RE: Cat tooth resorption, when to extract?

Lucy Tottey — Tue, 31 Jan 2023 13:54:00 GMT

Hello,

Thank you very much that is really helpful. I will discuss options with the owner regarding the other 3 canines. I agree now looking at the x-rays more that 204 looks a bit damaged on the crown, you can see a deficit on the tooth (I didn't take a photo of cat itself unfortunately). However, I need to go back for a stage 2 as have the other carnassial to extract and I will also explore that odd area at 409 as you suggest. That area appears sore so is obviously causing the cat some trouble. I can offer to send a sample for histo and saving it if we don't send straight away would be a sensible precaution.

Lucy

RE: Cat tooth resorption, when to extract?

Rob Davis — Tue, 31 Jan 2023 13:21:26 GMT

Hi Lucy

It is generally considered that tooth resorption is not painful until the area of resorption is exposed to the oral cavity. In this situation where the resorption appears to be confined to the apical portion of the roots, if there are no clinical signs of resorption on the crown (feel very carefully with the sharp explorer tip perpendicular to the tooth surface) then leaving them in situ is acceptable. I will usually discuss these with the owners - some prefer to extract now and be done with it, some prefer to leave and repeat the radiograph in due course (say 6-12 months). They will progress with time, but it is difficult to predict how long you have until they become problematic.

The radiograph of the upper left canine (204) looks concerning to me. There appears to be a significant enamel/dentine deficit, though it is easier to assess these clinically than radiographically. I would be suspicious that there could be pulp exposure at the tip (the pulp chamber is very tiny in this region and can be difficult to spot) so would probably be extracting that tooth. Do you have any photographs?

The radiolucent regions in the caudal right mandible (409 site) look a bit odd. This is not normal resorption - with type 2 resorption by definition the root would be replaced by bone. I suspect these areas are full of infected granulation tissue as a result of a periodontitis-affected tooth which has fallen out. I would, as you suggested, raise a flap and have a look. If it does look like granulation tissue then debriding and closing the flap should allow normal healing, but taking a biopsy is never wrong and is generally a good idea whenever things look "unusual" as long as finances allow. If finances are tight then I will often place the biopsy in formalin and stick it in a cupboard to be sent away in the future if the lesions do not resolve as expected.

Hope that helps

Rob