export_jvd oral med papers Flashcards
Hale Dental Caries in Dogs
JVD June 1998
435 dogs
What was the number of dogs with Caries and where were the caries
23 dogs 5.3%
47 caries
19 (40%) Pit Fissure
17 ( 36%)Smooth surface
11(23%) Root caries
How many dogs had symmetrical lesions and what teeth were most affected
12 dogs
Fourth premolar and first and second molar teeth
Caries definition
action of microorganismon carbohydrates causing decalcification of the inorganic portions of the tooth and accompanied by the disentigration of the organic portion Latin term for “Rottness”
What stain is specific for identifying areas of carious dentin from healthy dentin
Rhodamin B
What oral substance provides minerals and antibacterial properties to protect against caries forming?
Patient’s Saliva
Which portion of the tooth is lost first in caries?
Inorganic portion first
5 Reasons dogs have a low prevalence of caries?
- little to no salivary amylase to break down starch retained in the mouth
- higher salivary pH
- diet low in fermentable carbohydrates
- conical shape of most teeth
- Lower number of cariogenic bacteria in the normal oral flora
3 Factors of Dental Caries
- Susceptible Tooth Surface
- Cariogenic Bacteria
- Dietary fermentable carbohydrates (sucrose)
WHEN ALL THREE PRESENT HIGH RISK OF CARIES
3 acids produced from carbohydrates fermented by bacteria in the mouth
Lactic, acetic, Propionic
In humans the 2 predominate bacteria associated with caries
Strep Mutans
S. Sanguis
Acids initially dissolve what from the enamel ______ causing cavitation in the ______
- Surface Hydroxyappetitie crystals
2. Planes of Retzius
Once demineralization occurs what is the progression of caries
- Hydroyappetite dissolved micro caviatations plane of Retzius
- Coalescence of the micro cavitation
- Undermining of the overlying enamel and collapse
- Then digestion by bacteria of the protein organic matrix by enzymes
How are carious lesions reversible and when is it irreversible
By remineralization mostly by minerals in the oral fluids
Irreversible when the overlying enamel and protein matrix has collapsed
Caries can be classified in three stages
- Acute
- chronic
- arrested
GV Black’s Classification of dental caries and restorations
Class 1 - Pits and fissures of Anterior and Posterior teeth
Class 2- Proximal surface of posterior teeth
Class 3 - Proximal surface of anterior teeth not involving the incisal edge
Class 4 - Proximal surface of anterior teeth involving the incisal edge
Class 5 - Cervical 1/3 of the F and L surface
Class 6 - Incisal edge of anterior teeth or cusp tips of posterior teeth
Smooth surface caries need what to start
Plague they cause a cone shaped lesion in the enamel followed by another cone shaped lesion when the penetrate the dentin. or a stacked up pattern of 2 snow cones
Pit and fissure caries need plaque to form Tor F
False it the impaction of food into the pits and fissures
What is an important feature of dentin that leads to expansion of the caries 2 things
- Spread through the tubules
2. Protein matrix provides nutritional support to the bacteria
In humans factors that increase caries formation
- Xerostomia
- decreased brushing
- hormonal imbalance
- Chronic dehydration or dry mouth
all particularly increase risk of cervical caries
What type of caries are more likely treated by extraction
Root
The single most common site for caries in the dog in this paper was?
Maxillary first molar
Dentigerous Cyst in a dog
JVD 16 1999
Sitzman
2 year old springer spaniel neutered male
Unerupted Left canine tooth.
Dentigerous cysts are
subclassification of odontogenic cysts
1. Eruption cysts
- follicular cysts (Dentigerous cysts are follicular )
Proliferative Gingival lesion in a Cat with Disseminated Cryptococcosis
Odom and Anderson
JVD 17 Dec 2000
case of disseminated cryptococcus in 11 year-old Siamese Cat
What was the initial complaints
- chronic non productive cough
- Left ante brachial cutaneous mass
- Proliferative gingival mass @ 404
What is the most common fungal disease in cats?
Route of infection?
What percent of cats have cutaneous lesions?
Cryptococcus
Inhalation
30-50% have cutaneous forms
What is seen in the nasal passages of some cats with Cryptococcus
Polyps that may protrude from the nostril, sneezing, and discharge
What should be tested for in these cats
FELV/FIV
Cryptococcus Titer
In Tx montior hepatic function and renal function
What other fungal disease can cause oral granulomatous lesions
Blastomyces dermatididus
Candidiasis can cause oral lesions when especially?
Immunocompromised patients or long term antibiotics
what test is used for Cryptococcus
CALA=
Cryptococcal Antigen Latex Agglutination - evaluated serum or CSF
What stain is used for cryptococcus
Romanowsky type stains
Organism stains pink to bluish purple with a clear capsule
How long is treatment for cryptococcus
Long, median treatment is 8.5 months. Base treatment on serum titers, oral fluconazole
Metaplasia
When a mature epithelium changes to a different form of mature epithelium.
osseous metaplasia
- in response to trauma
- involves mesenchymal tissue
- bone forms within collagen
3 drugs that can cause gingival hyperplasia
- Phenytoin
- Cyclosporine
- Ca channel blockers
3 types of gingival hyperplasia
- Inflammatory
- Non-inflammatory or Fibrous
- Combination of inflammatory and fibrous
What are the grades of mast cell tumors?
Grade 1 - well diferentiated, stay within dermis, low metastatic potential (<10-25%)
Grade 2 - moderately differentiated, invade into surrounding tissues, moderately low metastatic rate (15-40%)
Grade 3 - poorly differentiated, invade tissues, (50-95%); special stains may be needed to identify intracytoplasmic granules in these MCTs
(Nerdbook)
What grade was the mast cell tumor in this dogs
Grade 2
What were the biopsy results of the the three masses biopsied in this dog
- Inflammatory and fibrous
- Fibroumatous epulis
- Grade 2 mast cell tumor
Dental and Craniofacial finding in 8 miniature schnauzer dogs affected by Myotonia Congenita
Gracis, keith,Vite
JVD 17 2000
Minature schnauzers appear to have this disease due to an autosomal recessive mode of inheritance
It is associated with a defective chloride ion conductance across the skeletal muscle membrane
Signs of Myotonia Congenita
delay of skeletal muscle relaxation after the cessation of electrical, mechanical stimulation, or voluntary activity
Craniofacial signs related to Mytonia Congenita
- delayed eruption of deciduous and permanent teeth
- Persistent decidous teeth
- unerupted or partially erupted permanent teeth
- Crowding of teeth decreased space k-9-I3
- Flatten zygomatic arches, malocclusion increase in mandibular body curvature and disto-occlusion of mandible
Skeletal signs of Mytonia Congenita
- Dimpled tongue
- Muscle stiffness that decreases with exercise Bunny hopping gait
- Postural reactions, segmental reflexes, sensation, and cranial nerves are normal
- Skeletal muscle Hypertrophy is severe!!!!!!!!
What is the electromyographic findings
Waxing or waning sound or classic Dive bomber sound
What drugs are used to treat Myotonia Congenita
Antiarrhythmic agents
Procamide, mexilitene
How many dogs were evaluated with MC and how many without
8 with
45 without
Why did the propose the zygomatic arches were flattened and the mandibular bodies had a greater curvature?
