Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Evelyn Barbour-Hill — Sat, 22 Aug 2015 20:10:42 GMT

[quote user="Suzanne Kelly"]the dog is happier[/quote]

The proof of the pudding.......

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Suzanne Kelly — Sat, 22 Aug 2015 16:38:37 GMT

It's done! We used a flowable composite for the 204 and 104 and fissure sealed the rest. So far so good, the dog is happier and everything seems good 10 days on. Pics attached. Fingers and toes crossed!

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Evelyn Barbour-Hill — Fri, 31 Jul 2015 01:13:23 GMT

[quote user="Suzanne Kelly"]At the risk of sounding supremely ignorant, how will I know if the damage has gone below the gumline? I think her teeth probed relatively ok.[/quote]

Well, I mean by just looking it seems to me that on the 204 the cratery bit goes down to the gum so probably goes below it? If not sure, run explorer down edge of lesion and see where it goes.

[quote user="Suzanne Kelly"]Would I be better off to do full mouth radiographs first and plan the restoration for another day or do it all under the one GA? [/quote]

I'd do as much as possible under the one GA, however long it takes, me.

[quote user="Suzanne Kelly"]Re scaler don't worry, surely it's possible to do damage like that if someone had used the tip and gone a bit heavy handed? [/quote]

Yes, it's possible.

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Suzanne Kelly — Thu, 30 Jul 2015 23:39:27 GMT

At the risk of sounding supremely ignorant, how will I know if the damage has gone below the gumline? I think her teeth probed relatively ok. Would I be better off to do full mouth radiographs first and plan the restoration for another day or do it all under the one GA? Re scaler don't worry, surely it's possible to do damage like that if someone had used the tip and gone a bit heavy handed?

Rob - tore the house apart, couldn't find the journal, had all the others, finally found it in the dark recesses of under the bed! Am now in a bomb site house with journals thrown everywhere but very happy and vowing to keep my journals neatly filed in future

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Evelyn Barbour-Hill — Thu, 30 Jul 2015 20:20:22 GMT

Looks very much as if Vertise would work well, but it looks as if you'll have trouble at the gum line. The degenerate area seems to go right to the gum so probably underneath it – is that right? So you may have to raise flaps.

I wasn't suggesting that you were causing damage with your scaler! I just wondered if bits of degenerate tooth substance were coming off with the scaler, indicate that even what was left was unsound. But it doesn't look like that in the pictures.

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Suzanne Kelly — Thu, 30 Jul 2015 14:42:49 GMT

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Suzanne Kelly — Thu, 30 Jul 2015 14:41:29 GMT

Wah! Had written a huge long spiel to accompany those rads and stupid work computer wiped it. ( and I type with 2 fingers)

Photos to follow. 104 has issues as well. The owner has been brushing but not much. A colleague did the dental 6 months ago, he may not have picked up the enamel issues but he's very unlikely to have caused it.

I had no issues scaling, we have a piezo electric scaler ( EMS mini piezon). It's old, but we change the tips regularly and have had no issues with it. I have round burs down to 1/4 and 701s. I don't have the white finishing ones but have no problem getting them. I have a curing light ( purchased in a fit of optimism a few years back, still in it's packaging.)

I should have that journal Rob, I'll tear the house apart over the w/e and see. The human dentist will bring anything I need, she's doing this as a favour, the dog is a staff pet ( no pressure ...)

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Rob Davis — Tue, 28 Jul 2015 16:39:06 GMT

[quote user="Rob Davis"]

[quote user="Evelyn Barbour-Hill"]I expect Rob Davies will be along tomorrow with the exact reference anyway. [/quote]

Sorry to disappoint....

[/quote]

Journal of Veterinary Dentistry Volume 31, number 4, Winter 2014 pp280-288.

Just came across it while clearing out my tray!

If you do go ahead, please post photos!

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Evelyn Barbour-Hill — Tue, 28 Jul 2015 15:56:40 GMT

Where we see that bone loss between 205 and 206, is there any dentine exposed on those teeth? That could be really sensitive.

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Evelyn Barbour-Hill — Tue, 28 Jul 2015 15:36:42 GMT

Xrays, yes I think all is OK on those two, except bone level loss. Slightly abnormal appearance in pulp chamber of what I presume is 206, but I think that's just incidental. Odd internal bulge in pulp of 204, or is that artefact? Probably incidental anyway.

