Medical records and radiographs were retrospectively reviewed over a 3-year period (2012-2015) from dogs presented to a private dental referral practice. Medical records were evaluated for the diagnosis of impacted or embedded teeth. The identified dogs' radiographs were reviewed for the presence of radiographically significant cystic lesions that were associated with the impacted or embedded teeth. Radiographic criteria were established by the authors for the purposes of identifying cystic lesions in dogs of different breeds and sizes, using established indices from human dental pathology as a basis. When histopathology results were available, they were reviewed and reported. In this study, 136 dogs ranging in age from 3 months to 17 years were diagnosed with 213 unerupted teeth during the study period. There were 62 (29.1%) of the 213 radiographically apparent cystic lesions identified based on the criteria proposed in this study. In this study, 146 (68.5%) of the 213 unerupted teeth were identified as mandibular first premolar teeth. Histopathology was obtained on 28 (45.1%) of the 62 diagnosed cystic lesions. Dentigerous cysts accounted for 20 (71.4%) of the 28 cystic lesions. Brachycephalic breeds were overrepresented in this study. Boxer, pug, Shih Tzu, and Boston terrier dogs were most likely to present with cystic lesions associated with unerupted teeth. Seventeen (85%) of the 20 cases with a histopathologic diagnosis of dentigerous cyst were found within these 4 brachycephalic breeds.
Medical records of patients with a histopathological diagnosis of oral osteoma were reviewed for information on signalment, body weight, history, clinical signs, physical examination and diagnostic imaging findings, surgical procedure performed, and histopathologic characteristics. Clinical signs related to the mass were noted in 2 dogs. One mass was documented to have been present for > 3-years, 3 of the masses were noted on physical examination, and 2 masses were noted during professional scaling and survey intraoral radiographs. All six masses had radiographic signs of bone proliferation without bone lysis. One case had radiographic root resorption of adjacent dentition. Four of the masses were classified as central osteoma and 2 were classified as peripheral osteoma based on clinical and radiographic findings. Four masses were treated with excisional biopsy that consisted of wide excision (rostral maxillectomy) [n = 1] and 3 had marginal excisions (en bloc resection) [n = 3]. Two of the masses were debulked with subsequent biopsy. There was no indication of recurrence in the cases with excisional biopsy and minimal progression in the cases that had lesions debulked > 5.5-months following surgery.
An association between unerupted teeth and dentigerous cysts is well known, 1 – 4 however little is known about the presence of disease and histopathologic changes in unerupted teeth without radiographic evidence of cyst formation. Forty-two dogs representing 25 breeds, ranging in age from 5 months to 12 years were selected based on radiographic evidence of an unerupted tooth or teeth, either as a primary complaint or incidental finding. Dogs meeting the study criteria were presented to a private dental referral practice within a period of eighteen months from December 2016 through May 2018. Patients were treated with conservative en bloc resection of the unerupted tooth and overlying bone as well as debridement of any cystic structure and biopsy of the samples collected. Radiographs were evaluated using criteria previously established to assess for evidence of a cyst. 1 , 5 – 7 A total of 68 unerupted teeth were identified; 63 (92.7%) were mandibular first premolar teeth. Of the 63 unerupted mandibular first premolar teeth, 28 (44.4%) had radiographic evidence of a cystic structure. Histopathology revealed that 21 of 28 (75.0%) had evidence of non-keratinizing stratified squamous epithelium consistent with a cyst lining. Of the remaining 35 of 63 (55.6%) mandibular first premolar teeth with no radiographic evidence of a cyst, 27 (77.1%) had no histologic evidence of epithelium associated with the impacted tooth. Notably however, the remaining 8 of 35 (22.9%) unerupted teeth without radiographic evidence of a cyst did have histologic evidence of non-keratinizing stratified squamous epithelium associated with the impacted tooth.
Mesioverted maxillary canine teeth in combination with linguoverted mandibular canine teeth are a common ramification of persistent deciduous maxillary and mandibular canine teeth. Without the physical presence of the mandibular canine teeth, the maxillary third incisor and canine teeth diastemata are frequently narrowed. The creation of normal occlusion requires treatment of all 4 canine teeth; the mandibular canine teeth must be tipped labially and the maxillary canine teeth must be tipped and/or partially translated distally. This case report discusses the novel integration of 2 well-described orthodontic techniques to simultaneously treat both mesioverted maxillary canine teeth and linguoverted mandibular canine teeth, achieving a comfortable, functional occlusion.
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