Abstracts

Tooth extraction is the most common oral surgical procedure performed in human and veterinary dentistry. One possible complication during extraction is root fragment displacement into adjacent anatomical spaces. Root fragment displacement into adjacent anatomical spaces can lead to serious side effects including pain and infection, therefore displaced fragments should be removed when possible. Root fragment removal techniques from the mandibular canal have not been studied in veterinary or human dentistry. A reported complication of dental implant placement in humans is displacement into the mandibular canal, and techniques have been developed to remove these displaced implants. This lecture compares two techniques to remove displaced root fragments from the mandibular canal in canine cadavers based on previously published methods to remove displaced dental implants from the mandibular canal in humans.

Pain of unknown origin in the oral and maxillofacial region is a common clinical problem in veterinary medicine. The differential diagnosis list is extensive and may include periodontal disease, endodontal disease, neoplasia, skeletal abnormalities and trauma, just to name a few.

Positron emission tomography (PET) is most used for oncologic imaging in dogs, however PET is not specific for neoplastic disease. Computed tomography is regarded as the modality of choice for oromaxillofacial imaging in small animals, but only provides structural imaging. The goal of this study was to assess whether the addition of dual tracer PET, using both 18F-Fluorodeoxyglucose (18F-FDG) and 18F-Sodium Fluoride (18F-NaF) to CT would be pertinent for oromaxillofacial imaging in dogs. Eight dogs presenting for assessment of oromaxillofacial pain were prospectively included in this study. Dual tracer PET and CT were performed under a single anesthetic episode using a PET-CT scanner with an extended axial field of view (480 mm). The main abnormalities identified included bilateral TMJ arthritis and coronoid process inflammation, a periapical lesion on the maxillary molar tooth, a deep lingual abscess, pterygoid myopathy and marked inflammation of the oropharynx. Injecting 18F-FDG first was identified as the preferred order, as the presence of marked 18F-NaF uptake in the alveolar bone tends to mask more subtle gingival 18F-FDG uptake. PET was pertinent at clearly identifying margins of inflamed areas and regional variation for assessment of periodontal disease. We conclude that dual tracer PET-CT is suitable as a pertinent imaging modality for advanced characterization of oromaxillofacial disease.

Prevalence of incidental dental disease in rabbits undergoing CT scan for non-dentistry presentations: a retrospective study

Background
Dental disease is common in domestic rabbits and often subclinical. Recent prevalence studies relying on visual or otoscopic examination suggest rates around 15%, but these methods may underestimate disease burden. Computed tomography (CT) provides superior detection of early and occult dental pathology, yet systematic data on incidental findings in rabbits are lacking.

Objectives
To determine the prevalence of incidental dental pathology detected by CT in rabbits undergoing imaging for non-dental conditions, and to assess whether normal visual clinical examinations reliably exclude dental disease.

Methods
Clinical records and head CT scans of rabbits referred to a specialist hospital over a 2-year period were reviewed. Inclusion required CT performed without prior suspicion of dental disease. CT studies were assessed for malocclusion, tooth abnormalities, periapical changes, and bony lesions.

Results
Data collection is ongoing. We hypothesise that a substantial proportion of rabbits will demonstrate CT evidence of dental disease despite unremarkable visual oral examinations.

Conclusion
This study is expected to provide the first CT-based prevalence estimate of incidental dental pathology in rabbits, highlighting the diagnostic limitations of visual examination and informing future screening recommendations.

Objective
The aim of the project was to investigate whether the shedding of the incisor teeth can be used as an evidence based tool to estimate the age of a puppy.
Animals
Owners of puppies with a known and reliable birthdate were asked to send twice a week a frontal viewed picture of their dogs teeth and measure weekly the weight .
Procedures
Data collection started at the age of 10 weeks until the dog has shed all 12 incisor teeth. Dogs were arranged according to the breed and assigned to a weight category.
Results
For the analysis complete data of 629 pups was used. More than one hundred different breeds participated. The shedding process follows a fixed pattern: starts with the mesial-, followed by the middle and ends with the lateral incisors. This is similar for the maxilla and the mandible. Dogs from breeds with higher weights (> 15 kg) start shedding at the mean age of 108 days (15.4 weeks). Dogs with very low weights

