Consequences of untreated periodontal disease in dogs and cats

Feasibility of Nanostructured Lipid Carrier Loaded with Alpha-Mangostin and Clove Oil for Canine Periodontal Therapy

Nanostructured lipid carriers (NLC) represent the second generation of nanoparticles, offering numerous advantages over conventional delivery systems. These include improved stability, enhanced drug-loading capacity, and controlled release profiles, making them highly attractive candidates for a wide range of therapeutic applications. Their suitability for hydrophobic drugs like a traditional medicinal plant of Thailand as clove oil and alpha-mangostin. We investigated into nanostructured lipid carriers loaded with Alpha-Mangostin and clove oil (NLC-AMCO) into the physicochemical and biological characteristics to identify the formulation with the highest efficacy for treatment. The particle size, charge, polydispersity index, and other characterizations were recorded. The realtime ex vivo penetration was explored using canine gingival tissue. Drug sustained release was assessed by HPLC. Moreover, the antibacterial properties were tested by conventional methods. The NLC-AMCO can be stored at up to 40 °C for 60 days without any alterations in particle characteristics. Gingival tissue penetration and sustained drug release were superior compared to unencapsulated counterparts. It exhibited greater effectiveness in inhibiting bacterial growth than the antibiotics tested, particularly against bacteria from the oral cavities of dogs. Therefore, this alternative treatment approach offers cost-effectiveness and ease of administration for pet owners and reduces discomfort for the animals during restraint.

Effect of dental chew on reducing dental plaque, dental calculus and halitosis in beagle dogs

Periodontosis is the most common clinical disease in adult dogs, which is mainly caused by plaque accumulation and seriously endangers the oral health of dogs and even cause kidney, myocardial, and liver problems in severe cases. The aim of this study was to determine the clinical efficacy of dental chew (Cature Brushing Treats product) with mechanical and chemical properties in beagles. The dogs in the experimental group were fed with a dental chew twice a day after meals; The control group had no treatment. Dental plaque was evaluated on the 14th day and 29th day, respectively. The concentration of volatile sulfur compounds (VSC) in the breath and dental calculus were also evaluated on the 29th day. The results showed that there was no significant difference in the indexes of dental plaque on the 14th day. While they had significantly reduced accumulation of plaque (37.63%), calculus (37.61%), and VSC concentration (81.08%) compared to when receiving no chew on the 29th day.

Treatment of an Infrabony Defect of a Maxillary Canine Tooth Using Enamel Matrix Derivatives with Allogeneic Bone Augmentation in a Dog

A 5-year-old Miniature Dachshund was presented having an infrabony pocket on the palatal aspect of the right maxillary canine tooth. The bony defect had worsened despite previous closed root planing and administration of a perioceutic agent. A second surgery using an allogeneic cancellous bone augmentation with an enamel matrix derivative was performed in the infrabony defect following open root planing. Eight months after the periodontal surgery, the osseous defect showed healing by improved periodontal probing measurements and increased radiopacity using dental radiography and computed tomography.

Preliminary evaluation of the impact of periodontal treatment on markers of glycaemic control in dogs with diabetes mellitus: A prospective, clinical case series

BACKGROUND

Periodontal disease (PD) can adversely affect glycaemic control in humans. However, it is unknown if a similar association exists in dogs.

METHODS

Ten client-owned dogs with poorly regulated diabetes mellitus (DM) and PD were prospectively enrolled. A complete blood count, serum biochemistry, urinalysis and measurement of C-reactive protein, interleukin-6 (IL-6), tumour necrosis factor-α, haemoglobin A1c (HbA1c) and fructosamine concentrations were performed before periodontal treatment (PT) and monthly thereafter for 3 months. A periodontal disease severity score (PDSS) was determined during PT. The effects of time post-PT and PDSS on markers of inflammation and glycaemic control were determined by generalised estimating equation analysis.

