the mandible itself, especially in small‐breed dogs. Gingival margins may indicate no external problems, so careful probing is essential.
Periodontal explorerSharp tip is very tactile:Evaluate areas of tooth wear or fracture to determine if canal is exposed (Figure 2.9) (see Chapter 26).Evaluate areas of potential resorptive lesions in cats (Figure 2.10) (see Chapter 40).
Figure 2.6 Probing the palatal surface of this left maxillary canine (204) reveals extensive pocket depth that may be indicative of oronasal fistulation.
Figure 2.7 Increased pocket depth at the mesial aspect of the mandibular canine (304) can often be treated with periodontal therapy.
Figure 2.8 A pocket at the distal aspect of the right mandibular first molar (409) indicates significant attachment loss.
Figure 2.9 The explorer should be used on worn tooth surfaces to determine if a canal is exposed or, as in this case, if the explorer glides along the very smooth surface of the worn tooth manifesting reparative dentin (brown appearance); gradual wear may keep the pulp protected.
Figure 2.10 The explorer tip can be used to detect resorptive lesions, especially those hidden under inflamed gingiva.
COMMENTS
Every clinic should provide sufficient instrumentation and sufficient time to thoroughly examine and probe the periodontal tissues around every tooth. It is a simple procedure that is often overlooked or underperformed.
See also the following chapters:
Appendix C (Furcation Involvement/Exposure)
Abbreviations
AL = attachment loss
CEJ = cementoenamel junction
FE = furcation exposure
ONF = oronasal fistula
PP = periodontal pocket
RE = root exposure.
Internet Resources
https://avdc.org/avdc‐nomenclature/
Author: Heidi B. Lobprise, DVM, DAVDC
Consulting Editor: Heidi B. Lobprise, DVM, DAVDC
Chapter 3 Intraoral Radiology and Advanced Imaging
INDICATIONS
Intraoral radiology is an integral part of veterinary dentistry, from diagnostics to therapy to evaluation of response to therapy.
Necessary: full mouth radiographs on every patient, each dental visit.
Survey: assess normal anatomy, use as baseline.
Tooth abnormalities: size, structure, variation in number (absence or multiple).
Periodontal disease: assess extent and nature of periodontal bone loss. It is critical to assess prior to treatment to recognize potential for iatrogenic fracture before tooth exfoliation.
Endodontic disease: assess pulpal vitality (canal width and any periapical bone loss).
Acquired diseases (caries, resorptive lesions). Feline root resorption and neck lesions are often undetected until late in the disease when radiographs have not been taken.
Trauma: evaluate extent of osseous and dental damage.
Neoplasia: evaluate extent of osseous involvement.
Post procedure: document complete extraction for medical record.One study [1] has shown that 86% of extracted dog and cat carnassials with expected complete extraction left behind retained roots, sources of infection and pain. Use post‐extraction radiographs to confirm the entire tooth has been removed.Showing radiographs and images to clients improves patient care and acceptance of treatment plans [2].
EQUIPMENT
Radiographic unit (Figure 3.1)A dental radiographic unit at the dental station provides convenience to take intraoral radiographs of every patient: this can be wall‐mounted, on a movable stand, or hand‐held units.Cone beam computed tomography (CBCT)Three‐dimensional view (voxels) of the hard tissues with less patient and operator radiation exposure [3].Soft tissues imaged with high‐definition volumetric imaging (HDVI).*90–1000 μm resolution depending on selected system capability.Figure 3.1 Radiographic generators: examples of wall‐mounted (left) and hand‐held (center) dental radiographic generators. Always stand at least 6 feet (2 meters) away from the beam and/or 270° to the side. (Right) Example of a cone beam