Chapter 15: Endodontics
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Crowded and Rotated Teeth Crowded Teeth Are Common in Small Breed Dogs, While Crowded and Rotated Premolars Are Typically Seen in Brachycephalic Breeds
1 Crowded and rotated teeth Crowded teeth are common in small breed dogs, while crowded and rotated premolars are typically seen in brachycephalic breeds. To some this might suggest that the propensity for crowded, rotated teeth have a hereditary link. Studies show that the smaller the dog, the larger the teeth are in proportion to the mouth when compared to the teeth and mouths of larger dogs. Rotated and/or crowded conditions can occur in a single tooth, in multiple teeth, or in any combination. It is not uncommon to find crowded mandibular incisors in brachycephalic breeds. (Figure 1). Another common finding in many breeds, but especially in brachycephalics, is maxillary third premolars crowded with maxillary fourth premolars or the mandibular fourth premolars crowded with first molars. The maxillary third premolars and mandibular fourth premolars are usually also rotated in this condition .(Figure 2) Another common condition is incisors crowded together but also against the canine teeth Figure 1: Crowding of the mandibular incisors. Treatment included extracting the right and left mandibular second incisors. Figure 2: Crowded and rotated maxillary third premolars in a brachiocephalic dog 2 Rotation and crowding can cause pain from chronic tooth on tooth contact. This might be compared to the pain that humans experience from a caries that has been overfilled. It is a condition that generally does not result in clinical signs; however, it can be quite painful. The chronic trauma resulting from tooth on tooth contact can lead to tooth non vitality. Rotation and crowding can also result in tooth on soft tissue contact, which can be not only painful but can result in soft tissue defects. -
Veterinary Dentistry Extraction
Veterinary Dentistry Extraction Introduction The extraction of teeth in the dog and cat require specific skills. In this chapter the basic removal technique for a single rooted incisor tooth is developed for multi-rooted and canine teeth. Deciduous teeth a nd feline teeth, particularly those affected by odontoclastic resorptive lesions, also require special attention. Good technique requires careful planning. Consider if extraction is necessary, and if so, how is it best accomplished. Review the root morphology and surrounding structures using pre-operative radiographs. Make sure you have all the equipment you need, and plan pre and post-operative management. By the end of this chapter you should be able to: ü Know the indications for extracting a tooth ü Unders tand the differing root morphology of dog and cat teeth ü Be able to select an extraction technique and equipment for any individual tooth ü Know of potential complications and how to deal with them ü Be able to apply appropriate analgesic and other treatment. Indications for Extraction Mobile Teeth Mobile teeth are caused by advanced periodontal disease and bone loss. Crowding of Teeth Retained deciduous canine. Teeth should be considered for extraction when they are interfering with occlusion or crowding others (e.g. supernumerary teeth). Retained Deciduous Teeth Never have two teeth of the same type in the same place at the same time. This is the rule of dental succession. Teeth in the Line of a Fracture Consider extracting any teeth in the line of a fracture of the mandible or maxilla. Teeth Destroyed by Disease Teeth ruined by advanced caries, feline neck lesions etc. -
A Minimally Invasive Approach Using a 4-Mm Implant Without Extraction of Impacted Maxillary Canine: Four-Year Postloading Results
819 A Minimally Invasive Approach Using a 4-mm Implant Without Extraction of Impacted Maxillary Canine: Four-Year Postloading Results Pietro Felice, MD, DDS, PhD1 The maxillary canines are the most Carlo Barausse, DDS2 commonly impacted permanent Martina Stefanini, DDS, PhD3 teeth after the third molars.1 Be- Roberto Pistilli, MD4 tween 25% and 50% of the general 5 Giovanni Zucchelli, DDS, PhD population are affected by impact- ed teeth,2 with the prevalence of The aim of this case report was to suggest an alternative minimally invasive maxillary canine impaction ranging surgical approach to an impacted maxillary canine using a 4-mm-long implant from 1% to 3%.3–5 Impactions are for a fixed prosthetic rehabilitation, avoiding tooth extraction or surgically twice as common in females (1.17%) forced extrusion and exploiting the 6 mm of coronal bone availability. At 4 as in males (0.51%); of all patients years postloading, the implant was healthy and well integrated with stable marginal bone levels. The 4-mm length of the implant reduced operative with maxillary impacted canines, it times, postsurgical morbidity, possible complications, and costs. Short implants is estimated that 8% have bilateral might be an alternative to traditional, more invasive surgical procedures impactions.4 The most common used in the rehabilitative treatment of impacted maxillary canines. Int J causes for canine impactions are Periodontics Restorative Dent 2017;37:819–824. doi: 10.11607/prd.3334 the result of any one or a combina- tion of the following factors: -