Feline chronic gingivostomatitis (FCGS) is an immune-mediated debilitating chronic oral mucosal inflammatory disease in cats. Partial to full-mouth dental extractions remain the treatment of choice, improving quality of life in 60–70% of cases. Refractory cases showing little to no improvement following dental extractions may benefit from immunomodulatory therapy. Oromucosal recombinant feline interferon omega (rFeIFN-ω), cyclosporine, and mesenchymal stem cells have been studied and demonstrated clinical effectiveness. A study has reported the outcome of oromucosal rFeIFN-ω in 39 refractory cases.
This study aimed to assess whether previously reported response rates to oromucosal rFeIFN-ω (~45%) could be reproduced in a larger retrospective cohort of cats with refractory FCGS.
We reviewed the medical record of 162 cats diagnosed with refractory FCGS and treated with oromucosal rFeIFN-ω at our referral hospital between 2010 and 2024. They presented persistent clinical signs and oral lesions after extractions impairing quality of life, with dental radiographs confirming the absence of root remnants. Of the 162 cases identified, 94 were excluded due to deviation from protocol, use of forbidden treatments, or loss to follow-up before 3 months, resulting in a final cohort of 72 cats.
Collected data included age at treatment initiation, viral status (FCV, FHV, FeLV/FIV), pre-treatment bloodwork, and prior therapies. Clinical parameters such as pain-related signs, activity level, body weight, and diet changes potentially linked to oral discomfort were assessed at three time points: at the start and end of treatment, and during post-treatment follow-up. In addition, lesion characteristics — including type, anatomical location, and inflammation scores — were systematically evaluated at the same three time points to document the progression or resolution of the disease. A coding system developed for this study will be used to enhance the assessment of overall clinical outcome and support consistent inclusion or lesion characteristics in the statistical analysis.
Clinical remission was observed in 42% (30/72) of cats with complete outcome data, within 1 to 12 months. Among cats achieving remission, median treatment duration was 3.5 months, mean 4.0 months (range: 1–12). Thirteen cats were followed after the end of rFeIFN-ω treatment for 1 month to 4 years; one showed clinical relapse after one year.
These findings suggest that oromucosal rFeIFN-ω induces remission in a substantial proportion of refractory FCGS cases, with outcomes consistent with prior reports. Among this population, 50% achieved remission within 3.5 months. Ongoing statistical analysis will further assess the significance and predictive value of these outcomes.

Objective: Feline chronic gingivostomatitis (FCGS) is a debilitating condition that often requires full mouth extraction and/or intensive medical management. Despite these interventions, unmet need persists for new therapies.
Hyaluronic acid (HA) has demonstrated therapeutic benefits in analogous human pathologies, such as aphthous ulcers, oral lichen planus, and in furcation defects. A recent pilot study in 16 FCGS patients revealed that 75% of cats improved clinically and on Stomatitis Disease Activity Index (SDAI) scores with topical HA application. Suggesting that HA may be an important new therapeutic option. This second longer-term study seeks to evaluate the efficacy/safety of topical HA for FCGS cats at 7 days, 30 days, and 60 days.
Animals: Felines with confirmed diagnosis of FCGS. Additional inclusion / exclusion criteria:

• Inclusion Criteria:

o Either treatment-naïve or refractory to surgical and therapeutic interventions.
o Owner consent to participate and ability to comply with topical applications and study follow-up.

• Exclusion Criteria:

o Severe systemic illness unrelated to stomatitis.
o COHAT/extractions within 3 months from enrollment.
o Any changes to existing treatment regimen within 1 month from enrollment through study period.
Procedures: After consent and intake demographics, patients are assessed for baseline stomatitis severity via the SDAI scoring system and clinical photographs. Clients are educated on topical application of HA gel, and the first application is placed in the veterinary providers office. Clients are provided HA gel for once-daily home applications through day 60. Patients’ SDAI score is reassessed in office at Day 7, 30 and 60.
Results and Conclusions: The initial HA pilot study of 16 FCGS patients concluded that 75 % (p=.007) of patients improved, there were no adverse effects, and that topical applications was a feasible at-home regimen. This submission is for a trial out to Day 60, with scoring at Day 7, 30 and 60. Full enrollment and analysis are pending with final manuscripts forthcoming once data is collected and evaluated.

