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Discussion on Research Summary: Treatment of Infected Cheek Teeth
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Moderator:
DrO
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Posted on Wednesday, Nov 12, 2008 - 8:47 am:
If I read this summary correctly, the infected tooth was accessed via a hole made in the skull so that the apex (bottom) of the infected tooth root could be removed, the pulp canals filed, cleaned, and then filled. The procedure can save teeth that would otherwise have to extracted but at this time only has a fair prognosis of success.
DrO
Vet J. 2008 Nov 5;
A long-term study of apicoectomy and endodontic treatment of apically infected cheek teeth in 12 horses.
Simhofer H, Stoian C, Zetner K.
Clinic for Large Animal Surgery and Orthopaedics, Department IV, University for Veterinary Medicine, Veterinaerplatz 1, A-1210 Wien, Austria.
The aim of this study was to evaluate the long-term results of apicoectomy and retrograde endodontic treatment in 12 horses with apical cheek teeth infections. The affected apices were removed using a diamond bur mounted on a dental drill, and after pulp removal the root canals were filed with Hedstrom files and then alternately flushed with sodium hypochlorite, hyDrOgen peroxide and alcohol. The pulp canals were dried and filled with endodontic cement and gutta-percha points. An undercut was made in the apical aspect of the root canals that were then sealed with self-curing glass ionomer cement. Follow up information was obtained 38-67 months following treatment and indicated that the treatment had been successful in 7/12 horses (58%), partially successful in 2 horses (17%) and unsuccessful in 3 (25%). With good case selection, apicoectomy can preserve a proportion of apically infected cheek teeth. The use of advanced imaging techniques and improved surgical techniques could increase the success rate.
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Member:
paul303
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Posted on Monday, Nov 24, 2008 - 1:31 am:
You read this exactly right, Dr.O. I've had this procedure done ( Lee vs. a pogo stick many, many years ago )myself. I believe that healing could be optimized by taking the affected tooth out of occlusion ( slightly ) by the use of power instruments immediately following surgery. I believe that the post-op swelling ( slight as it is ) within the socket puts adverse pressure forces on the periodontal membrane and can cause a loss of attachment fibers. This eventually results in the loss of the tooth. I believe the relieving of the the occlusion will enhance healing of the socket and, if the adjustment is minor, the "bite" will re-establish itself in time.
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Moderator:
DrO
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Posted on Monday, Nov 24, 2008 - 8:54 am:
Thanks for your take Lee and the advice that might improve the prognosis.
DrO
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