Commissurotomy is a surgical technique whereby the lip commissure is incised. Indications for commissurotomy include cheiloplasty, partial commissurectomy, or access to the caudal portion of the maxilla or mandible for oral surgery. Carbon dioxide (CO2) laser was used for commissurotomy in dogs for partial commissurectomy (n = 7) or access for oral surgery (n = 60). All dogs had oral or maxillofacial neoplasms that required resective surgery. The CO2 laser was used to perform commissurotomy or commissurectomy, as indicated. Commissurotomy healing was evaluated at 2 weeks with longer-term follow-up of a minimum of 6 weeks (104.6 ± 99.2 weeks) postoperatively. Postoperative complications related to commissurotomy (n = 6) included mucosal dehiscence (n = 3) less than 1.5 cm, lip margin dehiscence (n = 2) less than 1.0 cm, and complete commissurotomy wound dehiscence (n = 1). Two wound dehiscence cases, including the complete wound dehiscence, had uncomplicated healing following revision surgery. Minor marginal and mucosal dehiscence cases healed by the second intention. Periwound edema ranged from mild to severe and resolved by the 2-week postoperative examination. Statistical analysis showed that complications associated with commissurotomy/commissurectomy were independent of the type of surgical procedure, tumor type, and surgical margin evaluation when using the CO2 laser. Commissurotomy using CO2 laser provided rapid and unimpeded exposure with minimal hemorrhage of the caudal maxilla and mandible for resective oral and maxillofacial surgery.

Canine acanthomatous ameloblastoma (CAA) has been reported to be the most prevalent odontogenic tumor in dogs. The most common location of this tumor is the rostral mandible. Symphyseal-sparing mandibulectomy has been shown to be an effective technique to maintain mandibular continuity and promote early return to function. In this retrospective study, 35 dogs with CAA associated with a mandibular canine tooth were evaluated following a symphyseal-sparing rostral mandibulectomy. Dogs with intraoperative transection of the canine tooth root and subsequent root fragment extraction were included. The objective of this study was to evaluate outcome following excision of CAA with mid-root transection. Data retrospectively evaluated in this study included the following: narrowest tumor margin, narrowest tumor margin at the border associated with the transected canine root, tumor size, and prevalence of local recurrence. This study showed that 82.86% of CAA were completely excised with tumor-free margins (N = 29). The median narrowest overall tumor-free margin was 3.5 mm (interquartile range [IQR] 2.0-6.5 mm) and the median tumor-free margin associated with the border of the transected canine root was 5.0 mm (IQR 3.1-7.0 mm). Follow-up data was obtained in 25 cases via phone interviews with referring veterinarians and clients. No local tumor recurrence was reported in cases with incomplete tumor excision (N = 5). All dogs with follow-up data survived at least 1 year following surgery. It was concluded that segmental or rostral mandibulectomy with wide margins to include the entire mandibular canine tooth with subsequent mandibular instability may not be warranted for dogs with CAA associated with this tooth.

The objective of this retrospective pilot study was to describe potential risk factors for failure of hard palate mucoperiosteal flaps (HPF) transposed for closure of oronasal communication. Dogs (n = 28) with acquired oronasal communication defects were included in the study population. Functional success of an HPF was determined by visual inspection at the last examination and lack of clinical signs. Risk factors for HPF failure including age, sex, body weight, presence of neoplasia at the time of surgery, presence of neoplasia after surgery due to incomplete or narrow margins, use of CO2 laser, previous surgeries in the same location, HPF blood supply, size of the HPF as a percentage of the total area of the hard palate mucoperiosteum, and distance traveled by the apex of the HPF were evaluated using descriptive statistics and unadjusted logistic regression modeling. Seven out of 28 (25%) hard palate flap procedures resulted in persistent oronasal communication and were considered failures. Body weight (Median: 17 vs. 25 kg, OR = 0.94, 80% CI = 0.90, 0.99), presence of neoplasia at the time of surgery (86 vs. 57%, OR = 4.50, 80% CI = 1.01, 20.06), HPF area (Median: 0.49 vs. 0.41, OR = 84.40, 80% CI = 1.66, 4,298) and apex travel distance (Median: 2.06 vs. 0.67, OR = 5.15, 80% CI = 2.14, 12.38) were associated with flap failure. Within this sample, the presence of neoplasia at the time of initial surgery, increasing the area of the HPF, and distance traveled by the HPF apex were associated with a greater odds of HPF failure. Further studies with larger sample sizes are needed to confirm repeatability of these results. HPFs remain a viable surgical option for closure of oronasal communication. Careful surgical planning, strict adherence to surgical principles, and awareness of anatomical limitations can increase the likelihood of success.

