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The Veterinary Dental Patient: A Multidisciplinary Approach


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(b) a foreign body (g...Figure 17.9 Incidental discovery of a retained root of the right maxillary s...Figure 17.10 (a) Oronasal fistula. (b) After repair.Figure 17.11 Iatrogenic left mandibular fracture caused during an extraction...Figure 17.12 (a) Poor extraction technique in this cat and lack of suturing ...Figure 17.13 Root pushed into nose, diagnosed after several months of nasal ...Figure 17.14 Keeping an index finger close to the working tip of the elevato...

      18 Chapter 18Figure 18.1 Persistent deciduous dentition causes numerous problems, includi...Figure 18.2 Juvenile gingivitis in (a) cats and (b) dogs can be associated w...Figure 18.3 The gingival sulcus cannot be correctly developed in the presenc...Figure 18.4 (a) By definition, persistent deciduous teeth are those whose en...Figure 18.5 Adverse dental interlock caused by persistent deciduous dentitio...Figure 18.6 Class II malocclusion is very often traumatic, regardless of whe...Figure 18.7 A fractured deciduous tooth always requires action.Figure 18.8 Complications of neglected tooth fracture: periapical lesion in ...Figure 18.9 Dentigerous cyst associated with an impacted canine tooth (Aster...Figure 18.10 Radiographic appearance of a dentigerous cyst associated with a...Figure 18.11 Enamel hypoplasia present on multiple teeth.Figure 18.12 Periostitis ossificans visible in a young dog mandible as a “do...Figure 18.13 (a) Fused incisor teeth in a six‐month‐old whippet. (b) Invagin...Figure 18.14 Proliferative juvenile gingivitis in a Maine Coon cat.Figure 18.15 (a,b) Periodontal disease and (c) oral tumors occur more often ...Figure 18.16 Ankylosis and teeth resorption are more frequent in geriatric p...Figure 18.17 Tooth resorption may be associated with oral tumors. In this do...Figure 18.18 Bad habits like chewing on hard objects cause generalized teeth...Figure 18.19 Right maxillary canine tooth (104) extrusion in a cat can be as...Figure 18.20 Transparent and brittle enamel can be one of the signs of teeth...Figure 18.21 Alveolar bone atrophy is often diagnosed in older toy‐breed dog...

      19 Chapter 19Figure 19.1 PetSmile Campaign posters.Figure 19.2 Incidental finding of oral growth in a patient undergoing nonden...Figure 19.3 Whiteboard drawing explaining a problem to a pet owner.Figure 19.4 Example “against medical advice” (AMA) release form.Figure 19.5 Example estimate and consent form.Figure 19.6 Example anesthesia record.

      20 Chapter 20Figure 20.1 Use of visual educational materials during conversation with a p...Figure 20.2 A veterinary technician (nurse) properly attired in PPE.Figure 20.3 Manual descaling forceps in action.Figure 20.4 Cooling spray (cavitation) from an ultrasonic scaler, associated...Figure 20.5 Use of the terminal 1–3 mm of a mechanical scaler tip is recomme...Figure 20.6 The cooling spray prevents thermal injury to vital tissue by the...Figure 20.7 Correct grasp of a mechanical scaler handpiece.Figure 20.8 The working tip must be placed almost parallel to the tooth surf...Figure 20.9 The quality of the working tip must be checked on a frequent bas...Figure 20.10 The places predisposed to periodontal diseases which require pa...Figure 20.11 A manual scaler can only be applied supragingivally.Figure 20.12 Modified pen grasp of a curette Source: Emilia Klim.Figure 20.13 Position of a scaler's blade (a) at the gingival margin and (b)...Figure 20.14 (a) Universal curette. (b) Gracey curette.Figure 20.15 Manual subgingival scaling step one: The blade of the instrumen...Figure 20.16 Manual subgingival scaling step two: The curette is rotated so ...Figure 20.17 Manual subgingival scaling step three: The curette is inserted Figure 20.18 Manual subgingival scaling step four: Once the bottom of the po...Figure 20.19 Mechanical subgingival scalers.Figure 20.20 Mechanical smoothing of the root surface: (a) removal of the ca...Figure 20.21 Checking the descaled crown surface with an explorer.Figure 20.22 Coating the tooth surface prior to polishing.Figure 20.23 Polishing the crown starts from the gingival margin.Figure 20.24 Gingival sulcus lavage with the use of a blunt‐ended cannula.Figure 20.25 Application of fluoride foam in a cat following professional te...Figure 20.26 Probing the gingival sulcus of the right maxillary canine tooth...Figure 20.27 The minimum six places around the tooth that should be probed (...Figure 20.28 Normal probing depth in toy‐breed dogs (≤2 mm).Figure 20.29 The Triadan system of dental nomenclature: (a) cat; (b) dog.Figure 20.30 Preliminary radiographic assessment can fit in six radiographs:...

