Abstracts for 41:1 (January 2024)

Alexandra L. Wright, Nadine Fiani, Santiago Peralta, Manish Arora, and Christine Austin

Microspatial distribution of trace elements in feline dental hard tissues: early life exposure to essential and toxic elements. Front Vet. Sci. 2023:10.

Introduction: Trace elements play a key role in dental tissue development, as dental hard tissues accumulate both essential and toxic trace elements during mineralization. Characterization of the spatial accumulation pattern of trace elements may provide insight into exposure to toxic elements over time and to the nature of disease processes affecting the hard dental tissues. Here, we present the first report of the use of laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) to map the microspatial distribution of multiple trace elements, essential and toxic, across feline dental hard tissues. Methods: Eleven teeth were extracted from 8 cats. Nine teeth were from 7 cats diagnosed with idiopathic tooth resorption on intraoral radiographs prior to extraction. Two teeth were included from a cadaver that had no signs of tooth resorption on intraoral radiographs. The normal dental tissue was analyzed from each sample using LA-ICP-MS to map the microspatial distribution of essential and toxic trace elements across feline enamel, dentin, and cementum. Results: Results showed a higher accumulation of barium and strontium in coronal dentin as compared to root dentin. The timing of the accumulation mirrors nursing timelines seen in teeth from human and nonhuman primates, consistent with barium and strontium being sourced from maternal milk. Results also showed a higher uptake of lead in the coronal dentin, suggesting this lead exposure was likely passed from mother to offspring. Discussion: This work characterizes a baseline for elemental distribution in feline teeth linked to early life exposure to toxic elements such as lead and provides a framework for future studies investigating long-term environmental exposures to trace elements, essential and toxic, and their involvement in feline systemic and dental diseases.

Leah Taylor, Lan Lui, and Stephanie Goldschmidt

Success of orthodontic treatment of linguoverted mandibular canine teeth using a direct inclined plane appliance. Front Vet Sci. 2023:10.

This study evaluated the success rate of orthodontic treatment of linguoverted mandibular canines in dogs using a directly applied inclined plane device. Medical records were retrospectively evaluated at 11 veterinary dental specialty hospitals from 1999 to 2021. Malocclusion classes included 41.7% in class 1, 47.2% in class 2, 6.9% in class 3, and 4.2% in class 4. The severity of linguoversion was mild in 7.6% of teeth, moderate in 33.9%, and severe in 58.5%. There was complete resolution of linguoversion in 71.2% of teeth, functional resolution in 25.4%, and failure in 3.4%. The median treatment time was 42 (11–174) days. Adjuvant orthodontic treatments were performed at the same time as the inclined plane in 45.7% of teeth, including active force orthodontics, extractions of nonstrategic teeth, gingivectomy, and odontoplasty. While the inclined plane was in place, 31.4% of dogs required an anesthetized appliance adjustment, and at the time of appliance removal, complications occurred in 19.4% of dogs. Of the teeth that had an initial resolution, 14.4% had rebound movement that required additional treatment. This study supports the idea that an acrylic inclined plane is a good treatment option for linguoverted mandibular canines, with a 96.6% success rate within a median of 6 weeks. Yet, orthodontic retention may be necessary in these cases to avoid the need for additional therapies.

Chun-Geun Kim, Ga-Won Lee, and Heemyung Park

Ghost cell odontogenic carcinoma in a dog: diagnostics and surgical outcome. Front Vet Sci. 2023:10.

A 6-year-old spayed female Poodle presented with a mandibular mass. Radiographic examination revealed osteolysis from the right mandibular canine to the fourth premolar, along with horizontal bone loss and dorsal displacement of the right mandibular first and second premolars. Skull cone beam computed tomography revealed osteolysis at the level of the right mandibular canine and fourth premolar. A destructive bone lesion was observed in the apical area of the right mandibular canine, with mass invasion of the interradicular bone of the right mandibular first molar near the mandibular canal. Consequently, unilateral total mandibulectomy and skin flap surgery were performed. Histopathological examination revealed poorly demarcated and infiltrative neoplastic epithelial cells that formed small islands and trabeculae. Neoplastic cells exhibited the malignant features of cytological atypia and high mitotic activity. Furthermore, the neoplastic epithelial cells frequently showed ghost cell changes and were diagnosed as ghost cell odontogenic carcinoma (GCOC). The dog was followed up for 1 year, during which no severe complications or local recurrence was observed, except for slight mandibular drift, tongue protrusion, and drooling. This case report describes the clinical features, diagnostic imaging, and histologic features of an unreported GCOC in a dog and the favorable outcome following surgical resection.

