Successful treatment of chronic periapical osteomyelitis in a Parma wallaby (Macropus parma) using comprehensive endodontic therapy with apicoectomy.

Although necrobacillosis remains a common condition of captive macropods, there have been limited reports of successful treatment modalities by which it can be treated. Comprehensive endodontic therapy with apicoectomy has been used reliably in human and domestic animal dentistry. This report describes a case of periapical osteomyelitis involving a mandibular incisor in a Parma wallaby (Macropus parma) that was successfully treated using these techniques in conjunction with low-level laser therapy at 810 nm, which was used for decontamination of the pulp cavity, anti-inflammatory, and biostimulatory effects.

Mandibular incisor apicoectomy in a Canadian Beaver.

A 52-month-old Canadian beaver was presented for treatment of lip trauma resulting from overgrowth of the right mandibular incisor tooth following earlier loss of the right maxillary incisor tooth. Extraction of the affected tooth was considered, but rejected due to the length of the embedded portion of rodent mandibular incisor teeth. The lip injury was managed by crown reduction (odontoplasty) of the overgrowing incisor tooth pending a more permanent treatment plan. A 2-cm apicoectomy of the right mandibular incisor tooth was performed to arrest growth of the tooth when the beaver was 82-months-old. The remainder of the tooth continued to erupt and was completely expelled during a 9-month period with one additional odontoplasty being required. The beaver continued to feed normally with just the left maxillary and mandibular incisor teeth until its death at 118-months, with odontoplasty performed twice on the remaining incisor teeth during the 30-months following exfoliation.

A long-term study of apicoectomy and endodontic treatment of apically infected cheek teeth in 12 horses.

The aim of this study was to evaluate the long-term results of apicoectomy and retrograde endodontic treatment in 12 horses with apical cheek teeth infections. The affected apices were removed using a diamond bur mounted on a dental drill, and after pulp removal the root canals were filed with Hedstrøm files and then alternately flushed with sodium hypochlorite, hydrogen peroxide and alcohol. The pulp canals were dried and filled with endodontic cement and gutta-percha points. An undercut was made in the apical aspect of the root canals that were then sealed with self-curing glass ionomer cement. Follow up information was obtained 38-67 months following treatment and indicated that the treatment had been successful in 7/12 horses (58%), partially successful in 2 horses (17%) and unsuccessful in 3 (25%). With good case selection, apicoectomy can preserve a proportion of apically infected cheek teeth. The use of advanced imaging techniques and improved surgical techniques could increase the success rate.

Tooth root abscesses in llamas and alpacas: 123 cases (1994-2005).

OBJECTIVE: To determine features, outcome, and complications of surgical treatment of camelid tooth root abscesses. DESIGN: Retrospective case series. ANIMALS: 123 camelids with tooth root abscesses. PROCEDURES: Signalment, history, teeth involved, surgery performed, ancillary diagnostic tests, and short-term complications were recorded from each medical record. An owner questionnaire was used to obtain long-term (> 1 year) follow-up information. RESULTS: The most common surgical treatments included tooth extraction (n = 106) and apicoectomy (13). Owners provided follow-up information on 84 animals. Postoperative complications were reported in 42 of 84 animals. The most common complications included reinfection (n = 15), chronic draining tract (14), and osteomyelitis (14). Significantly more camelids that were in good or obese body condition at the time of surgery were alive at the time of follow-up, compared with those with thin body condition at the time of surgery. Camelids with 2 teeth extracted had significantly more complications than those with 1 tooth extracted. Thirty-four of 47 owners reported that they were completely satisfied with the outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Owners of camelids in poor body condition should be forewarned that such animals are at greater risk for complications following dental surgery. Clinicians should recognize that the number of teeth affected was not associated with a poorer outcome.

In vitro comparison of three materials as apical sealants of equine premolar and molar teeth.

REASONS FOR PERFORMING STUDY: Surgical endodontic therapy is a conservative dental technique used in horses with some degree of clinical success. Failure of this procedure can partially be explained by inadequate sealing of the root apices with resultant microleakage in the periapical area. OBJECTIVES: To assess and compare in vitro sealing ability of 3 different dental restorative materials used as apical sealants during equine surgical endodontics. METHODS: Thirty extracted equine cheek teeth were divided randomly into 3 groups and subjected to apicoectomy and apical sealing using 3 materials: reinforced zinc oxide-eugenol cement; intermediate restorative material (IRM); a resin-modified glass ionomer; and amalgam. After apical sealing, the teeth were submerged in a solution of Procion Brilliant Cresyl Blue stain for a period of 7 days. The teeth were then washed, embedded in resin, sectioned and assessed microscopically for dye leakage around the apical restorations. RESULTS: Although the materials proved effective as apical sealants, some dye leakage was encountered in all 3 groups with no statistical difference (P = 0.114). CONCLUSIONS AND POTENTIAL RELEVANCE: IRM, a resin-modified glass ionomer and amalgam all showed comparative features as apical sealants when used in vitro in equine teeth. IRM is currently regarded as the superior material in clinical situations due to its ease of handling and lesser sensitivity to environmental moisture during placement compared to the other 2 materials.

[Veterinary dentistry (15). Apex resection in the horse]. / Veterinaire Tandheelkunde (15). Apexresectie bij het paard.

Periapical disorders in horses can be treated by resection of the apex. The indications, contraindications, diagnosis, treatment and complications of the intervention are discussed. Four case reports of horses in which apicoectomy with retrograde endodontic treatment was performed are reviewed.

Apicoectomy on an incisor tooth of a Victorian koala (Phascolarctos cinereus victor).

An eight-year-old Victorian koala was presented with a discharging mandibular sinus of at least one month duration. On examination, a dental abscess of the right mandibular incisor tooth was found. During the course of endodontic treatment, a size 2 Gates Glidden bur separated from the shank and was lodged in the canal. Due to the anatomy of the tooth the bur could not be removed and an apicoectomy was performed. Following the apicoectomy (follow-up period two years), the periapical pathology resolved.

Development of a teaching model for surgical endodontic access sites in the dog.

A dolicocephalic canine skull was used to develop a teaching and study model for surgical endodontic access sites of the maxillary and mandibular canine teeth, the maxillary fourth premolar and the mandibular first molar teeth. Coronal endodontic access sites were created, and endodontic files were inserted through the access preparation into the root canal system. The teeth were radiographed to determine the ideal surgical access points. Barium markers were placed over these points and each tooth was radiographed again to confirm the appropriate location of the marker. Surgical accesses to the apices were created by drilling through the barium markers and underlying bone. Following localization of the apices, apicoectomies were performed, exposing the apical portion of the pulp canal. The maxillary and mandibular canine teeth, the maxillary fourth premolar tooth, and the mandibular first molar tooth and surrounding bone were harvested from a similar dolicocephalic dog following euthanasia. The specimens were embedded in methylmethacrylate, sectioned, and mounted on slides to reveal the structures located around the surgical access sites.