I hope your dentist friend will bring his lightcure gun with him! I'm sure you need something light cured here because using chemical cure takes so much longer and actually needs more practice, and you'll be struggling a bit with moisture control so you want something you can get placed and zapped immediately.

[quote user="Rob Davis"]PS What's with the "e", I'm not Welsh, you know.....[/quote]

Ah, sorry about that

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Suzanne Kelly — Tue, 28 Jul 2015 15:22:40 GMT

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Rob Davis — Tue, 28 Jul 2015 11:58:49 GMT

What he said!

Pictures would be great, radiography would be essential before embarking on any restoration.

[quote user="Evelyn Barbour-Hill"]I don't think you can learn restoration from tips and tricks, nor really from books and articles for that matter. I certainly would not care to teach you how to do it in a post like this.[/quote]

As somebody who has relatively recently started doing restorations, I can vouch for the fact that pratice is required. There are a mind-boggling array of different materials available so always read the instructions carefully. Cadaver practice is really useful. Vertise flow is indeed relatively easy to use, but it is also relatively expensive and will require a curing light, which if you are not intending to use regularly is also a significant cost.

[quote user="Evelyn Barbour-Hill"]I expect Rob Davies will be along tomorrow with the exact reference anyway. [/quote]

Sorry to disappoint....

PS What's with the "e", I'm not Welsh, you know.....

RE: Kerry Blue enamel dysplasia/hypoplasia - calling the dentists :)

Evelyn Barbour-Hill — Mon, 27 Jul 2015 23:05:49 GMT

This is all going to be a bit rambling. I haven't seen your patient and I'm not quite sure what's going on; what I'm visualising from your description might be all wrong. Any chance of a photo?

It all seems a bit odd – lots of enamel dysplasia on one side, complete health on the other. Halitosis and pain as a result, perhaps, though it's not usually so obvious. Was it you who did the "dental in the last six months", or do you mean someone else did that and you recently had to do some more?

Teeth without enamel obviously can be or will be sensitive – so that's why she reacted as you scaled them (was there much calculus? How much plaque was there? Is she having any oral hygiene?

I'd want Xrays before making decisions – I'd want to know if there's anything abnormal about the pulp, the root and the alveolar bone – you might be wasting your time just restoring the outside.

Does the damage go below the gum line? That's going to complicate matters – you will need to keep the gum away from the surface you are trying to restore with absolutely no contamination with blood , moisture or anything. Moisture control is essential.

Are you absolutely sure that the hard tissue remaining is not actually degenerating? Did any come away when you were scaling? (Which make of scaler were you using?) There is no point whatsoever in trying to bond restorative material to unsound tissue.

I'm glad you have a dentist coming to co-operate, because, please don't take this the wrong way, I wouldn't choose this case as my first essay in restorative dentistry if I had any option. I don't think you can learn restoration from tips and tricks, nor really from books and articles for that matter. I certainly would not care to teach you how to do it in a post like this.

Off hand, I can't think of any good up to date veterinary books that would be of help. However if you'd like to try a dental textbook, a remarkably clear one is Restorative Dentistry Ed.2, by Walmsley, Walsh, Lumley and others, Churchill Livingstone 2008. ISBN 9780-443-10246-2, specifically chapter 8 but read the introductory chapters too.

I think there was a "how-to" article in Journal of Veterinary Dentistry quite recently, but I can't tell you which one right now. I'll try and dig it out, or maybe you can Google it. I expect Rob Davies will be along tomorrow with the exact reference anyway.

Have you the machinery to prepare the lesions you are restoring? And to finish the restoration? I know you have the high speed and slow handpieces, but do you have some fairly fine small round burs or 701 burs? Some finishing burs? Some composite polishing discs or similar?

As far as I can judge from your description, I'm thinking that a light-cured flowable composite would be ideal for the purpose. I think that Vertise is the bees' knees. It's relatively easy to use, though you must follow the instructions exactly, and if you are quite artistic in applying it it will need little finishing, which not only gives you less hassle but is a Good Thing for technical reasons.

That's all I can think of for now. I hope it helps.