Tooth Root Abscess Research Articles

Camelid care essentials: Managing common diseases and disorders

This presentation aims to highlight crucial aspects of man­aging common diseases and disorders in camelids, focusing on llamas and alpacas. With their unique physiological traits and health requirements, camelids present a distinct set of challenges in veterinary care. By understanding and address­ing these challenges, veterinarians can improve the health and welfare of these animals. The conditions covered include Munge, tooth root abscesses, neurological diseases, choke, ar­thritis, GI obstructions, mites, and intestinal parasites.

Ventricular empyema in a dog diagnosed by magnetic resonance imaging and immediate postmortem cerebrospinal fluid culture

AbstractA 1‐year 5‐month‐old, female, neutered springer spaniel presented collapsed in extensor rigidity. The dog had undergone ovariectomy 6 weeks previously, and a tooth root abscess was documented 2 months before this. Neurological signs were first reported 24 days after surgery, starting with lethargy and tremors, which progressed to generalised tonic‐clonic cluster seizures with inter‐ictal neurological deficits by 33 days after surgery. Magnetic resonance imaging of the brain revealed a conspicuous fluid–fluid level in the lateral ventricles consistent with ventricular empyema. Treatment was declined in favour of euthanasia, but postmortem cerebrospinal fluid sample showed marked pleocytosis with elevated protein and cultured a heavy growth of Staphylococcus pseudintermedius. The magnetic resonance imaging findings and positive cerebrospinal fluid culture were consistent with bacterial meningoencephalitis. Aetiology in this case was unknown, but may have been secondary to haematogenous spread, which is a rare but potential sequel to abdominal surgery, or intracranial extension of an oral infection.

A histological description of alpaca (Vicugna pacos) cheek teeth: Findings and anatomical variations in macroscopically normal molars.

Scientific literature on veterinary dentistry in alpacas has historically focused on the description of tooth root abscesses. However, recent studies have shown a variety of other, sometimes preceding dental conditions to be widespread in this species. To allow the development and finetuning of treatment strategies in this species, a more thorough understanding of the underlying etiopathogenesis of dental disease is required. Histological studies focusing on normal dental and surrounding tissues might serve as a basis for this purpose. Nine teeth, extracted from seven alpacas were collected. All samples were retrieved from animals that died or were euthanized for non-dental reasons. Histological sections were prepared at three different levels in each tooth and examined using light microscopy focusing on the assessment of pulp tissue, dentin, cementum, periodontal tissues and the apical region. The histological appearance of the investigated dental tissues in alpacas showed great similarities with other hypsodont species. However, a rather rare type of dentin called "vasodentin" could be identified in all examined cheek teeth. Another species-specific finding was the extremely close proximity of varying neighboring tooth roots that seemed to be responsible for inducing massive resorptive lesions. The results of this study might contribute to a better understanding of the etiopathogenesis of some dental diseases in the alpaca.

2022 AAFP/AAHA Antimicrobial Stewardship Guidelines.

2022 AAFP/AAHA Antimicrobial Stewardship Guidelines.

Current practices in nutrition management and disease incidence of common marmosets (Callithrix jacchus).

A survey was developed to characterize disease incidence, common pathology lesions, environmental characteristics, and nutrition programs within captive research marmoset colonies. Seventeen research facilities completed the electronic survey. Nutritional management programs varied amongst research institutions housing marmosets; eight primary base diets were reported. The most common clinical syndromes reported were gastrointestinal disease (i.e. inflammatory bowel disease like disease, chronic lymphocytic enteritis, chronic malabsorption, chronic diarrhea), metabolic bone disease or fracture, infectious diarrhea, and oral disease (tooth root abscesses, gingivitis, tooth root resorption). The five most common pathology morphologic diagnoses were colitis, nephropathy/nephritis, enteritis, chronic lymphoplasmacytic enteritis, and cholecystitis. Obesity was more common (average 20% of a reporting institution's population) than thin body condition (average 5%). Through review of current practices, we aim to inspire development of evidence-based practices to standardize husbandry and nutrition practices for marmoset research colonies.

