Apex Of Tooth Research Articles

Autogenous Tooth Transplantation of Canines—A Prospective Clinical Study on the Influence of Adjunctive Antibiosis and Patient-Related Risk Factors during Initial Healing

Abstract: Objectives: This prospective clinical study investigated the efficacy of adjunctive antibiotic therapy (doxycycline) and the patient’s risk factors during initial healing of autogenous canine tooth transplantations. Methods: Sixty-seven patients (ranging from 11 to 37 years of age) treated with tooth transplantations were allocated to three parallel groups based on the tooth’s intraoperative extraoral storage time (EST 0–3, 4–6, and 7–15 min) receiving different antibiotic regimens: (1) no antibiotics; (2) intraoperative intravenous (i.v.) single-shot antibiotics; and (3) intraoperative i.v. single-shot plus postoperative oral antibiotics for five days. Initial healing was rated according to pain intensity and clinical signs of pathology over a 21-day period. The influence of the following parameters was investigated using RStudio (linear regression and partial eta squared statistics): group, sex, age, nicotine abuse, tooth apex condition, preoperative ankylosis, displacement severity, jaw location, the number of simultaneous transplantations and other interventions, preoperative orthodontic extrusion, EST, and intraoperative complications. Results: No significant influence for sex (43 females, 24 males), tooth apex condition (19 open, 48 closed), displacement severity, jaw location (51 upper, 16 lower jaw), EST (mean 4.99 min), intraoperative complications (n = 13), or antibiotic regimen on pathology signs or pain intensity were found. Six patients reported medication side effects. Preoperative ankylosis (n = 15) and unsuccessful orthodontic extrusion (n = 16) increased postoperative pain (p = 0.020, ηP2 = 0.08; p = 0.035, ηP2 = 0.07). Multiple transplants (n = 14) and interventions in multiple regions (n = 27) affected pain and pathology (p = 0.002, ηP2 = 0.14; p = 0.001, ηP2 = 0.17). Increased age and nicotine abuse (n = 6) were associated with increased pathology signs (p = 0.024, ηP2 = 0.08; p = 0.029, ηP2 = 0.07). Conclusions: The results suggest that personalized rather than routine antibiotic therapy might be sufficient for initial healing in canine tooth transplantation. Deteriorating factors include preoperative ankylosis, orthodontic extrusion, an increased number of surgical sites, age, and nicotine abuse. Clinical Significance: Routine antibiotic prevention regimes may not be mandatory for initial healing in autogenous tooth transplantation, but a nuanced antibiotic strategy tailored to each patient’s specific risk factors, which is in line with the principle of antibiotic stewardship, is needed.

The Occurrence and Outcomes of Cemento-Osseous Dysplasias (COD) in the Jaw Bones of the Population of Lower Silesia, Poland.

Background: Cemento-osseous dysplasias (CODs) are rare lesions of the jawbone. Their occurrence, localization, type, size, and shape can vary between cases. This fibro-osseous lesion is typically found in the jaw near tooth-bearing areas and is often asymptomatic, discovered incidentally, and may be associated with the periapical region of the teeth. In rare cases, COD can lead to secondary bone osteomyelitis. Currently, there is limited information in the literature on the occurrence and characteristics of COD. This paper's main aim was to focus on the authors' COD experience in the lower Silesian area. Methods: A retrospective evaluation of radiographies (RTG-Panx, cone-beam computed tomography (CBCT)) was conducted on patients treated, diagnosed, or consulted by the authors. A statistical correlation analysis was made to establish any relationship within the gathered data. Results: COD is predominantly an incidental finding in the mandibular bone near tooth apices. It is most commonly diagnosed in females. Both CBCT and panoramic radiographies are generally sufficient for diagnosing the lesion. COD rarely requires treatment. Conclusions: COD lesions are mostly discovered incidentally during routine radiographies or cone-beam computed tomography (CBCT) scans. In most cases, clinical and radiological monitoring is sufficient, along with evaluating the teeth's response to cold stimuli and assessing the surrounding bone structures. Biopsies or tooth extractions are seldom necessary. When oral hygiene is well-maintained and no periapical inflammation is present, COD lesions typically remain asymptomatic.

