Journal of Veterinary Dentistry最新文献

This article reviews the human and veterinary literature regarding liposome encapsulated bupivacaine use in dentistry and oral and maxillofacial surgery. The purpose of this review is to present available information on this local anesthetic in a manner that will allow veterinary dentists and oral and maxillofacial surgeons to use evidence-based information when considering incorporating liposomal bupivacaine into their practice. The twelve human clinical studies and three veterinary reports that met the literature search criteria do not support the use of liposomal bupivacaine in veterinary dentistry and oral and maxillofacial surgery.

The effects on the stress response, postanesthetic sedation, and altered behavior were evaluated following regional anesthesia and dental treatment in 40 dogs. Serum cortisol and blood glucose concentrations were measured following the administration of levobupivacaine (LBUP) 0.5% and dexmedetomidine (DEX) (0.5 µg/kg) or a placebo. The dogs were randomly assigned to 4 groups of 10 dogs each. All dogs received a regional nerve block using LBUP 0.5%. Group 1 (LBUP + DEX IV) also received DEX intravenously (IV); group 2 (LBUP + PLC IV) also received a placebo IV; group 3 (LBUP + DEX IO) also received DEX in one infraorbital (IO) block; and group 4 (LBUP + DEX IA) also received DEX in one inferior alveolar (IA) block. Serum cortisol and blood glucose concentrations were determined before the administration of oral blocks and at the end of the procedure. Sedation and behavior scores were assessed before premedication and hourly for 6 h after the end of anesthesia. Cortisol concentration did not change in any group at either evaluation time. The glucose concentration was higher (P < .05) only in the LBUP + DEX IA group at the end of the procedure. The sedation score was higher until the end of the observation period only in the LBUP + DEX IV and LBUP + PLC IV groups. No change in behavior score was observed in any of the groups. The reduction of perioperative stress response in all groups was due to the use of LBUP and not DEX.

Maxillary nerve blocks (MNBs) commonly facilitate dental surgeries in standing horses. The goal of this prospective, blinded, cross-over design trial including 15 client-owned horses was to evaluate 3 methods of sensory function testing for confirming a successful MNB. Testing was performed bilaterally before sedation, 5 min after sedation, and 15 and 30 min after MNB with 0.5% bupivacaine and involved a needle prick dorsal to each naris, hemostat clamping of each nostril, and gingival algometry (measuring sensitivity to pain). Responses to stimulation were numerically scored and scores were summed up to a total score. Total score increases on the blocked side by ≥ 2 between baseline and 30 min Post MNB recordings signified a successful MNB. Sedation in the preceding 6 h, presence of sino-nasal disease, side of dental pathology, age, butorphanol administration, and detomidine dosing (µg/kg/min) throughout the tooth extraction procedure were recorded. In 73% of horses, MNB was successful. Sedation in the preceding 6 h (P = .732), age (P = .936), side of pathology (P = .516), and sino-nasal disease (P = .769) were not associated with total scores. Detomidine dosage and butorphanol use did not differ between horses in which the MNB was considered successful and for those in which it was not (P = .967 and P = .538, respectively). Scores obtained with gingival algometry were less closely associated with total scores (rho = .649) than those obtained with needle prick and nostril clamping (rho = .819 and .892, respectively). Therefore, needle prick and nostril clamping are considered the more reliable methods for use in clinical practice to determine the success of an MNB.

Medical and surgical procedures involving the canine maxilla can be painful both during and for several hours post-procedure. The length of this pain may exceed the predicted duration of standard bupivacaine or lidocaine. The goal of this study was to determine the duration and efficacy of sensory blockade of the maxilla produced by liposome-encapsulated bupivacaine (LB), compared to standard bupivacaine (B) or saline (0.9% NaCl) (S), when administered as a modified maxillary nerve block in dogs. Eight maxillae were studied bilaterally from 4 healthy dogs of the same breed and similar age. This prospective, randomized, crossover, blinded study evaluated a modified maxillary nerve block using 1.3% LB at 0.1 mL/kg, 0.5% B, or S at an equivalent volume. An electronic von Frey aesthesiometer (VFA) was used to evaluate mechanical nociceptive thresholds at 4 locations on each hemimaxilla at baseline and at specific intervals up to 72-h post-treatment. Both B and LB treatments resulted in significantly higher VFA thresholds when compared to S. Dogs that received B had VFA thresholds significantly higher than S for 5 to 6 h. Dogs that received LB had thresholds significantly higher than S for 6 to 12 h depending on the site of measurement. No complications were observed. Maxillary nerve block with B provided up to 6 h, and LB 12 h, of sensory blockade depending on the site tested.