Constant muscle activity and the insertion points
Eruption schedule in dogs deciduous teeth
Canines
Incisors
Premolars
Canine first
I3,I2,I1
PM3,PM4,Pm2
Maxillary generally first
Eruption of teeth in dog by age
D-I 3-4w P-I3-5M
D-C 3w P-C 4-6M
D-PM4-12w P-PM4-6 M
P-M 5-7 M
Odontoclastic resorptive lesions of a RmanM1 in a cougar
Mendoza Mangra Klippert
JVD 17 2000
2 year-old neutered male cougar
FRL was first described by
Hopewell-smith in 1920’s
The incidence in north american zoos is higher than that of european zoos what was the percentage in European zoos that was stated in this paper
<2% thought to be due to a more natural diet
Which tooth was affected in this paper in the cougar
409
What were the premed for sedation in the cougar
Ketamine
Medetomidine
What was absent from the Histo report that was surprising
Osteoclasts and odontoclasts thought to cause initial resorption of cementum,dentin and bone. Proposed that this was due to chronic nature and after granulation tissue is present these cell types are no longer a factor
Scanning EM description of cellular activity and mineral changes in FRL Lesions
Gauthier, Boudigues,Aguado etc
JVD 18 2001
10 teeth from 10 different cats
What were the teeth preserved in
4% Glutaraldehyde for 2 hours at 4C
What was placed on the teeth to allow imaging with SEM
Gold- Palladium
Teeth for mineral composition testing with electron micropore analysis were fixed in what?
10% Formol solution and were carbon coated
Where were resorptive cells not seen?
Enamel surface
What minerals were found to be higher in FRL lesions in the dentin and what happened to the Ca/P ratio
Was enamel changed?
Increased levels of Mg,P and Na and lower Ca/P ratio
Enamel was normal composition
How were the odontoclasts thought to move on the dentin
Filopodia and microvilli on the cell membranes
They proposed that the darker dentin was what
Poorly mineralized tissue and not a reparative bone/cementum like tissue, (resorptive lesions)
This study supports the theory of what for FRL lesions
Confirmed a cellular etiology for FRL of a odontoclastic like cell which progressively destroyed dentin and caused changes in the mineral makeup of dentin further allowing dissolution and facilitating elimination
Describe the embryologic development of the infundibulum
cone-shaped invagination from the occlusal surface of the tooth.
What provides the necessary means for caries within an infundibulum
Voids in the deposition of cementum allowing food to impact
The rate of decay is balanced by what?
Eruption and attrition of the equine tooth
Complications of progressive tooth decay
sagittal fracture, pulp exposure, and periodontal disease
In the author experience what material was suitable for restoration of infundibular caries
hybrid composite resin in 2mm layers
Gingival Hemangiosarcoma in a dog
JVD 2002
Spelling is wrong in the paper
10 year-old spayed female Golden R
Gingival swelling 104-105
What teeth were extracted and what were the surgical margins in this case?
104 and 105 with 0.5 cm margins because the thought it was an epulis
what was different about this lesion and the response to the teeth than epulis like lesions
Resorptive like lesions of the tooth crown, CEJ, and root
Was there reoccurrence at 1year clinically
No although radiographs were not obtained
Which LN receive afferent lymphatics from the head and neck?
- mandibular
- parotid
- medial retropharyngeal
which of the 3 nodes receives efferent lymph from the other 2 nodes
Medial retropharyngeal recieves efferent lymphatics from the mandibular and the parotid
what was suggested as the best way to evaluate and determine lymph node involvement
Open surgical biopsy
Where is the parotid LN found?
How many nodes in lymphocentrum?
- along rostral edge of parotid salivary gland
- 1-3 at a level paralleling the ventral border of the zygomatic arch
Medial retropharyngeal node is what shape
Elongated and overlying the thyropharyngeus muscle
How many nodes does the mandibular lymphocentrum have?
Where are they located?
1- 5
- between tributaries of the jugular vein and the division of the linguofacial vein into the lingual and facial veins
Recurrent Ossifying Epulis in a dog
Woodward
JVD 19 (2) June 2002
7 YO MN Siberian Husky LmaxPM1,PM2
The oral cavity is the ___ most common site for neoplasia,
accounting for___ % of all malignant neoplasms
- 4th
- 5%
The epulides are the most common oral neoplasms accounting for what % of all oral neoplasms
List the 3 types
30%
1.Fibromatous
- ossifying
- Acanthomatous
What origin are epulides
Periodontal ligament and are benign
Typical % solution of oral chlorhexidine
0.12%
Are epulides sensitive to radiation treatment
Yes but is generally not done due to cost and side effects
Neoplasms are surrounded by 3 layers what are they
- Pseudocapsule
- reactive zone
- Normal tissue
- what are 4 types of oncological surgical dissection?
- intracapsular (within pseudo capsule)
- marginal (removal within reactive zone)
- wide excision (removal with margin of normal tissue)
- 4. radical - removal of supporting tissue compartment (e.g. entire margin) e.g.. a whole mandible
- wide excision (removal with margin of normal tissue)
What types of excision is required for each type of epulis
Fibromatous= Mariginal or in the reactive zone Ossifying = Wide or more aggressive than fibromatous
CAA is wide or radical
What are factors in treatment planning for a tumor
- Tumor type
- biologic behavior
- clinical appearance
- location of the tumor
How much tissue should be included in the sutures and how far apart should the sutures be?
2-3mm of tissue
2-3 mm apart
How long was bupivacaine in the infraorbital nerve block expected to last?
3-6 hours
Ameloblastic Fibro-odontoma in a G shepherd dog
Boyd JVD 19(3) SEP 2002
8 month old male GS right mandible mass at 403-408, 404 missing
Polyglactin 910
Vicryl Absorbable braided multifilament 75% at 2wks 50% 3 weeks Absorption 56-70d
Suture used in this case
https://s3.amazonaws.com/classconnection/199/flashcards/1405199/jpg/ameloblastic_fibro-odontoma_jvd2002_19(3)-14BB2C385172F882D25.jpg
Extra oral radiographic view of the rostral mandible showing radiolucent expansile lesion, impacted canine
What was the first diagnosis that carried a fair to guarded prognosis
ameloblastic odontoma
What was the final diagnosis by a second pathologist
ameloblastic fibro-odontoma
What is the description of ameloblastic fibro- odontoma
A benign mixed odontogenic neoplasm composed of odontogenic epithelium embedded in cellular mesodermal tissue and is capable of elaborating dentin and enamel than may appear as tooth structure
Where have ameloblastic Fibro odontomas been reported in dogs?
both mandible and maxilla more common in humans in the mandibles of teenagers
What is the difference between ameloblastic fibroma and ameloblastic fibro-odontoma
Odontoma has tooth material
What is the difference radiographically between Ameloblastic Fibro odontomas and odontomas
AFO has a wider area of radiolucency around the mass and less dense tooth structure
Oral SCC in in a pregnant mare
Faragalla
JVD 19(2) June2002
17 YO mare pregnant right mandible mass at 406-408 and draining tract
What was given to reduce hemorrhage during the extraction procedure
20 ml amincaproic acid
Erupted Bilateral compound odontomas in a dog
Eickhoff, Seeliger,Simon, Fehr
JVD 19(3) Sep2002
6 month old black russian terrier Male
R and L mandM1-M2
tissue of origin of odontomas
odontogenic epithelium
Compound odontoma vs complex
Compound composed of toothlike structure (denticles)
Complex is unorganized at cellular level and no toothlike structures
Tomes fibers
Odontoblastic processes - cytoplasmic extensions of cell body
What is incidence of odontogenic tumors in dogs and cats?
humans?
- 0.5 - 0.7% dogs and cats
- 1.3% humans
diagnosis of odontoma is often associated with a failure of what?
eruption of normal secondary tooth
3 types of Mixed Odontogenic Tumors?