Management of radicular cyst – A case report

Radicular cysts are common jaw lesions, typically asymptomatic, and often found near the tooth apices. Radiographically, they appear as oval or pear-shaped unilocular radiolucencies in the periapical region. This case report highlights the successful surgical management of a large infected radicular cyst through enucleation and apicoectomy. These procedures were crucial in removing the cyst and promoting healing, with no post-surgical complications. Surgical intervention is vital in managing extensive radicular cysts to prevent further infection and damage to adjacent structures.

Relationship between orthodontic treatment and bone densit

The aim of this study is to examine the change in bone density around the apex of mandibular anterior teeth in groups formed based on malocclusion types after orthodontic treatment. A total of 18 individuals were included in the study, grouped according to malocclusion types (Class I, Class II, and Class III). This retrospective study analyzed the bone density around the apex of mandibular anterior teeth using fractal analysis on panoramic images. Bone density increased around the apex of mandibular anterior teeth in individuals with Class I, Class II, and Class III malocclusions after orthodontic treatment. Statistically significant differences were found in the change of bone density before and after orthodontic treatment among the malocclusion groups. The greatest change in bone density was observed in the Class III group, while the least change was in the Class I group. The fractal analysis method is a technique that facilitates the diagnosis of minimal changes occurring in patients undergoing orthodontic treatment. Potential changes in teeth and adjacent tissues should be carefully evaluated, and orthodontic treatments should be planned in accordance with these evaluations.

New data on fossils in the Mesolithic of the Polish Plain

Two fossil shark teeth (B1 and B6/2014) were discovered in a cluster of flints excavated in 2014 on the Mesolithic site Wierzchowo 6, in Pomerania, NW Poland. Found a small distance apart the surface of both teeth displays natural modifications. The apex of tooth B1/2014 was broken off after deposition, and on its surface were some marks of trampling and transport. On tooth B6/2014 marks clustered on three surfaces labelled G1-G3. The most apparent striations and irregular points seen on surface G1are interpreted as trampling marks caused by low intensity action of the sand deposit. The occasional occurrence of fossil shark teeth in Quaternary sediments in Poland suggests the specimens from Wierzchowo were brought deliberately to the camp site by Mesolithic settlers. Fossilized shark teeth are recorded in Palaeolithic and Mesolithic sites in Europe and have been used for various practical and symbolic purposes by modern age foragers.

Radiographic differences in deep fascial space infections versus localized acute apical abscesses: A cone-beam computed tomographic-based observational study

ABSTRACT Aim: The objective of this study was to evaluate anatomical differences and patterns of bone loss in patients with acute apical abscess (AAA) clinically presenting as a localized swelling or with concomitant fascial space involvement (FSI) using cone-beam computed tomographic (CBCT) imaging. Materials and Methods: Thirty CBCT images of AAA cases presenting with fascial space involvement (FSI) and 31 cases of localized acute apical abscess (LAAA) were evaluated. Factors that were recorded included the presence/absence of cortical disruption, the distance of the involved tooth apex to the buccal and lingual/palatal cortex, the length of the anatomic root/s of the involved tooth, and the volume of the endodontic lesions. Results: The median for the volume of the lesions was 138 mm3 for the FSI group and 154 mm3 for the LAAA group (P > 0.05). Radiographic evidence of cortical disruption was seen in 26.7% of the cases with FSI and 41.9% of the cases with LAAA (P > 0.05). The mean for the distance of the apex to the buccal cortex was the only statistically significant difference between the two groups and was 4.2 mm for the FSI group and 3 mm for the LAAA group (P < 0.05). Conclusions: CBCT assessment showed root apices associated with fascial space involvement tended to be more confined in cancellous bone. Although a significant difference between the two conditions was found, the inflammatory process is complex, and CBCT assessment alone cannot predict AAA remaining as a localized swelling versus spreading to fascial spaces.

