Jane's 5 point perio articles Flashcards
Marshall M, Wallis C, Milella L, Colyer A, Tweedie A, Harris S. A longitudinal assessment of periodontal disease in 52 miniature schnauzers. BMC Veterinary Research. 2014;10(1):166.
- 60 week study evaluating periodontal parameters every 6 weeks with probing and charting but no rads
- If a tooth developed periodontitis (defined as any attachment loss) it was scaled and removed from the study, If a dog developed 12 teeth with periodontitis it was removed from the study (35 /52 dogs)
- Most commonly affected teeth were incisors, and fourth premolars, more commonly on palatal/lingual side of incisors and buccal sides of other teeth
- With every year’s increase in age there was a reduction in time to periodontitis of 5.5 (s.e. 1.21) weeks (Figure 5) demonstrating that as dogs age they progress to periodontitis significantly faster than younger dogs.
- current gingivitis state of a tooth does not predict the time that tooth will take to get periodontitis, most sites of gingivitis did not progress to periodontitis
Effect of Frequency of Brushing Teeth on Plaque and Calculus Accumulation, and Gingivitis in Dogs
Colin Harvey, BVSc, FRCVS; Laurie Serfilippi, VMD; Donald Barnvos, MS
- Comparison of 4 frequencies of brushing for effectiveness, Daily, EOD, Weekly, EOW, control with standardized brushing protocol
- Scored VOHC teeth – entire tooth for calculus, only gingival half for plaque
- For gingivitis if brushed daily 61% reduction, if brushed EOD 33% reduction
- For plaque if brushed daily 37% reduction, EOD 24% reduction
- For calculus, if brushed daily 80% reduction, EOD 62% reduction, weekly 22% reduction
- For gingivitis and plaque, only reduction with daily or EOD, calculus had reduction with weekly brushing
Glickman LT, Glickman NW, Moore GE, Goldstein GS, Lewis HB. Evaluation of the risk of endocarditis and other cardiovascular events on the basis of the severity of periodontal disease in dogs. J Am Vet Med Assoc. 2009;234(4):486-494.
- Large retrospective Banfield study of ~120,000 dogs, half with periodontal disease half without tested for association between periodontal disease stage and a variety of conditions
- Dogs were put into periodontal disease categories at hundreds of practices by different vets using awake oral exam comparison to photographs provided by the authors, also no defined parameters for cardiac conditions
- Endocarditis 6 x more likely to be diagnosed in a dog with PD3 (their stages only went to 3) than non-periodontal cohort
- HCM ~4 x more likely in periodontal disease stage 3
- DCM ~2.5x more likely in periodontal disease stage 3
Evaluation of the diagnostic yield of dental radiography and cone-beam computed tomography for the identification of anatomic landmarks in small to medium-sized brachycephalic dogs
Sophie Döring dvm Boaz Arzi dvm Catherine R. Barich dvm David C. Hatcher dds, msc Philip H. Kass dvm, phd Frank J. M. Verstraete dr med vet
- CBCT compared with dental radiography in brachycephalic dogs for identification of 26 landmarks
- NSD for 7 landmarks – Symphysis, R & L mandibular canine, M1’s and mand canal
- Overall best method was the slices method, good to excellent scores for all categories, then 3d method, then rads and pano
- Dental radiographs still had superior resolution and could see lamina dura (couldn’t on CBCT)
- Structural complexity of the skull of brachycephalic dogs was responsible for difficulties in evaluation of dental radiographs and that the overall diagnostic yield did not depend on resolution but, instead, depended primarily on unobstructed visibility of these structures.
Pavlica Z, Petelin M, Juntes P, Erzen D, Crossley DA, Skaleric U. Periodontal disease burden and pathological changes in organs of dogs. J Vet Dent. 2008;25(2):97-105.
