Veterinary Clinics of North America: Small Animal Practice
Review articleFeline odontoclastic resorptive lesions: An unsolved enigma in veterinary dentistry
Section snippets
Extension of periodontal disease
Chronic inflammation of the periodontium was suggested to be a cause of FORLs [11], [12], [13], [14], [15], [16], [17]. Plaque accumulation can cause inflammation of periodontal tissues, leading to local immune responses and release of inflammatory elements (eg, cytokines) and bacterial products (eg, lipopolysaccharides) that stimulate differentiation and migration of clastic cells [18], [19], [20]. Cytokines, such as interleukin (IL)-1 and IL-6, are secreted locally by epithelial and
Prevalence and predisposition
A significant increase of FORLs has been recognized since the 1960s, with the frequency varying from 2% to 75% depending on the population of cats studied and the investigative methods applied (Table 3). The populations are described as “random,” meaning there was no specific reason for the veterinary examination; “mixed,” meaning that cats were presented to a veterinarian for treatment; and “dental,” meaning that cats were examined during a procedure scheduled for examination or treatment of
Classification
FORLs are clinically and radiographically classified into five stages [52], although earlier reports combined stages 4 and 5 for therapeutic reasons [144]. Stage 1 lesions extend into the cementum only (Fig. 4). They do not enter the dentin and are not sensitive. They may be difficult to detect because of their microscopic size. The authors of the present article think that most lesions diagnosed as stage 1 lesions may already be stage 2. Stage 2 lesions progress through cementum into crown or
Histopathologic appearance
FORLs were first recognized and histologically differentiated from caries in the 1920s [57], [148], but they were not reported again in the veterinary literature until after the mid-1950s, when they were thought to be carious lesions [149], [150], [151], [152], [153], [154], [155]. Two histopathologic studies in the 1970s again revealed that “neck lesions,” now referred to as FORLs, were not caries but a type of tooth resorption [25], [156]. Subsequent studies in the 1980s [10], [80], [157],
Clinical signs
Although cats with FORLs can present with halitosis, dysphagia, ptyalism, anorexia, dehydration, weight loss, lethargy, and discomfort [5], [144], [175], most affected cats do not show distinct clinical signs. Head shaking, sneezing, and excessive tongue movements have also been observed [46]. Cats may sometimes show spontaneous repetitive jaw motions while eating, drinking, or grooming. Signs related to oral pain may include dropping food while eating, refusing to eat hard food, “hissing” and
Comparison with other defects of the dental hard substances
FORLs are often confused with hard tissue defects that are not resorptive in nature [44]. “Attrition” is defined as normal or excessive loss of tooth substance caused by tooth-by-tooth frictional contact, usually as a result of mastication or malocclusion [185]. “Abrasion” is defined as tooth wear caused by frictional contact of a tooth with a nondental material [185], such as that found in teeth in carnivores (common in dogs with untreated pruritic dermatoses; excessive chewing on hard toys,
Tooth resorptions in nonfelidae
There are several reports describing canine odontoclastic resorptive lesions in domestic dogs [1], [189], [190], [191], [192], [193], [194], [195], [196], [197], [198], [199], [200], [201], [202]. In one study, root resorption was reported in 17.9% of randomly selected dogs [203]. In the authors' own experience, the prevalence of canine odontoclastic resorptive lesions is low. Resorptions of permanent teeth have been reported in the dolphin, Montana black bear, and Rocky Mountain elk. Most of
Treatment
The ultimate goal of any treatment option is to provide the cat with a healthy pain-free mouth [177]. Determining the underlying etiology and predisposing factors for FORLs is essential for making future recommendations on preventative measures and successful treatment options. Historically, a common approach for the treatment of FORLs included fluoride treatment of stage 1 lesions, restoration of stage 2 lesions, and extraction of teeth graded stage 3 or higher [15]. Fluoride treatment remains
Conclusion
Approximately one third of all domestic cats may develop FORLs during their life span, and the risk of developing FORLs increases with age. Extraction is the current treatment of choice. The etiology of FORLs remains unknown. Finding the causative factors that alter the resorption-inhibiting characteristics of the outer tooth surface may be the clue to the enigma of FORLs.