Dental disease in alpacas. Part 2: Risk factors associated with diastemata, periodontitis, occlusal pulp exposure, wear abnormalities, and malpositioned teeth.

BackgroundDental disorders, of which tooth root abscesses are best documented, are highly prevalent in alpacas. Identification of risk factors can be valuable for prevention of dental disorders in this species.Hypothesis/ObjectivesTo identify risk factors associated with wear abnormalities, malpositioning, diastemata, periodontal disease (PD), and occlusal pulp exposure at the level of the cheek teeth.AnimalsTwo hundred twenty‐eight alpacas (Vicugna pacos) from 25 farms.MethodsCross‐sectional study. Dental examinations were performed on sedated animals. Risk factors were determined by clinical examination and interview. Multivariable logistic regression was used to identify risk factors for wear abnormalities, malpositioned teeth, diastemata, PD, and occlusal pulp exposure.ResultsMandibular swelling was significantly associated with PD (odds ratio [OR], 11.37; 95% confidence interval [CI], 3.27‐48.81; P < .001). Nearly 73% of included animals with mandibular swelling concurrently had PD. For every increase in herd size of 1 animal, the risk for PD increased by 2% (95% CI, 1‐4%; P = .01). The association between severe stages of PD and body condition score (BCS) indicates a painful situation, impairing animal welfare (P < .001). For each 1‐day increase in interval between pasture cleanings, the odds of finding pulp exposure for a single animal was estimated to increase by 1% (95% CI, 0‐2%; P = .05).Conclusion and Clinical ImportanceSimple management tools such as measuring BCS, palpating the mandible for bony swellings, removing feces from pasture on a regular basis and decreasing herd size might help identify animals at risk for dental disorders or prevent their development.

Dental disease in alpacas. Part 1: Prevalence of dental disorders and their mutual relationships.

BackgroundDental disease is a troublesome health concern in alpacas. Specifically, the occurrence of tooth root abscesses has been described in veterinary literature. Nevertheless, no objective prevalence data are available for dental disorders in alpacas.Hypothesis/objectivesTo determine the prevalence of dental disorders in alpaca herds in Belgium and the Netherlands. To study the associations between the different dental disorders encountered in alpacas.AnimalsA total of 228 alpacas (Vicugna pacos) originating from 25 farms.MethodsThis is a cross‐sectional study. Dental disorders were diagnosed by dental examination of sedated animals using a dental mirror or a portable rigid oroscope.ResultsAt the animal level, 82% (n = 187) had dental disorders of which 74.6, 41.7, and 3.9% were cheek teeth, incisor disorders, and canine disorders, respectively. At the level of the cheek teeth, diastemata (43.1%) were most common, followed by wear abnormalities (WA; 39.6%) and periodontal disease (PD; 33.3%). A significant association was detected between the presence of diastemata and PD (odds ratio [OR], 13.1; 95% confidence interval [CI], 6.6‐27.7; P < .001). Pulp exposure was significantly associated with the presence of diastemata (OR, 11.8; 95% CI, 3.8‐51.5; P < .001), PD (OR, 8.2; 95% CI, 3.1‐25.3; P < .001) and WA (OR, 2.9; 95% CI, 1.2‐7.4; P = .002).Conclusion and Clinical ImportanceDental disorders are highly prevalent in alpacas in Belgium and the Netherlands. Several dental disorders in alpacas had significant associations. To prevent the development of advanced stages of dental disease, routine dental examinations are advised to allow early detection and prompt treatment.

Pain management of a mandibular fracture in an alpaca (Vicugna pacos) via epidural catheter placement in the mandibular foramen

A nine-year-old female alpaca with a history of a recurrent tooth root abscess presented for further investigation of a swelling of the left mandible and possible tooth extraction. During the...