1) Odontoma
2) Ameloblastic Fibroma
3)Ameloblastic Fibro-odontoma
presence of denticles is pathognomonic for ___.
Odontoma
What is a proposed mechanism of odontoma formation
Local hyperactivity of dental lamina resulting in multiple schizodontia
what did they consider these bilateral odontomas to be likely caused by
Developmental “error” not a spontaneous neoplastic disease process
What can be used to induce odontogenic tumors in the hamster and rat
Trauma in the rat and N-nitrosourea in the hamster and rat
Location of Complex versus compound odontomas in humans
Compound = incisor canine region
Complex odontoma and ameoloblastic fiber odontoma the posterior region.
Dogs not known from the literature
Odontomas are usually associated with what
Abnormally erupted or Unerupted tooth
This was a different case because the denticles were erupted
In humans, incidence has been reported at 41%, 61% and 75%.
Lymph node staging of oral and maxillofacial neoplasms in 31 dogs and cats: Herring, smith, et al JVD 19 (3) Sep 2002
28 dogs, 3 cats with confirmed neoplasms
All visible LN in each of the 3 regional lymphocentrums (parotid, mandibular, medial retropharyngel) were removed surgically in 25 cases through one incision (2 actually had bilateral lymphocentrum removal since the tumor was midline)
Lymph node staging of oral and maxillofacial neoplasms in 31 dogs and cats, herring and smith
- of palpably enlarged mandibular ln’s, 17% had metastatic dz histologically
- thoracic metastatic dz was in 7%
- pre-operative cytologic evaluation of the mandibular ln concurred with histo in 90%
- post-op cytologic evaluation of regional ln’s concurred with histo results in 80%
- Only 54% of cases with metastatic dz had mets to the mandibular ln’s (so they might not be as useful in staging)
Mean age of the dogs
9 years
Cats were what age
12 y
What percentage of patients in this study had metastatic disease to lymph nodes?
- 35.5% to one or more LN:
- parotid, mandibular and medial retropharyngeal
mandibular lymph node metastasis was positive in only __% of the positive cases
in only 54.5% of all of the cases with mets
How accurate was FNA of the mandibular lymph node in detecting metastasis in the mandibular LN?
90.5% concurrence with the LN histopath results
What percent of enlarged lymph nodes had metastasis
20.0%
What percent of palpable normal lymph nodes were reactive histologically
58.3%
Conclusions of the LN article
- LN aspirates are very accurate and sensitive
- Mn Ln not only LN that shows mets, Mn LN, since only 54% of these met to the Mn LN
- enlarged LN do not always indicate mets, non enlarged LN can be positive
Lingual Calcinosis Circumscripta in a Dog
Collados Rodriguez Quiros Roman
JVD 19(1) March2002
8 month old German shepherd X male
A calcium supplement had been given during the first 3 months Post Partum
calcinosis circumscripta or tumoral calcinosis
characterized by mineral deposits that are located in soft tissues (especially near joints), and it’s most common in young adult dogs, 5-15 months especially German shepherds common in foot pads
calcinosis circumscripta
idiopathic deposition of amorphous calcified material in the skin and subcutaneous tissues of large breed dogs
RARE in dogs and cats
What were potential causes for Calcinosis Circumscripta
repeated trauma that caused dystrophic mineralization, Neoplasms, chronic inflammation and Foreign body reaction or pyoderma.
What was stated to be a refuted theory for C Circumscripta
Apocrine gland of the oral cavity mucosa undergoing degeneration.
Fibrous dysplasia of mandibular bone in a dog
Fitzgerald, Slocombe, Caifa
JVD 19(2) June 2002
9 yo G shepherd left mandibular PM3,PM4 lingual side.
Fibrous dysplasia of bone
rare non aggressive radiolucent non neoplastic lesion considered developmental in origin
Osteoma, Ossifying fibroma, and fibrous dysplasia are benign lesions found in what type of bone?
Intramembranous bone
- Origin of which is osteogenic connective tissue
- Only ossifying fibroma is restricted to the facial bones
Hallmark histologic features of Fibrous dysplasia is
Presence of thin, arched trabeculae of poor quality woven bone forming in a fibrous connective tissue stroma.
Fibrous dysplasia differs from ossifying fibroma how
In fibrous dysplasia, pre-existing bone is replaced by an expansile mass of fibro-osseous tissue. Ossifying fibroma tends to have an intermediate achitecture comparatively.
The bone in FD is fused with the normal bone where the OF does not.
Radicular cyst of the premaxilla in a dog
Beckman
JVD 20(4) Dec 2003
13 YO male neutered border collie Lmax I2
Radicular Cysts
- Aka apical periodontal cyst or Periapical cyst
- True cyst consisting of pathologic cavity lined by stratified squamous epithelium.
- Occurs in association with the root of a nonvital tooth and apical periodontitis.
- Result of inflammatory activation of the epithelial cell rests of Malassez adjacent to the tooth root in the periodontal ligament
Radicular cysts
- most common cyst in humans
- are associated with inflammation of the periodontal ligament at the root apex
- also referred to as apical periodontal cysts
- aggressive nature
- potential for malignant transformation to odontogenic cysts.
Histologic appearance of radicular cysts
- Stratified squamous epithelium supported by dense fibrous CT with inflammation
- Rushton bodies (calcification within lining) and cholesterol clefts (in lumen) are common
They stated a difference between True periapical cysts and periapical pocket cysts what are they and why is it important in RCT
- Periapical true cysts lined by epithelium and do not communicate with the root canal.
- Periapical pocket cysts have sac like epithelium that communicates directly with the root canal.
Can not tell radiographically which is which but if Pocket cysts then it will heal with RCT treatment, radicular cyst will not.
Radicular cysts form as a result of chronic apical periodontitis, which is…
reaction to the destruction of the pulp and microbial occupation of the root canal.
Trismus Secondary to Squamous cell carcinoma in a cat
Brown
JVD 20(4) 2003
15 year old cat MN DSH Left side mass base of ear to commissure
Cats >10 years what is the % of all oral tumors that are SCC
60-75%
Where does SCC metastasize first and then in late stages
Regional lymph nodes first and in late rare stages is found in the lungs
Most oral SCC in cats occur…
at base of tongue, but also can affect lips, gingiva, palate, and tonsils as well as maxilla and mandible.
trismus
difficulty opening mouth
Prevalence of dental resorptive lesions in Swedish Cats
Mannerfelt
JVD 20(3) Sept 2003
96 cats oral exam radiographs
32 % had lesions either gross or radiographically and there was a positive relationship with age
cats over the age of 10, % with resorptive lesions?
76%
What was important about this study populations?
Randomized cats not admitted for primary dental disease
What were other cited studies results and why were they potentially higher or lower in prevalence
- Not randomized cats were presented for dental disease =higher %
- Radiographs not obtained= lower % prevalence
- Dental disease presented cats and radiographs obtained = higher % prevalance
Compound odontoma in 3 dogs
Felizzola et al
JVD 20(2) June2003
3 young F dogs, stage III tumors, partial mandibulectomy or maxillectomy, aggressive sx resulted in prolonged tumor free interval
Odontomas arise from ____?
Odontogenic epithelium.
