CASE QUIZ #32
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What abnormalities are identified during the conscious oral examination in this 10-month-old mixed breed dog?
- The left maxillary 3rd incisor (203) is partially erupted
- The left mandibular canine (304) is in a traumatic malocclusion resulting in trauma to the palate and tooth 203
- Enamel hypoplasia/hypocalcification is present on the premolars and canines.
What are the treatment options for the malocclusion?
a. Extraction of 203 and gingivoplasty to create occlusal space for tooth 304
b. Several orthodontic devices, in sequence, in order to extrude tooth 203 followed by tipping of 304 (a relatively difficult and prolonged treatment).
Treatment, after performing an infraorbital nerve block,included extraction of tooth 203 and gingivoplasty. A #12 fluted bur was utilized to reduce gingiva in the diastema between teeth 203 and 204 in order to create space for tooth 304. Postoperative analgesia is continued for 3-5 days postoperatively as indicated. The enamel defects are treated via odontoplasty (to remove unsupported enamel), sealing with a unfilled resin or appropriate dental sealant, or restoration, as indicated..Composite restorations can be challenging due to the poor quality tooth substance and difficulty in obtaining adequate micromechanical bonding.
The client is counseled to maintain oral hygiene with daily brushing after the surgical sites have healed.
The patient at the 30 day reexamination.