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Soltero-Rivera MM, Nguyen R, Goldschmidt SL, Hatcher DC, Arzi B. Diagnostic yield of dental radiography and digital tomosynthesis for the identification of anatomic structures in cats. Front Vet Sci 2024; 11:1408807. [PMID: 38756522 PMCID: PMC11096483 DOI: 10.3389/fvets.2024.1408807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Digital tomosynthesis (DT) has emerged as a potential imaging modality for evaluating anatomic structures in veterinary medicine. This study aims to validate the diagnostic yield of DT in identifying predefined anatomic structures in feline cadaver heads, comparing it with conventional intraoral dental radiography (DR). Methods A total of 16 feline cadaver heads were utilized to evaluate 19 predefined clinically relevant anatomic structures using both DR and DT. A semi-quantitative scoring system was employed to characterize the ability of each imaging method to identify these structures. Results DT demonstrated a significantly higher diagnostic yield compared to DR for all evaluated anatomic structures. Orthogonal DT imaging identified 13 additional anatomic landmarks compared to a standard 10-view feline set obtained via DR. Moreover, DT achieved statistically significant higher scores for each of these landmarks, indicating improved visualization over DR. Discussion These findings validate the utility of DT technology in reliably identifying clinically relevant anatomic structures in the cat skull. This validation serves as a foundation for further exploration of DT imaging in detecting dentoalveolar and other maxillofacial bony lesions and pathologies in cats.
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Affiliation(s)
- Maria M. Soltero-Rivera
- School of Veterinary Medicine, Veterinary Surgical and Radiological Sciences, University of California, Davis, Davis, CA, United States
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Bartocetti F, Radice M, Simoi AD. Reverse Pedicle U-Shaped Palatal Flap: An Innovative Technique for Repair of Severe Caudal Palatal Defects in Two Dogs. J Vet Dent 2024; 41:58-67. [PMID: 37365864 DOI: 10.1177/08987564231177589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
An acquired palatal defect in dogs is a pathologic condition in which there is communication between the oral cavity and nasal cavities, maxillary recesses, or orbits. Many different causes exist and must be considered. Two dogs were presented for severe palatal defects secondary to a foreign body trapped between maxillary dental arches. Numerous techniques have been previously described to repair palatal defects, and the most appropriate choice is based on the clinical features of the defect and information obtained from advanced diagnostic imaging. Acquired palatal defects are not predictable in shape, size, and location; therefore, although the literature contains many different surgical techniques, these are not always reliable. The aim of this article is to describe an innovative surgical approach to repair severe acquired caudal palatal defects in two different dogs.
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Jung JW, Castejón-González AC, Stefanovski D, Reiter AM. Etiology, clinical presentation, and outcome of temporomandibular joint luxation in cats: 21 cases (2000-2018). Front Vet Sci 2023; 10:1274193. [PMID: 38026672 PMCID: PMC10655099 DOI: 10.3389/fvets.2023.1274193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
This study was performed to report etiology, clinical presentation, treatment, and outcome of temporomandibular joint (TMJ) luxation in 21 cats (2000-2018). TMJ luxation was diagnosed by either dental radiography or computed tomography (CT). Causes for TMJ luxation included altercation with a dog (38%), hit-by-car (19%), unknown (19%), fall (19%), and ran into inanimate object (5%). The most common complication was development of permanent malocclusion (24%), followed by reduced vertical mandibular range of motion (5%). Reduction of TMJ luxation was successful in 94.7% of the cases. Reduction of the TMJ luxation was significantly associated with time from injury to treatment. No other significant associations were observed between cause of injury, type of TMJ stabilization, and outcome. TMJ luxation in cats carries an excellent prognosis with early joint reduction and supportive care. Concurrent dental trauma and maxillofacial injuries are common, and all patients with head trauma must be stabilized and evaluated with a thorough examination.