- Post-mortem study of all toy and miniature poodles trying to correlate degree of periodontal involvement with pathological changes in other organs
- Measured depth of pocket at 6 sites on all teeth, and multiplied by circumference of tooth to give an ‘area’ of periodontal disease burden
- Collected samples of organs and evaluated for pathology via histo
- Greater chance of pathology in left AV valve, Liver and renal tubular degeneration for every cm2 of perio disease burden
- No significant difference for Right AV valve, coronary artery or carotid artery
Davis EM. Gene Sequence Analyses of the Healthy Oral Microbiome in Humans and Companion Animals: A Comparative Review. Journal of Veterinary Dentistry. 2016;33(2):97-107.
- The16S ribosomal RNA (rRNA) gene in prokaryotes (bacteria and archaea) and the 18S rRNA gene in microscopic eukaryotes (protozoa and fungi) have both highly conserved regions and uniquely variable regions that together permit taxonomic classification
- Estimated that only 3% of microbes will grow in culture
- Human oral microbiome: Communities were similar at some sites, but totally different to others – clusters were:
- buccal mucosa, keratinized gingiva, and the hard palate;
- saliva, tongue, tonsils, and throat;
- dental plaque collected from subgingival and supragingival
- 6 bacterial phyla predominate in human, dog and cat – ABFFPS
- Actinobacteria, Bacteroidetes, Firmicutes, Fusobacteria, Proteobacteria, and Spirochetes
- In several studies, gram negatives more prevalent in health, and gram positives more prevalent in disease.
Reiter AM, Lewis JR. Dental bulge restoration and gingival collar expansion after endodontic treatment of a complicated maxillary fourth premolar crown-root fracture in a dog. J Vet Dent. 2008;25(1):34-45.
- Biologic width is approximately 2 mm in the dog – 1 mm for gingival fibre attachment to the tooth, 1 mm for junctional epithelium
- This 2 mm distance must be maintained from the edge of any restorative placed to the crest of the alveolar bone (i.e. must recontour bone to preserve this 2mm when placing subgingival restorations)
- The dental bulge is a protective feature of the tooth, helping to direct food and debris away from the sulcus
- Gingival collar expansion was accomplished by means of an oblique sliding flap
Mestrinho LA, Louro JM, Gordo IS, et al. Oral and dental anomalies in purebred, brachycephalic Persian and Exotic cats. Journal of the American Veterinary Medical Association. 2018;253(1):66-72.
- Prospective cross-sectional study of 42 Persian and 8 exotic cats, oral exam and complete rads under anesthesia
- 72% have a malocclusion – MOST COMMON Class I (36% - mostly incisor orientation); Class III (28%);
- 70% have an abnormal number of teeth – 64% hypodontia with 106/206 missing most commonly
- 88% of cats have some perio – mostly stage I, worst teeth are max P4 and Mand M1
- 70% of cats have some TR; Premolars most affected with inflammatory, Canine most affected with replacement
Kouki MI, Papadimitriou SA, Kazakos GM, Savas I, Bitchava D. Periodontal Disease as a Potential Factor for Systemic Inflammatory Response in the Dog. Journal of Veterinary Dentistry. 2013;30(1):26-29.
- 71 dogs, prospective trial examining parameters of systemic inflammation – CRP, albumin, and did TMPS-G and TMPS-P scoring for all animals, about half of dogs had a CBC.
- Correlation between higher TMPS-G score and CRP, WBC’s and neutrophils
- NO COORRELATION between TMPS-P score and any parameter
- Suggested gingivitis more indicative of active inflammation and that periodontitis index representative of past destruction, but not necessarily active
Clarke DE, Servet E, Hendriks W, Thomas DG, Weidgraaf K, Biourge VC. Effect of Kibble Size, Shape, and Additives on Plaque in Cats. Journal of Veterinary Dentistry. 2010;27(2):84-89.