Ectopic Dental Canal: A Case Report Highlighting a Unique Bifid Mandibular Canal Variant

Bifid mandibular canals are common anatomical findings with variations based on direction and location of branching, which carry significant clinical implications for endodontic and surgical dental procedures. This case report describes a previously unreported ectopic dental canal that branches off the superior border of the mandibular canal, enters the apex of a mandibular second molar, traverses through the root, anastomoses with the root canal system, and subsequently exits through the lingual aspect of the root. The anastomosis of this ectopic dental canal with the mesial lingual canal led to significant bleeding during rotary instrumentation. This unique anatomical variation demonstrates the importance of a thorough cone-beam computed tomography analysis to identify critical structures prior to undertaking dental procedures involving the root apices of mandibular posterior teeth and adjacent areas.

Anatomical relationship between maxillary posterior teeth and the maxillary sinus in an Indonesian population: a CT scan study

BackgroundThe anatomical proximity between the root apex of the maxillary posterior teeth and the maxillary sinus can lead to complications, including odontogenic maxillary sinusitis. While several studies have investigated similar variables in different populations, there is limited research on the Indonesian population. This study aimed to describe the anatomical position of the maxillary posterior teeth in relation to the floor of the maxillary sinus using CT scans.MethodsA total of 122 patients (432 maxillary premolars and 1,282 maxillary molars) underwent CT scans to evaluate 1,711 roots. The vertical relationship between the root apex of the maxillary posterior teeth and the maxillary sinus was classified into three types: IS (inside sinus), CO (sinus contact), and OS (outside sinus).ResultsThe IS type was predominantly found in the palatal roots of the first molars, accounting for 20% of the total roots in this type. The CO type was most frequently observed in the mesiobuccal roots of the second molars, representing 18% of the total roots in this type. The OS type was most commonly found in the first premolar, comprising 20% of the total roots in this type.ConclusionsThe palatal roots of the first molars exhibited the highest frequency of proximity to the maxillary sinus. CT scans can effectively assess the relationship between the root apex of the posterior teeth and the maxillary sinus.Clinical RelevanceClinicians should consider this information comprehensively when planning treatments for maxillary molars.

Precision Medicine for Apical Lesions and Peri-Endo Combined Lesions Based on Transfer Learning Using Periapical Radiographs.

An apical lesion is caused by bacteria invading the tooth apex through caries. Periodontal disease is caused by plaque accumulation. Peri-endo combined lesions include both diseases and significantly affect dental prognosis. The lack of clear symptoms in the early stages of onset makes diagnosis challenging, and delayed treatment can lead to the spread of symptoms. Early infection detection is crucial for preventing complications. PAs used as the database were provided by Chang Gung Memorial Medical Center, Taoyuan, Taiwan, with permission from the Institutional Review Board (IRB): 02002030B0. The tooth apex image enhancement method is a new technology in PA detection. This image enhancement method is used with convolutional neural networks (CNN) to classify apical lesions, peri-endo combined lesions, and asymptomatic cases, and to compare with You Only Look Once-v8-Oriented Bounding Box (YOLOv8-OBB) disease detection results. The contributions lie in the utilization of database augmentation and adaptive histogram equalization on individual tooth images, achieving the highest comprehensive validation accuracy of 95.23% with the ConvNextv2 model. Furthermore, the CNN outperformed YOLOv8 in identifying apical lesions, achieving an F1-Score of 92.45%. For the classification of peri-endo combined lesions, CNN attained the highest F1-Score of 96.49%, whereas YOLOv8 scored 88.49%.

