Clinical success of guided tissue regeneration for treating vertical bone and furcation defects in dogs

This study evaluated the clinical success rate of guided tissue regeneration (GTR) for treating advanced periodontal disease in a large canine cohort. A total of 112 GTR procedures performed from 2003-2021 were retrospectively evaluated, including pre- and post-treatment (3-12 months) periodontal probing depths of 104 treated teeth, dental radiographs of 73 treated teeth, and both diagnostic modalities in 64 treated teeth. Probing depth, radiographically apparent bone height, bone graft material, barrier membrane material, and tooth extraction adjacent to the GTR site were investigated as factors affecting success. Vertical bone defects were evaluated separately from furcation defects. GTR was clinically successful, defined as objective improvement in probing depth, objective decrease in radiographic vertical bone defect, and subjective radiographic gain in bone height in 90.3% of vertical bone defects. Success was significantly associated with the magnitude of initial probing depth and the type of barrier membrane used. GTR was clinically successful, defined as objective improvement in furcation probing and subjective radiographic improvement of the bone in the furcation in 22.2% of furcation defects. When F3 lesions were excluded, GTR was successful in 64.3% of furcation defects. GTR is an appropriate treatment to maintain teeth in the oral cavity of dogs with proper client counseling and patient selection, but it is most likely to be successful in vertical defects.

Revisiting Periodontal Disease in Dogs: How to Manage This New Old Problem?

Periodontal disease (PD) is one of the most prevalent oral inflammatory diseases in dogs. PD onset begins with the formation of a polymicrobial biofilm (dental plaque) on the surface of the teeth, followed by a local host inflammatory response. To manage this disease, several procedures focusing on the prevention and control of dental plaque establishment, as well as on the prevention of local and systemic PD-related consequences, are essential. The removal of dental plaque and the inhibition of its formation can be achieved by a combination of dental hygiene homecare procedures including tooth brushing, the application of different oral products and the use of specific diet and chew toys, and regular professional periodontal procedures. Additionally, in some cases, periodontal surgery may be required to reduce PD progression. Associated with these measures, host modulation therapy, antimicrobial therapy, and other innovative therapeutic options may be useful in PD management. Moreover, PD high prevalence and its relation with potential local and systemic consequences reinforce the need for investment in the development of new preventive measures, treatments, and oral procedures to improve the control of this disease in dogs. Knowledge on the specific guidelines and diversity of the available products and procedures are fundamental to apply the most adequate treatment to each dog with PD.

Treatment of Naturally Occurring Periodontitis in Dogs With a New Bio-Absorbable Regenerative Matrix

Although periodontal disease is one of the most common (oral) diseases in dogs, an effective treatment approach to periodontitis lacks. The aim of this study was to evaluate the safety and efficacy of a regenerative, bio-absorbable implant biomaterial made of medical-grade porcine gelatin, which is cross-linked by transglutaminase into a porous scaffold for the treatment of periodontitis in dogs in a clinical setting. Nine client-owned dogs were included in this multicenter, prospective interventional clinical study. A split-mouth design was used to treat any teeth with periodontitis; teeth on one side of the mouth were treated with open periodontal therapy alone (control teeth) and teeth on the other side were treated with open periodontal therapy and the tested implant (teeth treated with the implant). A recheck under general anesthesia was performed 3 months after the initial treatment and included periodontal probing, dental radiographs, and/or cone-beam computed tomography (CBCT) of the teeth included in the study. This revealed a reduction of the probing depth (PD) at all teeth, but in teeth treated with the implant, a statistically significant improvement (average 2.0 mm) over control teeth (average 1.0 mm) was diagnosed. Similarly, alveolar bone height was increased at most of the teeth, but in teeth treated with the implant, a statistically significant improvement (average 1.26 mm palatally and 1.51 mm buccally) over control teeth (average 0.58 mm palatally and 0.7 mm buccally) was observed for the buccal site. Open periodontal therapy alone improves clinical parameters and alveolar bone height in dogs with periodontitis, which is further significantly improved by the addition of the implant used.

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.

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.

Guided Tissue Regeneration Therapy With Bone Augmentation in a Lingual, Infrabony Osseous Defect of a Mandibular Canine

This case report describes the use of canine demineralized freeze-dried membrane allograft and cancellous bone graft material to treat an infrabony osseous defect along the lingual aspect of a left mandibular canine in a 10-year-old miniature dachshund. Postoperative examination 6 and 12 months postoperatively showed osseous integration at the infrabony defect and improvement in periodontal probing measurements.

Biocompatibility of allogenic canine fascia lata: In vitro evaluation and small case series

OBJECTIVE

To evaluate the biocompatibility of canine fascia lata (FL) in vitro and after FL allograft implantation in dogs with clinical disease.

STUDY DESIGN

In vitro experiment and small case series.

SAMPLE POPULATION

Six dogs treated with allogenic freeze-dried FL.