- Prospective randomized controlled trial to evaluate the effect of 4 different diets
- (Small triangular, small triangular with additive STPP (polyphosphate), Large rectangular, Large rectangular with additive STPP (polyphosphate) and PRN (vitamin C related product)
- Coating small kibble with STPP made no difference
- Larger kibble reduced plaque by ~20% at day 7 and day 28
- Larger kibble with STPP and PRN reduced plaque by ~30% at day 7 and day 28
- Concluded while the shape of the food enhanced its mechanical action, PRN contributed to a reduction in plaque adhering to the tooth surface, allowing it to be effectively brushed away by the action of the food as the cat chewed
Wallis C, Allsopp J, Colyer A, Holcombe LJ. Validation of Quantitative Light-Induced Fluorescence for Quantifying Calculus on Dogs’ Teeth. J Vet Dent. 2018;35(3):187-194.
- Prospective trial using chew vs no chew in a clean mouth model for calculus accumulation using both Warrick-Gorrel method of quantifying calculus as well as QLF scoring VOHC teeth
- Warrick Gorrel method showed a 43% reduction in calculus and the QLF methd showed a 65% reduction in calculus for dogs receiving the chew
- Retrospective analysis showed that to show a significant difference with the QLF method, 12-15 dogs would be required versus >30 for Warrick-Gorrel
- Benefits of QLF are it Correlates well with existing systems, less variability, does not require trained observers, higher sensitivity, can detect a difference between groups with fewer animals, photos create a permanent record
- Reduction for average mouth score are greater than for weighted mouth score (small teeth contribute more in an average score)
Skinner A, Niemiec B. Semilunar Coronally Advanced Periodontal Flap to Increase Soft Tissue Coverage of a Maxillary Fourth Premolar in a Dog. J Vet Dent. 2017;34(2):100-105.
- Goal of the procedure is to increase soft tissue coverage of the tooth
- Only suitable for the maxilla (gravity, no sutures) and for Miller Class I (no interdental bone loss)
- 3mm increase in coverage created for this patient, at one of the rechecks had a 4 mm pocket (1 year – doxirobe placed)
- NEEDS homecare to be successful
Rawlinson JE, Reiter AM. Repair of a gingival cleft associated with a maxillary canine tooth in a dog. Journal of Veterinary Dentistry. 2005;22(4):234-242.
- Case report of a 4yo cavie with a distal UCRF and a gingival cleft associated with 204 – This was a Miller Class II (tissue recession and loss of interdental bone)
- Did a lateral sliding gingival flap from over the maxillary incisors, RP/O, BG, and XSS 205
- With Class I and II miller’s gingival recession, can expect 100% root coverage, with class III expect partial root coverage and with class IV can not expect rot coverage
- 10 month follow up, complete coverage was attained and BG had incorporated into surgical site
Oba PM, Devito FC, Santos JPF, et al. Effects of Passive Immunization by Anti-Gingipain IgY on the Oral Health of Cats Fed Kibble Diets. Journal of Veterinary Dentistry. 2018;35(4):275-280.
- Gingipains are proteases secreted by Porphyromonas that promote the disruption of cell adhesion and the differentiation of osteoclasts.
- 2 groups of 10 cats, each fed a diet for 40 days, (then crossover) differing by coating one with IgY directed at gingipains
- At the end of the study after 40 days of feeding diet, plaque index significantly lower than baseline, and no change with control diet – did not give a percentage
- No Significant Difference for calculus, gingivitis, and % PG-OC (porphyromonas gingivalis in the oral cavity)
- NOTE – they PCR’d for the human pathogen – P. gingivalis, not the feline P. Gulae
Mele RE, Caiafa A, Kurtzman GM. Dental Implants and Incisor Bridge Placement in a Dog. Journal of Veterinary Dentistry. 2016;33(4):249-258.
- Proof of concept case report with a 3 year follow up showing osseointegration of implants and successful maintenance of incisor bridges
- Extraction of incisors and bone grafting followed by implant placement after 8 months.
- Insertion torque of 50 N-cm
- The different implant abutments used: screw cover, then healing abutment, impression abutment, and finally implants placed
- Case selection, technical skills of the operator, limiting excessive forces to implant/crowns, and homecare maintenance are paramount to the success of the implant/crown.