Network analysis of three-dimensional hard-soft tissue relationships in the lower 1/3 of the face: skeletal Class I-normodivergent malocclusion versus Class II-hyperdivergent malocclusion

BackgroundThe determining effect of facial hard tissues on soft tissue morphology in orthodontic patients has yet to be explained. The aim of this study was to clarify the hard-soft tissue relationships of the lower 1/3 of the face in skeletal Class II-hyperdivergent patients compared with those in Class I-normodivergent patients using network analysis.MethodsFifty-two adult patients (42 females, 10 males; age, 26.58 ± 5.80 years) were divided into two groups: Group 1, 25 subjects, skeletal Class I normodivergent pattern with straight profile; Group 2, 27 subjects, skeletal Class II hyperdivergent pattern with convex profile. Pretreatment cone-beam computed tomography and three-dimensional facial scans were taken and superimposed, on which landmarks were identified manually, and their coordinate values were used for network analysis.Results(1) In sagittal direction, Group 2 correlations were generally weaker than Group 1. In both the vertical and sagittal directions of Group 1, the most influential hard tissue landmarks to soft tissues were located between the level of cemento-enamel junction of upper teeth and root apex of lower teeth. In Group 2, the hard tissue landmarks with the greatest influence in vertical direction were distributed more forward and downward than in Group 1. (2) In Group 1, all the correlations for vertical-hard tissue to sagittal-soft tissue position and sagittal-hard tissue to vertical-soft tissue position were positive. However, Group 2 correlations between vertical-hard tissue and sagittal-soft tissue positions were mostly negative. Between sagittal-hard tissue and vertical-soft tissue positions, Group 2 correlations were negative for mandible, and were positive for maxilla and teeth.ConclusionCompared with Class I normodivergent patients with straight profile, Class II hyperdivergent patients with convex profile had more variations in soft tissue morphology in sagittal direction. In vertical direction, the most relevant hard tissue landmarks on which soft tissue predictions should be based were distributed more forward and downward in Class II hyperdivergent patients with convex profile. Class II hyperdivergent pattern with convex profile was an imbalanced phenotype concerning sagittal and vertical positions of maxillofacial hard and soft tissues.

Osteoporosis and Apical Periodontitis Prevalence: A Systematic Review.

Osteoporosis is a common systemic bone disorder in the elderly, characterized by low bone mineral density and deterioration of bone structure. Apical periodontitis is an inflammatory response to the microbial infection of root canals, typically characterized by apical bone destruction surrounding the tooth's apex. This systematic review aimed to determine if osteoporosis affects the prevalence of apical periodontitis in adults. PRISMA guidelines have been followed. It included randomized clinical trials, cross-sectional, cohort, and case-control studies, and excluded non-relevant investigations and various secondary sources. A comprehensive search was performed in PubMed, Scopus, and Web of Science, until 13 March 2024. The Newcastle-Ottawa Scale was used to assess the quality of the three selected studies: two cross-sectional studies and one case-control study. One investigation only included post-menopausal women recruited at a dental university clinic, the other integrated data from the total hospital patients' population, and the third selected patients referred to the university dental clinic from the university hospital. The findings varied: one study noted a marginal association between low bone mineral density and apical periodontitis, another found a significant association, and the third, with the lowest risk of bias, reported no link. The main limitations were the scarcity of eligible studies and their overall quality. The review was registered in the PROSPERO database (CRD42024523705), applied strict inclusion criteria and thorough searches by experienced and independent reviewers. There is no strong evidence that adult individuals with osteoporosis have a higher probability of developing apical periodontitis. However, clinicians should remain cautious of osteoporosis's potential impact on apical periodontitis development.

