Veterinary Medicine - July 2008 - (Page 370)

Dental Corner PEER-REVIEWED 6A 6B 6A–6D. The chief steps in bonded composite restoration on a right mandibular canine tooth in a dog. In 6A, the uncomplicated enamel fracture is seen, and the white arrow points to the exposed dentin. Note that the pulp chamber is not exposed. In 6B, a dentinbonding agent is being applied to an already-acid-etched surface. In 6C, a light-activated, low viscosity composite is being introduced to the prepared surface. In 6D, an ultraviolet light is curing the composite. TREATING ENAMEL FRACTURES Enamel fractures do not expose dentin, and as enamel is essentially impermeable, the pulp should not become infected or sensitive. Obtain dental radiographs to look for other pathology. Additionally, if an enamel fracture is present, pulpitis may occur from the concussive trauma, so yearly radiographs are recommended. Because the enamel layer in dogs and cats is relatively thin, true enamel fractures in these species are rare. Treatment options for enamel fractures include either bonded composite restoration or no treatment with frequent (every six to 12 months) monitoring. 6C 6D sions of the tooth and the complete dentition, including a wax registration of the occlusion, are made and submitted to a dental laboratory. The laboratory creates the new crown through a process called the lost wax technique. After the crown has been sent back to the clinician and evaluated, it is bonded to the tooth with resin cement. The crown may be made of metal, ceramic, or porcelain fused on metal. Of these materials, metal is the most durable and the most commonly used. In a study investigating the long-term results of crown therapy in dogs, 17 of 19 crowns were intact and functional at a mean follow-up time of 32 months.15 TREATING UNCOMPLICATED FRACTURES IN VITAL TEETH With uncomplicated crown fractures, exposed dentin can result in painful pulp stimulation and bacterial infection leading to pulp necrosis, especially immediately after the fracture when the dentinal tubules have been freshly exposed. Treatment should include composite restoration of the defect and possibly preparing for and placing a fullor partial-coverage crown. Recent information has shown that canine dentin has less intertubular dentin (dentin between tubules) than human dentin does, possibly decreasing the bond strength of modern composites compared with those placed on Extraction Although it is preferable to salvage teeth, it may not be possible because of extensive trauma, ﬁnancial restrictions, or other circumstances. Successful extraction depends on your having the proper equipment and skills. 370 July 2008 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - July 2008

Veterinary Medicine - July 2008 Contents Leading Off Practical Matters Idea Exchange Clarification Dental Corner The Diagnostic Approach to Hematuria Guidelines for Evaluating Hypercalcemic Cats CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - July 2008

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