Medical records were searched for dogs that had received curative intent surgery for oral malignant melanoma and ipsilateral excisional regional lymph node biopsy. Twenty-seven dogs were operated on and 25 dogs of these dogs met the inclusion criteria of signalment, post-excision margin status, presence of metastasis for each biopsied lymphocentrum, survival time post-excision, presence of recurrence or metastasis at follow-up or at death/euthanasia, location of the primary tumor, and any postoperative adjuvant treatment. These 25 dogs had complete tumor excision with tumor-free margins and 19 (76%) had postoperative adjuvant therapy. Median survival time after excision for the dogs in this study was 335.5 days. Results of this study support previous work that documents prolonged survival time following complete excision of oral malignant melanoma with tumor-free surgical margins in dogs. Additionally, 4 dogs (16%) had histologically confirmed regional lymph node metastasis at the time of definitive surgery.

Drs Reiter and Gracis provide the discipline of veterinary dentistry with an excellent textbook. It covers all of the major subdisciplines in veterinary dentistry. Specific chapters include: dental anatomy and physiology; dental and oral examination and recording; dental oral diagnostic imaging and interpretation; commonly encountered dental and oral pathologies; anesthetic and analgesic considerations in dentistry and oral surgery; management of periodontal disease; management of selected non-periodontal inflammatory, infectious and reactive conditions; management of dental and oral trauma; management of dental, oral and maxillofacial developmental disorders; management of oral and maxillofacial neoplasia; and closed and open tooth extraction. In addition, there are chapters dedicated to the important topics of ethics and perioperative planning providing a total of 13 chapters authored by distinguished international leaders in veterinary dentistry. Chapters are written in a clear, precise manner with the text formatted in an easyto-read style. The photographical and diagrammatic images are excellent. A particular strength of the book includes photographic images of the maxilla and mandible showing the eruption of permanent and deciduous teeth as it occurs daily until complete eruption of the permanent dentition. This presentation method is superior to memorizing a dental eruption formula that is dynamic during tooth eruption. The highlight of the book is the presentation of important techniques in a step-by-step manner so that the veterinarian can perform the technique with this chairside textbook tutorial. These techniques are easy to locate in the textbook since the dedicated pages are highlighted in a different color. Operative technique topics presented include: full-mouth dental radiographs in the dog and cat; professional dental cleaning and closed periodontal therapy; open periodontal therapy; gingivectomy and gingivoplasty; vital pulp therapy; standard root canal therapy; dental defect preparation and restoration; interarch splinting; circumferential wiring; interdental wiring and splinting; obtaining a full-mouth impression, bite registration, and creating stone models; fabrication of a direct inclined plane; active orthodontic appliance with brackets, buttons, or wires and elastic chain; unilateral rostral maxillectomy; mandibular rim excision; bilateral rostral mandibulectomy; mandibular canine tooth extraction in the dog; maxillary canine tooth extraction in the dog; maxillary fourth premolar tooth extraction in the dog; mandibular first molar tooth extraction in the dog; extraction of the maxillary canine and cheek teeth in the cat; extraction of the mandibular canine and cheek teeth in the cat; and crown amputation and intentional retention of resorbing root tissue in the cat. The editors fulfill their stated goal in the Preface by “delivering well-referenced knowledge that is supported by an abundance of image material.” The editors should be congratulated for producing a valuable resource for veterinary dental trainees and veterinarians and nurses/technicians with a keen interest in dentistry.

This chapter reviews the principles and indications for axial-pattern flap development. It reviews specific application of axial-pattern flaps for oral and maxillofacial reconstruction following oncologic surgery and trauma, including the caudal auricular, superficial temporal, angularis oris, and transverse facial axial-pattern flaps. Intraoperative and postoperative flap management techniques are reviewed, including flap viability assessment and treatment of complications.