RESULTS

HbA1c (mean; 95% confidence interval [CI]) decreased 3 months post-PT (32.1 mmol/mol; 21.1-43.1 mmol/mol vs. 44.3 mmol/mol; 36.4-52.0; p = 0.003). PDSS at enrolment was significantly (p = 0.031) positively associated with HbA1c concentration. Due to a significant (p < 0.001) interaction between PDSS and time post-PT in the analysis of fructosamine, dogs with low (1-3) PDSS and high (7-9) PDSS were analysed separately. Fructosamine (mean; 95% CI) significantly decreased 1 month post-PT (570 μmol/L; 457-684 μmol/L vs. 624 μmol/L; 499-748; p = 0.001) in the high PDSS group but not in the low PDSS group. Fructosamine concentration upon enrolment and PDSS were correlated (r = 0.73, p = 0.017). IL-6 concentration significantly decreased 3 months post-PT (9.9 pg/mL; 8.5-11.3 pg/mL vs. 11.2 pg/mL; 9.7-12.7; p = 0.002).

LIMITATIONS

Limitations of the study included the small number of dogs, the lack of a control group and the inability to assess PDSS during follow-ups.

CONCLUSIONS

These findings support a potential detrimental interaction between PD and DM. The apparent beneficial effect of PT on markers of glycaemic control was most conspicuous in dogs with more severe PD.

Effectiveness of silver diamine fluoride 38% on reduction of gingivitis in dogs: a randomized clinical trial

Introduction

Periodontal disease is a ubiquitous disease in small animal veterinary medicine. Currently regular professional dental cleaning and daily tooth brushing are considered gold standards in the prevention of periodontal disease. Efforts to find a noninvasive, cost effective and easy to use preventative for periodontal disease are ongoing. The primary objective of this double-blind randomized clinical trial was to determine if a single application of silver diamine fluoride (SDF) 38% on the buccal surface of all teeth would reduce gingivitis within 3 months in dogs with stage two periodontal disease.

Methods

Twenty-nine client-owned dogs 3-12 years old, 6-35 pounds were randomized 1:1 into active and placebo-control groups. Both groups underwent a baseline treatment and a three-month follow-up under general anesthesia. Gingival Index (GI), Plaque Index (PI), and Calculus Index (CI) were assessed and recorded at each event.

Results

A single application of SDF 38% did not significantly lower GI relative to the control group. However, the GI score dropped significantly in both groups relative to baseline, with a 53% reduction in the average GI score for dogs that received SDF 38% treatment and a 44% reduction for dogs that received placebo treatment. There were no differences in PI or CI scores compared to control groups.

Conclusion

Further research is needed to determine if a more frequent application or a longer study duration would yield a different outcome.

Periodontal disease in cats under primary veterinary care in the UK: frequency and risk factors

OBJECTIVES

Periodontal disease is a multifactorial inflammatory disease that can have major welfare implications in cats. This study aimed to report the frequency and demographic risk factors of periodontal disease and to explore associations with common comorbid disorders in cats in the UK.

METHODS

The study included a random sample of 18,249 cats obtained from 1,255,130 cats under primary care during 2019 from clinics participating in the VetCompass programme. All disorders recorded during 2019 were extracted and reported. Risk factor and comorbid disorder analysis used multivariable logistic regression modelling.

RESULTS

Periodontal disease had a 1-year period prevalence of 15.2% (95% confidence interval [CI] 14.72-15.76). Breeds with the highest prevalence included Siamese (18.7%, 95% CI 12.24-26.72) and Maine Coon (16.7%, 95% CI 11.37-23.18). The median age of cats with periodontal disease (9.47 years, interquartile range [IQR] 5.96-12.97) was higher than for cats without periodontal disease (4.94 years, IQR 1.95-9.51; P <0.001). Increasing adult body weight, increasing age and sex-neuter status were significantly associated with rising odds of periodontal disease. Cats with periodontal disease had a higher median count of comorbid disorders per individual cat (3, IQR 2-4, range 1-14) than cats without periodontal disease (1, IQR 0-2, range 0-15; P <0.001). Cats with periodontal disease had 1.79 times the odds (95% CI 1.62-1.99, P <0.001) of diagnosis with at least one comorbid disorder disease than cats without periodontal disease.

