Dental Feature: Flap Surgery


Breed: Afghan Hound

Impacted Tooth Within a Dentigerous Cyst

Dogs should have four teeth (first, second, third and fourth premolars) between the lower canine and first molar. Upon oral examination, this patient was missing the right mandibular first premolar and a significant swelling was present between the right mandibular canine and the second mandibular premolar.

Right mandibular, missing first premolar

Dental radiographs revealed an impacted tooth within a dentigerous cyst. A dentigerous cyst is a lesion that presents in radiographs as a radiolucent halo originating from the neck of an embedded tooth. The cyst is typically lined with stratified squamous epithelium. As the cyst increases in size, it destroys surrounding tissue and alveolar bone.

Radiograph of right mandibular, missing first premolar

This dentigerous cyst occurred as a result of the impacted first premolar. Unfortunately, the cyst was so extensive that it incorporated the second mandibular premolar. Flap surgery was performed by incising caudally from the canine to the second premolar and vertically caudal to the second premolar. This exposed the cyst. The impacted first premolar, cyst wall and the second premolar were removed.

After flap surgery exposure

The cavity was filled with a resorbable bone graft substitute that provided scaffolding for the patient's new bone to grow and repair the defect. The patient was back to chasing and chewing sticks in no time.

Radiograph after extraction and synthetic bone placement

Closure of surgical site

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