Feline Dentistry: Cats Are Not Small Dogs Matt Lemmons, DVM, DAVDC Medvet Indianapolis Carmel, IN
Basics for Practitioners: Oral Anatomy and Pathology Matt Lemmons, DVM, DAVDC MedVet Indianapolis Carmel, IN Dentistry is truly a branch of medicine and surgery. A strong knowledge of normal anatomy and pathology is cornerstone to adequate diagnosis and treatment of diseases of the oral cavity. The majority of oral related disease is inflammatory (periodontal disease) or traumatic (fractured teeth, orthopedic injuries) in nature. However other causes are not rare and need to be recognized. The basic dental unit is the tooth and surrounding periodontium. The tooth consists of the crown and root. The crown is covered in enamel and the root by cementum. Deep to the crown and cementum is the dentin. Dentin is a porous hard tissue which continuously grows toward the center of the tooth as long as the tooth is vital. Deep to the dentin is the pulp which consists of nerves, blood vessels, connective tissue, fibroblasts and odontoblasts. The periodontium is composed of the cementum, periodontal ligament, alveolar bone, and gingiva. The periodontal ligament serves to anchor the cementum to the alveolar bone, act as a shock absorber and aid in sensation. The gingiva is attached to the bone (attached gingiva), tooth by connective tissue and the most apical extent is not attached and is known as the free gingiva. The potential space between the free gingiva and tooth and ending apically at the sulcular epithelium is the gingival sulcus. In health this should be less than 3mm in depth in dogs and 1mm in cats. When addressing the teeth and periodontium, directional nomenclature is not similar to directional nomenclature of the rest of the body. -
Dental Anatomy
Lecture Permanent canines General characteristic features of the canines 1.The canines are placed at the corners of the mouth, which help in keeping facial expression at the cosmetic value. 2.The canines are the longest teeth in the mouth. 3.They are the strongest teeth in the mouth. General characteristic features of the canines 4.They are the most stable teeth in the mouth because of the followings: • They have larger labio-lingual dimension. • They have long roots, which are more anchored in the alveolar bone. • The crown shape allow for “self cleansing” so they stay for longer time. 5.The middle labial lobe is highly developed incisally into a strong well-formed cusp. Principle identifying features of the permanent maxillary canine 1.Single pointed cusp. 2.The distal slope of the cusp is longer than the mesial slope. Maxillary right canine, lingual and incisal aspects. CL, Cervical line; C, cingulum; MMR, mesial marginal ridge; MLF, mesiolingual fossa; MCR, mesial cusp ridge; DCR, distal cusp ridge; LR, lingual ridge; DLF, distolingual fossa; DMR, distal marginal ridge. Principle identifying features of the permanent maxillary canine 3.Marked convex labial outline and bulky palatal cingulum. 4.Very long single root. Maxillary right canine, lingual and incisal aspects. CL, Cervical line; C, cingulum; MMR, mesial marginal ridge; MLF, mesiolingual fossa; MCR, mesial cusp ridge; DCR, distal cusp ridge; LR, lingual ridge; DLF, distolingual fossa; DMR, distal marginal ridge. Labial aspect 1.The mesial outline of the crown is convex from the cervical line to the crest of curvature, which is located at the junction of incisal and middle thirds. -
Lance Canines: an Illustrated Exploration I Would Like to Discuss a Recent Case of a Young Sheltie with a Couple of Dental Problems
Lance Canines: An Illustrated Exploration I would like to discuss a recent case of a young sheltie with a couple of dental problems. The first problem was a common one in shelties and is variably called lance canines, rostrally displaced maxillary canines or mesially displaced maxillary canines. Whatever name you choose, the problem is that the permanent maxillary canine teeth erupt pointing in the wrong direction. To understand a problem, you must first understand normal so I will review the normal relationship of the canine triad. The canine triad is composed of the maxillary lateral incisor and the canine teeth on one side and is depicted in Figure 1. In this picture, you can see that the crowns of the canine teeth are basically vertical. There is a large space between the maxillary lateral incisor and the maxillary canine and this space is known as a diastema. When the mouth is closed, the mandibular canine crown resides in the centre of the diastema so that it does not contact either of the other teeth in the triad. Figure 1: The normal canine triad. In affected shelties, one or both of the maxillary canines is malpositioned so that it is lying more horizontally. As such, the crown crosses the diastema and blocks the mandibular canine out as in Figure 2. Now on closure, the mandibular canine contacts the maxillary canine and is often forced to tip labially. Owners notice this because the mandibular canine then starts to catch on the upper lip. There is variability in the degree to which the maxillary canine is malpositioned. -
Treatment of a Patient with an Impacted Transmigrant Mandibular Canine and a Palatally Impacted Maxillary Canine
