Today's Veterinary Practice

MAY-JUN 2017

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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45 MAY/JUNE 2017 ■ TVPJOURNAL.COM CONTINUING EDUCATION (ie, periodontitis) has allowed bacteria to enter the pulp cavity via the apical delta or accessory canals, with ensuing apical periodontitis. The radiographic characteristics usually include some degree of alveolar bone loss and periapical lucency around the root(s) ( Figure 12 ). The prognosis of periodontal–endodontic lesions is poor. Endodontic Findings Crown integrity may be lost because of traumatic fractures. Tooth fractures are visible radiographically, although pulp exposure cannot be reliably diagnosed on a radiograph (it is determined clinically). The loss of crown integrity ( Figure 13A ) should alert and encourage clinicians to look for radiographic indicators of FIGURE 12. Periodontal–endodontic lesions. This radiographs shows a right mandibular first molar tooth in a 7-year-old dog. There is moderate to severe combined horizontal and vertical bone loss and well- defined periapical lucencies at both roots. FIGURE 13. Endodontic disease. FIGURE 13A shows an occlusal maxillary radiograph of a 5-year-old dog; note the fractured crown of the right maxillary canine tooth and the relatively wide pulp cavity when compared with the contralateral tooth. FIGURE 13B shows a fractured middle cusp of the left mandibular first molar tooth in a 6-year-old dog; note the well- defined periapical lucencies at both roots. FIGURE 13C shows the occlusal maxillary radiograph of a 9-year-old dog with severe abrasion of several incisors; note the relatively wide pulp cavity of the right maxillary first incisor tooth and the associated well-defined periapical lucency. FIGURE 13D shows pulp stones at the mesial and middle pulp horns of the left mandibular first molar tooth in a 4-year-old dog; the tooth is otherwise periodontally and endodontically sound. A C B D FIGURE 11. Alveolar bone loss. FIGURE 11A shows moderate horizontal bone loss with furcation exposure affecting the left mandibular fourth premolar and first and second mandibular teeth of a 10-year-old-dog. The first molar tooth also has vertical bone loss at the mesial aspects of both roots. Note the inflammatory root resorption affecting the distal root of the second molar tooth. FIGURE 11B shows near-total loss of attachment due to severe horizontal bone loss at the left mandibular first and second incisors in the same dog and left and right mandibular canine teeth. Note the inflammatory root resorption at the apical area of the first incisor tooth; also note the calculus deposits on the crowns of the canine teeth. Figure 11C shows moderate horizontal bone loss with furcation exposure at the right mandibular fourth premolar and first molar teeth in a 15-year-old cat; note the inflammatory root resorption at the furcation areas. FIGURE 11D shows buccal bone expansion affecting the right maxillary canine tooth more than the left in a 9-year-old cat; note the inflammatory root resorption affecting the right canine tooth; note also the retained roots present at the incisor area. B D A C

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