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49 MAY/JUNE 2017 ■ TVPJOURNAL.COM CONTINUING EDUCATION (CT) is the imaging modality of choice to detect mandibular and/or maxillary fractures. 15 Symphyseal separation may be observed if the fibrocartilaginous fibers at the symphysis have been stretched or torn as a result of trauma. The symphyseal space may appear wider than usual and an occlusal discrepancy between the right and left incisor teeth may be observed ( Figure 20 ). Limitations of Dental Radiography Dental radiographs have some limitations and disadvantages compared with other modalities. For instance, unlike advanced imaging modalities (eg, CT, cone-beam CT), dental radiographs represent 2-dimensional images of 3-dimensional structures. Given the anatomic complexity of certain areas (eg, caudal maxilla) and the level of superimposition of dental and related structures, radiographs may fail to reveal lesions depending on their nature, location, extent, and severity. Moreover, dental radiographs are useful only for imaging teeth and associated structures in the immediate vicinity. They have little or no value for imaging other maxillofacial structures. In cases of maxillofacial trauma, temporomandibular joint disorders, and neoplasia of the head and neck (including oral tumors), CT (multislice or cone- beam CT) may be indicated. 14–16 If a CT scan of the head is already available, dental radiographs may not be necessary to detect radiographic signs of periodontitis or endodontic disease. 17 Cone-beam CT has been proposed as a valid imaging modality for the diagnosis of dental disease in animals, but its precise clinical applications and limitations have not been systematically investigated. 18 Dental radiography has traditionally been, and still is, considered the gold standard for the diagnosis of dental disease in dogs and cats. In a general practice setting, its diagnostic value and the relatively low cost of required equipment make dental radiography the most practical imaging modality. References 1. Eisner ER. Standard of care in North American small animal dental service. Vet Clin North Am Small Anim Pract 2013;43:447-469. 2. Holmstrom SE, Bellows J, Juriga S, et al. 2013 AAHA dental care guidelines for dogs and cats. JAAHA 2013;49:75-82. 3. Verstraete FJ, Kass PH, Terpak CH. Diagnostic value of full-mouth radiography in dogs. Am J Vet Res 1998;59:686-691. 4. Verstraete FJ, Kass PH, Terpak CH. Diagnostic value of full-mouth radiography in cats. Am J Vet Res 1998;59:692-695. 5. Shabestari L, Taylor G, Angus W. Dental eruption pattern of the beagle. J Dent Res 1967;46:276-278. 6. Wiggs RB, Lobprise HB. Veterinary Dentistry: Principles and Practice. Lippincott-Raven Publishers, 1997. 7. Verstraete FJ, Zin BP, Kass PH, et al. Clinical signs and histologic findings in dogs with odontogenic cysts: 41 cases (1995-2010). JAVMA 2011;239:1470-1476. 8. Fulton AJ, Fiani N, Verstraete FJ. Canine pediatric dentistry. Vet Clin North Am Small Anim Pract 2014;44:303-324. FIGURE 19. Mandibular fracture. This radiograph shows a comminuted mid-body fracture between the left mandibular third and fourth premolar teeth in an 8-year-old dog. FIGURE 20. Symphyseal separation. This radiograph shows an abnormally wide space at the symphysis of a 2-year-old dog consistent with symphyseal separation.