Dental Feature: Extraction of Maxillary Canines

Picture of Cat  

Breed:Domestic Shorthair

Condition:
Alveolar bone expansion and tooth resorption

Oral swelling is often a sign of a much more serious oral condition. This eight-year-old cat was experiencing swelling around the upper maxillary canines. A physical examination revealed multiple tooth resorptions as well as many areas of oral inflammation.

Maxillary swellings around the canine roots
Maxillary swellings around the canine roots
Tooth resorption of the left maxillary third and fourth premolars
Tooth resorption of the left maxillary third and fourth premolars
Tooth resorption of the right maxillary third and fourth premolars
Tooth resorption of the right maxillary third and fourth premolars
Tooth resorption of the left mandibular third premolar
Tooth resorption of the left mandibular third premolar
Tooth resorption of the right third premolar and molar
Tooth resorption of the right third premolar and molar

The cat’s owner consented to a tooth-by-tooth examination under general anesthesia and intraoral dental X-rays in order to determine why the swellings were occurring and how best to treat the issues. To ensure that the cat was a good candidate for anesthesia, blood, urine and EKG tests were performed and chest and abdomen X-rays were taken. The cat’s tests were within normal limits, so an intravenous catheter was placed and preanesthetic medication was administered to allow intubation and general anesthesia.

X-rays under anesthesia revealed alveolar bone expansion (alveolar osteitis). Clinically, this condition presents as bulging alveoli around one or both maxillary or mandibular canines. On X-rays, this lesion appears as bone loss around the root and expansile alveolar bone growth.

X-ray of the maxillary canines and alveolar bone expansion and tooth root resorption
X-ray of the maxillary canines and alveolar bone expansion and tooth root resorption

The patient was also diagnosed with periodontal support loss and Stage 3 tooth resorption of the right and left maxillary third and fourth premolars and left and right mandibular third premolars. Normal periodontal probing depths are approximately 2 mm, but this cat’s probing depths were 12 mm around the right and left maxillary canines.

X-ray of the mandibular canines and incisors showing supereruption and root resporption of the left imaged canine tooth
X-ray of the mandibular canines and incisors showing supereruption and root resporption of the left imaged canine tooth
X-ray of the right mandible showing tooth resorption of the third premolar and molar
X-ray of the right mandible showing tooth resorption of the third premolar and molar

Treatment involved extracting the maxillary canines and other teeth affected with resorption. A wing-tipped elevator was used to excise the periodontal ligament surrounding the maxillary canines. Once sufficiently mobile, the canines were delivered from their alveoli with extraction forceps.

Vertical incisions were made on both sides of the maxillary swellings. A full thickness flap was created, exposing the buccal alveolus with the help of a #2 molt periosteal elevator. A high-speed water-cooled drill loaded with a #4 round bur was used to remove the buccal alveolus. The reflected gingiva was sutured with 4-0 catgut. The teeth affected by resorption were then extracted after exposing the root with a full thickness flap.

Rostral maxilla after removing the canines and alveolar expansion
Rostral maxilla after removing the canines and alveolar expansion
Sutured left maxilla after extractions
Sutured left maxilla after extractions

The patient was fed a soft diet for several days and provided both pain control and antimicrobial medication. The surgical sites were reexamined every two weeks until clinical healing was confirmed.

®/™ Trademarks © The Nutro Company 2017. Other trademarks are property of their respective owners.