Abstracts

Autologous Conditioned Serum (ACS) as Adjunctive Therapy for Post-Extraction Wound Healing in Dogs

Laura Šakarnytė, Indrė Matsuzaki, Julien Troillet, Modestas Ružauskas

This retrospective study investigated the therapeutic potential of autologous conditioned serum (ACS) as an adjunctive therapy to improve periodontal wound healing after 109, 209 tooth extraction in dogs. Tooth extraction is a common procedure in veterinary dentistry practice with reported complications such as wound dehiscence, delayed healing, alveolar osteitis, and infection. ACS, derived from the patient's own blood, exhibits biologic activity that offers promising potential as an adjunctive therapy to accelerate tissue repair processes. Serum contains biological active components like growth factors and cytokines, that promote cellular activation, angiogenesis, and regeneration.
Data from 20 dogs that received adjunctive ACS treatment were compared to data from 20 dogs that received standard of care. ACS was applied locally to the extraction site via soaked collagen sponges before surgical closure. Pre-and postoperative dental radiography was conducted for all cases. All dogs received caudal maxillary regional block, and were sedated with the same protocol. All surgical sites were closed with 5-0 Poliglecaprone 25. Following the procedure meloxicam was applied orally for 5 days. No antibiotics were administered.
Healing outcomes were assessed retrospectively using the Early Wound Healing Score (EHS) system applied during follow-up examinations on days 3, 7, and 14 post-extractions. Animals with recorded aggression or other behavioral issues were excluded. Analysis revealed that dogs treated with ACS exhibited a significantly improved healing process compared to controls. By day 3, the ACS group showed a 71% increase of EHS from baseline compared to a 47% increase in the control group (p = 0.011, d = 0.79). By day 7, the ACS group’s EHS reached 91% while the control group’s EHS was 78% (p = 0.046, d = 0.81). By day 14, no significant differences between EHS scores were identified. Notably, these improvements were consistent across subgroups, regardless of the dog’s age, weight, breed, feeding type, tooth position or reason for extraction.
Our findings support the hypothesis that autologous conditioned serum facilitates early wound stabilization, resolves inflammation, and accelerates soft tissue regeneration after tooth extraction, eliminating the risk of complications. ACS may represent a valuable addition to minimally invasive regenerative medicine strategies in veterinary dentistry.

Tooth extractions are commonly performed in adult dogs, mostly due to advanced periodontal and/or endodontic disease. Generally, extraction site in dogs is clinically healed within 2-4 weeks. Dehiscence following exodontia is the most common complication in dogs, leading to delayed wound healing and possibly alveolar osteitis. However, there is a surprising lack of detailed literature in veterinary dentistry exploring extraction wound healing complications.
The aims of this prospective study are to evaluate the incidence of wound healing complications associated with extraction sites following permanent tooth extractions in healthy dogs and to investigate potential contributing factors.
Client-owned dogs scheduled for dental extractions due to different reasons are being included in the study. Dogs with underlying diseases and/or undergoing treatments, that could contribute to healing complications, are excluded from the study. All procedures are performed as clinically indicated following contemporary surgical principles, including routine preoperative local nerve blocks. No antibiotics nor antiseptics are used perioperatively. All dogs recieve analgesia as clinically indicated with an in-person clinical re-check scheduled in 10 days after the extraction(s).
A preliminary cohort of 68 dogs was evaluated at this point. In total, 416 teeth were extracted, most commonly due to advanced periodontal disease (79,6%). 173 teeth were removed via closed extraction, while 243 required surgical extraction, corresponding to 150 extraction sites with created mucoperiosteal flaps and varying amount of ostectomy.
Wound dehiscence and wound healing complications following tooth extraction were observed in 25% (17/68) of dogs and at 5.3% extraction sites (17/323). Apart one site (closed extraction), all complications were related to sites where ostectomy was performed. Complications were the most common following extractions due to complicated crown fractures (35.3% of the sites with complications) and complicated crown–root fractures (29.4% of the sites with complication). Although periodontal disease was the leading overall indication for extraction, it accounted for only 17.6% of sites in which dehiscence developed. Dehiscence occurred most frequently at canine teeth extraction sites (29.4%), followed by maxillary fourth premolar teeth sites (23.5%).
Dehiscence/wound healing complications were reported as early as five days post-extraction, but all sites healed without surgical intervention within 2–4 weeks.
Analgesia with an NSAID was prolonged in 4 dogs with dehiscence and a course of an antibiotic was prescribed in 3 of these dogs.
Current findings from this study suggest that wound dehiscence is a relatively frequent complication, particularly associated with the extraction of large periodontally healthy teeth. Conservative approach with medical (mostly pain) management is a viable option in most dogs to address dehiscence of extraction sites.

