Peri-apical bone loss in the left maxillary premolar tooth



The dog was presented with a swelling on the left side of his face. The patient is a two year old male Springer Spaniel.

Peri-apical bone loss in the left maxillary premolar tooth







x-ray of the dog's maxillary premolar 


  1. Which tooth is this?
  2. What pathology can you see?
  3. What is the most likely cause?
  4. What are the treatment options for this tooth?





  1. This is the left maxillary fourth premolar tooth (sometimes referred to as a carnassial tooth). Dogs typically have four maxillary and four mandibular premolars. The maxillary fourth premolar is a three rooted tooth with two mesial and one distal roots
  2. There is evidence of peri-apical bone loss affecting all three roots of the left maxillary premolar tooth. This will be associated with inflammation and often infection in this area
  3. The most likely cause is a complicated crown fracture. Complicated crown fractures are tooth fractures that expose the pulp. Pulp exposure will result in infection and inevitable pulp necrosis
  4. The treatment options for this tooth are either extraction or endodontic treatment. Teeth that have pulp exposure should always be treated. Extraction of teeth in dogs is a surgical procedure which often involves raising a muco-periosteal flap, removing bone and sectioning the tooth into single rooted sections. It is a significant surgical procedure with potential complications. Endodontic treatment would involve root canal treatment in this case. The benefits of endodontic treatment are that it is non-invasive, there are fewer potential complications and an important strategic tooth is preserved

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