September 2011

What abnormal finding is present in this 5-year-old male Staffordshire terrier?

Erythema is present coronal to the mucogingival line at the level of  the left maxillary fourth premolar (208) distal root and interdental space between 208 and the left maxillary first molar (209).

A similar lesion is present on the right side.

No periodontal probing abnormalities exist nor is there any history of trauma.  No radiographic changes are detectable. What are some options for obtaining a diagnosis?

A periodontal flap will aid in rapid, visual examination of the area surrounding the defect.  Periodontal disease has resulted in compromise of the vestibular (buccal) bone adjacent to tooth 208, leaving most of the junctional epithelium intact.

Why wasn’t this defect detected radiographically?

The vestibular bone is very thin and superimposed over the much more radiodense tooth. Summation of the radiodense structures makes it challenging, and necessary to meticulously interpret the intraoral radiograph.

What are some treatment options?

Extraction or periodontal debridement and osteoplasty with primary closure of the mucogingival flap.