalment and skull type were recorded. The anatomic form of each defect was characterized by use of a widely used human oral-cleft classification system on the basis of CT findings and clinical images. Other defect morphological features, including shape, relative size, facial symmetry, and vomer involvement, were also recorded.
RESULTS 9 anatomic forms of cleft were identified. Two anatomic forms were identified in the 23 dogs with cleft palate, in which differences in defect shape and size as well as vomer abnormalities were also evident. Seven anatomic forms were observed in 9 dogs with cleft lip or cleft lip and palate, and most of these dogs had incisive bone abnormalities and facial asymmetry.
CONCLUSIONS AND CLINICAL RELEVANCE The morphological features of congenitally acquired cleft lip, cleft palate, and cleft lip and palate were complex and varied among dogs. The features identified here may be useful for surgical planning, developing of clinical coding schemes, or informing genetic, embryological, or clinical research into birth defects in dogs and other species.
Abstract
OBJECTIVE To compare the biomechanical behavior of mandibular critical-sized defects stabilized with 2 plating configurations under in vitro conditions resembling clinical situations.
SAMPLE 24 mandibles harvested from 12 adult canine cadavers.
PROCEDURES 8 mandibles were kept intact as control samples. A critical-sized defect was created in 16 mandibles; these mandibles were stabilized by use of a single locking plate (LP [n = 8]) or an LP combined with an alveolar miniplate (LMP [8]). Mandibles were loaded in cantilever bending in a single-load-to-failure test with simultaneous recording of load and actuator displacement. Stiffness, yield, and failure properties were compared among groups. Mode of failure was recorded. Radiographic evidence of tooth root and mandibular canal damage was quantified and compared between groups.
RESULTS Stiffness and yield loads of single LP and LMP constructs were < 30% of values for intact mandibles, and failure loads were < 45% of values for intact mandibles. There were no consistent biomechanical differences at failure between single LP and LMP constructs, but the LMP construct had greater stiffness and strength prior to yield. Frequency of screw penetration of teeth and the mandibular canal was significantly greater for LMP than for single LP constructs.
CONCLUSIONS AND CLINICAL RELEVANCE Both fixation methods were mechanically inferior to an intact mandible. The LMP construct was mechanically stronger than the LP construct but may not be clinically justifiable. Addition of an alveolar miniplate provided additional strength to the construct but resulted in more frequent penetration of tooth roots and the mandibular canal.
Abstract
OBJECTIVE To evaluate biomechanical properties of intact feline mandibles, compared with those for mandibles with an experimentally created osteotomy that was stabilized with 1 of 2 internal fixation configurations.
SAMPLE 20 mandibles from 10 adult feline cadavers.
PROCEDURES An incomplete block study design was used to assign the mandibles of each cadaver to 2 of 3 groups (locking plate with locking screws [locking construct], locking plate with nonlocking screws [nonlocking construct], or intact). Within each cadaver, mandibles were randomly assigned to the assigned treatments. For mandibles assigned to the locking and nonlocking constructs, a simple transverse osteotomy was created caudal to the mandibular first molar tooth after plate application. All mandibles were loaded in cantilever bending in a single-load-to-failure test while simultaneously recording load and actuator displacement. Mode of failure (bone or plate failure) was recorded, and radiographic evidence of tooth root and mandibular canal damage was evaluated. Mechanical properties were compared among the 3 groups.
RESULTS Stiffness, bending moments, and most post-yield energies for mandibles with the locking and nonlocking constructs were significantly lower than those for intact mandibles. Peak bending moment and stiffness for mandibles with the locking construct were significantly greater than those for mandibles with the nonlocking construct. Mode of failure and frequency of screw damage to tooth roots and the mandibular canal did not differ between the locking and nonlocking constructs.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that both fixation constructs were mechanically inferior to intact mandibles. The locking construct was mechanically stronger than the nonlocking construct.
Abstract
OBJECTIVE
To evaluate and quantify the kinematic behavior of canine mandibles before and after bilateral rostral or unilateral segmental mandibulectomy as well as after mandibular reconstruction with a locking reconstruction plate in ex vivo conditions.
SAMPLE
Head specimens from cadavers of 16 dogs (range in body weight, 30 to 35 kg).
PROCEDURE
Specimens were assigned to undergo unilateral segmental (n = 8) or bilateral rostral (8) mandibulectomy and then mandibular reconstruction by internal fixation with locking plates. Kinematic markers were attached to each specimen in a custom-built load frame. Markers were tracked in 3-D space during standardized loading conditions, and mandibular motions were quantified. Differences in mandibular range of motion among 3 experimental conditions (before mandibulectomy [ie, with mandibles intact], after mandibulectomy, and after reconstruction) were assessed by means of repeated-measures ANOVA.
RESULTS
Both unilateral segmental and bilateral rostral mandibulectomy resulted in significantly greater mandibular motion and instability, compared with results for intact mandibles. No significant differences in motion were detected between mandibles reconstructed after unilateral segmental mandibulectomy and intact mandibles. Similarly, the motion of mandibles reconstructed after rostral mandibulectomy was no different from that of intact mandibles, except in the lateral direction.
CONCLUSIONS AND CLINICAL RELEVANCE
Mandibular kinematics in head specimens from canine cadavers were significantly altered after unilateral segmental and bilateral rostral mandibulectomy. These alterations were corrected after mandibular reconstruction with locking reconstruction plates. Findings reinforced the clinical observations of the beneficial effect of reconstruction on mandibular function and the need for reconstructive surgery after mandibulectomy in dogs.
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.
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.
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.