Case Report Treatment of a Patient with an Impacted Transmigrant Mandibular Canine and a Palatally Impacted Maxillary Canine Joe Rebellato, DDSa; Brian Schabelb Abstract: Very few people have seen transmigrant mandibular canines and little has been presented in the literature about this rare phenomenon. In this case report, identi®cation techniques and treatment options are presented along with the treatment results of a patient diagnosed with a transmigrant mandibular canine. This rare condition usually requires extraction of the involved tooth because orthodontic forces are seldom successful at erupting these teeth into their proper location. The treatment protocol for this patient involved a combination of orthodontic procedures, surgical extractions, gingivectomy and frenectomy, and implant replacement of the impacted transmigrant tooth. Through a collaborative effort of a team made up of an orthodontist, periodontist, prosthodontist, and oral surgeon, these techniques were used to achieve an excellent esthetic and functional outcome. (Angle Orthod 2003;73:328±336.) Key Words: Transmigrant mandibular canines; Multidisciplinary care; Implant replacement; Root re- sorption; Ankylosis; Autotransplantation; Malposition; Impaction INTRODUCTION migratory mandibular canines from 1952 to 1994, Joshi6 found that 89% were impacted, and 91% were unilateral. Impaction refers to a failure of a tooth to emerge into These teeth are generally asymptomatic7 and although the the dental arch, usually due either to space de®ciencies or tooth is far from its original site, it maintains its nerve 1 the presence of an entity blocking its path of eruption. supply from the side which it came.8 Transmigrant teeth Although heredity has long ago been described as playing usually require clinical and radiographic examination to di- 2 a role, many times the etiology is unknown. -
A New Spring for Correction of Maxillary Canine-Premolar Transposition
©2008 JCO, Inc. May not be distributed without permission. www.jco-online.com A New Spring for Correction of Maxillary Canine-Premolar Transposition MARCELLA BAITELLI BRUNO, DDS MÁRCIO BARROSO SALOMÃO, DDS, MS OSWALDO DE VASCONCELLOS VILELLA, DDS, MS, PHD JOSÉ NELSON MUCHA, DDS, MS, PHD he JOB Spring (the acronym is formed from Tthe names of the last three authors of this article) was developed to facilitate correction of partial canine-first premolar transposition in the maxillary arch.1-6 This new device helps move the premolar toward the center of the palate to allow mesial displacement of the canine. The spring is attached to the archwire and can be activated either outside or inside the mouth. Appliance Fabrication and Use The JOB Spring is fabricated by bending a double open-coil loop into a segment of rectangu- Fig. 1 JOB Spring. lar .019" × .026" stainless steel wire (Fig. 1). One end of the spring is bent to allow insertion into the slot of the first premolar bracket, and the other end is soldered to the archwire. The spring is activated placed on the distal side of the edentulous site. The by opening the anterior leg of the first loop and/ first premolar bracket was soldered to the distal or the posterior leg of the second loop with a bird- surface of the orthodontic band, facilitating move- beak plier, generating a constant moment of force. ment of the tooth toward the center of the palate. A stainless steel ligature is used to tie the end of the spring to the slot of the first premolar bracket. -
Maxillary Incisor Root Resorption and Interceptive Treatment
Faculty of Health Sciences Department of Clinical Dentistry Ectopic and normal maxillary canine eruption: maxillary incisor root resorption and interceptive treatment Sigurd Hadler-Olsen A dissertation for the degree of Philosophiae Doctor — Author’s name and last name A dissertation for the degree of Philosophiae Doctor – Month Year “When meditating over a disease, I never think of finding a remedy for it, but, instead, a means of preventing it”. Louis Pasteur (1822–1895) 2 1 Contents 1 Contents .............................................................................................................................. 3 2 Acknowledgements ............................................................................................................ 5 3 List of papers ...................................................................................................................... 7 4 Abbreviations and terms ..................................................................................................... 8 5 Summary ............................................................................................................................ 9 6 Introduction ...................................................................................................................... 11 6.1 Normal maxillary canine eruption ............................................................................. 11 6.2 Ectopic maxillary canine eruption ............................................................................. 12 6.2.1 Definition .......................................................................................................... -