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Affiliation(s)
- Jin W. Jung
- Tribeca Veterinary Dentistry and Oral Surgery, New York, NY, United States
| | - Ana C. Castejón-González
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Darko Stefanovski
- Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Alexander M. Reiter
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Kling K, Marretta SM. Approach and Interfragmentary Stabilization of Caudal Mandibular Fracture in the Cat. J Vet Dent 2023; 40:81-88. [PMID: 36177536 DOI: 10.1177/08987564221128663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
An approach to caudal mandibular fracture stabilization is described along with three cases wherein the approach was applied in relatively young cats with traumatic mandibular fractures caudal to or involving the mandibular first molar. This approach was well-tolerated and facilitated a quick return to function as supported by minimal or no reliance on esophageal feeding tubes.
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Affiliation(s)
- Katherine Kling
- Veterinary Clinical Medicine, 14589University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Sandra Manfra Marretta
- Veterinary Clinical Medicine, 14589University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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Villamizar-Martinez LA, Ferro DG, Carvalho VG, Ferreira J, Reiter AM. Caudal and middle segmental mandibulectomies for the treatment of unilateral temporomandibular joint ankylosis in cats. JFMS Open Rep 2022; 8:20551169221086438. [PMID: 35386208 PMCID: PMC8978324 DOI: 10.1177/20551169221086438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Case series summary Three cats affected by unilateral temporomandibular joint ankylosis underwent segmental mandibulectomy, while one cat with bilateral ankylosis underwent right temporomandibular joint gap arthroplasty and left segmental mandibulectomy. Minimal intraoperative complications were linked to the segmental mandibulectomies in the cases reported. All cats recovered their ability to open the mouth, and the vertical range of motion was unaltered during the postoperative period. Mandibular drift and dental malocclusion were the main postoperative complications related to the segmental mandibulectomies. Relevance and novel information Surgical excision of ankylotic tissue at the temporomandibular joint region may be technically challenging and associated with severe iatrogenic trauma of surrounding tissues. The results of this case series suggest that middle or caudal segmental mandibulectomy is a safe, feasible and effective surgical procedure to treat unilateral temporomandibular ankylosis in cats and could be considered as an alternative surgical technique to surgical excision of ankylotic tissue at the temporomandibular joint.
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Affiliation(s)
- Lenin A Villamizar-Martinez
- Dentistry and Oral Surgery Service, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Daniel G Ferro
- Dentistry and Oral Surgery Service, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | | | | | - Alexander M Reiter
- Dentistry and Oral Surgery Service, Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Villamizar-Martinez LA, Tsugawa AJ. Diagnostic Imaging of Oral and Maxillofacial Anatomy and Pathology. Vet Clin North Am Small Anim Pract 2021; 52:67-105. [PMID: 34838256 DOI: 10.1016/j.cvsm.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article describes the technical principles and indications for the most often encountered diagnostic imaging modalities in veterinary dentistry and oral surgery; with extensive coverage of intraoral (and extraoral) dental radiographic imaging and interpretation through detailed example figures of common dental and maxillofacial diseases in the dog and cat. Multidetector/multislice computed tomography (MDCT/MSCT) and emergent technologies such as cone-beam computed tomography (CBCT) are presented here in detail. Magnetic resonance imaging (MRI) and diagnostic ultrasound, which are used less frequently, are briefly discussed.
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Affiliation(s)
- Lenin A Villamizar-Martinez
- North Carolina State University College of Veterinary Medicine, Department of Clinical Sciences, 1060 William Moore Dr, Raleigh, NC 27607, USA.
