What is your evaluation of this radiograph of the left mandible of a 13-year-old spayed female dachshund?
Mild interproximal marginal bone loss between the left mandibular fourth premolar and the first molar (teeth 308 and 309). Fifty percent loss of marginal bone surrounding the one-rooted (normally two roots) left mandibular second molar. Widening of the periapical periodontal ligament space of questionable significance associated with the roots of tooth 309.
What would be your recommendation considering tooth 409 had a similar appearance periapically?
In this case, the recommendation was made to monitor teeth 309 and 409 with repeat radiographs in 6-12 months to confirm or refute radiographic progression of the lucency.
As time progressed, this patient showed increasing lethargy and intermittent anorexia. Thorough medical workup showed no explanation for the clinical signs. After the medical workup, the client pursued radiographic follow-up of teeth 309 and 409 one year after the initial films were obtained. Note the profound changes around teeth 308 and 309. Tooth 409 showed no evidence of progression.
Outcome: In this case, extraction of teeth 308 and 309 completely resolved the chronic progressive lethargy and anorexia within 24 hours postoperatively.