The aim of this study was to determine the biomechanical strength of two different condylar titanium plating systems (trapezoid and lambda subcondylar plates) in medium to large breed dogs for repair of mandibular condylar fractures under physiologic bite forces. Using a block study design, twelve medium- to large-breed adult dog cadaver heads were used to simulate a mandibular condylar process fracture. The selected implant was applied to the simulated fracture, and the cadavers were loaded in a single-load-to failure test simulating the direction of force of the masseter, temporalis, and medial and lateral pterygoid muscles. All implants failed at simulated bite forces greater than 600N. The mean force to failure was 1006.5 N (344.7) for the lambda plates and 847.8 N (78.0) for the trapezoid plates. There was no statistically significant difference in mean force to failure when comparing the different types of plates. Some degree of screw pull-out occurred in 50% of specimens tested with the trapezoid plates. There was no significant difference in mode of failure between the two groups. The most common mechanism of failure was breakage of the loading apparatus. Both condylar lambda plates and trapezoid plates are able to sustain expected physiologic bite forces in domestic dogs after implantation. There is no significant difference in the force to failure for either type of implant. Based on biomechanical testing, both lambda condylar plates and trapezoid plates are suitable for open reduction and internal fixation of mandibular condylar process fractures in medium to large-breed dogs

Objective - To assess the success rate, and the factors which may affect outcome, of vital pulpotomy in cats.
Design – A retrospective, multicentered study
Methods & Materials - Medical records were collated from several referral practices located in North America and reviewed, noting patient signalment, presenting complaint, materials used, and any intra-operative complications. Radiographs from the time of initial treatment, and those from the last available follow-up were evaluated. Treatment outcomes were categorised as successful, no evidence of failure (NEF), or failure according to the endodontic outcome guidelines established by the European Society of Endodontology.
Results (Preliminary) - At the time of writing, treatment was classified as either successful or no evidence of failure in all teeth (100%), with no teeth exhibiting any evidence of failure (0%) radiographically.
Conclusions - Vital pulpotomy in cats appears to have a high success rate when utilising either mineral trioxide aggregate or bioceramic material as a direct pulp capping agent. Vital pulpotomy is a suitable treatment for pulp exposure during crown reduction, and in cases of recent fracture, in the canine teeth of cats. Further studies, ideally prospective in nature, with a larger sample size, and long-term follow-up are required.

Vital pulp therapy (VPT) is an established treatment in human and canine dentistry, but evidence in feline patients remains limited. At DentalVets, we have collected and reviewed a case series of nearly 20 cats treated with VPT for complicated crown fractures and other pulp exposures. Each case was managed using a standardized protocol, and follow-up periods range from 4 months to over 2 years.

This presentation will share the preliminary results of an ongoing retrospective study, focusing on clinical and radiographic outcomes, treatment indications, materials used, and long-term tooth vitality. Cases include both young and adult cats, and follow-up data have been collected through routine rechecks and dental imaging.

The goal of this work is to assess the viability and predictability of VPT in feline patients and to help define its role in feline dentistry. This presentation will be of particular interest to general practitioners, residents, and specialists seeking evidence-based approaches to preserving pulp vitality in cats.

Congenital secondary cleft palate is a common developmental abnormality affecting various dog breeds. Due to the large oro-nasal communication, affected puppies are prone to malnutrition, aspiration pneumonia, and early mortality without supportive care and eventual surgery. Computed tomography (CT) is an invaluable tool in orofacial cleft diagnosis, which helps to evaluate the extent of the fissure and any potential co-morbidities that may affect the skull. Selective tooth extractions, performed typically 6-8 weeks before definitive surgical repair of secondary cleft palate, can enhance the available soft tissues, thereby increasing the chances of a successful defect closure. The overlapping flap technique is one of the surgical methods described for closure of secondary cleft palates in dogs, used especially in cases of wide defects, providing a robust closure.
The lecture will discuss the results of a retrospective case series assessing the outcomes of congenital secondary cleft palate repair and cleft morphology (based on clinical photographs and CT scan images) in ten client-owned dogs using the overlapping flap technique with or without prior selective tooth extractions, treated between 2015 and 2025 at Easctott Veterinary Referrals.

Oral squamous cell carcinoma (OSCC) is the most common oral malignancy of epithelial origin in dogs, representing ~6% of all cancers in this species. Current standard of care consists of wide-margin surgical excision in eligible patients according to stage of disease. Although long-term remission can be achieved, surgery is invasive and results in varying degrees of dysfunction. We have previously shown that the MAPK pathway is hyperactivated in canine OSCC, and that oral administration of the small-molecule inhibitor trametinib can significantly reduce local tumor burden in some patients and represents a clinically applicable neoadjuvant strategy. However, not all tumors are sensitive to trametinib, and the response appears to be at least partially dependent on the presence of specific underlying somatic variants including the well-known MAPK pathway-activating BRAF V595E mutation. These observations suggest that tumors that carry wild-type BRAF alleles likely harbor oncogenic mutations in genes that dysregulate other pathways not inhibited by trametinib, or that confer tumor cells the ability to evade MAPK-pathway inhibition. However, the mutational landscape of OSCC has not been thoroughly investigated, and it remains unknown whether other somatic mutations underlie the apparent oncogenic signaling heterogeneity. In this study, we investigated the somatic mutational landscape of canine OSCC by performing high-coverage whole-genome sequencing of OSCC tumor tissues compared with matched blood-derived germline DNA from 15 dogs known to be sensitive (n=6) or resistant (n=9) to trametinib. Results confirmed the presence of BRAF V595E alleles in most responders, and showed that canine OSCC is genetically heterogeneous, that non-responder dogs have a higher somatic mutational burden compared to responders, and that somatic mutations predicted to have a deleterious effect are relatively common in genes such as TP53, CDH10, HRAS, and FAT2, among others. A larger cohort tied to clinical outcomes, complemented with transcriptional and functional data, will help identify other molecular vulnerabilities and ways to more robustly stratify dogs considered potential candidates for targeted interventions.

