Would you remove this tooth?

RE: Would you remove this tooth?

Simon Vogel — Sat, 18 Dec 2021 13:28:14 GMT

Unless you live with a dentist…

RE: Would you remove this tooth?

Rob Davis — Sat, 18 Dec 2021 13:04:24 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234552#234552"]

Note - For the mortals amongst us an endodontic file looks like

[/quote]

I would opt for a hand file more like this:

available here if anyone is interested.

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234552#234552"]The more I read into this, the more it looks like DIY, maybe I should have got into this years ago?[/quote]

It is a bit like doing DIY in a playmobil house.

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234556#234556"]even engine stud removers to extract tooth fragments [/quote]

If anyone manages to make a prototype for less than $180 each then I would be happy to try it out!

RE: Would you remove this tooth?

Clive Ansell — Sat, 18 Dec 2021 12:05:03 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234554#234554"]I come from a dairy farm, which do you think?[/quote]

Yep, I'm from a farming background too, so will turn my hand to almost anything - even engine stud removers to extract tooth fragments

RE: Would you remove this tooth?

Neil Wheadon — Sat, 18 Dec 2021 11:49:35 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234553#234553"]DIY or endodontics? [/quote]

I come from a dairy farm, which do you think?

Neil

RE: Would you remove this tooth?

Clive Ansell — Sat, 18 Dec 2021 11:44:35 GMT

DIY or endodontics?

It's a fairly straightforward idea; drill or ream a hole into the pulp cavity, then tap a thread into it to attach an instrument - simples.

The proper ones are expensive, but not massively so.

RE: Would you remove this tooth?

Neil Wheadon — Sat, 18 Dec 2021 11:36:36 GMT

Note - For the mortals amongst us an endodontic file looks like

The more I read into this, the more it looks like DIY, maybe I should have got into this years ago?

Neil

RE: Would you remove this tooth?

Rob Davis — Sat, 18 Dec 2021 11:29:18 GMT

[quote userid="2211" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234545#234545"]You could try an endodontic file. [/quote]

Indeed, and I occasionally do this, but most are unlikely to have them lying around....

RE: Would you remove this tooth?

Simon Vogel — Sat, 18 Dec 2021 10:33:42 GMT

You could try an endodontic file.

RE: Would you remove this tooth?

Clive Ansell — Sat, 18 Dec 2021 10:12:10 GMT

Are they single use, and if not how long do they last?

Simple idea, would it be possible to improvise?

I've got a set of something similar to these

RE: Would you remove this tooth?

Rob Davis — Sat, 18 Dec 2021 08:40:20 GMT

[quote userid="2131" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234530#234530"]Considering the extreme rarity with which I have used them – probably not.[/quote]

When you have used them, do they work as intended?

PS for anyone interested this is what we are talking about.

RE: Would you remove this tooth?

Evelyn Barbour-Hill — Sat, 18 Dec 2021 02:46:30 GMT

[quote userid="2235" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234513#234513"]

Evelyn Barbour-Hill said:
I have a ridiculously expensive instrument forom "Dr. Shipp's" which screws into the pulp canal, but unless you've got one of those...

I've looked at these for years and been intrigued to try them, but I have been put off by the exorbitant price...... Are they worth it?

[/quote]

Considering the extreme rarity with which I have used them – probably not.

RE: Would you remove this tooth?

Rob Davis — Fri, 17 Dec 2021 19:01:49 GMT

[quote userid="2131" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234510#234510"]I have a ridiculously expensive instrument forom "Dr. Shipp's" which screws into the pulp canal, but unless you've got one of those...[/quote]

I've looked at these for years and been intrigued to try them, but I have been put off by the exorbitant price...... Are they worth it?

RE: Would you remove this tooth?

Evelyn Barbour-Hill — Fri, 17 Dec 2021 18:24:40 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234506#234506"]

I had a quick look. The gingiva has not healed over. The tooth fell out 2 weeks ago

Neil

[/quote]

Then I would attempt removal. It does look as if careful work with good luxators would pop it out, but it might prove more difficult – there's a certain amount of resorption around the apex. Also there's no way to grasp it. (I have a ridiculously expensive instrument forom "Dr. Shipp's" which screws into the pulp canal, but unless you've got one of those...) I'm not convinced heavy bone surgery would, on balance, be a good idea. But if it just needs a little bone removal... I can't say.