Glossary of Commonly Used Dental Terms
Glossary of Commonly Used Dental Terms A • Abutment: A tooth or implant used to support a prosthesis. A crown unit used as part of a fixed bridge. • Abscess: A localized inflammation due to a collection of pus in the bone or soft tissue, usually caused by an infection. • Amalgam: A dental filling material, composed of mercury and other minerals, used to fill decayed teeth. • Alveoloplasty: A surgical procedure used to recontour the supporting bone struc tures in preparation of a complete or partial denture. • Anesthetic: A class of drugs that eliminated of reduces pain. See local anesthetic. • Anterior: Refers to the teeth and tissues located towards the front of the mouth (upper or lower incisors and canines). • Apex: The tip end of a root. • Apexification: A method of inducing apical closure, or the continual apical develop ment of the root of an incompletely formed tooth, in which the pulp is no longer vital. B • Bicuspid: A two-cuspid tooth found between the molar and the cuspid also known as an eye tooth or canine tooth. • Biopsy: A process of removing tissue to determine the existence of pathology. • Bitewing x-ray: X-rays taken of the crowns of teeth to check for decay. • Bleaching: The technique of applying a chemical agent, usually hydrogen peroxide, to the teeth to whiten them. • Bondin: A process to chemically etch the tooth's enamel to better attach ( bond ) composite filling material, veneers, or plastic/acrylic. • Bone loss: The breakdown and loss of the bone that supports the teeth, usually caused by infection or long-term occlusal ( chewing areas of the teeth ) stress. -
Dental Radiographs
The Importance of Dental Radiographs a b a a b b b b a Figure 7: Type I feline tooth resorption (TR). • Complete extraction of all roots is required for Type I TR. • These teeth have significant coronal resorption (a), but normal root structure (b). Figure 1: Normal dental radiograph, feline mandible. • Mandibular symphysis (a). • Canine roots (b). Roots of the canine teeth comprise the majority of the mandible. Figure 3: Advanced periodontal disease of the Figure 4: Small enamel fractures are very Figure 5: Seemingly normal teeth may be Figure 6: Feline tooth resorption (TR) is very mandible. common. infected. common. • Severe periodontal disease of the right lower quad- • Apparently healthy tooth with a small cusp fracture • This patient has one broken incisor (upper), but the • Minimal clinical evidence of pathology (upper) rant is evident on physical examination (upper). b d (upper). adjacent incisors appear normal. • Painful pathology missed without radiographs d • Radiograph reveals thin bone in the area of the first • This tooth is endodontically infected, as noted by • Radiograph reveals additional pathology (lower). (lower) molar (lower). the dark areas around the root tip (lower). Radiograph all teeth adjacent to pathologic teeth. Full mouth radiographs are recommended for all c Dental radiographs can help prevent iatrogenic • This infection would be missed without dental This illustrates the value of full-mouth dental a feline patients. damage (such as jaw fractures) during extractions. radiographs radiographs. c Figure 8: Type II feline tooth resorption (TR). Dental radiographs are required for all fractured teeth Often Type II TR results in replacement of tooth c to rule out hidden pathology. -
Guidelines for the Assessment of the Impacted Maxillary Canine
Orthodontics Kate Counihan EA Al-Awadhi and Jonathan Butler Guidelines for the Assessment of the Impacted Maxillary Canine Abstract: Canine impactions are frequently encountered, occurring in 1.7% of the population. The aim of this paper is to provide guidance on the assessment and management of cases which present in general dental practice. Canine position is considered in four categories; canine overlap with adjacent incisor, vertical canine height, angulation to midline and position of canine root apex. Good, average and poor prognostic outcomes are considered for each category and a brief outline of their management is included. Clinical Relevance: Canine impactions frequently present during routine examination. Appropriate recognition, investigation and referral, if necessary, are paramount to successful treatment. Dent Update 2013; 40: 770–777 Treatment of impacted maxillary canines 8% are bilateral.5 The canine has a long arch. Occasionally, canines can be found is a common challenge faced by dental root and good bony support, which is lying horizontally above the apices of the professionals in daily practice. According advantageous in lateral excursions, and maxillary incisors, or displaced near to Mead, an impacted tooth is one that it serves as an excellent abutment for the nose. is prevented from erupting into position fixed and removable prostheses. For because of malposition, lack of space or these reasons, the canine is often referred other impediments.1 After lower third to as the ‘corner stone of the maxillary Aetiology molars, maxillary canines are the most arch’. An absent canine poses aesthetic Buccally and palatally impacted frequently impacted teeth.2 The incidence and functional problems and should be canines have different aetiologies.