Kehn E. Yapp, Mo’ayyad Suleiman, Patrick Brennan, and Ernest Ekpo

Periapical radiography versus cone beam computed tomography in endodontic disease detection: a free-response, factorial study. J Endodod. 2023;49(4):419–429.

Aim: To assess and compare reader performance in interpreting digital periapical (PA) radiography and cone beam computed tomography (CBCT) in endodontic disease detection, using a free-response, factorial model. Materials and Methods: A reader performance study of 2 image test sets was undertaken using a factorial, free-response design, accounting for the independent variables: case type, case severity, reader type, and imaging modality. Twenty-two readers interpreted 60 PA and 60 CBCT images divided into 5 categories: diseased-subtle, diseased-moderate, diseased-obvious, nondiseased-subtle, and nondiseased-obvious. Lesion localization fraction, specificity, false positive (FP) marks, and the weighted alternative free-response receiver operating characteristic figure of merit were calculated. Results: CBCT had greater specificity than PA in the obvious nondiseased cases (P = .01) and no significant difference in the subtle nondiseased category. Weighted alternative free-response receiver operating characteristic values were higher for PA than CBCT in the subtle diseased (P = .02) and moderate diseased (P = .01) groups with no significant difference between the obvious diseased groups. CBCT had higher mean FPs than PA (P < .05) in subtle diseased cases. The mean lesion localization fraction in the moderate diseased group was higher in PA than in CBCT (P = .003). No relationships were found between clinical experience and all diagnostic performance measures, except for in the obvious diseased CBCT group, where increasing experience was associated with mean FP marks (P = .04). Conclusions: Reader performance in the detection of endodontic disease is better with PA radiography than CBCT. Clinical experience does not impact upon the accuracy of interpretation of both PA radiography and CBCT.

Natali Nunez, Ozge Erdogan, Sharon M Casey, Reinaldo Hernandez, Summer Tan, and Jennifer L Gibbs

Elevated cytokine levels in gingival crevicular fluid of teeth with apical periodontitis. J Endodod. 2023;49(6):657–663.

Introduction: Biomarkers assayed from gingival crevicular fluid (GCF) are a potential tool for endodontic diagnosis and for monitoring treatment response. This cross-sectional study measured cytokines in GCF from teeth with apical periodontitis and evaluated their relationship with preoperative pain and other clinical findings. Methods: Participants presenting for root-end resection surgery due to apical periodontitis diagnosis (n = 56) underwent standardized clinical testing and completed preoperative questionnaires. GCF from diseased and control teeth were collected, processed, and analyzed. Mann-Whitney U and Wilcoxon tests were used to examine the cytokine levels in diseased compared to healthy control teeth. We also assessed the relationship of cytokine levels with clinical findings. Results: Interleukins (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, interferon-γ, and tumor necrosis factor-α (TNF-α) were detected in GCF. TNF-α levels were significantly higher in GCF collected from diseased versus control teeth (P = .02) and increased IL-1β levels in diseased teeth were detected (P = .06). Lower IL-10 levels were observed in teeth with a sinus tract and/or swelling compared to teeth without a sinus tract and/or swelling (P = .08). Cytokine levels did not clearly relate to the presence of pain. Conclusions: Elevated levels of proinflammatory cytokines, including TNF-α and IL1- β, were detected in GCF from diseased teeth compared to the healthy controls. Additional studies are needed to further investigate the utility of these biomarkers for objectively evaluating periradicular pathology.

Claudia Azucena Palafox-Sanchez, Alvaro Cruz, Diana Celeste Salazar-Camarena, et al.

Evaluation of serum levels of cytokines in acute apical abscess: a longitudinal observational study. J Endodod. 2023;49(9):1090–1098.

Introduction: Cytokine levels are related to the etiopathogenic of acute apical abscesses (AAA); however, the specific cytokine profiles in these cases are unclear. This study aimed to investigate the changes in systemic cytokine levels in patients with AAA and trismus onset, postantibiotic treatment, and postroot canal disinfection. Methods: In total, 46 AAA patients with trismus and 32 control subjects were included. After 7 days of antibiotic therapy, root canal disinfection was performed in the AAA patients. The serum levels of cytokines were evaluated at basal, 7, and 14 days after endodontic treatment. Quantification of cytokines from T helper (Th) 1, Th2, Th17, and regulatory T cells profiles was determined using the BioPlex MagPix system, and the obtained data were analyzed using SPSS statistical software (P < .05). Results: AAA patients showed higher tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, and IL-10 levels than control subjects, at basal measurement (P < .05); there were similar levels of interferon gamma, IL-1β, IL-4, and IL-17 between groups (P > .05). IL-6 and IL-10 levels decreased after antibiotic treatment (P < .05), which was also associated with clinical improvement in patients with AAA and trismus. Patients with AAA had a positive correlation with higher serum levels of IL-6 and IL-10. In addition, TNF-α levels decreased only after antibiotic and endodontic treatment. Conclusions: In conclusion, patients with AAA had increased systemic serum levels of TNF-α, IL-6, and IL-10. Moreover, increased levels of IL-6 and IL-10 are associated with acute inflammatory symptoms. However, IL-6 and IL-10 levels decreased after antibiotic treatment, while TNF-α levels decreased after antibiotic and endodontic treatment.