Diagnosis and treatment of mesenteric volvulus in a red kangaroo (Macropus rufus)

An 8-year-old male red kangaroo (Macropus rufus) was evaluated with a 2-week history of vomiting and anorexia. Four days prior, the patient became refractory to medical management. The kangaroo was admitted for diagnostic testing and treatment including whole body CT, blood work, and emergency laparotomy. CT findings of a severely enlarged stomach, splenic displacement, and a whirl sign were indicative of mesenteric volvulus with gastric dilatation-volvulus (GDV). Contrast enhancement of abdominal viscera suggested intact arterial blood supply; however, compression of the caudal vena cava and portal vein indicated venous obstruction. Results of preoperative blood work suggested biliary stasis without evidence of inflammation. Additionally, a tooth root abscess was diagnosed on the basis of results of CT. Exploratory laparotomy confirmed the diagnosis of mesenteric volvulus and GDV. The volvuli were corrected by clockwise derotation, and a gastropexy was performed. Tissue samples were obtained from the spleen and liver for evaluation. The kangaroo recovered from surgery, and the abscessed tooth was extracted 6 days later. Eight days after initial evaluation, the kangaroo was discharged. In the present report, the CT whirl sign was used to diagnose volvulus of the abdominal viscera, which suggests that this diagnostic indicator has utility in veterinary patients. Mesenteric volvulus with GDV was successfully treated in a nondomestic species. The tooth root abscess, a common condition in macropods, may explain the historic episodes of anorexia reported by the owner and may have contributed to the development of mesenteric volvulus and GDV in this kangaroo.

Evaluation of hypoxia in a feline model of head and neck cancer using 64Cu-ATSM positron emission tomography/computed tomography

BackgroundHuman and feline head and neck squamous cell carcinoma (HNSCC) share histology, certain molecular features, as well as locally aggressive and highly recurrent clinical behavior. In human HNSCC, the presence of significant hypoxia within these tumors is considered an important factor in the development of a more aggressive phenotype and poor response to therapy. We hypothesized that feline head and neck tumors, particularly HNSCC, would exhibit hypoxia and that 64Cu-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM) positron emission tomography/computed tomography (PET/CT) would permit detection of intratumoral hypoxia.Methods12 cats with measureable head and neck tumors were given 64Cu-ATSM and iodinated contrast for PET/CT scan. The presence or absence of hypoxia was also assessed using an intratumoral fluorescent life-time probe to quantitate pO2 and pimonidazole immunohistochemical staining in biopsy specimens. In two cats, intratumoral O2 and 64Cu-ATSM uptake was measured before and after treatment with anti-angiogenic agents to determine the effect of these agents on hypoxia.ResultsEleven of twelve feline tumors demonstrated significant 64Cu-ATSM uptake, regardless of malignant or benign etiology. The presence (and absence) of hypoxia was confirmed using the fluorescent O2 detection probe in nine tumors, and using pimonidazole staining in three tumors. Squamous cell carcinomas (HNSCC) demonstrated the highest degree of hypoxia, with Tmax/M ratios ranging from 4.3 to 21.8. Additional non-neoplastic tissues exhibited 64Cu-ATSM uptake suggestive of hypoxia including reactive draining lymph nodes, non-malignant thyroid pathology, a tooth root abscess, and otitis media. In two cats with HNSCC that received anti-vascular agents, the pattern of 64Cu-ATSM uptake was altered after treatment, demonstrating the potential of the feline model to study the modulation of tumor oxygenation.ConclusionFeline HNSCC serves as a clinically relevant model for the investigation of intratumoral hypoxia including its measurement, modulation and targeting.

Causes, examination and treatment of dental disease in rabbits

There are numerous dental problems that can affect rabbits including tooth root abscesses, periodontitis, jaw abnormalities, caries, and traumatic injury, however, the most common problems are malocclusions and most of these can be attributed to lack of wear and tooth elongation. Dental disease can be pronounced with visible protrusion of overgrown incisors, but often disease can only be assumed by observing clinical signs such as anorexia, weight loss, swelling of the jaw, hypersalivation, and an inability to fully close the mouth. The incidence of dental disease is very high so rabbits should be routinely examined for evidence of dental disease. Veterinary nurses should also actively educate clients about dental disease including preventative care, correct husbandry and routine observations for signs indicating early onset disease.