- further potential sites of origin are the cell rests of Malassez, original enamel organ or the odontogenic epithelium that is incorporated into the gingival epithelium
3 classification of odontomas
ameloblastic
complex
compound
World health organization tumor stages
- stage 0: carcinoma in situ (absence of tumor invasion into surrounding tissue)
- stage I: localized cancer, can be surgically removed
- stage II: locally advanced; can be treated by chemotherapy, radiation or surgery
- stage III: even more locally advanced; can be treated by chemotherapy; radiation or surgery
- stage IV: metastasized cancer, spread to other organs; can be treated by chemo, radiation, or surgery
Harmartomas
Developmental anomalies characterized by the proliferation of normal tissue with an abnormal organization
Odontogenic periorbital fistula in a cat
Negro and Hernandez
JVD 20(1) March2003
4 YO female DSH, chronic history of periorbital fistula, treated for 3 mo w/AB
What was diagnosis?
devitalization of 108, with chronic periapical periodontitis and root resorption, and secondary involvement of 109.
* rare case cats generally due not get big periapical lucencies
Pharyngeal-Laryngeal Blastomycosis in a Dog JVD 20(3)2003
6 year old 32 kg lab progressive dyspnea and respiratory stridor of 1 month duration
What was the reason for the difficulty breathing
Laryngeal paralysis secondary to Blastomycosis infection of the larynx.
Labs are #2 dog to get Blasto, Mix breed is #1, followed by Dobe, and GR.
Labs are also predisposed to getting Laryngeal paralysis than other breeds.
Calcifying Epithelial Odontogenic tumor in a Dog, Castejon
JVD 21(1) March 2004
10 YO Male Giant Schnauzer
Diagnosis Calcifiying epithelial odontogenic tumor CEOT instead of Amyloid Producing odontogenic tumor
Calcifying Epithelial Odontogenic tumor
CEOT, low incidence, originates from embryonic remnants of dental epithelium and is considered slow growing, locally invasive, noninductive, epithelial odontogenic tumor. most frequently located in the mandible
canine tumors derived from odontogenic epithelium include…
ameloblastoma/keratinizing ameloblastoma, CEOT, amyloid-producing odontogenic tumor (APOT), acanthomatous ameloblastoma, ameloblastic fibroma, ameloblastic fibro-odontoma, and complex odontoma
Gingival Hyperplasia and Granulation Tissue Associated with a Feline Resorptive Lesion JVD 21(1) Mar 2004
9 year old Spayed Female DSH, intraoral mass at missing left mandibular canine
Type 1 FRL ?
Type I RL clinical appears as focal area of resorption commonly seen at the cervical portion of the tooth with invasion of adjacent gingiva and no loss of radicular density.
Type II FRL lesions
Ankylosis or bone replacement type of resorption often treated by crown amputation if periodontal ligament and pulp is not detected on rads
How fast does oral epithelium migrate per day?
0.4mm per day, more rapid than regular epithelium
Is exuberant granulation tissue and gingival hyperplasia like that seen in this case common with TR?
no, rare to see this. (but will see focal fibrous hyperplasia associated with RL)
Feline dental resorptive lesions in the 13th and 14th centuries
Berger et al
JVD 21(4) DEC 2004
The Schild excavation (1971-1975) 1871 feline bones from 181 cats seven of the 189 mandibles on of the 126 skulls were investigated. Results demonstrated that cats from 800 years ago did have FRL lesions
exam of 3 mandibles and one skull
Schleswig, Germany
Knoop hardness test
- Hardness is a property measured by scientific instruments that press into the surface of a material
- Hardness is calculated based on the size of the identification – Range 10-1000g
- Enamel is the hardest biological tissue in the human body – 350 KHN
- Dentin is 70 KHN – Acrylic is 20 KHN
- Diamond – 8000 KHN
https://s3.amazonaws.com/classconnection/199/flashcards/1405199/jpg/type_i_tr-14BB8B94F9B1CF7266F.jpg
Type I TR,
focal or multifocal radiolucency is present in the tooth with otherwise normal radiolucency and normal periodontal ligament space
https://s3.amazonaws.com/classconnection/199/flashcards/1405199/jpg/type_ii_tr-14BB8BB789F315AB817.jpg
Type II TR,
Narrowing or disappearance of the periodontal ligament space at least in some areas, and decreased radiopacity of at least some of the tooth.
https://s3.amazonaws.com/classconnection/199/flashcards/1405199/jpg/type_iii_tr-14BB8BCFC6721736062.jpg
Type III TR,
Features of both type I and Type II TR, areas of normal and areas of lost periodontal ligament space, focal or multifocal radiolucency and decreased radioopacity in some areas of the tooth.
What type of TR is this?
Type I TR
What type of TR is this?
Type II TR
what type of TR is this?
Type III TR
Mapping of the radiographic central point of feline dental resorptive lesions: Harvey, et al, JVD 21(1) Mar 2004
217 cats, examined each radiograph
RL identified in 107 cats (49.3%)
Mapping only possible on canines and man pm/m.
RL most common on molars and maxillary canines, least common on mandibular 4th PM
Widely scattered on PM/M teeth (more common in coronal portions of the root) and canine teeth tended to be apically situated
2002 microscopic study of teeth from FRL lesions demonstrate that there are abnormalities of cementum and PDL in affected cats and the microscopic lesions are wide spread on root of feline teeth
Feline odonclastic resorptive lesions unveiling the early lesion. J sm animal practice 2002
Gorrell
Feline odontoclastic resorptive lesions: unveiling the early lesion. J sm animal practice 2002(43), 482-488
Gorrell
2002 microscopic study of teeth from FRL lesions demonstrate that there are abnormalities of cementum and PDL in affected cats and the microscopic lesions are wide spread on root of feline teeth
What did Gorrell study show?
FORL is a non-inflammatory replacement resorption, resulting in ankylosis. The PDL lack normal fibrous architecture, but was not inflammed. Different from peripheral inflammatory root resorption due to periodontal disease.
IN the Gorrel study, what was the difference between the PDL in the teeth with resorptive lesions and the normal teeth?
The normal teeth have PDL that is horizontally and obliquely organized in the PDL space. In the teeth with FORL, the PDL is vertically aligned and is thinner and does not have normal fibrous architecture and has an edematous appearance.
replacement resorption
- absence of vital PDL cover on root
- damaged PDL, replaced with progenitor cells from bone,
- results in fusion between bone and root
- form of healing where bone accepts tooth as part of it.
For canine teeth the resorptive lesions were centered where?
Apical to CEJ
Lesions for PM and Molar teeth center of FRL lesions
Slightly more coronal than the K-9 teeth
First molar teeth had the lesions slightly more _____ in the root crown segment
Distal than the rest of the teeth
What tooth had the lowest number of FRL lesions in this study?
Mandibular 4th premolar
The teeth most affected by FRL lesions in this study were?
Mandibular 1st molar - 103/419,
96 max can, 82 man can, 82 man 3rd PM, 56 man 4th pm
What was the proposed reason for center of FRL on the distal root of MandM1
Smaller root with increased force applied compared to the medial larger root
Bilateral Periodontal Ligament Hartoma in a Dog, Taney, Dubielzig, Trotter, et al.
JVD 22(2) 2005
12.5 Yo Doberman Pincher dog presented for severe perio, and bilateral maxillary enlargement
cryoprecipitatewas used what is it?
contains fibrinogen, factor 8, factor 13, vWF, fibronectin
treat issues with fibrinogen or factor 9
Difficiency in factor VIIIvW (vonwillibrands factor-part of factor 8). One component is factor VIII. The other component is VIIIc. T or F.
