KEEP IT LOCAL Veterinary Endodontic Treatment

By : Jennifer Keegan, DMD

When Spike, an explosive detection K9 came in for his annual checkup, a bump on his gums led to the discovery that he had a tooth infection on his bottom left molar. The Tinker AFB Dental team was asked to help restore Spike’s health, so that he can focus on his very important job! Prior to this 2023 check-up, Spike was seen in August 2019 with two gingival masses located on the F gingiva of tooth #309. A punch biopsy was taken during that time, and the results showed chronic granulation material with intralesional foreign material. The veterinarian suspected the foreign material was due to a stick that Spike chewed on. Now, 4 years later, Spike presents with another lesion on his gingiva that needs further evaluation. Tooth 309 was evaluated. Radiographically: a periapical radiolucency was noted around both the mesial and distal roots. Clinically, a round 3x3mm gingival abscess was noted on the F gingiva of #309. A gutta percha master cone was placed in that draining abscess and was traced to the D root apex. The decision was made to proceed with a root canal on tooth 309. Spike was intubated and placed under general anesthesia.

The tooth had three separate pulp chambers and two different canals. The central pulp chamber connected to both the M and D canals. Due to the unique morphology of the tooth, it was accessed separately from all three cusps, and the initial apical file lengths was verified using radiographs. The initial apical file length was determined to be 17mm on the D and 19mm on the M (see the radiograph below). Hand files were initially used up to the maximum size that the veterinary office had (100) and then a combination of rotary files (Lightspeed LSX size 90 and ProTaper Gold size F5) was used to clean and shape the canals. The two canals were significantly wider than 100 (estimating close to 160-200 in size for the master apical file). Thus, focus was put on taking the largest rotary files and copious amounts of NaOCl to meticulously clean the walls of the chambers and canals.

While humans have apical foramina, canine apices have “apical deltas” which are usually predictable stops for obturation. However, since the periapical radiolucency and draining abscess was connected to the D canal, extra focus was put on length control to ensure the obturating material did not exit out of the D apex. Both canals were obturated with BC sealer and warm vertical gutta percha.

The three chambers were restored using amalgam. Overall, an excellent result came out of the procedure and, more importantly, an explosive detection K9 can focus on his duty and not on a toothache.

Tinker AFB Dental Clinic extends its’ appreciation for the opportunity to collaborate with the Tinker AFB Veterinary Clinic team led by Dr. Heather Cameron.