Nemec Ana, Gracis Margherita, Monreal-Pawlowsky Tania, Magnone William, Pritelli Antonella, Bell Cynthia
Dentistry and Oral Surgery Department, Small Animal Clinic, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia.
Department of Dentistry, Oral, and Maxillofacial Surgery, Istituto Veterinario di Novara AniCura, Novara, Italy.
Front Vet Sci. 2024 Feb 13;11:1335960. doi: 10.3389/fvets.2024.1335960. eCollection 2024.
Seven teeth extracted from two adult California sea lions () due to pulp exposure and/or to gain access to the mandibular canine teeth were histologically evaluated, and the findings were compared with clinical and radiographic findings. Three teeth were diagnosed with pulp exposure, and two of these showed no radiographic signs of endodontic disease and were histologically vital with prominent coronal pulpitis and a pulp polyp. Another tooth with pulp exposure was showing clinical and radiographic signs of endodontic disease and was histologically confirmed with pulp necrosis. A discoloured incisor tooth was showing radiographic signs of endodontic disease and was also histologically non-vital. Two clinically and radiographically healthy mandibular first premolar teeth and one second incisor tooth had no evidence of pulpitis or pulp necrosis but had pulp canal obliteration. Regular clinical and radiographic follow-up for 5 months to 3 years after the procedures confirmed uneventful healing of the extraction sites, despite initial flap's dehiscence. Although extractions of affected teeth in California sea lions are considered the most practical and beneficial therapy, these are associated with the risks of extensive trauma and anaesthesia and the need to perform these surgical procedures on-site under variable conditions. As California sea lions can be trained to allow conscious dental radiographic re-checks, monitoring teeth with clinical signs of pulp polyp formation and without radiographic signs of endodontic disease warrant further evaluation/reconsideration from previous recommendations. Endodontic treatment of abscessed teeth in California sea lions is reportedly unsuccessful and is discouraged. However, vital pulpectomy could be an alternative treatment to extraction in teeth with pulp polyps as it was found to be highly successful in humans, but the possibility of endodontic failure and need for further treatments should be weighted in the treatment choice.
对两只成年加利福尼亚海狮因牙髓暴露和/或为获取下颌犬齿而拔除的七颗牙齿进行了组织学评估，并将结果与临床和放射学检查结果进行了比较。三颗牙齿被诊断为牙髓暴露，其中两颗没有牙髓病的放射学迹象，组织学检查显示牙髓活力正常，有明显的冠部牙髓炎和牙髓息肉。另一颗牙髓暴露的牙齿有牙髓病的临床和放射学迹象，组织学检查证实有牙髓坏死。一颗变色的门牙有牙髓病的放射学迹象，组织学检查也显示牙髓无活力。两颗临床和放射学检查均健康的下颌第一前磨牙和一颗侧切牙没有牙髓炎或牙髓坏死的证据，但有根管闭锁。尽管最初皮瓣有裂开，但术后5个月至3年的定期临床和放射学随访证实拔牙部位愈合良好。虽然拔除加利福尼亚海狮患牙被认为是最实用和有益的治疗方法，但这些治疗与广泛创伤和麻醉风险以及在可变条件下现场进行这些外科手术的必要性相关。由于加利福尼亚海狮可以被训练接受清醒的牙科放射学复查，对于有牙髓息肉形成临床症状且无牙髓病放射学迹象的牙齿，值得根据先前的建议进行进一步评估/重新考虑。据报道，加利福尼亚海狮脓肿牙的牙髓治疗不成功，不建议采用。然而，对于有牙髓息肉的牙齿，活髓切断术可能是拔牙的替代治疗方法，因为它在人类中被发现非常成功，但在治疗选择中应权衡牙髓治疗失败的可能性和进一步治疗的必要性。