Cannabinoid receptors 1 (CB1R) and 2 (CB2R) are integral components of the endocannabinoid system and play key roles in modulating immune responses and tumor progression. The orphan receptor GPR55, sometimes referred to as a “third cannabinoid receptor,” has been increasingly implicated in oncogenesis, being associated with pro-proliferative and pro-metastatic signaling. Canine oral melanomas, particularly the amelanotic subtype, are highly aggressive and share biological similarities with human mucosal melanomas, making them valuable spontaneous models for translational research.
AIMS:
To assess the immunohistochemical expression of CB1R, CB2R, and GPR55 in canine amelanotic oral melanomas.
METHODOLOGY:
Twenty samples of canine oral amelanotic melanomas were analyzed. Indirect immunohistochemistry was performed using anti-CB1R (Origen®), anti-CB2R (Abcam®), and anti-GPR55 (Abcam®) antibodies, diluted 1:100, 1:200, and 1:200, respectively. Mucosa epithelium served as internal positive controls. Receptor expression in neoplastic cells was semi-quantitatively scored on a scale from 0 (negative) to 3 (strong) by three independent blinded observers.
RESULTS:
CB1R expression was absent or minimal

Medication Related Osteonecrosis of the Jaw (MRONJ), also referred to as Antiresorptive Agent Related Osteonecrosis of the Jaw (ARONJ) and formerly known as Bisphosphonate Related Osteonecrosis of the Jaw (BRONJ), is a rare but intractable disease in humans linked with long term use of potent antiresorptive medications, such as bisphosphonates (BP) and denosumab, and angiogenesis inhibitors. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has preferred the term “medication related osteonecrosis of the jaw” (MRONJ) to include other antiresorptive and antiangiogenic drugs that have also resulted in necrosis of the mandible, maxilla or both. This talk will discuss salient aspects of medication related osteonecrosis of the jaws in cats, specifically bisphosphonate related osteonecrosis of the jaw. Though more commonly published in human literature, this presentation is rare in cats.

Referring to recently published study of 20 cats with MRONJ, learning objectives of this lecture include discussing MRONJ in cats (and humans) and how this disease is thought to occur, and then highlighting presenting concerns, clinical findings, risk factors, diagnoses, interventions, outcomes (including adverse events), and follow-up that can aid in improved prognosis for cats with MRONJ. Given the limited literature in veterinary patients, discussion about MRONJ in humans will be included, where relevant.

The aforementioned case series revealed that cats with feline idiopathic hypercalcemia treated with bisphosphonates (alendronate) may be at a risk for development of MRONJ, a serious oral condition with significant morbidity. Prior dental extraction sites in patients concurrently treated with bisphosphonate medications were often associated with MRONJ lesions. Therefore, any needed dental surgery should be performed prior to the use of bisphosphonates where possible. Diagnosis of MRONJ was made by a correlation of diagnostic findings and patient history. No single diagnostic, or combination was pathognomonic for lesion diagnosis. As well, there were no statistically significant associations between patient variables assessed and the overall patient outcome.

Given the serious morbidity of this disease, and its rarity in the literature, the hope is that this talk will bring light to MRONJ diagnosis and treatments in cats, to ensure appropriate monitoring, client discussion, diligent follow-up and rapid diagnosis and treatment, if a lesion is to ensue.

References:

1. Hatunen SL, Anderson JG, Bell CM, Campos HC, Finkelman MD and Shope BH (2024) A retrospective case series on bisphosphonate related osteonecrosis of the jaw in 20 cats. Front. Vet. Sci. 11:1436988. doi: 10.3389/fvets.2024.1436988
2. Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. American Association of Oral and Maxillofacial Surgeons’ position paper on medication-related osteonecrosis of the jaws—2022 update. J Oral Maxillofac Surg. (2022) 80:920–43. doi: 10.1016/j.joms.2022.02.008
3. Stepaniuk K. Bisphosphonate related osteonecrosis of the jaws: A review. J Vet Dent. (2011) 28:277–81. doi: 10.1177/089875641102800413
4. Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi S, Soen S, et al. Antiresorptive agent-related osteonecrosis of the jaw: position paper 2017 of the Japanese allied committee on osteonecrosis of the jaw. J Bone Min Metab. (2017) 35:6–19. doi: 10.1007/ s00774-016-0810-7