Content continues after advertisement

Complicated Crown Fractures in Dogs

Kendall Taney, DVM, DAVDC, FAVD, Center for Veterinary Dentistry & Oral Surgery, Gaithersburg, Maryland

Sign in to Print/View PDF

In the Literature

Almansa Ruiz JC, Jonker A, Bosman AM, Steenkamp G. Bacterial profile and antibiogram of the bacteria isolated from the exposed pulp of dog canine teeth. Vet Rec. 2018;183(3):97.


FROM THE PAGE …

This study isolated and identified the bacteria present in the root canals of dogs with nonvital pulps exposed as a result of complicated crown fractures. Twenty-seven samples were obtained from the root canals of canine teeth from 20 dogs, and culture and susceptibility testing was performed. Positive cultures were reported in 92.59% of samples; of these, facultative anaerobes were most commonly isolated (77.56%). Aerobes and strict anaerobes were isolated in 18.36% and 4.08%, respectively, of the remaining samples. Susceptibility testing of aerobic and facultative anaerobic bacteria showed gentamicin and enrofloxacin to be most effective.

Treatment of complicated crown fractures with systemic antibiotics is generally unnecessary and ineffective. Systemic antibiotics rely on circulation to bring the active drug to an infected site that may no longer possess a normal blood supply, as seen in teeth with nonvital pulps. Intracanal antibiotics may be more effective for delivery into the endodontic system. Exceptions for systemic antibiotic use include patients with clinical signs (eg, significant and painful facial swelling, draining tracts, pyrexia); however, treatment of the tooth would still be indicated in these patients. Although susceptibility testing is preferred when using systemic antibiotics, empiric prescriptions are more realistic in clinical situations due to the time delay for culture results. Studies such as this can provide insight into the typical endodontic microbiota and help guide empiric use of systemic antibiotics when their use is necessary. 


… TO YOUR PATIENTS

Key pearls to put into practice:

1

Clinicians should remember that complicated crown fractures will result in bacterial colonization in the root canal system.

2

Infection and unnecessary pain in patients is best avoided through prompt treatment of a broken tooth; watching and waiting is not an appropriate action plan. Treatment options include extraction and endodontic therapy. Extraction may be elected if there is minimal remaining tooth structure, significant facial swelling indicating an end-stage periapical infection, or radiographic evidence of significant root pathology. If the behavior that caused the complicated crown fracture cannot be corrected, extraction may be the best option. When maintenance of the tooth is desired, root canal therapy is indicated. Endodontic treatment should be performed by a board-certified veterinary dentist to eliminate bacteria in the root canal system through debridement, disinfection, and obturation of the canal, followed by restoration of the crown fracture site.

3

Although the bacteria isolated in this study were susceptible to antibiotic treatment, this does not correlate to clinical treatment of complicated crown fractures.

References

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

Material from Clinician's Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.

Continuing Education

Welcome to your new CE platform

Get started here.

With RACE-approved courses for the brief, relevant Clinician’s Brief articles you love, we’re your home for online CE.
Earn Hours
39.5
Earn up to 39.5 hours of RACE-approved CE with Clinician’s Brief content.
Clinician's Brief provides relevant diagnostic and treatment information for small animal practitioners. It has been ranked the #1 most essential publication by small animal veterinarians for 9 years.*

*2007-2017 PERQ and Essential Media Studies

© 2018 Educational Concepts, L.L.C. dba Brief Media ™ All Rights Reserved. Privacy Policy (Updated 05/08/2018) Terms of Use (Updated 05/08/2018)