True. Vonwillebrands factor and VIIIc come together to work together.
cryoprecipitate
contains factors VIII and XIII (von willebrand and fibrinogen) - used for pts w/ bleeding disorders
Desmopressin
Was used what is it?
vasopressin analog selective for V2
Does diuretic actions of vasopressin, but much less of the pressor activty
Oral, intranasal, parenterally
Internasal or oral for diabetes insipidus
can be used for Von Willebrand disease type 1 and hemophillia A, and to decrease noctural polyuria
adverse: hyponatremia
Desmopressin
Vasopressin analog, causes release of vWF from endothelial cells
What did the histologic report mimic
Fibromatous epulis of periodontal ligament origin
Due to it not growing and the diagnosis of Harmatoma was used.
Formation of cementum
Begins at the neck of the tooth= CEJ rupture of the Hertwig’s root sheath allow the mesenchymal cells of dental sac to contact newly formed dentin and differentiate into cementoblasts and odontoblasts. Cementoblast secrete cementum as they move away from the dentinocemental junction. Two types: acellular (primary) and cellular (secondary)
primary cementum
original cementum that does not contain bone-type cells and is uniform in surface texture. also called acellular (without cells) cementum, covers cervical 2/3 of root
secondary cementum
contains bone type cells and usually forms on the lower root surface as a result of stimulation, attrition and wear, called cellular cementum
Cementoblastoma
Mesodermal odontogenic tumor
-true neoplastic expansile lesion showing cemental differentiation.
Premolar/molar region frequently
FUSED to the root of a vital tooth, which is resorbed.
Observations of the periodontal ligament and cementum in cats with dental RLs: Roux, et al: JVD 22(2)2005
22 teeth harvested from 7 cats (clinically normal teeth)
Radiographed and looked at histologically
14 of the teeth were also looked at histometrically
8 teeth had histologic evidence of PDL degeneration with cementum resorption
10 teeth had varying degrees of resorption
Mandibular molar and PM teeth had distal drift, and mandibular canines had mesial drift
SO, alterations in the PDL might represent a preclinical stage of RL?
So, this study concludes that canine and PM/M teeth undergo what type of drift?
canines- mesial
PM/M- distal
This paper cited that FRL lesions are located coronally to or on the alveolar crest in what % of lesions
The rest of the lesions ____% happen below the alveolar crest
- 0% Coronally to
- 5% at the alveolar crest
The rest 87.5% below the alveolar crest
JVD 22 2005
How many teeth appeared clinically normal but had resorptive lesions with 4 of them demonstrating radiographic evidence of FRL
10 of 22 or 45.5%
Were resorptive cell noted such as odontoclasts?
No
Some of the resorptive lesions were filled with reparative tissue what as this composed of?
Fibroblast, collagen fibers and Epithelial Rest of Malassez cells (ERM)
Only one of the PM/Molar teeth was found to not be drifting distally what was proposed as the reason?
Ankylosis
Caries develop when 4 conditions are met
- Metabolically active biofilm
- Susceptible tooth surface
- low molecular weight sugars in the diet
- Contact time w plaque and or calculus
Incipient Enamel Caries have 4 zones describe them:
Strudevant’s Ch3 Cariology,p94-95
Zone 1 - Inner (Deepest) translucent zone reflecting the initial loss of minerals from the enamel. No remineralization
Zone 2 - Middle dark zone. More demineralization and is a location of remineralization.
Zone 3 - The body of the lesion where the majority of the mineral loss has occurred. no remineralization
Zone 4 surface of tooth remineralization happens here
thickness enamel cats and dogs
cats 0.1-0.3 mm
dogs 0.1-1.0.mm
Crossley JVD 1995
Diagnosis and management of Wegener’s Granulomatosis in a dog
Krug, Manfra
JVD 2006 Dec 23(4)
- 4 year old MC Mix dog
- autoimmune vasculitis
- immunosuppressive drugs resulted in complete resolution
most common reported autoimmune disorders in companion animals with oral lesions
Pemphigus vulgaris and Bullous pemphigoid
features of oral Wegener’s granulomatosis (WG)
hyperplastic gingivitis with purple coloration and petechia (strawberry gingivits)
uncommon immune mediated microvasculitis in humans, also affects respiratory tracts and urinary
This is first reported case
What is the treatment for Wegener’s Granulomatosis?
Immunosuppressive drugs:
Cyclophosphamide and steroids
What serological test is useful in the dx of Wegener’s Granulomatosis?
ANCA (antineutrophilic cytoplasmic antibody-90% active disease) - human test
What was a side effect of TX in the dog with wagerer’s Granulomatosis?
Hematuria thought to be cyclophosphamide CTX, alternative is azathioprine
Spontaneous Oral Fibrosarcoma in a New Zealand Rabbit JVD 23(2) June2006
Brower, Goldstein
Nine month old New Zealand white rabbit
Common bacteria in oral abscess of rabbits
Pasturella
Klebsiella
Pseudomonas
Slobbers in rabbits
wet dewlap
Pasteurella should always be considered the causative agent.
oral osteomyelitis
rule outs for the mass on the mandible of the rabbit
osteomyelitis
abscess
neoplasia
fibrosarcoma, in the rabbit, regardless of treatment has a ___ prognosis
poor
What virus in rabbits is associated with spontaneous tumors
Shope fibroma virus
Use of the CO2 laser as an adjunctive treatment for caudal stomatitis in a cat. Lewis, Reiter
JVD 24(4) Dec 2007
Photothermal effects:
- tissue at 60-65 degrees C causes protein denaturization and necrosis
- tissue at 100 degrees, water turns to steam and results in explosive vaporization
- temps greater than 150 degrees,rapid protein breakdown results in a char layer (layer of carbonization)
LASER
LASER= light amplification by stimulated emission of radiation
Lasers
Electromagnetic energy is created in the form of photons each of which is produced by excitation of a specific element or compound and therefore each photon is of a characteristic wavelength
Heat effects on tissue
150C carbonization due to protein breakdown char should be removed as it heat sinks and causes tissue necrosis
CO2 lasers use what for transmission
Reflective surfaces
Diode and various YAG lasers use what for delivery
Transmitting fibers
Wide tips on lasers =
Narrow tips =
Wide= ablation
Narrow=cutting
Which laser delivery type can be used in an endoscopic channel
Diode and YAG using fiber transmitting delivery system
Which lasers are well absorbed in water
CO2 and Erbium series lasers best
Wavelength of CO2 lasers
10,600 nm wavelength
Invisible, infrared, non ionizing
Non contact laser use
Diode lasers wavelength
800-980 near infrared,invisible, non ionizing fiber transmitted and highly absorbed by pigmented tissue.
What benefits do lasers have on dentin
Seal dentinal tubules
What was the first laser specifically designed for dentistry
Nd:YAG Neodyium-doped Yttrium-aluminum-garnet
1064 nm near-infrared, invisible, non ionizing highly absorbed by water and pigmented tissue
Contact or non contact
Ho: YAG laser have..
- a wavelength of 2120nm
- a high affinity to water
- but not to tooth structures
- is used for soft tissue surgery
Contact use
Er:Yag
Wavelength: 2940nm
Caries debridement popping sound, not good hemostatic laser
non contact
What laser can cure composite
Argon 488nm to 514nm activates camphoroquinone the photo initiator in light cured resins.
Also used for caries detection and tooth whitening
What organism in this study was proposed as a reason for proliferative tissue
Bartonella
What did they cite as a good monitoring tool for patient comfort and success?