CONCLUSIONS AND RELEVANCE

Periodontal disease is the most common specific diagnosis in cats and is confirmed as a leading health issue in cats. Ageing is identified as the strongest predictor of periodontal disease risk in cats, suggesting the potential for increasing health gains from emphasis on dental care and health in cats as they age. The study offers evidence on a close link between periodontal disease and reduced overall health in cats.

Diagnosis and Management of Furcation Lesions in Dogs - A Review

The furcation is the anatomic area where the roots divide on a multirooted tooth. Periodontal disease causing alveolar bone loss can lead to furcation lesions of various stages. Once furcation involvement has occurred, the area can be more difficult to clean or treat due to the complex anatomy and morphology of furcations. Teeth with short root trunks, longer tooth roots, and roots with wide furcation entrance areas/degrees of separation and wide root divergence are considered better candidates for long term maintenance. Dog teeth possess many of these advantageous anatomic features compared to human teeth. Treatment options for teeth with furcation lesions include: closed debridement, open debridement, furcation plasty, tunneling, partial tooth or root resection, root separation (hemisection or trisection), regenerative therapies, or exodontia. There are many factors to consider in determining treatment options. The favorable and unfavorable characteristics for maintenance of teeth with furcation lesions are summarized. Home care and ongoing professional care are important aspects of periodontal disease control for any patient. Studies of systemic and local antibiotic therapies in human patients have not demonstrated reduction of furcation stages, and probiotic effects at furcation sites have not been specifically examined. Human review studies show that most molar teeth once deemed "hopeless" due to stage 3 furcation lesions can be maintained for at least 5 to 15 years with supportive periodontal therapy. Similar long term studies in dogs are needed to improve the evidence-based management of canine patients with furcation lesions.

World Small Animal Veterinary Association Global Dental Guidelines

Dental, oral, and maxillofacial diseases are some of the most common problems in small animal veterinary practice. These conditions create significant pain as well as localized and potentially systemic infection. As such, the World Small Animal Veterinary Association (WSAVA) believes that un- and under treated oral and dental diseases pose a significant animal welfare concern. Dentistry is an area of veterinary medicine which is still widely ignored and is subject to many myths and misconceptions. Effective teaching of veterinary dentistry in the veterinary school is the key to progression in this field of veterinary medicine, and to the improvement of welfare for all our patients globally. These guidelines were developed to provide veterinarians with the information required to understand best practices for dental therapy and create realistic minimum standards of care. Using the three-tiered continuing education system of WSAVA, the guidelines make global equipment and therapeutic recommendations and highlight the anaesthetic and welfare requirements for small animal patients. This document contains information on common oral and dental pathologies, diagnostic procedures (an easily implementable and repeatable scoring system for dental health, dental radiography and radiology) and treatments (periodontal therapy, extractions). Further, there are sections on anaesthesia and pain management for dental procedures, home dental care, nutritional information, and recommendations on the role of the universities in improving veterinary dentistry. A discussion of the deleterious effects of anaesthesia free dentistry (AFD) is included, as this procedure is ineffective at best and damaging at worst. Throughout the document the negative effects of undiagnosed and/or treated dental disease on the health and well-being of our patients, and how this equates to an animal welfare issue, is discussed.

Prevalence, Radiographic, and Demographic Features of Buccal Bone Expansion in Cats: A Cross-Sectional Study at a Referral Institution

Buccal bone expansion (BBE) refers to bulbous enlargement of the periodontium in domestic cats. The origin of BBE is unknown, and some of its epidemiological, clinical, and radiographic features have not been fully characterized. The purpose of this study was to determine whether specific demographic characteristics are associated with BBE in cats; and whether BBE is associated with other relevant radiographic findings. Pertinent data were collected from archived dental radiographs and electronic medical records of 97 client-owned cats. Results showed that BBE is common in cats presented for evaluation and treatment of dental disease; that breed, sex, and age are not associated with BBE; that BBE is not associated with a pattern of horizontal alveolar bone loss/extrusion or tooth resorption; that a pattern of vertical alveolar bone loss is a typical feature of BBE; and that BBE represents a common cause of canine tooth loss in cats.

