Page 1966 - Cote clinical veterinary advisor dogs and cats 4th

982 Tooth Resorption

○ Transposition of tooth/root into mandibu- preserved with endodontic therapy rather Vital pulp therapy must be performed as
than being extracted.
lar/infraorbital canal and nasal passages • Although root canal therapy can be per- • Root canal therapy causes less postoperative
soon as possible.
VetBooks.ir Recommended Monitoring formed for almost any dog tooth, endodontic discomfort than tooth extraction.
○ Iatrogenic jaw fracture
therapy in cats is often not feasible because
Endodontic procedures require follow-up
radiography under sedation/anesthesia at 6 of size, except for the canine teeth. SUGGESTED READING
Soukup JW, et al: Classification and epidemiology of
months postoperatively and yearly thereafter. Prevention traumatic dentoalveolar injuries in dogs and cats:
• Control aggressive chewing behavior. 959 injuries in 660 patient visits (2004-2012). J
PROGNOSIS & OUTCOME • Avoid chewing on hard objects. Vet Dent 32:6, 2015.
• Excellent with extraction if entire tooth has Technician Tips AUTHOR: Lenin A. Villamizar-Martinez, DVM, MS, PhD
EDITOR: Alexander M. Reiter, DVM, Dr. med. vet.,
been removed • Discuss with owners appropriate chewing DAVDC, DEVDC
• Root canal therapy fails in only 6% of treated habits, treats, and toys during wellness visits.
roots (depends on skill of the operator). • Technicians may be the first to notice subtle
• Animals that continue abusive chewing habits tooth fractures during professional dental
may benefit from placement of prosthodontic cleanings. Bring these fractures to the veteri-
crowns. narian’s attention and become accustomed to
taking dental radiographs of fractured teeth.
PEARLS & CONSIDERATIONS
Client Education
Comments • Complicated crown fracture in immature
• Functionally important teeth (i.e., those for permanent teeth is considered a true emer-
chewing, prehending, cosmesis) should be gency if the objective is to save the tooth.

Tooth Resorption Client Education
Sheet

BASIC INFORMATION • Increased vitamin D levels in commercial PHYSICAL EXAM FINDINGS
diets Oral exam (p. 1140) can reveal crown defects
Definition filled with inflamed granulation tissue, fractured
Loss of tooth substance due to resorption by ASSOCIATED DISORDERS crowns, root remnants, bulging gingiva in areas
odontoclasts • Thickening of bone at the alveolar margin of missing teeth, thickening of bone at the
(alveolar bone expansion) alveolar margin of canine teeth, and abnormal
Synonyms • Abnormal tooth extrusion (particularly extrusion of canine teeth.
• Feline odontoclastic resorptive lesion canine teeth)
(FORL), odontoclastic resorptive/resorption Clinical Presentation Etiology and Pathophysiology
lesion, external root resorption, cervical line • Suggested causes include periodontal disease,
erosion/lesion, feline caries, neck lesion DISEASE FORMS/SUBTYPES anatomic peculiarities, mechanical trauma,
• The term neck lesion is a topographic distinc- Tooth resorption is classified based on severity increased vitamin A and vitamin D intake,
tion only. The terms erosion and caries are (stages 1-5) and radiographic appearance (types abnormal calcium homeostasis, and viruses
inappropriate because the dental defect is 1-3) (https://www.avdc.org/Nomenclature/ causing immunosuppression.
resorptive in nature and not caused by acidic Nomen-Intro.html): • Association of multiple tooth resorption in
or bacterial insult, respectively. • Dentoalveolar ankylosis (ankylotic fusion cats with excessive dietary intake of vitamin
between root and bone) and replacement D (not proved):
Epidemiology resorption (resorption followed by bone ○ Histologic exam of healthy teeth from
SPECIES, AGE, SEX replacement) cats with tooth resorption of other teeth
The condition affecting multiple or all perma- • Inflammatory resorption (vascular and shows periodontal ligament degeneration,
nent teeth is seen predominantly in domestic inflamed granulation tissue filling a resorptive hypercementosis, decreased width of the
cats 4 years of age or older, with a reported defect) and alveolar bone resorption (near periodontal space, and dentoalveolar
prevalence of 25%-75%. It is now seen more the resorptive defect) ankylosis, indicating that inflammatory
frequently in dogs than in years past. cells may not play a primary role in the
HISTORY, CHIEF COMPLAINT development of tooth resorption. Similar
GENETICS, BREED PREDISPOSITION Patients may present with red spots on their changes can be found after administration
No obvious breed predisposition; purebred teeth (crown defect filled with granulation of high doses of vitamin D or vitamin D
cats have been reported to be affected at a tissue), repetitive lower jaw motions (jaw metabolites in experimental animals.
younger age opening reflex; teeth chattering), fractured ○ Cats with tooth resorption have significantly
crowns, root remnants, and missing teeth. higher serum levels of 25-hydroxyvitamin
RISK FACTORS These animals may also have difficulty eating D compared with cats without tooth
• Periodontal disease hard food and may refuse to drink cold water. resorption, indicating that those with
• Trauma from occlusion The majority of cats are diagnosed with tooth tooth resorption must have had a higher
• Dietary composition resorption from dental radiography. intake of dietary vitamin D.

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