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Today's VeTerinary PracTice | January/February 2016 | tvpjournal.com PracTical denTisTry Peer reviewed 90 Figure 6. indications for guided tissue regeneration. (a) intraoral dental picture of a 14-mm periodontal pocket on the palatine aspect of the left maxillary canine (204) in a border terrier. Note that this pocket does not communicate with the nasal cavity. if this was the case, an oronasal fstula would be present and extraction the only reliable treatment. (B) intraoral dental radiograph of a vertical (angular) defect on the distal surface of the distal root of the right mandibular frst molar (409) (red arrow). Note that the second molar appears to be periodontally healthy ( blue arrow). (C) intraoral dental picture of a left maxillary fourth premolar (208) in a dog with Stage 2 furcation exposure on the palatine aspect. Periodontal fap surgery is necessary for complete cleaning of the root surface and furcational area. in addition, this is an excellent candidate for guided tissue regeneration, especially since it is a strategic tooth. Alternatively, the tooth could be extracted. Note that this tooth is clean with minimal gingival infammation, which demonstrates the importance of anesthetized examinations and probing, regardless of clinical signs. in addition, the palatal involvement requires a thorough examination. topical application may be favorable for the treatment of local oral infammatory diseases, including periodontitis. 44 a particular fatty acid, 1-tetradecanol complex, is an esterifed monounsaturated fatty acid with positive effects in rabbits. in 2 in vivo studies on new Zealand rabbits, topical administration stopped the progression of periodontal disease and signifcantly reduced macroscopic periodontal infammation, attachment, and bone loss. 87,88 Histologic assessment demonstrated that it also inhibited infammatory cell infltration and osteoclast activity. Other Nutraceuticals. Milk basic protein (MBP) supplementation is effective in increasing bone mineral density (BMd), and this increase in BMd may be primarily mediated through the promotion of bone formation and inhibition of bone resorption. 89 When administered at high doses, it has been shown in experimental rat models to aid in the recovery of periodontally lost alveolar bone. 90,91 coenzyme Q10 defciency has been shown in humans with periodontal disease. 92,93 conversely, supplementation (systemic or topical) may have a benefcial effect on periodontal health in humans. 94-96 s tudies in humans have also demonstrated that folic acid is effective in preserving gum tissue and reducing risk for gingivitis and periodontitis. 97 Nutrition Finally, proper nutrition (see Home Care, page 87), including vitamin supplementation, appears to be an important aspect of periodontal care. 98,99 studies have found that vitamin supplementation provides benefcial effects for periodontal patients. 100-102 A B C