Acknowledgements
The authors thank Colin E. Harvey, BVSc, FRCVS, and Sandra Manfra Marretta, DVM, for their time, effort, and contribution in proofreading this article.
References (240)
- et al.
Etiopathogenesis of feline dental resorptive lesions
Vet Clin North Am Small Anim Pract
(1992) - et al.
Gingivitis/stomatitis in cats
Vet Clin North Am Small Anim Pract
(1992) - et al.
Anatomy of the mouth and teeth of the cat
Vet Clin North Am Small Anim Pract
(1992) - et al.
Changes in periodontal membrane and bone following experimental pulpal injury in deciduous molar teeth in kittens
Arch Oral Biol
(1965) - et al.
Possible role of tensile stress in the etiology of cervical erosive lesions of teeth
J Prosthet Dent
(1984) - et al.
Stress-induced cervical lesions: review of advances in the past 10 years
J Prosthet Dent
(1996) - et al.
Diet as a risk factor for feline external odontoclastic resorption
J Nutr
(1994) - et al.
The dental pathology of feral cats on Marion Island,part II: periodontitis, external odontoclastic resorption lesions and mandibular thickening
J Comp Pathol
(1996) Feline experimental models for control of periodontal disease
Vet Clin North Am Small Anim Pract
(1992)- et al.
Feline dental disease
Vet Clin North Am Small Anim Pract
(1986)
Idiopathic dental root replacement resorption in old dogs
J Vet Dent
Radiographic signs and diagnosis of dental disease
Semin Vet Med Surg
Veterinaire tandheelkunde (10). Tandhalslaesies bij katten. Etiologie–Klinische diagnostiek—Therapie
Tijdschr Diergeneeskd
Tooth resorption
Quintessence Int
Feline dental resorptive lesions
Semin Vet Med Surg
Inflammatory oral diseases of the cat
Literatuuronderzoek: tandhalslaesies bij katten. Fakulteit Diergeneeskunde, Vakgroep Geneeskunde van Gezelschapsdieren
Epidemiologische und morphologische Untersuchungen am KatzengebiβII. Mitteilung: Morphologische Untersuchungen der “neck lesions”
Kleintierpraxis
“Neck Lesions” bei Grosskatzen: Untersuchungen beim Leoparden (Panthera pardus)
Kleintierpraxis
Krankheiten der Zähne und des Kiefers
Cervical line lesions: an update
Can Vet J
Feline cervical line lesions
Vet Med Rep
Krankheiten der Zähne und des Kiefers
“Resorptive lesions” bei der Katze. Eine klinische Untersuchung zur Versorgung mit “Dyract.”
Kleintierpraxis
Challenges in treatment of external odontoclastic resorptive lesions in cats
Compend Contin Educ Pract Vet
Nekrobazillose der Zähne bei der Katze
Tierärztliche Umschav
Serum antibody response to antigens of oral gram-negative bacteria in cats with plasma cell gingivitis-stomatitis
J Dent Res
Neck lesions in the teeth of cats [abstract]
Vet Rec
Physical examination and radiographic analysis to detect dental and mandibular bone resorption in cats: a study of 81 cases from necropsy
J Vet Dent
Studies on dentin 2—transient vasodentin in the incisor teeth of a rodent (Perognathus longimembris)
Acta Anat
Tooth enamel thickness in the mature dentition of domestic dogs and cats—preliminary study
J Vet Dent
Microhardness of enamel and dentine of cat premolar teeth
Jpn J Vet Sci
Endodontics
Small animal dentistry
Cemento-enamel junction—revisited
J Periodontal Res
Periodontal attachment responses to surgical injury in the cat
J Clin Periodontol
An alternative hypothesis from veterinary science for the pathogenesis of noncarious cervical lesions
Quintessence Int
Acquired feline oral cavity diseasePart 2: feline odontoclastic resorptive lesions
In Practice
Sneezing in a cat secondary to caries lesion in the left canine tooth
J Vet Dent
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