Abstract
Lack of dental eruption may be accompanied by development of dentigerous cysts and has also been rarely associated with neoplasia. However, little information is available on prevalence of unerupted teeth and associated lesions in dogs and cats. The main objective of this study was to describe the epidemiologic data of canine and feline dental patients with unerupted teeth, and assess the prevalence of associated dentigerous cysts and tumors. Secondary aims included the evaluation of possible factors implicated in cystic development, and description of the histological features of dentigerous cysts. Medical and dental records, intraoral photographs, intraoral radiographs of client-owned dogs and cats with clinically missing teeth examined between 2001 and March 2018 were reviewed. Collected data included signalment, reason for presentation, number, type, depth of inclusion and angulation of unerupted teeth, presence of cystic lesions or tumors, abnormalities affecting involved teeth, histopathological findings, performed treatment and outcome. Seventy-three animals (69 dogs and 4 cats) with 113 unerupted teeth were included. The most frequent unerupted tooth in dogs was the first premolar teeth (78%), followed by the canine and third molar teeth. Dentigerous cysts were diagnosed associated with 48 (44.4%) teeth in dogs and one out of five unerupted teeth in cats. The affected teeth in dogs were predominantly in horizontal inclination (40%) and in soft tissue inclusion (77%). Brachycephalic canine breeds were overrepresented. The only unerupted tooth in boxer dogs was the first premolar tooth (32 teeth). Ninety percentage of boxers with unerupted teeth developed associated lesions (25 dentigerous cysts and one tumor). Two ameloblastomas (one in a dog and one in a cat) and one osteosarcoma (in a dog) were diagnosed in association with three unerupted teeth. Histology was essential in diagnosing two odontogenic cysts not evident on radiographs. In all cases that were followed-up, treatment (i.e., extraction, extraction and surgical curettage, or operculectomy) appeared successful. Untreated dentigerous cysts showed progression at re-examination. None of the unerupted teeth without evidence of cyst at the time of diagnosis showed incipient cystic development. None of the evaluated factors were associated with lack of eruption and/or development of associated lesions.
Highlights
An unerupted tooth is a tooth that does not emerge into the mouth within the expected time frame because of lack of space, malposition, and other physical impediments such as the presence of a tumor or fibrous tissue along the path of eruption, or because of a lack of eruptive forces [1].Clinical, radiographic and pathological features associated with unerupted teeth are well-described in humans [2], but only a few reports are present in the veterinary literature.In human patients, the prevalence varies considerably in different countries [3, 4]
Data collected for each patient included: signalment, main reason for presentation, number and type of unerupted teeth, presence or absence of clinically and/or radiographically visible signs indicative of cystic lesions, presence of neoplastic lesions associated with unerupted teeth, histopathological findings, depth of inclusion and inclination of the unerupted teeth in the jaw, radiographic abnormalities affecting unerupted tooth/teeth and adjacent teeth, treatment performed, treatment outcome, and follow-up findings
Seventy-three cases [69 (94.5%) dogs and 4 (5.5%) cats] with a total of 113 unerupted teeth were included in the study (Supplemental Table 1)
Summary
An unerupted tooth is a tooth that does not emerge into the mouth within the expected time frame because of lack of space, malposition, and other physical impediments such as the presence of a tumor or fibrous tissue along the path of eruption (impacted tooth), or because of a lack of eruptive forces (embedded tooth) [1].Clinical, radiographic and pathological features associated with unerupted teeth are well-described in humans [2], but only a few reports are present in the veterinary literature.In human patients, the prevalence varies considerably in different countries (from 8 to 38%) [3, 4]. Radiographic and pathological features associated with unerupted teeth are well-described in humans [2], but only a few reports are present in the veterinary literature. Unerupted teeth are typically asymptomatic, but pain may be reported because of inflammation of the soft tissues surrounding the crown (pericoronitis), or pressure resorption of adjacent roots [1]. Extraction is the treatment of choice in case of loss of bone around the impacted teeth, presence of cysts or tumors, displacement of the adjacent teeth, or chronic pain [1]. Treatment is recommended even in the absence of clinical or radiographic pathologic findings, as a preventive method against the development of cystic lesions that can lead to severe loss of surrounding bone and resorption of adjacent teeth [7]. Surgical exposure and orthodontic treatment may be attempted in select cases [5]
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