Actinomyces endogenous endophthalmitis in a cat following multiple dental extractions

An 8-year-old, brachycephalic, mixed breed cat underwent full mouth tooth extractions for the treatment of tooth root abscessation. Subsequently, the cat developed anterior uveitis refractory to topical therapy that eventually necessitated enucleation. Actinomyces species were isolated from both the tooth root abscesses and the anterior chamber after enucleation. Histopathology of the enucleated eye revealed panophthalmitis with abundant intralesional bacteria morphologically consistent with Actinomyces. Between the time of tooth root extraction and enucleation (20 weeks), the cat was diagnosed with hyperthyroidism and treated with oral steroids for inflammatory bowel syndrome. We believe this report represents a rare case of endogenous endophthalmitis secondary to dental disease, possibly precipitated by concurrent immunosuppression.

RADIOGRAPHY AND COMPUTED TOMOGRAPHY IN THE DIAGNOSIS OF NONNEOPLASTIC EQUINE MANDIBULAR DISEASE

We compared the information gained from computed tomography (CT) vs. radiography in horses with nonneoplastic disease of the mandible. We hypothesized that CT would provide additional diagnostic information. Medical records, radiographs, and CT images of horses with nonneoplastic mandibular disease evaluated between 1994 and 2008 were reviewed. Nineteen horses were identified; 11 had a tooth root abscess and related disease, four had a fracture of the teeth and/or mandible, and four had a nonneoplastic mass. Both CT images and radiographs allowed identification of diseased teeth that appeared clinically normal otherwise. CT allowed identification of teeth that were clinically affected but appeared normal radiographically. Parameters such as tooth pulp involvement, lamina dura destruction, presence of bone fragments, lingual and buccal mandibular bone periosteal reaction, and cortical bone destruction were more conspicuous with CT. Performing radiography and CT in horses with nonneoplastic mandibular disease provides a more complete evaluation than either technique alone. CT contributes additional information that could otherwise be overlooked with radiographs alone in horses with a mandibular fracture. CT provides ancillary information to radiographs in horses with dental infection or a nonneoplastic mass of the mandible.

Bilateral abscesses of the maxillary carnassial teeth in a female Pekinese

Tooth infections are typically seen in older dogs as a result of poor oral hygiene (periodontal disease) or traumatic tooth fractures (endodontic and periapical disease). An 8-year-old female Pekinese was presented due to bilateral draining tracts located just under its eyes, and a history of healing and recurrence of the lesions after about 3 weeks of systemic antibiotic therapy. Dental radiography revealed bilateral carnassial tooth root abscesses. Both teeth were extracted under general anesthesia. With proper postoperative care the abscesses healed with no further complications.

Frequency of a dental source for acute maxillary sinusitis

To identify radiographic features of odontogenic acute maxillary sinusitis and to determine the frequency of a causative dental infection in patients with radiographic evidence of maxillary sinus fluid. Retrospective review of 101 sinus computed tomography scans with unilateral or bilateral maxillary sinus fluid. Each maxillary sinus was graded for extent of fluid, degree of mucosal thickening, and presence of dental pathology. Univariate chi-square analysis was used to identify potential radiologic and demographic features predictive of sinus fluid. Multivariate logistic regression was then used to determine which features were independently predictive. 124 of the 202 maxillary sinuses (61%) had sinus fluid. Univariate analysis excluded age, gender, and prior surgery as predictive features. The multivariate analysis included the radiographic features of oroantral fistula, periapical abscess, periodontal disease, projecting tooth root, and dental caries. Of these, only oroantral fistula and the combination of periodontal disease with either a projecting tooth root or periapical abscess were identified as significant sources of maxillary sinusitis. In sinuses that were <1/3 opacified by fluid, 17% had a dental source of infection. In sinuses with 1/3 to 2/3 fluid opacification, 53% had an identifiable dental source, and in sinuses that were >2/3 opacified by fluid, 79% had an identifiable dental source. Mucosal thickening demonstrated a similar relationship with dental sources, so that sinuses having both >2/3 fluid opacification and moderate mucosal thickening were 86% likely to have an identifiable dental source. Odontogenic infections are often the source of acute maxillary sinusitis, especially if the radiographic findings of sinusitis are severe.