| | - Anson J Tsugawa
- Dog and Cat Dentist, Inc, 9599 Jefferson Boulevard, Culver City, CA 90232, USA
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Aghashani A, Verstraete FJM, Arzi B. Temporomandibular Joint Gap Arthroplasty in Cats. Front Vet Sci 2020; 7:482. [PMID: 32903530 PMCID: PMC7438723 DOI: 10.3389/fvets.2020.00482] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/29/2020] [Indexed: 01/08/2023] Open
Abstract
Temporomandibular joint (TMJ) ankylosis is defined as fibrous or bony fusion of the mandibular head of the condylar process and the mandibular fossa of the squamous part of the temporal bone. Ankylosis of the TMJ may be intraarticular, extraarticular, or both. The objective of this report is to describe the surgical planning, technique, and outcome of gap arthroplasty for extensive TMJ ankylosis in cats. Client-owned cats (n = 7) were examined clinically and surgical planning included the use of cone-beam computed tomography (CBCT) and tridimensional (3D) printed models. In six of the seven cats, temporary tracheostomy intubation was required. Gap arthroplasty included zygomectomy, coronoidectomy, condylectomy, as well as fossectomy (removal of the mandibular fossa of the temporal bone) and was performed using a piezosurgical unit. In all seven cats, gap arthroplasty was performed without surgical complications. In addition, a clinically acceptable mouth opening was achieved in all cases. However, a noticeable mandibular instability was observed. Medium-term follow-up demonstrated acceptable quality of life with one case of recurrence of ankylosis requiring repeated bilateral surgery, and a second case with recurrence of ankylosis not requiring surgical intervention at the time of manuscript preparation. We concluded that TMJ gap arthroplasty in cats is a salvage procedure indicated in cases of severe intraarticular and extraarticular ankylosis. Diagnostic imaging by means of CBCT and 3D printing are essential for precise surgical planning. The use of a piezosurgical unit allows for safe and precise ostectomy. Clinically, despite the resulting mandibular instability, appropriate prehension of food and water was possible.
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Affiliation(s)
- Armeti Aghashani
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Frank J M Verstraete
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
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Berning JA, Snyder CJ, Hetzel S, Sarment DP. Analysis of the Anatomic Relationship Between the Mandibular First Molar Roots and Mandibular Canal Using Cone-Beam Computed-Tomography in 101 Dogs. Front Vet Sci 2020; 6:485. [PMID: 32039247 PMCID: PMC6988828 DOI: 10.3389/fvets.2019.00485] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/09/2019] [Indexed: 11/30/2022] Open
Abstract
The mandibular first molar (M1) tooth of the dog is commonly involved in dental procedures. Tooth roots and the mandibular canal can vary in location, which has not been described on a large scale. The objective of this study was to describe the three-dimensional anatomic relationship of the mandibular M1 tooth roots and the mandibular canal in dogs. Cone-beam computed tomography (CBCT) was used to evaluate the anatomic relationship between the M1 tooth roots and the mandibular canal. CBCT images were collected from 101 canine cadaver heads from a variety of unknown breeds. All skulls used in this study were mesaticephalic, confirmed by facial index calculations. The position of the apex in relation to the mandibular canal and in relation to the buccal and lingual cortices was recorded and analyzed in relation to mandibular bone height: root length ratio. When evaluating the apex in a buccal-lingual relationship, the tooth roots were found to be located closer to the lingual cortex in 73.3% of M1 roots. Tooth root apical positions were found to be symmetric between the right and left side of the mouth in 93% of mesial roots and 95% of distal roots. Apical positions relative to the mandibular canal within the same tooth were found to be consistent in 52% of teeth. Teeth with roots dorsal to the mandibular canal were associated with the largest mandibular bone height: root length ratio. CBCT provides a more precise overview than dental radiographs of three-dimensional anatomy. The tooth root position can be estimated in a clinical setting based on the ratio of mandibular bone height to tooth root length obtained from intraoral radiographs. Understanding the relative location of important anatomic structures is key to avoiding complications associated with various dental procedures. This study has documented that assessing anatomic structures with 2D imaging alone is flawed, and the large majority of dogs have M1 roots closer to the lingual aspect than the buccal aspect of the mandible.
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Affiliation(s)
- Jamie A Berning
- Midwest Mobile Veterinary Dentistry, Dublin, OH, United States
| | - Christopher J Snyder
- Veterinary Dentistry and Oral Surgery, Department of Surgical Sciences, University of Wisconsin-Madison School of Veterinary Medicine, Madison, WI, United States
| | - Scott Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, United States
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