      21 Chapter 21Figure 21.1 Use of a tissue marker helps the surgeon follow section margins ...Figure 21.2 3D reconstruction utilized after CT scan helps in planning surge...Figure 21.3 It is essential to be able to see the structures during oral sur...Figure 21.4 Use of operating microscopy.Figure 21.5 Live presentation of a procedure on a display screen, which was ...Figure 21.6 Scar tissue (circle) in the oral cavity is elastic and functiona...Figure 21.7 Application of laser surgery during excisional biopsy.Figure 21.8 Application of electrosurgery with radio frequency: (a) gingival...Figure 21.9 Application of piezosurgery in (a) TMJ arthroplasty in a cat (b)...Figure 21.10 The use of stay sutures preserves the wound margins.Figure 21.11 During segmental mandibulectomy, it is important first to (a) i...Figure 21.12 It is important to identify the palatal artery when doing palat...Figure 21.13 A triangle flap is created by making a vertical incision at one...Figure 21.14 Fenestration involves cutting the periosteum to extend the flap...Figure 21.15 A partial‐thickness flap is created during pedicle sliding flap...Figure 21.16 Suturing a dressing to the skin to provide compression is indic...Figure 21.17 Perpendicular piercing reduces the amount of damage caused, whi...Figure 21.18 Double‐layer suturing in major oral surgery (e.g., maxillectomy...Figure 21.19 (a) A distance of 2–3 mm should be kept between the wound edge ...Figure 21.20 Standard interrupted sutures are often associated with irritati...Figure 21.21 Incisional biopsy with the use of trephine should be performed ...

      22 Chapter 22Figure 22.1 Preoperative radiographs allow visualization of (a) tooth abnorm...Figure 22.2 The first step in extraction is to cut the gingival attachment. ...Figure 22.3 The index finger should be placed near the tip when using an ele...Figure 22.4 Once the elevator is (a) inserted in the space between the bone ...Figure 22.5 Initial insertion of an iM3 Vet‐Tome blade into the periodontal ...Figure 22.6 Further steps in extraction with iM3 Vet‐Tome lead to (a) pullin...Figure 22.7 Use of extraction forceps to pull out a loosened tooth.Figure 22.8 Retained roots are a very common complication associated with de...Figure 22.9 Closure is best performed with a simple interrupted pattern, pla...Figure 22.10 When sectioning teeth, if possible start at the furcation and w...Figure 22.11 In multirooted teeth, (a) crown resection may be used prior to ...Figure 22.12 Designing an envelope flap for extraction of the maxillary cani...Figure 22.13 A full flap includes two vertical releasing incisions, which sh...Figure 22.14 Removal of the buccal alveolar bone helps in providing superior...Figure 22.15 Fenestration releases tension and extends the flap before closu...Figure 22.16 Tension‐free flap covering surgical access.Figure 22.17 Luxating elevators.Figure 22.18 Small‐sized extraction forceps are convenient for use in the mo...Figure 22.19 LaGrange tissue scissors.Figure 22.20a,b Two different extraction kits organized in an autoclavable c...Figure 22.21 Selection of burs recommended for surgical extraction.

      23 Chapter 23Figure 23.1 Oral injuries are very often the result of head injury, which ma...Figure 23.2 Distant complications of head injury: (a) TMJ ankylosis of the r...Figure 23.3 Measurement of intraocular pressure with a tonometer provides in...Figure 23.4 Example standard 2D imaging of the feline head (a) feline TMJs (...Figure 23.5 3D imaging allows for detailed information about the structures ...Figure 23.6 (a) Stable (fracture that runs in rostroventral direction) and (...Figure 23.7 Predisposition to pathologic fracture at the mandibular first mo...Figure 23.8 Tape muzzle on a cat.Figure 23.9 Stout multiple‐loop interdental wiring can be applied for a mand...Figure 23.10 Maxillary/mandibular fixation in a cat. Source: Emilia Klim.Figure 23.11 (a) Nonstable fracture of the left mandible. (b) Stabilization ...Figure 23.12 (a) Combination of interdental wiring and acrylic splint applie...Figure 23.13 Microplate application in multiple maxillofacial and cranial fr...Figure 23.14 Lower‐lip avulsion in a (a) dog and (b) a cat.Figure 23.15 Dorsorostral left TMJ luxation (circle) associated with left ma...Figure 23.16 Intracapsular bilateral TMJ fracture (arrows).Figure 23.17 Extraoral radiograph of Caudoventral TMJ luxation in a cat.Figure 23.18 Tape muzzle application in a dog, step by step.Figure 23.19 Tape muzzle application in a cat, step by step.Figure 23.20 Dentinal bonding procedure, step by step: (a) Uncomplicated cro...Figure 23.21 Radiographs of (a) symphyseal separation and (b) symphyseal sep...Figure 23.22 Often, a simple symphyseal separation can be stabilized by a si...Figure 23.23 More complicated symphyseal injuries must be stabilized with bo...

      24 Chapter 24Figure 24.1 Before oral cavity inspection in a cat, it is worth looking at i...Figure 24.2 Full‐mouth radiography is the gold standard in feline oral diagn...Figure