METHODS

Fibroblasts were cultured on disks of FL, polypropylene mesh (PM; negative control), and porcine small intestinal submucosa (SIS; positive control). Constructs were compared at 3, 7, and 14 days for water content, DNA amounts, scanning electron microscopy, and histology. Records of dogs treated with FL allografts with follow-up examination were reviewed for signalment, indication for surgery, surgical procedure, and outcomes. All owners were invited to complete a standardized questionnaire for long-term follow-up.

RESULTS

Water content was greater in FL and SIS than in PM (P = .03). Fascia lata constructs contained more DNA compared with PM constructs at days 7 and 14 (P < .05), whereas SIS constructs did not differ from FL or PM. Fibroblasts appeared spherical and distributed throughout FL constructs, whereas they appeared stellate and remained on the surface of SIS and PM. Fascia lata allografts were implanted in six dogs with surgical conditions. No incisional complications were noted. All dogs had good to excellent long-term outcomes, except one that experienced recurrence of a perineal hernia 2 years after repair.

CONCLUSION

In vitro, canine FL allowed attachment and proliferation of fibroblasts throughout layers of the graft. Canine allogenic FL was clinically well tolerated in this small population of dogs.

CLINICAL SIGNIFICANCE

Allogenic FL is biocompatible and can be considered an alternative to SIS for soft tissue augmentation in dogs.

Comparison of closed root planing with versus without concurrent doxycycline hyclate or clindamycin hydrochloride gel application for the treatment of periodontal disease in dogs

OBJECTIVE To compare improvements in values for periodontal disease indices in dogs following treatment with closed root planing (CRP) alone, CRP with concurrent 8.5% doxycycline hyclate gel application, and CRP with concurrent 2% clindamycin hydrochloride reverse-polymer hydrogel application. DESIGN Randomized, blinded, controlled clinical trial. ANIMALS 34 client-owned dogs with periodontal pockets measuring 3.5 to 5.5 mm deep. PROCEDURES Dogs were randomly assigned to receive 1 of 3 treatments: CRP alone (n = 10) or CRP plus 8.5% doxycycline hyclate (12) or 2% clindamycin hydrochloride (12) gel applied within the periodontal pockets. Indices of periodontal disease severity were recorded before and 12 weeks after treatment, and outcomes were compared among treatment groups. RESULTS Except for gingivitis index, no significant differences were identified among the 3 treatment groups in the amount of improvement observed in values for periodontal disease indices following treatment. A minor but clinically unimportant improvement in mean gingivitis index values was identified for dogs treated with CRP plus doxycycline gel, which differed significantly from improvements in the other 2 groups. Teeth that were initially more severely affected (pocket depths, 5.0 to 5.5 mm) had the greatest amount of improvement, whereas teeth with only mildly high initial pocket depths (3.5 to 4.0 mm) had less improvement. CONCLUSIONS AND CLINICAL RELEVANCE Overall, addition of doxycycline or clindamycin gel application to CRP for the treatment of periodontal disease in dogs yielded no clinically relevant benefit over CRP during the 12-week follow-up period.

Potential of two delivery systems for nisin topical application to dental plaque biofilms in dogs

BACKGROUND

Periodontal disease (PD) is caused by the development of a microbial biofilm (dental plaque) in the periodontium, affecting approximately 80% of dogs. Several bacterial species present in the canine oral cavity can be implicated in the development of this disease, including Enterococcus spp. To decrease antibiotic administration, a possible control strategy for dog's enterococcal PD may involve the use of the antimicrobial peptide (AMP) nisin. Nisin's inhibitory activity was evaluated against a collection of previously characterized enterococci obtained from the oral cavity of dogs with PD (n = 20), as well as the potential of a guar-gum gel and a veterinary toothpaste as topical delivery systems for this AMP. The Minimum Inhibitory (MIC) and Bactericidal Concentrations (MBC) and the Minimum Biofilm Eradication (MBEC) and Inhibitory Concentrations (MBIC) were determined for nisin and for the supplemented guar-gum gel. For the supplemented veterinary toothpaste an agar-well diffusion assay was used to evaluate its inhibitory potential.

RESULTS

Nisin was effective against all isolates. Independently of being or not incorporated in the guar-gum gel, its inhibitory activity on biofilms was higher, with MBIC (12.46 ± 5.16 and 13.60 ± 4.31 μg/mL, respectively) and MBEC values (21.87 ± 11.33 and 42.34 ± 16.61 μg/mL) being lower than MIC (24.61 ± 4.64 and 14.90 ± 4.10 μg/mL) and MBC (63.09 ± 13.22 and 66.63 ± 19.55 μg/mL) values. The supplemented toothpaste was also effective, showing inhibitory activity against 95% of the isolates.

CONCLUSIONS

The inhibitory ability of nisin when incorporated in the two delivery systems was maintained or increased, demonstrating the potential of these supplemented vehicles to be applied to PD control in dogs.