OBJECTIVE To determine and identify variables associated with outcomes of surgical repair of congenital palatal defects in dogs. DESIGN Retrospective case series with nested observational study. ANIMALS 26 dogs that underwent surgical repair of congenital palatal defects at 2 veterinary teaching hospitals from 2007 to 2016. PROCEDURES Data were collected from medical records regarding dog age and body weight at the time of surgical defect repair, prior surgical history, skull type (brachycephalic, mesocephalic, or dolichocephalic), surgical technique used for defect repair, and defect severity. Functional outcome as well as frequency and location of oronasal fistula (ONF) formation were recorded. These outcomes were compared among various groups. RESULTS Surgical defect repair achieved functional success in 22 of the 26 (85%) dogs. An ONF formed after initial repair in 13 (50%) dogs, and the most common location was the hard palate. Hard palate ONF formation was more common in dogs > 8 months of age at the time of initial repair; ONF at the junction between the hard and soft palates was more common in dogs > 8 months of age at the time of initial repair and in dogs with a history of failed surgical repair. An unsuccessful functional outcome was more common in dogs weighing < 1 kg (2.2 lb) at the time of initial repair. CONCLUSIONS AND CLINICAL RELEVANCE Patient age, patient size, and defect characteristics should be taken into consideration when planning and assessing prognoses for surgical repair of congenital palatal defects in dogs.
ObjectiveTo determine whether computed tomography (CT) and intraoral radiography are interchangeable for detecting signs of periodontitis and endodontic disease in dogs.Materials and methodsAn agreement study was performed using 40 dogs that previously underwent intraoral radiography and CT during the same anesthetic episode. Images of each tooth were examined by two blinded observers for signs of periodontitis and/or endodontic disease. Agreement between imaging modalities and between observers was assessed using the Kappa statistic.ResultsAgreement between modalities for detecting periodontitis in the maxillae ranged from poor to very good (κ 0.07–1.00) with 16/20 (80%) of the teeth having a score of moderate or better (κ ≥ 0.41). Agreement between modalities for detecting signs consistent with periodontitis in the mandibles ranged from poor to very good (κ 0.01–1.00) with 10/22 (45%) of the teeth having a score of good or better (κ ≥ 0.61); 50% of the disagreement was present in the incisors. Agreement between modalities for detecting signs consistent with endodontic disease in the whole mouth ranged from fair to very good (κ 0.21–1.00) with 30/42 (71%) of the teeth having a score of moderate or better (κ ≥ 0.41). Agreement between observers evaluating intraoral radiology ranged from poor to very good (κ 0.05–1) for detecting signs consistent with periodontitis and from fair to very good (κ 0.36–1) for detecting signs consistent with endodontic disease, in the whole mouth. Agreement between observers evaluating CT ranged from fair to very good (κ 0.35–1) for detecting signs consistent with periodontitis and from fair to very good (κ 0.36–1) for detecting signs consistent with endodontic disease, in the whole mouth.ConclusionPerforming both CT and intraoral radiography may be unnecessary to detect signs consistent with periodontitis and endodontic disease in dogs based on the amount of agreement between modalities and observers when CT images are acquired and reconstructed in 0.5 or 1 mm slice thickness, except for diagnosing periodontitis in the mandibular incisors.
A 7-year-old 15.9-kg (35-lb) castrated male Cocker Spaniel was referred to the dentistry and oral surgery service of a veterinary teaching hospital for evaluation of a mass on the caudal aspect of the right mandible. The clients first noted the mass approximately 3 weeks prior to referral. Clinical manifestations associated with the mass included halitosis; the patient was reported to have no other clinical signs. The pertinent medical history was unremarkable except for mitral valve disease with no overt clinical signs. The pertinent dental history consisted of extraction of the right mandibular fourth premolar and second molar teeth because of a suspected odontogenic infection 2 months prior to referral. No intraoral radiographs had been obtained at that time. The patient developed substantial halitosis after the extractions were performed.At the time of examination at the referral hospital, the patient was bright, alert, and responsive. Heart rate, respiratory rate, and body temperature were within the respective reference ranges. Thoracic auscultation revealed a grade II/VI systolic heart murmur consistent with previously diagnosed degenerative mitral valve disease and no signs of congestive heart failure. The patient appeared otherwise systemically healthy. Routine clinicopathologic testing was performed, including a CBC and serum biochemical analysis, and 3-view thoracic radiographs were obtained; no clinically important abnormalities were identified. Oral examination of the conscious patient revealed several missing teeth including those previously extracted, generalized calculus, and mild to moderate generalized gingivitis. A firm, approximately 10 X 30-mm expansile mass was palpable on the caudal ventral aspect of the right mandible. Palpation elicited signs of pain from the patient. Severe halitosis was appreciated during examination. Mild right mandibular lymphadenomegaly was noted on palpation.The dog was anesthetized, and a complete oral examination including periodontal probing and charting was performed. Relevant clinical findings included moderate generalized plaque and calculus accumulation, moderate generalized gingivitis, and exposed alveolar bone at the distal aspect of the right mandibular first molar tooth. Fullmouth intraoral radiography was performed with a standard technique 1 (Figure 1).Determine whether additional studies are required, or make your diagnosis, then turn the page → Figure 1-Images of a 7-year-old 15.9-kg (35-lb) castrated male Cocker Spaniel referred for evaluation of a caudal right mandibular mass. A-Clinical photograph of the right mandibular first molar tooth. B-Intraoral radiograph of the caudal aspect of the right mandible obtained by use of a standard parallel technique.
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