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Objective: Antimicrobial stewardship is critical for the prevention of antimicrobial resistance. A lack of prescribing guidelines makes overprescribing in veterinary dentistry likely and represents an opportunity for improvement of stewardship practices. This study described prescribing practices of residency-trained and board-certified veterinary dentists for dogs and cats undergoing dental procedures., Methods: Antibiotic-use data were collected from the first 10 patients presenting for a dental procedure at each of 22 participating clinics beginning on October 2, 2023., Results: 35% of patients undergoing procedures received 1 or more systemically administered antibiotic, most commonly amoxicillin-clavulanic acid, ampicillin-sulbactam, and clindamycin. Half (43 of 85 [50.6%]) of prescriptions for dogs were for perioperative or postoperative prophylaxis. For dogs, antibiotic duration for prophylactic versus treatment purposes was not significantly different. Common conditions included periodontal disease, tooth fractures, and oral masses. Comorbid conditions were present in 22.3% (49 of 220) of patients. Presence of comorbid conditions was not a risk factor for antibiotic prescribing. Tooth extractions were a risk factor for antibiotic prescribing among patients with periodontal disease, and those with ≥ 11 were more likely to receive antibiotics than those with < 5 extractions., Conclusions: This study characterized antibiotic use among canine and feline dental procedures performed by residency-trained and board-certified veterinary dentists and identified tooth extractions as a risk factor for antibiotic prescribing., Clinical Relevance: The results obtained from this study provide insight into prescribing practices in a referral setting and impetus to develop outcomes-based studies to determine the need for prophylactic antibiotics during specific procedures, especially tooth extractions.

Introduction: The purpose of this study was to evaluate the use of a novel imaging modality, digital tomosynthesis (DT), for identification of predefined anatomic dental and maxillomandibular structures in dogs., Methods: DT images were compared to conventional intraoral dental radiography (DR) for the diagnostic yield regarding the presence and quality of visualization of 35 structures. DT imaging and full mouth DR were obtained on 16 canine cadaver heads and a semi-quantitative scoring system was used to characterize the ability of each imaging method to identify the anatomic structures., Results: The results demonstrated that each imaging modality, and orientation, was superior for certain anatomic structures., Discussion: Overall, although one modality did not prove superior to the other, digital tomosynthesis appears to be an appropriate novel tool for identification of specific anatomic structures in the dog skull., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationship that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 May, Lommer, Arzi, Goldschmidt, Hatcher and Soltero-Rivera.)

Introduction: Digital tomosynthesis (DT) has emerged as a potential imaging modality for evaluating anatomic structures in veterinary medicine. This study aims to validate the diagnostic yield of DT in identifying predefined anatomic structures in feline cadaver heads, comparing it with conventional intraoral dental radiography (DR)., Methods: A total of 16 feline cadaver heads were utilized to evaluate 19 predefined clinically relevant anatomic structures using both DR and DT. A semi-quantitative scoring system was employed to characterize the ability of each imaging method to identify these structures., Results: DT demonstrated a significantly higher diagnostic yield compared to DR for all evaluated anatomic structures. Orthogonal DT imaging identified 13 additional anatomic landmarks compared to a standard 10-view feline set obtained via DR. Moreover, DT achieved statistically significant higher scores for each of these landmarks, indicating improved visualization over DR., Discussion: These findings validate the utility of DT technology in reliably identifying clinically relevant anatomic structures in the cat skull. This validation serves as a foundation for further exploration of DT imaging in detecting dentoalveolar and other maxillofacial bony lesions and pathologies in cats., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Soltero-Rivera, Nguyen, Goldschmidt, Hatcher and Arzi.)

