Journal of Veterinary Dentistry最新文献

Periodontal disease in dogs is common. Client compliance with oral hygiene and oral care for pets is low. The gold standard is annual dental prophylaxis under general anesthesia with imaging followed by home care including daily brushing. Clients should be offered methods to reduce calculus, plaque, gingivitis, and resulting halitosis that are time efficient, cost-effective, and easy to administer between annual preventative dental prophylaxis with the goal to move into maintenance phase of managing periodontal disease. This study aimed to evaluate the efficacy of a honeycomb-shaped dental chew in reducing hardened calculus, plaque, gingivitis, and malodor in client-owned dogs in their normal home environment including various breeds, skull types, ages, and weights. Calculus, plaque, and gingival scores with volatile sulfur compounds readings were performed under sedation and evaluated under general anesthesia after 60 consecutive days of receiving a daily honeycomb-shaped dental chew treat. There was an overall statistically significant percentage reduction of calculus (26.6%), plaque (14.2%), and malodor (46.71%). Gingival scores did not demonstrate statistically significant reduction (0.99%). Use of this honeycomb-shaped daily dental chew significantly reduced calculus, plaque, and associated malodor in dogs when fed consecutively for 60 days.

The objective of this study was to evaluate owner assessment of appetite, demeanor, and mouth soreness following dental extractions in dogs receiving either bupivacaine hydrochloride (BH) or liposomal encapsulated bupivacaine (LEB) for dental blocks. Thirty healthy, adult dogs requiring dental extractions were enrolled in the study. All procedures were completed with dogs under general anesthesia. A non-steroidal anti-inflammatory drug was administered subcutaneously in the preoperative period. Dogs were randomly assigned to receive BH or LEB. An owner assessment to evaluate appetite, demeanor, and soreness of mouth was completed at the end of both the first and second day after discharge from the hospital. The total of the owner assessments for day 1 and both days combined was significantly lower for dogs receiving LEB (P = .007). There were no differences in the number of extractions (P = .21), time from block to evaluations (P = .07), in-hospital pain assessments (P = .99), or number of dogs requiring rescue analgesia (P = .99). This study concluded, dogs that received LEB for dental blocks had improved appetite and demeanor, and reduced soreness of mouth, as evaluated by the owner two days postoperatively, when compared to dogs who received BH.

Dental disease is common in captive-managed macropods, including Bennett's wallabies, and is a significant cause of morbidity and mortality. Dental extractions and debridement of diseased tissue is often necessary for those undergoing treatment for severe dental disease. Regional anesthesia of the dentition is considered standard of care for domestic animals undergoing orofacial surgery, however, it is not routinely performed in macropods due to limited information on dental anatomy and block approaches. Regional block descriptions for the infraorbital, maxillary, inferior alveolar, and mental blocks in domestic dogs and cats were evaluated and adapted for use in Bennett's wallabies based on descriptions of their anatomy and examination of 2 skulls. These approaches were then performed on cadaver heads with iohexol and methylene blue dye, and block placement was assessed on computed tomography scans and by gross dissection. All block approaches described in this study resulted in appropriate placement of regional anesthesia of the dentition in Bennett's wallabies. They can thus be used by clinicians to improve the intra and postoperative pain control of patients and provide a high level of veterinary care.

Pain has been defined as an unpleasant sensory and emotional experience associated with or resembling that associated with actual or potential tissue damage. Pets often experience the same pain as people; however, dental pain is often overlooked, discounted, or unseen/hidden in patients, as the inability to communicate does not negate the possibility that a human or a nonhuman animal experiences pain. This article discusses types of pain and the methods and medications available to treat and prevent oral pain.

The use of proper sedative and regional anesthetic protocols is essential when performing equine dental surgical procedures under standing sedation. The efficacy of the rostral inferior alveolar nerve block via the mental foramen has not been previously studied. Aims of this study included determining the efficacy of the block, investigating whether any region (labial mucosa, alveolar mucosa, or teeth) was more reliably anesthetized, and if differences in efficacy existed between bilateral and unilateral blocks. In this blinded trial, 10 horses each were randomly assigned to receive a left unilateral block, right unilateral block or bilateral blocks and 5 horses were bilateral controls. For unilateral groups, the contralateral side of the horse acted as its own unilateral control. Mechanical nociceptive stimulus methods were used to determine response to stimulus at time points pre-sedation, post-sedation, and post-injection at 10, 30, 60, and 90 min. Results were evaluated in 4 groups: unilateral blocks, unilateral controls, bilateral blocks and bilateral controls. Overall, all groups were significantly less likely to respond to stimulus at time points post-sedation, T10, and T30, whereas only blocked sites were less likely to respond at T60 and T90 compared to pre-sedation. There was no significant difference in response to stimuli of blocked sites between the 3 regions at all time points. Overall, at T60 and T90, blocks produced regional anesthesia in 73% and 55% of sites, respectively. This study demonstrated the equine mental foramen regional nerve block has varied efficacy, producing partial or incomplete regional anesthesia in some cases.

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.