The objective of this retrospective clinical study was to confirm the validity of excisional biopsy of regional lymphocentrums for staging oral and maxillofacial neoplasms in a population of 97 dogs and 10 cats. Patients diagnosed with oral and maxillofacial malignant neoplasms underwent ipsilateral excisional biopsy of the mandibular, parotid, and medial retropharyngeal lymphocentrums that receive afferent drainage from the oral and maxillofacial region followed by curative intent surgery of the neoplasm. Biopsy specimens and the resected neoplasm were submitted to a commercial pathology laboratory for histopathologic assessment. The incidence of metastasis to one or more regional lymphocentrums was 14.0%. Of the cases with metastatic disease, 26.7% did not involve the mandibular lymphocentrum. Although the incidence of regional lymph node metastasis was less than reported previously, regional lymph node assessment is warranted in cases of oral and maxillofacial neoplasia.

134 Bilateral rostral mandibulectomy is the removal of a portion of the rostral aspect of both mandibles. The most common indication for a bilateral rostral mandibulectomy in the dog is excision of benign or malignant oral neoplasms that cross the midline rostral to the mandibular second premolar teeth. It is also used as a salvage surgical procedure in cases of severe osteomyelitis, rostral mandibular fractures, or other trauma when there is severe bone comminution, necrosis, or severe periodontal disease that prevents mandibular alignment and reconstruction. Bilateral rostral mandibulectomy results in mandibular prognathism, but prehension and mastication functions as well as aesthetic outcome are generally very good. Prior to mandibulectomy, surgical margins are determined, using high-quality digital skull and dental radiography, or preferably, computed tomographic (CT) imaging. Tumor staging, using the World Health Organization TNM (tumor-lymph node-metastasis) classification, is recommended. Bilateral rostral mandibulectomy is described step-by-step.

Of the six recognized types of tooth luxation injuries, intrusion generally carries the most guarded long-term prognosis due to the high risk of complications, including root resorption, ankylosis, marginal bone loss, and pulp canal obliteration or necrosis. The degree of traumatic intrusion and stage of root development affects the outcome and treatment planning. This report describes the clinical history, oral and radiographic examination findings, and rationale for surgical extraction in 2 dogs and 1 cat with traumatic intrusion of a maxillary canine tooth.

A dental wax was evaluated after unilateral application in 20 client-owned, mixed and purebred small dogs using a clean, split-mouth study model. All dogs had clinical signs of periodontal disease including plaque, calculus, and/or gingivitis. The wax was randomly applied to the teeth of one side of the mouth daily for 30-days while the contralateral side received no treatment. Owner parameters evaluated included compliance and a subjective assessment of ease of wax application. Gingivitis, plaque and calculus accumulation were scored at the end of the study period Owners considered the wax easy to apply in all dogs. Compliance with no missed application days was achieved in 8 dogs. The number of missed application days had no effect on wax efficacy There was no significant difference in gingivitis or plaque accumulation scores when comparing treated and untreated sides. Calculus accumulation scores were significantly less (22.1 %) for teeth receiving the dental wax.

Oral extramedullary plasmacytomas (EMP) are locally aggressive tumors in the dog that rarely metastasize. They represent 5.2 % of all canine oral tumors and 22.0 to 28.0 % of all EMPs diagnosed are in the oral cavity. EMPs consist of neoplastic plasma cells that do not arise from the bone marrow. No relationship between EMP and the development of multiple myeloma has been determined in dogs. Complete surgical excision is the primary treatment for this neoplasm and is usually curative. Multiple oral EMPs within the same patient have been rarely reported with tumors arising in the same location in the mouth. To the authors' knowledge, multicentric oral EMP, as described in the following cases, has not been reported in the dog.

A two-year-old Boerboel dog presented for a discolored left maxillary canine tooth. Dental radiographs revealed abnormally mineralized pulp within the discolored tooth. Similar radiographic findings were also seen in both maxillary third incisor teeth and in the remaining canine teeth to varying degrees. The discolored tooth was treated by surgical extraction and histopathology revealed abnormal dentin deposition within the canal indicative of dentin dysplasia. Although not previously documented in the dog, the pulpal changes in multiple teeth of the dog reported here were similar to those described for odontoblastic dysplasia in humans. This case report includes a review of developmental abnormalities of dentin in humans and pulpal response to inflammation and injury.

A 10-year-old Boston terrier dog was presented for treatment of a 2-cm mast cell tumor of the left upper lip and nasal planum immediately adjacent to the philtrum and ventral to the nares. CO 2 laser was used for resection of the lesion. Wound reconstruction was performed using bilateral labial advancement flaps.