Oronasal and Oroantral Fistulas Secondary to Periodontal Disease: A Retrospective Study Comparing the Prevalence Within Dachshunds and a Control Group

The prevalence of oronasal and oroantral fistulas (ONF/OAF) was retrospectively identified in a population of dachshund patients (dachshund group) and was compared to a population of small breed dogs of significantly similar age and weight (control group). When compared with the control group, the dachshund group was significantly more likely to have an ONF/OAF (P < .0001). The odds ratio indicates that dachshunds were 3.3 times more likely to have an ONF/OAF than individuals within the control group. This study statistically confirms previous reports and clinical observations that dachshunds are predisposed to ONF/OAFs. When ONF/OAFs are present, the maxillary canines are the most commonly affected dentition in both study groups.

Periodontal Therapy in Dogs Using Bone Augmentation Products Marketed for Veterinary Use

Periodontal disease is extremely common in companion animal practice. Patients presenting for a routine oral examination and prophylaxis may be found to have extensive periodontal disease and attachment loss. Vertical bone loss is a known sequela to periodontal disease and commonly involves the distal root of the mandibular first molar. This case report outlines two dogs presenting for oral examination and prophylaxis with general anesthesia. Both patients did not have any clinical symptoms of periodontal disease other than halitosis. Both patients were diagnosed with three-walled vertical bone loss defects of one or both mandibular first molars utilizing dental radiography as well as periodontal probing, measuring, and direct visual inspection. These defects were consistent with periodontal disease index stage 4 (>50% attachment loss). The lesions were treated with appropriate root planing and debridement. Bone augmentation products readily available and marketed for veterinary use were then utilized to fill the defects to promote both the re-establishment of normal alveolar bone height and periodontal ligament reattachment to the treated surface. Follow-up assessment and owner dedication is critical to treatment outcome. Both patients' 6 mo follow-up examinations radiographically indicated bone repair and replacement with visible periodontal ligament space.

Reduced Dental Plaque Formation in Dogs Drinking a Solution Containing Natural Antimicrobial Herbal Enzymes and Organic Matcha Green Tea

The results of an exploratory, multicenter clinical study confirmed the hypothesis that a novel, natural, and safe oral care product (OCP) reduced the rate of plaque formation on teeth of dogs consuming the OCP (antimicrobial plant-derived enzymes, organic matcha green tea, cultured dextrose, sodium bicarbonate, and ascorbic acid) compared to controls. Healthy dogs without periodontitis, of varying breeds, sex, and age, were recruited and enrolled, using nonrandomized stratification methods, into a control and treatment groups. Treatment group dogs drank only water into which OCP was suspended, for 28 days. Control group dogs drank their normal household water. On day 0 all teeth were cleaned by a veterinarian and gingivitis was assessed. On days 14, 21, and 28 plaque index, plaque thickness, gingivitis, freshness of breath, and general health were assessed. Over the 28 days of study, dogs on the OCP had significant reduction in plaque index and plaque thickness compared to controls. By day 14 OCP reduced plaque formation by 37%; the 28-day reduction in plaque index and coverage averaged 22% with no measurable gingivitis or calculus. Conclusion. Using the OCP attenuated dental plaque formation when consumed as normal drinking water and in the absence of other modes of oral care.

Comparing Intraoral Radiography and Computed Tomography for Detecting Radiographic Signs of Periodontitis and Endodontic Disease in Dogs: An Agreement Study

OBJECTIVE

To determine whether computed tomography (CT) and intraoral radiography are interchangeable for detecting signs of periodontitis and endodontic disease in dogs.

MATERIALS AND METHODS

An 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.

RESULTS

Agreement 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.

CONCLUSION

Performing 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.