Endodontic therapy focuses on treatment of the diseased pulp tissue.
- Root canal therapy involves the complete removal of pulp tissue (complete pulpectomy). Indications for root canal therapy include crown fractures that result in pulp exposure (complicated crown fractures), discolored teeth (pink, purple, blue, gray or dark beige), and asymmetrical canals (visible only on radiographs). Root canal therapy may be performed through the crown (standard root canal therapy) or when necessary may be achieved by accessing the root tip (surgical root canal therapy). Indications for a surgical root canal include apical lysis and failure of standard root canal therapy after multiple attempts.
- Vital pulp therapy may be performed on acutely fractured teeth (less than 24 hours in patients older than 12 months) or following a partial crown amputation to shorten the crown height. Shortening crown height is typically performed when a traumatic malocclusion is present (teeth traumatizing hard or soft tissue) or in special circumstances for disarming the patient. Vital pulp therapy is the removal of coronal pulp tissue followed by the placement of a medicament and the restoration material.
Oral surgery is performed on cats and dogs with diseases and injuries of the mouth. Procedures are performed most often after xrays are taken of the structures involved. Oral surgery includes procedures such as biopsy of abnormal tissues, fracture repair, removal of tumors of the upper or lower jaw, gums or tongue.
Orthodontics, formerly orthodontia (from Greek orthos "straight or proper or perfect"; and odous "tooth") is the first specialty of dentistry that is concerned with the study and treatment of malocclusions (improper bites), which may be a result of tooth irregularity, disproportionate jaw relationships, or both. Orthodontic treatment can focus on dental displacement only, or can deal with the control and modification of facial growth. Various devices such as braces are employed in veterinary patients to improve oral function.
Periodontal therapy focuses on the treatment of suprabony and infrabony pocket resulting in a diseased periodontium. The periodontium consists of the gingiva (free and attached), alveolar bone, periodontal ligament and cementum. The periodontal therapies provided are:
- Closed and open root planing: root planing or "deep cleaning" is the removal of calculus from the root surface. In conjunction with root planing is subgingival curettage; the removal of the diseased soft tissue from pocket. Closed root planing is performed on infrabony pockets less than 5 mm in depth. Closed root planing does not require a gingival flap to visualize the calculus on the root surface. Open root planing is performed on periodontal pockets 5mm and deeper. A gingival flap is raised to allow visualization of the root surface enabling complete removal of all calculus from the root surface.
- Bone augmentation: an osteoconductive material is placed in an infrabony pocket following open root planing.
- Multiple, complete or complicated extractions: multiple extraction and complete extractions may be required in cases of advanced periodontal disease in order to achieve oral health. Complicated extractions are those that require special care when extracting the tooth. For example with advanced alveolar bone loss in the region of the mandibular first molar in small breeds. Extraction may be challenging due to the potential for fracturing the jaw.
- Oronasal fistula repair: A mucoperiosteal flap is utilized to close the palatal defect.
- Gingivectomy: gingivectomy or removal of gingival tissue is typically performed when gingival hyperplasia is present creating a suprabony pocket.
Following the treatment of advanced periodontal disease close radiographic monitoring and professional cleaning will be required until it has been determined to be stable. Once the disease has been stabilized professional oral health is returned to the referring veterinarian.
Crown application is most commonly performed by veterinary dentists. At AVS, this work is very commonly done on police working dogs who need good dental function to perform their duties. Dr. Robert Ulbricht works with police departments from all over the St. Louis metropolitan area, southern Illinois and even Kentucky.