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Commonly encountered dental and oral pathologies

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Abstract

This chapter provides information about dental and oral pathologies commonly encountered in cats and dogs, including periodontal disease, gingival enlargement, autoimmune conditions, abnormal number and morphology of teeth, abnormal eruption of teeth, malocclusion, hard tissue defects, tooth displacement, jaw fracture, soft tissue injury, abnormalities of the palate and salivary gland pathology.

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Figures

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5.1 Generalized, marginal gingivitis with mild to moderate plaque and calculus accumulation in a dog. (© Dr Alexander M. Reiter)
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5.2 Gingivitis with mild (arrowheads) and severe (arrowed) gingival recession in a dog with moderate plaque and calculus accumulation. (© Dr Alexander M. Reiter)
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5.3 Periodontitis with severe gingival recession, severe plaque and calculus accumulation, and generalized horizontal alveolar bone loss in a dog. (a) Clinical photograph of the left upper and lower jaw quadrants. Dental radiographs obtained of the left (b, c) upper and (d, e) lower jaw quadrants. (© Dr Alexander M. Reiter)
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5.4 Periodontitis with severe plaque and calculus accumulation, as well as generalized horizontal and vertical alveolar bone loss in a dog. (a, b) Clinical photographs and (c, d) dental radiographs. (© Dr Alexander M. Reiter)
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5.5 Generalized gingival enlargement in a dog. (© Dr Alexander M. Reiter)
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5.6 (a) Occlusal and (b) lateral views of the teeth in a 6-month-old cat with juvenile hyperplastic gingivitis. (© Dr Margherita Gracis)
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5.7 Gingivitis and contact mucosal inflammation (contact mucositis) in a dog. The area of alveolar, labial and buccal mucosa that would be in contact with the plaque-laden tooth surfaces is ulcerated (*). (© Dr Alexander M. Reiter)
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5.8 Moderate stomatitis in a cat with gingivitis, alveolar mucositis and inflammation of the mucosa of the caudal oral cavity (*). Note also the missing incisor teeth, gingival recession at the mandibular canine teeth, and severe plaque and calculus accumulation at the maxillary cheek teeth. The palatal mucosa, however, is devoid of inflammation. (© Dr Alexander M. Reiter)
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5.9 Pemphigus vulgaris in a cat with inflammation of the dorsal surface of the tongue and palatoglossal folds. (© Dr Alexander M. Reiter)
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5.10 Bullous pemphigoid in a dog with inflammation of the (a) mucocutaneous junction and labial/buccal mucosa, (b) mucosa at the transition between the hard and soft palate and (c) dorsolateral tongue surface. (© Dr Alexander M. Reiter)
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5.11 Persistence of multiple deciduous teeth in a young adult dog. Crowding of teeth led to entrapment of debris, plaque and calculus accumulation, and early onset of periodontal disease. (© Dr Alexander M. Reiter)
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5.12 (a) Clinical photograph and (b) dental radiograph showing a supernumerary tooth palatal to the left maxillary fourth premolar tooth in a dog. There was severe bone loss noted upon periodontal probing with discharge of mucopurulent material. (© Dr Alexander M. Reiter)
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5.13 Supernumerary root (S) in between the mesial (M) and distal (D) roots of the right maxillary third premolar tooth (107) in a dog. (© Dr Alexander M. Reiter)
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5.14 (a) Delayed eruption of the permanent left canine (204 and 304) and carnassial (208 and 309) teeth in a young adult dog. (b) The dental radiograph of the unerupted permanent left mandibular first molar tooth shows bony (arrowed) and fibrous (arrowheads) tissue surrounding its crown. Note also the dilaceration (*) at the apex of the distal root of the unerupted tooth. (© Dr Alexander M. Reiter)
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5.15 (a) Clinical photograph and (b) dental radiograph of a dentigerous cyst with significant bone loss between the right mandibular canine (404) and third premolar (407) teeth in an adult dog. The cyst originates from the unerupted first premolar tooth (405). The second premolar tooth (406) is displaced and the roots are partially resorbed by the pressure exerted from the cystic lesion. (© Dr Alexander M. Reiter)
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5.16 (a) Both mandibular canine teeth in this cat appeared unremarkable on clinical oral examination. (b) However, a dental radiograph shows internal resorption (*) of the root of the left mandibular canine tooth. (© Dr Alexander M. Reiter)