Kittipun Lerdrungroi, Danuchit Banomyong, Kamolthip Songtrakul, Patcharin Porkaew, and Siriruk Nakornchai

Current management of dens evanginatus teeth based on pulpal diagnosis. J Endodod. 2023;49(10):1230–1237.

Introduction: Dens evaginatus (DE) is a dental anomaly with a supernumerary tubercle projection that typically contains dentin and pulp tissue. However, the tubercle projection can fracture, exposing the dentin and potentially the dental pulp, which induces pulpal diseases. Managing DE should be primarily based on the clinical diagnosis of the pulp. Methods: The literature search on prevalence, prophylaxis, and management of dens evaginatus was performed in the PubMed database as well as by manual search, in which the related contents were collected and descriptively analyzed. Results: Of the 264 searched literature, 62 articles were included in this scoping review. The prophylactic management of the tubercle of DE teeth with a normal pulp should be performed as early as possible by the prep-and-fill technique or the reinforcement technique to preserve tooth vitality and continued root development, with the former reported to be superior compared with the latter. Furthermore, DE teeth with reversible pulpitis should be managed with the prep-and-fill technique. For DE teeth with irreversible pulpitis, vital pulp therapy, ie, partial or full/coronal pulpotomy, should be considered when the pulpal inflammation is limited to the coronal pulp to preserve the vitality of the radicular pulp that induces apexogenesis. A pulpectomy should be performed if the pulpal inflammation has progressed into the radicular pulp. For DE teeth with pulpal necrosis (or after pulpectomy) and immature roots, mineral trioxide aggregate apexification or regenerative endodontic procedures are the treatment options. For DE teeth with pulpal necrosis and complete root formation, nonsurgical root canal treatment is the treatment of choice. A flow chart of the decision-making for managing DE teeth based on pulpal diagnosis is proposed. Conclusion: DE teeth should be properly managed, by prophylaxis or treatment, depending on pulpal diagnosis and related factors.

Negin Sadighnia, Farnoosh Arfaee, Azin Tavakoli, Alireza Jahandideh

Dextranase enzyme and Enterococcus faecium probiotic have anti-biofilm effects by reducing the count of bacteria in dental plaque in the oral cavity of dogs. J Am Vet Med Assoc 2023:261(10).

Objective: Periodontal disease is a common clinical complication and has a negative impact on the quality of life and the welfare of companion dogs. Periodontal disease occurs when pathogenic bacteria accumulate in the gingival sulcus, which favors biofilm formation. The oral health of dogs can be significantly compromised by dental plaque accumulation. Thus, this investigation demonstrates the effect of Enterococcus faecium probiotic, dextranase enzyme, and their combination on dental biofilm in the oral cavity of dogs. Animals: The 30 dogs were referred to Polyclinic with no oral ulcers, severe periodontitis, and internal diseases. Procedures: Dextranase enzyme, E faecium probiotic, and their combination were administered in the oral cavity of dogs. Microbiological samples were obtained from tooth surfaces and gums before and after intervention with the substances. Bacterial colonies were enumerated by using a colony counter. Also, Porphyromonas gingivalis hmuY gene expression was evaluated by reverse transcription quantitative real-time polymerase chain reaction (PCR) analysis. Results: The total colony count of the bacterial culture indicated that the dextranase enzyme, E faecium probiotic, and their combination significantly reduced the total bacteria count in the oral cavity. Moreover, in the reverse transcription quantitative real-time PCR analysis it was observed that using the combination of E faecium probiotic and dextranase enzyme decreases the hmuY gene expression of P gingivalis bacteria. Clinical relevance: The results clearly indicated that the dextranase enzyme and E faecium probiotic could be used as preventive agents to reduce oral biofilm in dogs. Furthermore, no side effects were observed while using these substances.