Veterinary Medicine - July 2008 - (Page 371)

human teeth.10 The decreased intertubular dentin could lead to weaker shearing forces and increased failure of composite restorations. Thus, placing a metal crown to protect the remaining tooth from further damage and bacterial ingress may be desired. However, the choice depends on the amount of remaining dental hard tissue, the thickness of the tooth axial walls surrounding the pulp, and client expectations. Frequent (every six to 12 months) radiographic monitoring is necessary. If radiographic evidence of endodontic disease is observed, root canal therapy or, though less desirable, extraction is indicated. root canal therapy is a good treatment option. The reported failure rate for root canal therapy in dogs was only 5%.19 Root canal treatment allows a patient to maintain tooth function and is often less invasive than extraction. After root canal treatment, the tooth is restored with tal pathology of feral cats on Marion Island, part 1: congenital, developmental and traumatic abnormalities. J Comp Pathol 1996;115(3):265 –282. 7. Whitney WO, Mehlhaff CJ. High-rise syndrome in cats. J Am Vet Med Assoc 1987;191(11):1399-1403. 8. Wiggs RB, Lobprise HB. Oral anatomy. In: Veterinary dentistry: principles and practice. Philadelphia, Pa: Lippincott-Raven, 1997;55-86. 9. Trowbridge H, Kim S, Suda H. Structure and functions of the dentin and pulp complex. In: Cohen S, Burns RC eds. Pathways of the pulp. 8th ed. St. Louis, Mo: Mosby, 2002;411456. The success of vital pulp therapy decreased to 0% when it was performed more than seven days after the injury. either a composite or metal crown, as mentioned above. If salvaging the teeth is impossible, the only other recommendation for teeth with pulp necrosis or imminent pulp necrosis is extraction. However, teeth with severe endodontic disease may still have healthy periodontal attachment, and extracting these teeth can be challenging. REFERENCES 1. Golden AL, Stoller N, Harvey CE. A survey of oral and dental disease in dogs anesthetized in a veterinary hospital. J Am Anim Hosp Assoc 1982;18:891-899. 2. Johnson N. DentalVets, North Berwick, United Kingdom. Personal communication, 2008. 3. Gioso M. University of Sao Paulo, Sao Paulo, Brazil. Personal communication, 2008. 4. Le Breech C, Hamel L, Le Nihouannen JC, et al. Epidemiological study of canine teeth fractures in military dogs. J Vet Dent 1997;14(2):51-55. 5. Brine EJ, Marretta SM. Endodontic treatment and metal crown restoration of a fractured maxillary right fourth premolar tooth: a case report. J Vet Dent 1999;16(4):159-163. 6. Verstraete FJ, van Aarde RJ, Nieuwoudt BA, et al. The den10. Robb L, Marx J, Steenkamp G, et al. Scanning electron microscopic study of the dentinal tubules in dog canine teeth. J Vet Dent 2007;24(2):86-89. 11. Hernandez SZ, Negro VB, Maresca BM. Morphologic features of the root canal system of the maxillary fourth premolar and the mandibular rst molar in dogs. J Vet Dent 2001;18(1):9-13. 12. American Veterinary Dental College. Veterinary Dental Nomenclature. Dental Fracture Classi cation. Available at www.avdc.org. Accessed April 30,2008. 13. Baumgartner JC, Hutter JW. Endodontic microbiology and treatment of infections. In: Cohen S, Burns RC eds. Pathways of the pulp. 8th ed. St. Louis, Mo: Mosby, 2002;501-520. 14. Briso AL, Rahal V, Mestrener SR, et al. Biological response of pulps submitted to different capping materials. Braz Oral Res 2006;20(3):219-225. 15. van Foreest AW, Roeters FJ. Long-term success rate of resinbonded metal crowns on the canine teeth of working dogs. Vet Q 1997;19(1):23-28. 16. Holmstrom SE, Fitch PF, Eisner ER. Endodontics. In: Veterinary dental techniques for the small animal practitioner. 3rd ed. Philadelphia, Pa: Saunders, 2004;339-414. 17. Harran-Ponce E, Holland R, Barreiro-Lois A, et al. Consequences of crown fractures with pulp exposure: histopathological evaluation in dogs. Dent Traumatol 2002;18(4):196-205. 18. Niemiec BA. Assessment of vital pulp therapy for nine complicated crown fractures and fty-four crown reductions in dogs and cats. J Vet Dent 2001;18(3)122-125. 19. Kuntsi-Vaattovaara H, Verstraete FJ, Kass PH. Results of root canal treatment in dogs: 127 cases (1995-2000). J Am Vet Med Assoc 2002;220(6):775-780. TREATING COMPLICATED FRACTURES IN NONVITAL TEETH Vital pulp therapy is a treatment option for acutely fractured teeth in patients less than 18 months old.16 Treatment success is related to the time between the injury that exposed the pulp and treatment. Marked bacterial contamination and histologic signs of inﬂammation in the coronal pulp occur just 48 hours after experimentally induced crown fracture.17 In a separate study, the success of vital pulp therapy decreased to 0% when it was performed more than seven days after the injury.18 If the therapy is unsuccessful or performed on a nonvital tooth, further pain and tissue loss from continued necrosis of the infected pulp may occur. Thus, vital pulp therapy is an excellent treatment option for intentional crown reduction procedures, but it should only be used for treating fractures that result from trauma in young (< 18 months) patients. Even then, the prognosis is guarded, and frequent radiographic follow-up is necessary. In adult animals or animals with fractures that are more than 48 hours old, Just Ask the Expert Got a question about a difﬁ cult dental fracture case or other dental problem? E-mail it to Dr. Carmichael by July 30, and look for his answer on vetmedpub.com in August! E-mail: vm@advanstar.com Subject line: Dental Question VETERINARY MEDICINE July 2008 371 http://www.avdc.org

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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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