Treatment options for impacted maxillary canines and occurrence of ankylotic and resorptive processes: a 20-year retrospective study

BackgroundThis 20-year retrospective study aimed to evaluate the treatment methods used in patients with impacted maxillary permanent canines and to determine the occurrence of ankylotic and resorptive processes and their association with potential risk factors.MethodsThe cohort consisted of 351 consecutive Caucasian patients (120 males and 231 females, mean age 18.4 and 19.9 years, respectively) with 420 impacted maxillary permanent canines. CT and CBCT findings were subsequently confirmed during surgery. Statistical analyses were performed by the generalized linear models, Pearson x2 and Fisher exact tests using the statistical programs R and Statistica v. 14.ResultsA total of 273 (65.0%) impacted canines were aligned in the dental arch by orthodontic traction after surgical exposure, this treatment was predominant in patients under 20 years of age. Surgical extraction was performed in 115 (27.2%) impacted canines and was more common in older patients. Ankylotic changes were recorded in 61 (14.5%) impacted canines. The probability of ankylosis increased with age, particularly after the patient’s 20th year of life (p < 0.001). Patients were 1.2% likely to develop ankylosis at age 15 years, 4.3% at age 20 years, 14.1% at age 25 years, and 96.8% at age 45 years. Invasive cervical root resorption (ICRR) was found in 8 (1.9%) canines. In 4 canines (1.0%), root ankylosis in addition to ICRR was observed. In contrast to ankylosis, whose frequency of occurrence increased with age, the occurrence of ICRR resulting from PDL damage during surgery was more typical in younger patients. Canines in a high position above the root apices of the adjacent teeth, with a horizontal inclination of the longitudinal axis, with the crown located deep in the center of the alveolar bone and with labiopalatal position, should be considered critically impacted canines with a high risk to failure of orthodontic traction.ConclusionIn conclusion, the treatment of impacted canines depends mainly on the age of the patient, and the position and inclination of the longitudinal axis of the impacted tooth. To select an adequate treatment method, we recommend CBCT examination, which allows a precise analysis of the position of impacted canines.

REGRESSÃO DE LESÃO RADIOTRANSPARENTE ÓSSEA APÓS TERAPIA ENDODÔNTICA CONSERVADORA

Periapical lesions are found associated with the apex of a tooth without vitality, after contamination of the root canals, characterized radiographically by the presence of a radiolucent image at the apex of the affected element. The objective of this work is to report the regression of a periapical lesion, with a diagnosis of periapical abscess without fistula, after conventional endodontic treatment, confirmed through radiographic examinations and clinical images. A 24-year-old female patient complained of pain in the right anterior region and, days before the initial consultation, reported drainage of purulent secretion through the gums. In the intraoral physical examination, edema was observed at the bottom of the vestibule close to the incisors, pain on horizontal and vertical percussion and on the periapical radiograph the presence of a radiolucent image was observed close to the apex of tooth 36. A cold pulp sensitivity test was performed, obtaining a negative result. . With the purpose of decontaminating the root canals, endodontic treatment was carried out, using a preparation technique associated with the activation of chemical irrigants and intracanal medication between sessions. After a few weeks, the remission of clinical signs of inflammation and infection was observed and, after 3 months, radiographically, the beginning of repair of the lesion with bone formation was evident. The reported case highlights the importance of effective decontamination of the root canal as a determining factor for the regression process of periapical lesions. A longer period of clinical and radiographic follow-up of the case is necessary to verify complete repair.

Cone-Beam Computed Tomography Evaluation of Maxillary Sinus Changes in Orthodontic Patients Treated With Extraction of Four First Premolars.

The objective of this study was to assess alterations in maxillary sinus mucosa thickness and the distances between the apexes of specific teeth and the maxillary sinus base in adult patients undergoing orthodontic treatment with the extraction of four first premolars. Twenty-one adults, averaging 24.85 years of age, received orthodontic therapy involving the extraction of all four first premolars. Cone-beam computed tomography scans were conducted before and after treatment to evaluate changes. Notably, post-treatment scans revealed a significant increase (P= 0.044) in the distance between the apex of the second premolar and the maxillary sinus floor, with an average augmentation of 1.0141 millimeters. However, no notable alterations were detected in the distances between the apexes of other teeth and the maxillary sinus or in maxillary sinus mucosa thickness. These findings suggest that orthodontic treatment with the extraction of four first premolars may elevate the distance between the maxillary sinus floor and the second premolar apex, which provides a reference for risk assessment and surgical design of first premolar extraction during orthodontic treatment.