Monitoring the weight of the cat
diagnosis and management of odontogenic myxoma in a dog: meyers et al
JVD2007 24(3),
- 3 year old JRT with large gingival mass, mandibular, 4th pm to 1st m
- moth-eaten, honeycomb like lysis of mandible
- mandibulectomy curative
- slow growing, locally destructive tumors, only been described in one dog previously
- they are tumors of odontogenic ectomesenchyme
https://s3.amazonaws.com/classconnection/199/flashcards/1405199/jpg/odontogenic_fibromyxoma-14BC7E5E81248F244A9.jpg
image of right mandible, odontogenic myxoma with mottled lytic appearance
Odontogenic myxomas are
Classified as mesenchymal tumors and or odontogenic ectomesenchymal tumors with or without odontogenic epithelium
synonyms fibromyxoma or myxofibroma
Radiographically odontogenic myxomas are
not encapsulated and are unilocular to multilocular radiolucent lesions having a soap bubble appearance.
Treatment for odontogenic myxoma
wide to radical excision remove intact due to gelatinous nature and help to prevent reccurance
vimentin testing in histo
mesenchymal origin fibers test positive
Surgical management of compound odontoma in a dog JVD 24(2) 2007 Klima
one year old beagle male neutered
3 embryologic structures are needed for tooth development
The enamel organ, dental follicle, and dental papilla
The dental organ,papilla, and follicle are what
The epithelium and ectomesenchyme that will lead to odontogenesis
Dental papilla induces what
invagination of the dental ridge epithelium and formation of the enamel organ
4 layers of enamel organ:
outer dental epith.
stellate reticulum
stratum intermedium
inner dental epith.
Inner Dental Epithelium?
- Layer bordering the Dental Papilla
- Eventually become Ameloblasts which will form the Enamel
- They also exert an organizing influence on the underlying mesenchymal cells in the Dental Papilla which later differentiate into Odontoblasts
Dental Papilla
- Arises from ectomesenchyme
- a condensed zone of cells beneath the enamel organ, separated by basement membrane
- it will form dentin and pulp
Outer Dental Epithelium
- cuboidal cells that cover enamel organ
- organize a network of capillaries that will bring nutrition to ameloblasts
- laid in folds to provide nutrition in late bell stage
Stellate reticulum
inner layer of star shaped cells forming a network within enamel organ that support enamel matrix production
Stratum intermedium
- forms during bell stage
- layer of cells between inner enamel epi and stellate reticulum
-shows activity of alkaline phosphatase – essential for mineralization
(Hertwigs) Root sheath
- epithelial cells of the inner and outer eipithelium proliferate to form the root sheath
- inner epithelial cells induce the ectomesenchyme cells to differentiate into dentin producing odontoblasts
- as the tooth grows, the root sheath is stretched, cells disassociate, and clusters of small epithelial cells are separated from the CT by a basal lamina
Cell rests of Malassez
- can become cysts
- proposed possible functions:
a) cementum repair
b) signaling function
c) epithelial-mesenchymal transformation
- clusters of leftover Hertwig’s root sheath that failed to disintegrate
- persists in adults within the PDL adjacent to surface of cementum
Feline tooth resorption in a colony of 109 cats: Girard, Hennet, et. al.
JVD 2008 25(3)
Abstract:
Prevalence was significantly higher in PB cats(70%) compared to mix-breeds (38%)
- 290 TR were diagnosed radiographically, 60% were type 2 compared with 40% type 1
- Increased prevalence in older mixed breeds and female purebreds
- Single dental exam in a population of cats housed at a feeding facility
Two groups of cats: MB and PB
mixed breed and purebred
Lesions classified by MDP, coronal or apical to the CEJ, and coronal or apical to the CBH, What are these abbreviations?
MDP -mesial distal position on tooth,
CEJ - cementoenamel junction
CBH - crestal bone height
% of MB cats with lesions
37.5%
% of PB cats with lesions
69.6%
For all lesions, __% were type I, and ___% were type II.
40% type 1
60% type 2
which teeth were mostly affectd in the MB population and the PB pop?
MB- maxillary PM’s and mand PM3 and M1, PB same but also incisors.
For Man M1- location of lesion was___,
for PM3 ___, for incisors ___
M1 - at CBH or CEJ,
PM3 - non specific, Incisors - apical to CEJ or CBH
JVD 2008
What were the two types of External RL described
Inflammatory stated as type I
Non inflammatory state as attachment damage state as Type II
What were the 2 reported prevalence of TR by other sources in the paper JVD 2008
- 0-67.0% Mostly veterinary associated populations
29. 0 % healthy cats J sm an Prac 2001 Ingham
- Define infraocclusion.
occlusion in which one or more teeth fail to project as far as the normal occlusal plane.
Type I TR was found most in which teeth
Mandibular 1st molars both MB and PB
Type II Tooth Resorption was found in which teeth mostly
MB Mandibular 3rd premolars
PB all incisors
Mixed breed prevalence of tooth resorption
37%
Prevalence in this study of PB cats
69.0%
How did sex affect prevalence of tooth resorption in these cats 109 JVD 2008
No difference in MB but was significant in PB Females greater
How was age a factor in the TR of the 109 cats
Both types of resorption increased with age
When looking at Type I only it increased
When looking at Type II it decreases
So Type I younger and Type II older and combining the types overall prevalence increases with age
Teeth with RL by Type and breed
MB Type I MandM1 Type II MandPM3
PB Type I MandM1
Type II all incisors
Canine dentin mineral ratios and composition compared to cats
Dogs lower CA/P ratio and lower MG, and Na ions
Did this study confirm the Vit D theory
No cats were all fed the same diet and it was low in Vit D
Significant association between tooth extrusion and tooth resorption in domestic cats; Lewis, Okuda, Shofer, et al
JVD 2008 vol 25(2)
- The distance b/ow alveolar margin (AM) and CEJ was measured
- Dead cats used, >1 year old
- oral exam performed and cats listed as TR-affected or TR free
- distal surface of the canine teeth used to measure the AM-CEJ
Explorer used in this study
Tufts # 17 explorer
Probe used?
Michigan O probe is finer at tip than Williams
The cementum was ____ in extruded teeth, compared to non extruded teeth.
Thicker in all areas
The mean AM-CEJ was significantly ___ in cats with TR
Greater 2.68mm in TR and 2.22mm without TR
The greatest change in PDL space of extruded teeth was where and it was what
Apical and thinner although the cervical area was also thinner
The histological evidence of tooth resorption was higher or lower than clinical and radiography
25% showed clinical and radiographic evidence of TR,
and 56% by histological
hypercementosis was evident in all ____ teeth and none of the ___ teeth
extruded teeth, none in the non extruded teeth
Periodontal growth or segmental alveolar bone growth
growth of the periodontal tissues in a coronal direction resulting in movement of the entire tooth in an occlusal direction
Passive eruption
Occurs with aging, when the gingival tissue recedes but no actual tooth movement takes place.
The AM to CEJ in cats that had healthy k-9 teeth was
> 1mm which is more than the standard accepted value of 1mm
Hertwigs epithelial root sheath are the precursor to what cell type ?
Cementoblasts and precusor for cell rest of Malassez
Hypercementosis
Deposited in layers of alternating acellular extrinsic fiber cementum and cellular intrinsic fiber cementum
Resorptive lesions frequently have what type of cementum
Cellular intrinsic fiber cementum
Buccal bone expansion in cats
46% of cats regardless of TR status
2 theories of buccal bone expansion causing tooth extrusion
- Formation of new apical alveolar bone decreases depth of alveolus and increase in length of clinical tooth crown (Not noted in this study
- Formation of new bone at alveolar MARGIN result in stretching of the supra-alveolar fiber apparatus with concomitant attempts by the dentogingival complex to maintain biologic width.