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5.17 Stages of tooth resorption. (a) In stage 1, there is mild dental hard tissue loss (cementum or cementum and enamel). (b) In stage 2, there is moderate dental hard tissue loss (cementum or cementum and enamel with loss of dentine that does not extend to the pulp cavity. (c) In stage 3, there is deep dental hard tissue loss (cementum or cementum and enamel with loss of dentine that extends to the pulp cavity); most of the tooth retains its integrity. (d) In stage 4, there is extensive hard tissue loss (cementum or cementum and enamel with loss of dentine that extends to the pulp cavity); most of the tooth has lost its integrity. (i) The crown and the root may be affected equally, (ii) the crown may be more severely affected than the root, (iii) or the root may be more severely affected than the crown. (e) Remnants of dental hard tissue visible only as irregular radiopacities; complete gingival covering. (© AVDC used with permission)
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5.18 Types of tooth resorption. (a) In type 1 resorption, there is a focal or multifocal radiolucency present in a tooth with otherwise normal radiopacity and normal periodontal ligament space. This type is also known as inflammatory resorption. (b) In type 2 resorption, there is narrowing or disappearance of the periodontal ligament space in at least some areas, and decreased radiopacity of the tooth. This type is also known as replacement resorption. (c) Features of both type 1 and type 2 resorption in the same tooth are present in type 3 resorption. A tooth with this appearance has areas of normal and narrow or lost periodontal ligament space, and there is focal or multifocal radiolucency in the tooth and decreased radiopacity in other areas of the tooth. (© AVDC used with permission)
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5.19 (a) Clinical photograph and (b) dental radiograph of inflammatory resorption of the right mandibular cheek teeth and adjacent alveolar bone in a dog. (© Dr Alexander M. Reiter)
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5.20 (a) Clinical photograph and (b) dental radiograph of dentoalveolar ankylosis and replacement resorption (*) of the mandibular canine teeth in a cat. (© Dr Alexander M. Reiter)
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5.21 Clinical photographs of the (a) right and (b) left mandibular canine teeth in a cat and (c) corresponding dental radiograph. Both teeth show significant dentoalveolar ankylosis and replacement resorption. As replacement resorption progressed coronally, a dental defect became apparent at the gingival margin of the labial aspect of the right mandibular canine tooth (arrowed), causing an inflammatory component to join the initially non-inflammatory lesion. (© Dr Alexander M. Reiter)
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5.22 (a) Clinical photograph and (b, c) dental radiographs of the right mandibular teeth in a cat. The crown of the canine tooth has fractured off, leaving an open wound behind (*). There is radiographic evidence of significant root replacement resorption. The first molar tooth shows an obvious defect filled with granulation tissue that manifests radiographically as a spherical lucency (arrowed). There is increased gingival inflammation at the third premolar tooth whose furcation appears to reveal early signs of resorption in addition to loss of periodontal ligament space. (© Dr Alexander M. Reiter)
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5.23 (a) Clinical photograph and (b) dental radiograph of an abnormally extruded right maxillary canine tooth, accompanied by thickening of the alveolar bone (*). (© Dr Alexander M. Reiter)
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5.24 Radiograph of the rostral lower jaw in a cat, showing bilateral alveolar bone expansion (arrowed) on the labial aspects of the canine teeth. The right mandibular canine tooth shows signs of dentoalveolar ankylosis and replacement resorption (*). (© Dr Alexander M. Reiter)
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5.25 (a) The occlusal surface of the right maxillary first molar tooth in a dog shows a dark spot suggestive of caries. (b) This should be examined using a sharp dental explorer. (© Dr Alexander M. Reiter)
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5.26 (a) Clinical photograph and (b) radiograph of the right mandibular first and second molar teeth with carious lesions (arrowed). The second molar tooth shows pulp exposure, and there are subtle signs of periapical lucencies around its root apices (arrowheads). (© Dr Alexander M. Reiter)
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5.27 Tooth abrasion affecting the maxillary incisor and canine teeth in a dog. Note the tertiary dentine on the worn occlusal surfaces of the affected teeth (*) and pulp exposure on the right maxillary canine tooth (arrowed). (© Dr Alexander M. Reiter)
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5.28 Tooth attrition affecting the mandibular incisor and canine teeth in a dog with mandibular mesiocclusion and level bite. Note the exposed and discolored dentine on the worn occlusal surfaces of the affected incisor teeth (*) and the mesial aspects of the canine teeth (arrowed). (© Dr Alexander M. Reiter)
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5.29 Tooth fracture classification. (a) Enamel infraction. (b) Enamel fracture. (c) Uncomplicated crown fracture. (d) Complicated crown fracture. (e) Uncomplicated crown-root fracture. (f) Complicated crown-root fracture. (g) Root fracture. (© AVDC used with permission)