Reliability of the AI-Assisted Assessment of the Proximity of the Root Apices to Mandibular Canal

Background: This study evaluates the diagnostic accuracy of an AI-assisted tool in assessing the proximity of the mandibular canal (MC) to the root apices (RAs) of mandibular teeth using computed tomography (CT). Methods: This study involved 57 patients aged 18–30 whose CT scans were analyzed by both AI and human experts. The primary aim was to measure the closest distance between the MC and RAs and to assess the AI tool’s diagnostic performance. The results indicated significant variability in RA-MC distances, with third molars showing the smallest mean distances and first molars the greatest. Diagnostic accuracy metrics for the AI tool were assessed at three thresholds (0 mm, 0.5 mm, and 1 mm). Results: The AI demonstrated high specificity but generally low diagnostic accuracy, with the highest metrics at the 0.5 mm threshold with 40.91% sensitivity and 97.06% specificity. Conclusions: This study underscores the limited potential of tested AI programs in reducing iatrogenic damage to the inferior alveolar nerve (IAN) during dental procedures. Significant differences in RA-MC distances between evaluated teeth were found.

Super natural power of MTA!! Successful management of badly mutilated young molars, report of two cases with 3 years follow up

Apexification in one visit with Mineral Trioxide Aggregate (MTA) is beneficial in effectively sealing the open apices of young mutilated teeth. Although, placement of MTA through canals is difficult and many a times leads to over extrusion due to wide apex. This case report presents the outcome of extruded MTA during apexification in mandibular young permanent molars in children. On long term follow-up, complete healing of the periapical radiolucency was evident around MTA without any symptoms. MTA apexification in incisors have been found in literature, but very few cases are reported with long term follow up regards to young molars.

Immediate Implant Placement at an Inflammatory Periapical Cyst Site in the Aesthetic Area

A healthy 47-year-old woman consulted the Oral Surgery and Implantology Unit of the University Hospitals of Geneva with a request to treat her painful tooth 11 and replace the missing tooth 21. The dental history revealed that the patient had lost teeth 21 and 22 due to advanced caries. On clinical examination, tooth 11 showed an ill-fitting prosthetic crown with overhanging margins, an increased localized probing depth of 8 mm in the disto-vestibular area, and sensitivity to percussion. The edentulous site 21 showed horizontal bone atrophy. Radiological examination revealed a well-defined unilocular radiotransparent lesion surrounded by a thin radiolucent border, located at the apex of tooth 11 and measuring 10 × 8 mm. The treatment consisted of extraction of 11, enucleation of the apical lesion, and insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure, with aesthetic and functional results at 3-year follow-up without any complications. Our case highlights that immediate implant placement in cases of cystic periapical lesions represents a good valid alternative to standard treatment.

Injury Risk Estimation in Mandible-Related Surgical Procedures: A CBCT Study Based on Vital Interforaminal Anatomical Structures.