Quantitative Light-induced Fluorescence – Extent & Density (QLF-ED) is a dental plaque and calculus objective scoring system designed to be used in VOHC® Seal of Acceptance trials.
Images are taken with a custom-made digital auto-focus camera equipped with both blue light and white light rings (QRayCam Pro). The images are then fed into a proprietary QLF software program (C4 – Inspektor Research Systems, NL) for analysis. Teeth to be scored are digitally contoured, then each 10x10 pixel square on the buccal crown surface of targeted teeth is analyzed for presence of and density of red fluorescence in the blue light image. The result is reported as the percentage of the crown covered by variable thickness plaque or calculus relative to maximum full-crown coverage.
To validate the use of QLF-ED, trials have been run where typical subjective scoring systems (e.g. Modified Logan -Boyce [ML-B] plaque score or Warrick-Gorrel [W-G] calculus score) and QLF images were both scored. The first data were from a dose-response trial; the correlation coefficient ‘r’ values comparing the disclosed subjective and disclosed QLF plaque and calculus scores indicated moderate or strong correlation; these data were based on dogs 21 days after scaling, which is shorter than the minimum required 28 days in VOHC® trials. Recently, additional data were obtained from dogs 30 days following scaling. Some of the teeth were completely covered by plaque, which results in QLF reporting a zero score, rather than 100%. In a previous report of scoring extent of disclosed plaque in dogs by QLF, this zero/100% problem was addressed by exporting the image to PhotoShop to add a white reference spot, then importing the image back into C4. As a result of recent C4 QLF-ED programming work, a one-mouse click reference spot system corrects the zero reports for fully plaque-covered teeth.
QLF-ED is expected to provide a more accurate assessment of plaque and calculus than subjective scores or the simple extent-only plaque QLF score previously described (Wallis et al, 2016), because it combines extent of coverage with fluorescence density (indicative of thickness) on multiple individual sites. The ML-B and W-G scores rely on subjective human eye assessment of coverage on a 0-4 scale and of thickness on a 1-3 scale, with the thickest area being recorded for that tooth.
VOHC® trial requirements include scoring of teeth stained by disclosing solution - scoring undisclosed calculus requires brushing or rubbing away superficial plaque, which would prevent scoring disclosed calculus.
The effect of application of disclosing solution on QLF scores has yet to be fully explored. Does it artificially distort the fluorescence score by augmentation or by creating ‘noise’? If so, scoring undisclosed teeth by QLF would be indicated. To date, while some teeth have been QLF scored for plaque before the disclosing solution is applied, no QLF data have been obtained on undisclosed calculus. Undisclosed plaque in some dogs has been scored, and results will be discussed.

Objectives: This study aimed to evaluate the effect of the buried-knot suture technique on gingival wound healing in cats undergoing dental extractions. We hypothesised that a simple buried-knot interrupted suture would provide a healing advantage at the extraction sites.
Methods: A prospective, randomised, split-mouth design was used, involving 40 cats sequentially included in the study. Each side of the mouth was sutured using simple interrupted sutures, with and without a buried knot. Healing was assessed at 2, 4 and 6 weeks postoperatively through visual inspection of the maxillary sites. Indicators of wound healing, such as swelling, bleeding on inspection, redness of the wound margins, dehiscence, ulceration, exudate, halitosis, pain on palpation, presence of necrotic tissue, flap instability, suture loosening and entrapment of food debris or foreign bodies were recorded.
Results: Although both sutures showed similar mechanical behaviour as assessed through flap stability, dehiscence, suture loosening and the presence of necrotic tissue, the buried-know technique was significantly associated with reduced inflammatory signs, including less swelling, bleeding on inspection, redness of wound margins, ulceration, exudate, halitosis and pain.
Conclusions: The findings suggest that simple interrupted sutures with a buried knot provide a healing advantage in gingival wound closure following dental extractions in cats.