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Malocclusion and tooth-on-tooth trauma
While an uncommon option, odontoplasty can resolve some cases


Photo 3: A radiograph of another patient showing an open apex of the right mandibular canine tooth (104).
If dentin is exposed, dentinal bonding, followed by a very thin layer of composite, seals the open dentinal tubules. Polishing disks prepare the composite for two additional layers of unfilled resin. This procedure allows the crown height to be reduced to eliminate all destructive occlusal forces. Consider using radiography to determine the tooth's further eruptive potential (Photo 3). In this case, the apices of the mandibular canines were radiographically closed, and further eruption was not anticipated.

A closer look at the dog's dentition showed a close relationship between the right mandibular canine tooth (404) and the right maxillary third incisor (103) (Photo 4). If odontoplasty is performed as described, 404 will then likely contact 103. So consideration must be given to performing odontoplasty on tooth 404 as well (Photos 5A and 5B).

Photo 4: A close relationship between the right mandibular canine tooth (404) and the right maxillary third incisor (103).

Photos 5A and 5B: Odontoplasty is followed by dentinal bonding, a thin composite, polishing and two additional layers of bonding agent on both mandibular canines. The result of odontoplasty and the composite restoration is seen here for both mandibular canines.

Next, you must determine if any other malocclusions will result from the new arrangement. Extubating the patient momentarily to check the occlusion and confirm that there are no additional problems is generally required. In this case, the molars came to rest in proper occlusion, and the mandibular incisors came to rest on the cingula of the maxillary incisors, recreating the normal occlusion as seen at the two-week recheck (Photo 6).

Photo 6: No additional problems were noted at the two-week recheck.

This concludes a three-part series on malocclusions. In the next series, I will demonstrate multiple examples of what appear to be normal mouths that radiographically are very abnormal.

Dr. Beckman is associated with Affiliated Veterinary Specialists, Orlando, Fla.; Florida Veterinary Dentistry and Oral Surgery, Punta Gorda, Fla.; Animal Emergency Center of Sandy Springs, Atlanta; and Dallas Veterinary Dentistry & Oral Surgery, Dallas.


Source: DVM360 MAGAZINE,
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