Locked jaw Syndrome in Dogs and Cats 37 cases
Gatineau et al
JVD 2008
84% of cases =Dogs, and adult dogs 81% of dogs
TMJ anklosis due to fracture was most common cause 54%
10 % Intraarticular and 90 % extraarticular
What muscles of mastication close the mouth
Temporalis
Masseter
Pterygoids
Innervated by trigeminal -mandibular nerve
Muscle to close mouth
Diagastricus specifically the caudal belly innervated by the facial nerve and the rostral belly is innervated by the mylohyoid nerve which is a branch of mandibular nerve also provide sensation to skin between the mandible
True ankylosis is intracapsular or extra capsular
Intracapsular
Trauma was responsible for what % of false ankylosis
65%
and vehicle trauma 77% (100% cats and 70% dogs)
Neoplasia in the TMJ region has been reported as what types
Osteosarcoma and multi lobular osteochondrosarcoma
TMJ dysplasia
Rare congenital disorder or developmental
abnormal development in TMJ
Basset hounds, Irish setters, American Cocker, Cavalier King Charles, Peke, Boxer, Golden, Labs, Bermese.
yawn and cannot close mouth
mandibular coronoid process locks outside zygomatic arch
Cats have the ability to luxe the TMJ which direction?
Rostrodorsal without symphyseal separation or mandibular fracture due to wide zygomatic arch.
Lateral displacement of the coronoid process to the zygomatic arches causes
Open mouth lock jaw
MMM causes trismus and what was the percentage in this study
41 %
The MMM test specificity and sensitivity
100% and 85-90 sensitive
Trigeminal nerve paralysis was diagnosed in what percent
29%
In Vitro Effect of Chinese Herb Extracts on Caries-related Bacteria and Glucan
Li, Liu.
JVD 25(4) Dec 2008
The results demonstrated that Tannic acid could inhibit bacterial growth more effectively than any other herb extracts (cariogenic bacteria tested)
Eugenol show a 46.87 and 36.67 inhibitory effect on insoluble and soluble gluten synthesis respectively
Cnidium, barbaloin, caryophyllim and piperine >40% inhibitory effect on soluble glucan synthesis
The expression of calretinin and cytokeratins in canine acanthomatous ameloblasoma and oral squamous cell carcinoma
Fulton
Vet Comp Oncology 2012
15 OSCC and 15 CAA, 6 tooth buds and 2 samples of gingiva
OSCC CK expression = CAA and tooth buds
Calretinin expression was high for OSCC 10/15 and low for CAA 2/15
Calretinin may be an important tool for differentiating CAA from OSCC
Oral neoplasm represent what percent of cancer in dogs
6%
OSCC is what percent of all oral neoplasms
17-25%
CAA represents what % of oral neoplasms and what percent of odontogenic tumors
5% and 45% of all odontogenic tumors
Where are most of the OSCC and CAA found
Rostral mandible
What are classical histologic features of odontogenic epithelium
Peripheral palisading with reverse polarization of the nuclei basilar clearing and a centralized stellate reticulum like appearance
cytokeratins
A family of intermediate sized filaments that form part of the cytoskeleton of epithelial cells. 20 to date each epithelium has a unique cytokeratin expression profile
odontogenic tumors express CK 5,6,14
Calretinin
Calcium binding protein of the EF -hand family
thought to have a role in calcium transportation and buffering and potentially a regulator of cell cycle and apoptosis
Vimentin staining tumors
Sarcomas and mesenchymal tumors and highlights the connective tissue
MRI imaging of a solid multi lobular ameloblastoma in the mandible of a pony
EVJ 2014
31 year old pony left mandible
blastomas
derived from immature cells
Carcinomas
- arise from epithelial tissue
sarcomas
malignant tumors of the supporting tissue
- bone
- muscle
- cartilage
- fat
fibromas
benign tumors of fibroblast origin
What type of imaging was done in this pony for Ameloblastoma
MRI
Resection of a mast cell of the lip in a Dog
Taney and Smith
JVD 26(1) spring2009
10 year old boston terrier left maxillary lip - grade 1 MCT
What does grade 1 mean?
Well differentiated mast cells, low metastatic rate, and surgical excision is best course of tx.
Mast cell tumors are the most common cutaneous tumor in the dog and ____ in the cat.
Most common dog and second in the cat
Mast cell are connective tissue hematopoietic cells derived from what
Bone marrow progenitor cells
What should be given prior to surgery of mast cell tumors
Antihistamines
Recommended surgical margins for Mast cell tumors in dogs
3cm in all directions
Did they remove the lymph nodes in this dog?
Yes
Immunohistochemical analysis of a dentigerous cyst in a dog: Kuyama et al
JVD 2009, summer, 26(2)
-nonkeratinized epithelium is immunoreactive for ssDNA and amelogenin
dentigerous cysts comprise approximately __% of all jaw cysts in humans and most commonly involves the maxillary permanent ___ and Mandibular ___ teeth
28.9%, canines and wisdom teeth
There are three types of lesions in animals that are referred to as dentigerous cysts
- cyst similar to humans
- ovine odontogenic cyst
- temporal teratoma in horse
Multilobular Tumor of Bone in the Mandible of a Dog, Eubanks
JVD 27(3) 2010
8YO Siberian husky
Grade 1 Multilobular tumor of bone in the mandibular incisor region
Multilobular tumor of bone
an uncommon primary bone tumor in dog s – usually confined to the skull
Potentially malignant, slow growing and locally invasive.
Metastasis uncommon, but usually lungs
What grade was this tumor?
Grade I
Oral Pathology in Swedish Dogs: A retrospective study of 280 biopsies: Svendenius, Warfvinge JVD 27(2) 2010
Reactive- 39%
Benign- 27%
Malignant 15%
Median age of dogs in study = 8 yrs, median age of dogs with malignant neoplasm _____.
10 years
Median age of dogs with reactive and benign neoplasms
8 Years
the most common type of malignant neoplasm in this study
malignant melanoma
Highest no of reactive lesions and benign tumors found in what breed?
Golden retriever
Intraosseous maxillary hemangioma in an immature bassett hound,
Hansen, Goldstein, et al JVD 27(4)2010
What is the characteristic radiographic appearance of this?
Soap-bubble lytic appearance to the bone
This is the only known reported hemangioma in the maxilla of a dog
This dog was how old
6 mo, FS Basset with a persistent 504 tooth
Oral hemangioma
Intr ao r a l d e nt a l ra di ogra ph s pr ov id e d a r a d iog r a phi c p atte rn s imil ar to w h at is r e p o rt ed in th e hum a n lit e r a tu re co n s i sti n g of a di ff u s e p oo rl y d ef in e d osteo l y ti c p a tt e rn w ith c h a n ges r ef l ec ti ve of th e r e p o rt e d “soa p bubbl e “ a pp ea r a n ce .
Hemangioma of the head
A lth o u g h r a r e , intr aosseo u s h e m a n g i o m as s h o ul d b e con s id e r e d in cases o f ex p a n s ile fac i a l bon y l es i o n s, w i t h co mp a tibl e c lini ca l s i g n s , in o rd er th a t th e c l i n ic i an m ay a nt icipate un ex p ec t e d , pr of u se i ntr ao p e r ative h e m o r rhage assoc i ate d with bi o p sy or d e nt a l extrac ti o n .
Polyamine Inhibitors for treatment of Feline Oral Squamous Cell Carcinoma A proof of Concept study, Lewis, O’Brien, Skorupski, et al.
JVD 30(3) 2013
This study assessed proof-of-concept for use of polyamine inhibitor 2-difluoromethylornithine (DFMO) as a treatment for oral squamous cell carcinoma (SCC) in client-owned cats.