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5.30 Enamel infraction of left maxillary and mandibular canine teeth in a dog. (© Dr Alexander M. Reiter)
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5.31 Enamel fracture of the left maxillary canine tooth in a dog. (© Dr Alexander M. Reiter)
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5.32 Uncomplicated crown fracture of the left maxillary fourth premolar tooth in a dog. (© Dr Alexander M. Reiter)
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5.33 Complicated crown fracture of the left maxillary fourth premolar tooth in a dog. (© Dr Alexander M. Reiter)
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5.34 Uncomplicated crown-root fracture of the left maxillary fourth premolar tooth in a dog. (© Dr Alexander M. Reiter)
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5.35 Complicated crown-root fracture of the left maxillary fourth premolar tooth in a dog. (© Dr Alexander M. Reiter)
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5.36 Metal staining and worn distal surfaces of the mandibular canine teeth in a dog. Note the complicated crown fracture of the right mandibular canine tooth. (© Dr Alexander M. Reiter)
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5.37 Purplish discoloration of the coronal third of the fractured or worn crown of the left maxillary canine tooth in a dog. (© Dr Alexander M. Reiter)
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5.38 (a) Swelling (*) palatal to the left maxillary third incisor tooth that shows a barely visible crown fracture (arrowed). (b) The dental radiograph reveals a well demarcated radiolucency (arrowed) associated with the apex of the left maxillary third incisor tooth (*). (© Dr Alexander M. Reiter)
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5.39 (a) A dog presented with severe, left-sided, periorbital swelling. (b) A standard lateral radiograph of the head was unremarkable. (c) Oral examination revealed a complicated crown-root fracture of the left maxillary fourth premolar tooth (*), resulting in periapical disease that can be noted on (d) dental radiography (arrowed). (© Dr Alexander M. Reiter)
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5.40 Hypercementosis of the mandibular incisor teeth in a dog. Note that the left mandibular second incisor tooth is missing. (© Dr Alexander M. Reiter)
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5.41 (a) Clinical photograph and (b) dental radiograph showing lateral luxation of the right maxillary canine tooth in a cat associated with alveolar bone expansion (*), infrabony pocket formation and abnormal tooth extrusion (double-ended arrows), which are present bilaterally. Incisor tooth root remnants are visible on the radiograph. (© Dr Alexander M. Reiter)
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5.42 Lateral luxation of the right maxillary canine tooth in a cat, causing inability to fully close the mouth. (© Dr Alexander M. Reiter)
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5.43 (a) Clinical photograph and (b) dental radiograph showing intrusion of the right maxillary canine tooth (*) into the nasal cavity of a dog. Only the tip of the crown of the intruded tooth is visible on oral examination. Note also the gingivitis, gingival cleft formation, alveolar bone exposure, and alveolar and labial mucositis. (© Dr Alexander M. Reiter)
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5.44 Favourable mandibular fracture. The arrows represent the forces exerted on the fracture line upon contraction of the masticatory muscles that close the mouth. (© Dr Alexander M. Reiter)
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5.45 Unfavourable mandibular fracture. The arrows represent the forces exerted on the fracture line upon contraction of the masticatory muscles that close the mouth. (© Dr Alexander M. Reiter)
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5.46 Fracture of the left mandible between the first and third premolar teeth in a dog. The second premolar tooth was missing prior to fracture. (© Dr Alexander M. Reiter)
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5.47 (a) Clinical photograph and (b) dental radiograph showing symphysis separation in a cat. (© Dr Alexander M. Reiter)
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5.48 (a) Clinical photograph and (b) dental radiograph showing maxillary fractures in a dog. Note that the left maxillary first incisor tooth (*) has a wider pulp cavity compared with the other incisor teeth, indicating that the loss of pulp vitality is unrelated to the recent motor-vehicle trauma that caused the maxillary fractures. (© Dr Alexander M. Reiter)
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5.49 Ventrodorsal radiograph of a cat showing the left temporomandibular joint area obtained with a dental film and extraoral film placement. There is a fracture of the left zygomatic arch (*) and separation of the left temporal bone from the parietal bone (arrowed). (© Dr Alexander M. Reiter)
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5.50 (a) Extraoral and (b) intraoral bite wounds in a dog. (© Dr Alexander M. Reiter)
