Diagnostic Imaging in Veterinary Dental Practice

Abstract

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.