Objective: To evaluate the kinematics and stability of the temporomandibular joint (TMJ) of cats and dogs with and without a TMJ replacement (TMJR) prosthesis under simulated bite forces and mouth opening., Animals: Sixteen cadaver skulls from domestic cats (n = 8) and medium- to large-breed dogs (n = 8)., Methods: Intact TMJs were tested. Following condylectomy and coronoidectomy, the skulls were fitted with a TMJR prosthesis unilaterally and retested. Prosthesis was similarly implanted in the contralateral TMJ in 4 cats and 4 dogs before retesting. Left and right bite motions were evaluated before bite contact to peak bite force (200 N in dogs, 63 N in cats). Mouth opening motion was recorded. Mandibular displacement under load was evaluated in 3 orthogonal planes. Maximal displacement was compared between TMJR groups and native TMJ. Prosthesis-bone motion of the temporal and mandibular components was evaluated during simulated bites and mouth opening., Results: TMJR resulted in joint motion not demonstrably different from the native TMJ, with the ability to fully open and close the mouth and with minimal laterotrusion. The TMJR prosthesis demonstrated similar stability after unilateral and bilateral replacement during bite force and with an open mouth. Mean implant-bone motion during bite simulations for the temporal and mandibular TMJR components was ≤ 60 µm in cats and ≤ 30 µm in dogs., Clinical Relevance: A novel TMJR can be implanted and allows normal jaw motion. Joint stability is maintained after TMJR implantation in the TMJ of dogs and cats TMJ that is devoid of muscular support.

Objective: To evaluate the knowledge, attitudes, and practices toward antibiotic use among board-certified veterinary dentists., Sample: 104 veterinarians board certified by the American Veterinary Dental College., Methods: A 30-question survey was generated from an online platform and sent via email listserv to board-certified veterinary dentists. Responses were examined to identify patterns or correlations among the variables of interest., Results: There were 104 board-certified veterinary dentists who responded. The majority reported using prophylactic intraoperative antibiotics sparingly for dental procedures and predominately for patients with historic endocarditis or on immunosuppressive doses of steroids. For healthy patients, they reported that antibiotics are often prescribed during jaw fracture repair, maxillectomy/mandibulectomy, and treatment of stage 4 periodontal disease or periapical lucencies. Knowledge of antibiotic resistance and evidence-based antibiotic use were not significantly different between different practice sectors (academia vs private practice) or dependent on the duration of board certification. Dentists who did not believe antibiotics used postoperatively reduce local postoperative infection rates were less likely to prescribe injectable intraoperative antibiotics for the prevention of postoperative infection. No other variables were associated with the likelihood of prescribing intraoperative antibiotics. More than 95% of veterinary dentists surveyed agreed that specific antibiotic use guidelines for veterinary dentistry would help reduce inappropriate use of antibiotics., Clinical Relevance: There are differences among veterinary dentists regarding which procedures and patient-specific comorbidities they believe necessitate the use of prophylactic antibiotics. The development of a consensus statement and prospective studies of current antibiotic use are important next steps to improving antibiotic stewardship in veterinary dentistry.

Background: Advanced diagnostic imaging is an essential part of preoperative planning for oral and maxillofacial surgery in veterinary patients. 3-dimensional (3D) printed models and surgical guides generated from diagnostic imaging can provide a deeper understanding of the complex maxillofacial anatomy, including relevant spatial relationships. Additionally, patient-specific 3D printed models allow surgeons and trainees to better examine anatomical features through tactile and visuospatial feedback allowing for improved preoperative planning, intraoperative guidance, and enhanced trainee education. Furthermore, these models facilitate discussions with pet owners, allowing for improved owner understanding of pathology, and educated decision-making regarding treatment., Case Presentation: Our case series consists of three 3D printed models segmented from computed tomography (CT) and cone beam CT (CBCT) and fabricated via desktop vat polymerization for preoperative planning and intraoperative guidance for resection of maxillary osteosarcoma, mandibular reconstruction after mandibulectomy, and gap arthroplasty for temporomandibular joint ankylosis in dogs., Conclusions: We illustrate multiple benefits and indications for 3D printing in veterinary oral and maxillofacial surgery. 3D printed models facilitate the understanding of complex surgical anatomy, creating an opportunity to assess the spatial relationship of the relevant structures. It facilitates individualized surgical planning by allowing surgeons to tailor and augment the surgical plan by examining patient-specific anatomy and pathology. Surgical steps may also be simulated in advance, including planning of osteotomy lines, and pre-contouring of titanium plates for reconstruction. Additionally, a 3D printed model and surgical guide also serve as invaluable intraoperative reference and guidance. Furthermore, 3D printed models have the potential to improve veterinary resident and student training as well as pet owner understanding and communication regarding the condition of their pets, treatment plan and intended outcomes., (© 2022. The Author(s).)