This article provides an overview of the neuroanatomy of the head with a detailed explanation and visual images to enable accurate placement of loco-regional nerve blocks to achieve pre-emptive blockade of the nociceptive input which occurs when performing oral surgery. Variations in anatomy and between species are addressed to assist in accurate placement.

Awareness among veterinarians has increased regarding the need for comprehensive pain relief, but many companion animal veterinarians do not administer regional analgesia pre-emptively during dental procedures. The middle mental nerve (MMN) block desensitizes the ipsilateral mandibular incisor and canine teeth as well as soft tissues rostral to the delivery site. There is little published information on the efficacy of the MMN block in dogs. The objective of this study was to determine injectate distribution within the mandibular canal using a radiopaque contrast media/methylene blue solution. Half a milliliter of solution was injected within the opening of the middle mental foramen using a standard hypodermic syringe and a 25G x 25 mm needle. The course of the injectate was traced both via computed tomography (CT) and, in some cadavers, gross dissection. Post-treatment CT revealed that in 90% of the cases, the contrast diffused at least as far caudally as the mesial root of the third premolar tooth. The injectate was not identified within the canal of 5% of cadaveric mandibles examined. Although the solution used diffused caudally within the mandibular canal when injected using recommended clinical techniques, this may not completely represent the extent of clinical effects experienced in live patients. This technique also confirmed that the needle does not need to be advanced into the mandibular canal to achieve adequate diffusion to at least the mesial root of the third premolar tooth.

Masticatory myositis (MM) is an inflammatory myopathy reported in dogs and is characterized by inflammation of the masticatory muscles (temporalis, masseter, and pterygoid muscles). Immunosuppressive therapy is the current recommended treatment for MM and may involve glucocorticoids, cyclosporine, azathioprine, mycophenolate mofetil, leflunomide, or a combination of these treatments that are slowly tapered to the lowest effective dose. However, side effects from multimodal medical therapy and complications associated with MM relapses have been reported. The purpose of this case series was to report oclacitinib as a treatment alternative to traditional medical management of MM. The intent of this alternative is to manage side effects from glucocorticoid use. Oclacitinib (1mg/kg per os q12h) was used solely for treatment of MM in three dogs. The dogs were followed up to >6 months after oclacitinib administration. An increase in oral range of motion, as determined by gape angle, was noted in all three dogs. However, a corresponding drop in antibody titers (2M fiber) did not occur. All dogs showed improvement in overall clinical management of MM, side effects from glucocorticoids, and clinical signs related to chronic prednisone use. Larger controlled trials with consistent measurements (interincisal distance, gape angle) and 2M fiber antibody titers are indicated to further assess validation of oclacitinib treatment of MM. The clinical outcome of all dogs was considered successful.

A 6-month-old intact male Dalmatian mix puppy was presented for the evaluation of left maxillary swelling due to a suspected cyst and an unerupted left maxillary canine tooth. Removal of the unerupted left maxillary canine tooth (204) and enucleation of the cyst was performed, followed by histological analysis, which identified the maxillary swelling to be a cystic ameloblastic fibroma. Ameloblastic fibromas are rare in companion animals, and to the best of the authors' knowledge, this is the first cystic variant reported in dogs. The clinical, radiographic, cone beam computed tomography, and histological findings of this case are discussed and compared with the findings of previously documented human and domestic animal cases.

Mesenchymal stem cells (MSCs) can be isolated from numerous tissues and have the potential for self-renewal and multidirectional differentiation. Evidence is accumulating which suggests that MSCs are also present in the gingival tissue. This study aimed to evaluate the feasibility of collecting, purifying, and amplifying gingival-derived MSCs (GMSCs) from canine gingiva and to obtain GMSC-derived exosomes (GMSC-exo). GMSCs were isolated and cultured; furthermore, cellular immunofluorescence demonstrated that GMSCs possess characteristic MSC markers, and in vitro differentiation was induced, indicating that GMSCs can differentiate into multiple lineages. GMSC-exo was successfully extracted from GMSCs supernatant and found that they exhibit the typical characteristics of exosomes as analyzed by transmission electron microscopy, nanoflow analysis, and western blotting. GMSC-exo promoted the proliferation and migration of Madin-Darby canine kidney cells. It was concluded that canine gingiva is a good source of MSCs. Additionally, GMSC-exo is a potentially promising cell-free therapeutic tool for the treatment of canine gingival diseases.