SCC in Cats
60-70% of all oral tumors
What is the average age of onset in cats with SCC? What were the ages of cats in this study?
Average age of onset is 11years.
Mean cat age ± SD was 13.5 ± 2.8-years (range, 9.3 to 19.3-years). Mean body weight was 4.5 ± 1.5 kg (range, 2.6 to 6.9 kg). There were 9 spayed females and 5 castrated males. Of the 14 cats, there were 10 domestic shorthair, 2 Himalayan, and 2 Maine Coon cats.
How many of the cats had Positive lymph node aspirates
30.8% Mandibular lymph nodes
DMFO study in cats with SCC
JVD 2013
Results of the present study are promising because significant toxicity was not observed, other than ototoxicity and non-clinical thrombocytopenia. Since post-treatment tumor polyamine levels were significantly less than pre-treatment levels, DFMO appears to be a rational therapy for feline patients with oral SCC.
Percutaneous Approach for Sialolith Removal in a Donkey, Rodrigues, Mora, Bastos, et al.
JVD 30(1) 2013
9 YO Donkey Sialolith Right Parotid Duct
Sialolith
4x4x8.5cm weighed 183 grams cereal grain found inside the wound
Sialolith surgery
Percutaneous 3 layer closure
Duct, Subcu and skin no dehiscence was noted
Appearance of maxillary feed impaction in the horse
Carmalt montgomery
JVD 2013
15 year old belgian Respiratory distress dental disease right maxilla
equine secondary sinusitis
In a study of 400 cases of equine dental disease, it was found that infections of the caudal maxillary cheek teeth with a concurrent secondary paranasal sinusitis had only a 33 % complete response to initial treatment. 3
Clincial Histological and computed tomographic features of oral papillary squamous cell carcinoma in dogs
2008-2011 9 cases
JVD 2013
Retrospective 2008-2011
Papillary SCC
The biologic behavior of PSCC is more aggressive than that of VC, being more likely to metastasize to regional lymph nodes and lungs, and is generally believed to have a better prognosis than SCC but a worse prognosis than VC.
Histologically Papillary Squamous cell and Verrucous carcinoma histologic presentations
Histologically, both VC and PSCC are described as being fairly well differentiated; the former being very well differentiated and the latter being moderately differentiated.
What was the difference in this study of Papillary SCC compared to others considering gender of the patient
Male and female equally weighted
Surgical margins for SCC in humans
JVD 2013
1cm in this paper
One dog in the JVD 2013 paper on PSCC was treated by what did not undergo surgery?
Piroxicam
Inflammatory mediator changes seen in cats with stomatitis
increased expression of mRNA for specific inflammatory mediators (IL-2, IL-4, IL-6, IL-10, IL-12 and IFN- γ )
Immunohistochemical analysis of predominate cells in stomatitis lesions
primarily CD79a+ IgG isotype plasma cells, along with CD8+ (cytotoxic) T cells,
Cyclosporine
Binds to cyclophilins. Complex blocks differentiation and activation of T-cells by inhibiting calcineurin, thus preventing production of IL-2 and its receptor
Cyclosporine
a lipophilic, cyclic peptide derived from fungi
Feline stomatitis improvement % after extraction of the PM and Molar teeth
60-80%
the remaining 20-40 % of cats with persistent inflam- mation typically require medical intervention to preserve their quality of life.
Feline stomatitis what is a new drug in europe?
Recently, a European study reported that recom- binant feline interferon omega (rFeIFN- ω ) delivered transmu- cosally was as effective as prednisolone
Cyclosprorine in stomatitis
reducing oral inflammation in the majority (8/9) of cats with refractory stomati- tis. Cats with trough cyclosporine blood levels above 300 ng/mL demonstrated a greater than 70 % reduction in their disease activ- ity index scores over the 6 week observation period.
Risk Assessment of Feline Tooth Resorption: A Portuguese
Clinical Case Control Study
Lisa A. Mestrinho, DVM, MSc; Jens Runhau, DVM; Mauro Bragança, DVM, MSc; Maria M.R.E. Niza, DVM, PhD
JVD 2013
The study included data from 71 cats admitted for general anesthesia for various reasons
The age group of 10 to 15-years showed an increased risk of 6.56 times for TR occurrence compared with the group 0 to 4-years of age.
Feline TR JVD 2013 Canine teeth were more likely to have which type of TR
Type II
P<0.001
There was a nearly significant association between Inflammation and which type of resorption
Type I
They proposed that Type 3 Lesions were
Potentially advanced stages of TR lesions
Cats were not excluded if they had
Oral disease
Age groups of the older cats were how much more likely to have tooth resorption?
The age group of 10 to 15-years showed an increased risk of 6.56 times for TR occurrence compared with the group 0 to 4-years of age.
____ relation was found between age or gingivitis index and lesion type.
NO
Mandibular third premolar and molar teeth were most commonly affected by TR, especially for type?
Type I
Odontoameloblastoma in a Calf
JVD 2013
A 6-month-old Chianina calf was referred for a large (5 x 4-cm), firm, ulcerated oval mass in the rostral portion of the mandible.
Ondotogenic Ameloblastoma
(WHO) as “a neoplasm that includes odontogenic ectomesenchyme in addition to odontogenic epithelium and resembles an ameloblastoma in both structure and behavior.
histological criteria of ameloblastoma
peripheral palisading ameloblasts with “reverse polarity”, circumscribing large areas of stellate reticulum - like tissue (fully developed enamel system)
Parotid Duct stenosis Following Caudal Maxilloectomy
JVD 2014
9YO dog Caudal maxillectomy 2 years prior for CAA
What was the complication noted in this case
Facial nerve paralysis for 2 weeks
In humans what is the percent of cases that develop facial nerve paralysis
32%
Is parotid duct stenosis a common complication of caudal maxillectomy
no
Maxillofacial injuries and diseases that cause an open mouth in Cats
JVD 2014
DDX
Luxation TMJ
Fracture TMJ
Caudal mandibular fracture
impingement of the coronoid process
Mechanical obstruction
Meuropathy
Injuries to TMJ and mandibular fracture account for what percentage of all fractures in cats?
11.3-23%
What was stated as an overlooked problem causing open mouth conditions in cats?
Periodontal disease causing tooth to tooth contact.
Which TMJ Luxation in the cat is rare and involves a fracture?
Caudal and generally fractures the retroarticular process
Brachycephalic breeds are more susceptible to what that causes open mouth locking
Coronoid process interfering with the zygomatic arch
Clinicopathologic Characterization of Oral Pyogenic Granuloma in 8 cats
JVD 2014
Propose that secondary traumatic contact of the opposing MaxP4 with the mandibular soft tissues is a possible contributing factor
How many cats with Pyogenic granuloma had bilateral lesions and where were the lesions in this case study
50%
Vestibular to the mandibular M1
How many of the Cats with Pyogenic granuloma had K-9 teeth fractures
37.5%
How many first attempts included odonotplasty and excision of the mass
- 3%
66. 6% included extraction of the MaxP4 and excision
In humans Pyogenic granuloma is seen in what % of all reactive lesions? and compose what % of all oral biopsies
- 2%-32.0% of reactive lesions
2. 8%-7.0%of all oral biopsies
In humans what is thought to be a factor in women.
Preganancy
What was the most common classification of oral osteoma found in the 6 dogs in this study?
JVD 2014
central (n=4) -only 2 were peripheral
Osteoma
Benign tumor
Peripheral=Periosteal
Central= Endosteal
Extraskeletal= soft tissue usually muscle
Largebreed dogs