The mandibular interforaminal region has been considered safe for surgical procedures; nevertheless, the risk of injury to neurovascular structures, such as the mental foramen (MF) and its related structures (anterior loop [AL] and lingual foramina [LF]) should not be overlooked. The study aimed to evaluate the relative risk of injury to these structures during surgical procedures in the anterior region of the mandible based on cone-beam computed tomography (CBCT) scans. A retrospective cross-sectional and observational study was performed on 250 CBCTs from adults (18-69 years) with dentate jaws. Linear measurements of the MF, AL, and LF were evaluated to estimate the risk of injury to these structures during chin-related surgical procedures. The most frequent distance between the base of the mandible (BM) and MF was 8 mm (30.2%). In addition, 20.4% of the CTs had 6 mm from the vestibular cortical bone to the LF. The commonly found measurement from LF to the apex of the nearest tooth was 7 mm (24.0%); 64.2% of the CTs showed a 2-mm distance between the most distal point of the dental implant site to the most anterior point of the AL. Safety distances for genioplasty techniques (MF to mandible base > 6 mm, 96.6% [CI 95%, 95.0%-98.2%]) were observed. Considering the 5-mm cut-off point between the lower limit of a hypothetical bone graft and the chin, 65.4% (CI 95%, 58.9%-71.9%) of CTs were within this distance. Regarding the safety margin of 8 mm, 85.6% (CI 95%, 80.8%-90.4%) were up to this value. This study found safety margins for genioplasty and chin bone grafting surgical techniques that adopt a 5-mm cut-off point. Further similar studies assessing other surgical methods and employing larger samples from different geographical origins may contribute to this field of investigation.

Three-dimensional analysis of the positional relationship between the dentition and basal bone region in patients with skeletal Class I and Class II malocclusion with mandibular retrusion.

This study aimed to determine the maxillary and mandibular basal bone regions and explore the three-dimensional positional relationship between the dentition and basal bone regions in patients with skeletal Class I and Class II malocclusions with mandibular retrusion. Eighty patients (40 each with Class I and Class II malocclusion) were enrolled. Maxillary and mandibular basal bone regions were determined using cone-beam computed tomography images. To measure the relationship between the dentition and basal bone region, the root position and root inclination were calculated using the coordinates of specific fixed points by a computer program written in Python. In the Class II group, the mandibular anterior teeth inclined more labially (P < 0.05), with their apices positioned closer to the external boundary. The apex of the maxillary anterior root was positioned closer to the external boundary in both groups. Considering the molar region, the maxillary first molars tended to be more lingually inclined in females (P = 0.037), whereas the mandibular first molars were significantly more labially inclined in the Class II group (P < 0.05). Mandibular anterior teeth in Class II malocclusion exhibit a compensatory labial inclination trend with the crown and apex relative to the basal bone region when mandibular retrusion occurs. Moreover, as the root apices of the maxillary anterior teeth are much closer to the labial side in Class I and Class II malocclusion, the range of movement at the root apex should be limited to avoid extensive labial movement.

Computed Tomographic Findings of Dental Disease and Secondary Diseases of the Head Area in Client-Owned Domestic Rabbits (Oryctolagus cuniculus): 90 Cases.

Domestic rabbits have teeth that grow throughout the animal's life and are prone to disease. Clinical signs of dental disease in domestic rabbits are non-specific, and, therefore, a definitive diagnosis usually requires additional methods. This study was carried out on a group of 105 domestic rabbits aged 3 to 9 years. In total, 90 domestic rabbits with dental disease visible on CT images and other secondary diseases of the head area qualified for this study. Malocclusion was found in 57 (63.3%). Retrograde elongation of the tooth apices in the mandible was present in 39 (43.3%), and it was present in the maxilla in 48 (53%). Clinical tooth crowns were overgrown in 39 (43%). Dental abscesses were present in 54 (63%). Secondary to the presence of a dental abscess, osteomyelitis was found in 43 (79% of the animals with a dental abscess). Dental inflammatory resorption was found in 36 (40%). Secondary to dental disease, nasal cavity inflammation was found in 18 (20%). Otitis media was present in six (6.7%). The most common dental disease found in this study's animals was malocclusion secondary to abnormal clinical crown abrasion and abnormal tooth growth. In domestic rabbits, osteomyelitis is a common complication of dental abscesses. Computed tomography is an invaluable diagnostic method in the diagnosis of dental disease and secondary diseases of the head area, such as inflammation of the nasal cavities or otitis media, in pet rabbits.