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5.51 Proliferative chewing lesions in the left sublingual and buccal mucosa (*) resulting from self-induced bite trauma in a dog. (© Dr Alexander M. Reiter)
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5.52 A wooden foreign body is stuck between the right maxillary fourth premolar and first molar teeth in a dog. (© Dr Alexander M. Reiter)
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5.53 (a) Gunshot trauma causing multiple soft and hard tissue injuries in a cat. (b) Dental radiograph of the rostral lower jaw in the same cat, revealing symphysis separation, parasymphyseal fracture, right mandibular body fracture, fractured teeth and numerous pieces of the impacting projectile. (© Dr Alexander M. Reiter)
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5.54 (a) Entrance wound of a hunting arrow at the dorsum of the nose in a dog. (b) Corresponding radiograph of the head in the same dog, showing the arrow pathway with its remaining carbon-fibre shaft and three-bladed broadhead tip. (© Dr Alexander M. Reiter)
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5.55 Oronasal fistula in the right maxillary canine tooth area of a dog with missing teeth. (© Dr Alexander M. Reiter)
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5.56 (a) Peripheral odontogenic fibroma centred between the left maxillary first and second premolar teeth in a dog. (b) The corresponding dental radiograph shows hard tissue (*) within the soft tissue contours of the tumour (arrowed). The root resorption associated with the first and second premolar teeth (205 and 206) is probably unrelated to the tumour, as it can also be seen on the third premolar (207) which is not affected by the tumour. (© Dr Alexander M. Reiter)
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5.57 (a) Acanthomatous ameloblastoma centred between the left mandibular third incisor and canine teeth in a dog. (b) The corresponding dental radiograph shows displacement of teeth, bone lysis (*) and a sunburst pattern (arrowed). (© Dr Alexander M. Reiter)
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5.58 Severe oral papillomatosis in a geriatric dog with malignant lymphoma treated with chemotherapy. (© Dr Alexander M. Reiter)
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5.59 (a) Clinical photograph and (b) dental radiograph of an osteoma (*) centred over the right maxillary second and third premolar teeth in a dog. (© Dr Alexander M. Reiter)
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5.60 Plasma cell tumour on the dorsal aspect of the tongue in a dog. (© Dr Alexander M. Reiter)
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5.61 Malignant melanoma on the dorsal aspect of the tongue in a dog. (© Dr Alexander M. Reiter)
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5.62 (a) Clinical photograph and (b) dental radiograph of a squamous cell carcinoma affecting the left lower jaw in a cat. Note the resorption of the left mandibular third premolar tooth and bone lysis with transportation of bony spicules to the periphery of the expanding tumour. (© Dr Alexander M. Reiter)
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5.63 (a) Clinical photograph and (b) dental radiograph of a fibrosarcoma affecting the rostral upper jaw in a dog. Note the bone lysis and widening of the interproximal spaces in between the teeth. (© Dr Alexander M. Reiter)
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5.64 (a) Clinical photograph and (b) radiograph of a malignant peripheral nerve sheath tumour affecting the right lower jaw in a dog. Note the bone lysis within the mandibular canal and thinning of the ventral mandibular cortex. (© Dr Alexander M. Reiter)
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5.65 (a) Clinical photograph and (b) radiograph of an osteosarcoma affecting the caudal right upper jaw in a dog. Note the bone lysis of the maxilla (around teeth 108, 109 and 110) and zygomatic arch (*). (© Dr Alexander M. Reiter)
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5.66 (a) Dorsoventral head radiograph and (b) computed tomographic scan of a multilobular tumour of bone affecting the coronoid process of the left mandible (*) in a dog. (© Dr Alexander M. Reiter)
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5.67 Mast cell tumour affecting the (a) right upper lip and (b) tongue in two dogs. (© Dr Alexander M. Reiter)
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5.68 Eosinophilic granuloma affecting (a) the upper lip and rostral soft palate in a cat, (b) the caudal hard palate, tonsillar region, soft palate and palatoglossal folds in a dog, and (c) the lateral aspect of the tongue in a cat. (© Dr Alexander M. Reiter)
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5.69 Pyogenic granuloma (*) near the buccal mucogingival tissues of the left mandibular first molar tooth in a cat. (© Dr Alexander M. Reiter)
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5.70 Erythema multiforme affecting the mucosa of the hard palate in a cat. (© Dr Alexander M. Reiter)
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5.71 (a) Clinical photograph and (b) radiograph of calcinosis circumscripta affecting the apex of the tongue in a young dog. (© Dr Alexander M. Reiter)

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