Lecture 6 Flashcards
(20 cards)
What diseases does chronic gingivostomatitis (CGS) have similarities with?
Feline inflammatory bowel disease (FIBD) and Crohns disease in man
What breeds are predisposed to CGS?
Siamese, Persians, Abyssinians and Somali
Which age groups tend to be affected by CGS?
Middle aged cats
What is the aetiology of CGS?
Multifactorial disease –> FIV, FeLV, Herpes, Calici virus and Bartonella
Can also be immune mediated
What are the similarities between CGS and IBD?
Breakdown in mucosal tolerance to Ag stimulation
How is a diagnosis of CGS made?
By ruling out other conditions
How do we manage CGS?
No one treatment works for all
Professional cleaning and homecare is best starting point
Antimicrobials –> seemed to assist in some way
Anti-inflammatories –> initial response was good but they fade over time
Immunosuppressant drugs –> safety margin is too narrow
What are the effects of oral cyclosporine?
Blocks T-helper cells and IL-2
Palatability is an issue, vomiting/diarrhoea are side effects
Also toxoplasma needs to be negative before using it and cats should be kept indoors during treatment
Can cause hyperplasia of the oral mucosa as well
What are some other ways to treat CGS?
Hydrolysed protein diets
Laser therapy
Stem cell therapy
What do you do if there is no improvement 60 days following FME or SME?
May require causal extractions if not entire dentition
Response to extractions may be slowed by chronicity of the disease
What is 1st, 2nd and 3rd line therapy?
1st = caudal/whole mouth extractions 2nd = corticosteroids 3rd = interferon or cyclosporine therapy
What is the appearance of TR or ORL (odontoclastic resorptive lesions)
Lesions at cervical area of the tooth and can progress coronally/apically
Usually the mandibular 3rd/4th PM and maxillary 4th PM
Type 1 TR?
Normal PDL space and radiodensity of the root structure
Type 2 TR?
Part of the lesion on the root surface
Absence of PDL space
Extensive root replacement by alveolar bone
Type 3 TR?
Same as type 2 except one root (multirooted teeth only) has a normal PDL space (type 1)
What is the aetiology of TR?
Unknown
May also have to do with diet, viral (calici, FIV), intrinsic acid attack, excessive Vit A and D
What are TR and CGS both associated with?
Both associated with PD
What is the treatment of type 1 TR?
Extraction is the current treatment
What is the treatment of type 2/3 TR?
Can only be diagnosed via intraoral radiographs
Crown amputation is an option then monitor healing
Extractions can be difficult due to root ankylosis
What are some other treatments for TR?
Use of alendronate to reduce osteoclastic activity –> slows progression of TR
Crown amputation provided there is no radiographic evidence of mod-severe PD or endodontic disease, FIV or stomatitis