Acute myeloid leukemia with multilineage dysplasia in an alpaca

An 18-year-old female alpaca was presented to the Colorado State University Veterinary Teaching Hospital for chronic ill thrift over a 1-year period. Six weeks previously, an infected left mandibular cheek tooth was removed by oral extraction. On physical examination the patient was cachectic, lethargic, and weak. Abnormalities on the CBC included neutropenia, thrombocytosis, and severe nonregenerative, macrocytic, hypochromic anemia. Dysplastic nucleated erythrocytes and micromegakaryocytes were observed on the peripheral blood smear. Neutrophils, bands, and metamyelocytes appeared markedly toxic. Numerous blasts containing variable numbers of fine azurophilic granules were also observed. Based on their morphology, the cells were interpreted to be progranulocytes and myeloblasts, and a presumptive diagnosis of acute myeloid leukemia (AML) was made. The blast cells accounted for 60% of the nucleated cell population on bone marrow aspirates, further supporting a diagnosis of AML with multilineage dysplasia. Post mortem examination showed infiltration of the neoplastic cells into spleen, liver, kidney, and lymph nodes. Based on histologic findings, the morphologic diagnoses were disseminated myeloid neoplasia, chronic regionally extensive tooth root abscess, and membranous glomerulonephritis. The neoplastic cells were CD172a-positive on flow cytometry, chloroacetate esterase-positive by cytochemistry, and myeloperoxidase-positive by immunohistochemistry, confirming myeloid origin. To our knowledge, this is the first case of AML with multilineage dysplasia in an alpaca, with only one other case of myelodysplasia described previously in this species.

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

To determine features, outcome, and complications of surgical treatment of camelid tooth root abscesses. Retrospective case series. 123 camelids with tooth root abscesses. 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. 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. 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.

Diagnosing a Tooth Root Abscess in a Guinea Pig ( Cavia porcellus) Using Micro Computed Tomography Imaging

Abstract Dental disease in rodents can be difficult to diagnose based on oral examination and radiography alone, but diagnosis can be aided with computed tomography (CT). An adult guinea pig presented with nonspecific signs of pain, mild exophthalmia, and strabismus. Initial complete blood count, plasma biochemistry, and radiographs were nondiagnostic, so high-resolution micro CT was performed. A diagnosis of a tooth root abscess of the left maxillary third molar and associated osteomyelitis was made based on CT images. Micro CT, which can provide superior resolution over conventional CT, has been used primarily for research purposes in veterinary medicine but proved beneficial in this case.

Calcification associated with the nasolacrimal system of a horse: case report and mineralogic composition

A 12-year-old Paso Fino mare was evaluated for a chronic nasal and ocular discharge. A calcification was identified eroding through the nasal mucosa of the middle meatus. Differential considerations for this mass included dacryolith, nasal calculus, or calcified tooth root abscess. Anatomical location and case history and progression supported a dacryolith. Following removal, the calculus was submitted for mineralogic analysis. The calculus was primarily carbonate hydroxylapatite (Ca10(PO4)3(CO3)3(OH)2) with a minor NaCl halite constituent. Dacryoliths, or nasolacrimal calculi, are an uncommon occurrence in animals, and sparsely reported in humans. The etiopathogenesis of dacryolith formation is unknown. The objective of this article was to report the first case report of an equine nasolacrimal system dacryolith and its mineralogic composition.

Periapical tooth root infections in llamas and alpacas

Head and neck abscesses are a common complaint in llamas and alpacas in North America representing 3% of clinical cases presented at the Veterinary Teaching Hospital at Ohio State University (OSU-VTH). Approximately 20% of infected teeth have infection of the pulp cavity most often associated with a patent infundibulum, approximately 60% have evidence of periodontal disease and compromised periodontal ligament, and 20% are of unknown cause. Differential diagnosis includes tooth root abscess, osteomyelitis, soft tissue abscess ( Corynebacterium pseudotuberculosis), foreign body, parotid duct lesion, facial bone fracture, retained food bolus, and malocclusion. The aim of this paper is to review available information and provide clinical observation on etiology, diagnosis, and treatment option for tooth root infection in llamas and alpacas.