Periodontal disease is one the most common disease pathologies in small animal medicine, yet new graduates report they feel unprepared to perform dentistry in general practice. Novel methodologies to close the knowledge gap in veterinary dentistry need to be identified. Typodonts (dental models) are commonly used in human dental schools to teach basic principles prior to practice on clinical patients and have been shown to be an effective teaching tool. The study aimed to determine if independent study and self-guided practice on a veterinary typodont prior to a structured, in-person cadaver laboratory with feedback increases students' perceived dentistry clinical skills in performing periodontal techniques. We calculated the knowledge gap before and after the cadaver laboratory by comparing the students' perceived and desired skill levels in performing periodontal charting, ultrasonic cleaning, hand scaling, and root planing. Ninety-six percent of students reported that practice with the dental typodont prior to the cadaver laboratory increased their comfort level in performing periodontal skills. However, practice did not result in a significant decrease in knowledge gap compared with participation in the cadaver laboratory alone. Although students perceived a benefit to practicing with the typodont, self-guided practice was not effective in decreasing the knowledge gap, most likely due to a lack of structured feedback with typodont use. Further investigation into the use of typodonts with direct feedback prior to structured laboratory or, alternatively, as an additional practice tool following a structured laboratory would further define if there is a benefit to typodont practice in veterinary dentistry.

Objective: To identify biometric skull measurements that are associated with tension and excess narrowing of the resultant nasal aperture during cosmetic nasal planectomy reconstruction., Study Design: Ex vivo study., Animals: Twenty cadavers of mesocephalic dogs., Methods: Cosmetic reconstruction was performed after incisivectomy and nasal planectomy. Preoperative and intraoperative skull measurements included width of the nasal planum, rostral and caudal maxilla, labial flap, and maxilla at ostectomy site; the length of the nose, labial flap, and philtrum incision; lip thickness; and philtrum placement. Ratios of select width to length measurements were calculated. Correlation was tested between skull biometrics and tension during reconstruction as well as resulting opening of the nasal aperture., Results: Breeds included golden retriever, pit bull, Labrador retriever, beagle, shepherd, basset hound, boxer mix, cocker spaniel, and Great Dane. No biometric ratios were predictive of procedural success. The most important objective measurements that were significantly correlated with inferior outcome included width of the nasal planum (>3 cm), width of the caudal maxilla (>6.2 cm), lip thickness (>0.5 cm), width of the labial flap (>2.9 cm), length of the incision created to make the cosmetic "philtrum" (longer incisions >2.8 cm), and philtrum placement (more dorsal placement)., Conclusion: Tension during reconstruction and decreased resultant nasal aperture were associated with wider facial features and thicker lips as well as directly impacted by cosmetic philtrum design and placement., Clinical Significance: Standardized preoperative measurements may help guide clinical decision making in choosing and executing a nasal planectomy reconstructive technique., (© 2020 American College of Veterinary Surgeons.)

Canine acanthomatous ameloblastoma (CAA) has been reported to be the most common odontogenic tumor in dogs. This retrospective study evaluated 263 dogs with histopathologically confirmed CAA. Within this data set, CAA presents most commonly in the rostral mandible in adult large breed dogs, with golden retriever dogs being overrepresented. Patients with appropriate follow-up after curative intent surgery were evaluated to assess the effect of histopathological margin on local tumor recurrence. No local recurrence was noted in any patient. This study raises questions about what the recommended surgical margin should be for treatment of CAA. It also serves as a stimulus for discussion as to whether further treatment for CAA is required when inadequate surgical margins are obtained, or if medical surveillance would be an appropriate management recommendation. Prospective studies are necessary to answer these questions.