[quote userid="2235" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234504#234504"] I would be thinking more of a traumatic fracture than resorption [/quote]

Yes, could be. In which case I'd reckon the actual trauma and fracture was some time ago and the tooth substance has been quietly degenerating around the fracture site ever since. Which would also account for the appearance of the bone in the area. I wonder if, with hindsight, the owners can think of any periods of pain or other symptoms which would go with this?

RE: Would you remove this tooth?

Kate Richardson — Fri, 17 Dec 2021 18:18:10 GMT

[quote userid="2131" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234502#234502"]I'd be thinking about getting rid of the remnants of the incisors on that side, though, and maybe 301 and 302; and I think 407 should be looked at[/quote]

Agree. 307 and 408 also look a little suspicious! really hard with the image upside down!!

RE: Would you remove this tooth?

Martin Hamilton — Fri, 17 Dec 2021 18:02:50 GMT

[quote userid="2235" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234504#234504"]In my opinion the fractured canine root should definitely go unless it is an old fracture and the gingiva has completely healed over with no visible inflammation.[/quote]

I would add that should this be the route you take, the retained tooth root should be monitored radiographically for evidence of the development of periapical pathology, probably on an annual basis (or sooner should cause for concern arise).

RE: Would you remove this tooth?

Neil Wheadon — Fri, 17 Dec 2021 18:01:58 GMT

I had a quick look. The gingiva has not healed over. The tooth fell out 2 weeks ago

Neil

RE: Would you remove this tooth?

Rob Davis — Fri, 17 Dec 2021 17:04:30 GMT

I see no radiographic reason to extract the intact canine with the needle beside it, but of course physical findings may put a different slant on it.

In my opinion the fractured canine root should definitely go unless it is an old fracture and the gingiva has completely healed over with no visible inflammation. I would be thinking more of a traumatic fracture than resorption given the adjacent fractured incisors and I would be inclined to extract those as well.

RE: Would you remove this tooth?

Evelyn Barbour-Hill — Fri, 17 Dec 2021 15:49:06 GMT

I might change my opinion if I could examine and probe, but as far as I can tell from the radiograph: the tooth with the needle next to it, which we are assuming is 304, I would notinterfere with if there is no periodontal disease beyond some gingivitisand a little loss of gingival width.

The 404, as Kate says, has "self-amputated" due to resorption. I would try to extract it, and it's true that it looks on the radiograph as if one could just pop it out. However you might find it more difficult than expected. I am not sure that it would be worth heavy bone removal just to get it out. I really can't decide from the radiograph alone. I'm aware this might be seen as controversial, but I'm for the pragmatic approach and treating the individual not the radiograph.

How old is the cat? How recent is the crown loss? If you peer into the alveolus, can you see the root remnant clearly, or just some bits, or is the alveolus already filing up with granulation tissue? The bone doesn't look very nice at the site, is there anything that might make you wonder abouit chronic infection, or neoplasia? Is there pain, difficulty eating, inappetence?

I'd be thinking about getting rid of the remnants of the incisors on that side, though, and maybe 301 and 302; and I think 407 should be looked at

RE: Would you remove this tooth?

Neil Wheadon — Fri, 17 Dec 2021 15:38:00 GMT

[quote userid="6386" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234497#234497"]Are you talking about 304?[/quote]

Yes

[quote userid="6386" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234497#234497"] I would however, remove the 404 root remnant![/quote]

I'll pass that on to the vet involved as they asked me, so thought it would make an interesting question

Neil

RE: Would you remove this tooth?

Kate Richardson — Fri, 17 Dec 2021 15:26:44 GMT

[quote userid="4331" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30118/would-you-remove-this-tooth/234498#234498"]I agree with Kate[/quote]

Norman Johnston you've just made my day

RE: Would you remove this tooth?

Norman Johnston — Fri, 17 Dec 2021 15:25:09 GMT

I agree with Kate

RE: Would you remove this tooth?

Kate Richardson — Fri, 17 Dec 2021 14:35:01 GMT

Hi Neal

Are you talking about 304? Assuming there is no mobility or deep pockets on probing, then no I don't think I would. I would however, remove the 404 root remnant! I doubt the crown just dropped out, the tooth has probably under gone resorption, then fractured as it has become weaker.