Today's Veterinary Practice

MAY-JUN 2017

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48 IMAGING ESSENTIALS PEER REVIEWED Other Dental Findings Tooth resorption may be secondary to inflammatory processes (ie, inflammatory root resorption) or of unknown origin ( Figures 15A through 15D ). 12 Although tooth resorption is often clinically detectable, radiographs are necessary to reveal the actual extent, severity, and radiographic pattern of resorption. The pattern and stage of tooth resorption help determine the surgical approach (ie, extraction or coronectomy), the level of surgical difficulty, and possible complications. 13 Caries have not been described in cats, and the prevalence of caries is relatively low in dogs compared to humans. The radiographic appearance of a caries lesion depends on the stage of disease. Very early caries lesions may or not be detectable radiographically. Advanced caries lesions involving the dentin appear as cup-shaped cavitated lesions that may or may not extend into the pulp cavity ( Figure 16 ). Abrasion and attrition are wearing of teeth due to contact with an external object or surface (abrasion) or another tooth (attrition). Radiographically, abrasion and attrition usually appear as even or smooth loss of tooth surfaces of varying severity, often affecting multiple teeth ( Figures 17A and 17B ). Wear of dental structures can result in damage to the pulp; therefore, clinicians should be attentive to radiographic signs of endodontic disease (see Endodontic Findings ). Jaw Structures Jaw lesions appear on dental radiographs as areas of bone loss of inflammatory, cystic, or neoplastic origin. The bone loss can have a geographic, permeative, or moth-eaten pattern. 14 A geographic pattern is characterized by an area of bone loss that is uniform in appearance and has well-defined borders ( Figure 18A ). In contrast, a permeative pattern of bone loss is an area with poorly defined borders ( Figure 18B ). Multiple contiguous areas of bone loss with poorly defined borders characterize a moth-eaten pattern. Maxillomandibular fractures may be detected on dental radiographs ( Figure 19 ). However, patients that have sustained maxillofacial trauma often have multiple injuries that are not detectable radiographically; therefore, computed tomography FIGURE 17. Abrasion and attrition. FIGURE 17A shows wear of the occlusal surface of the right mandibular second and third molar teeth in a 6-year-old dog. FIGURE 17B shows mild wear of the distal aspect of the right mandibular canine tooth in a 6-year-old dog, consistent with cage-biting behavior. A B FIGURE 18. Bone loss jaw lesions. FIGURE 18A shows a multilocular lesion of geographic bone loss involving the right mandibular third and fourth premolar teeth in a 5-year-old dog. FIGURE 18B shows extensive permeative bone loss affecting both rostral mandibles in a 15-year-old cat. A B FIGURE 16. Caries lesion. An advanced caries lesion affecting the left maxillary first molar tooth in a 5-year- old dog; note the loss of crown integrity and apical periodontitis secondary to pulp involvement.

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