PRACTICAL RELEVANCE: Tooth extraction is one of the most commonly performed surgical procedures in small animal practice. CLINICAL CHALLENGES: The clinician must be familiar with normal oral anatomy, utilize nomenclature accepted in dentistry and oral surgery, use the modified Triadan system for numbering teeth, identify normal structures on a dental radiograph, understand the tissues that hold the teeth in the jaws, know the biomechanical principles of tooth extraction, be able to choose the most appropriate instrument for removal of a tooth, extract teeth using closed and open techniques, and create tension-free flaps for closure of extraction sites. AUDIENCE: This review is intended to familiarize both the general and referral practitioner with feline oral anatomy and tooth extraction techniques. PATIENT GROUP: Tooth extraction is predominantly performed in cats with tooth resorption, chronic gingivostomatitis and periodontal disease. EQUIPMENT: The basic contents of a feline tooth extraction kit are explained. EVIDENCE BASE: The guidance contained within this review is based on a combination of the published literature, the authors personal experience and the experience of colleagues.

CASE SUMMARY: A 10-year-old castrated male domestic shorthair cat was presented for assessment of a gingival mass surrounding the left maxillary third and fourth premolar teeth. The mass was surgically removed by means of a marginal rim excision, and the tissue was submitted for histological assessment. It was identified as a benign cementoblastoma (true cementoma). There was proliferation of mineralized eosinophilic material with multiple irregularly placed lacunae and reversal lines, reminiscent of cementum. The cat recovered uneventfully from the anesthesia, and there was no evidence of tumor recurrence 6 months after surgery. RELEVANCE AND NOVEL INFORMATION: Cementoblastomas (true cementomas) in domestic animals are rare, with just a few reports in ruminants, monogastric herbivores and rodents. Cementoblastoma is considered a benign tumor that arises from the tooth root. The slow, expansive and constant growth that characterizes these masses may be accompanied by signs of oral discomfort and dysphagia. This case report is intended to increase knowledge regarding this tumor in cats and also highlights the importance of complete excision of the neoplasm. To our knowledge, there are no previous reports in the literature of cementoblastoma in the cat.

The objective of this study was to evaluate the prevalence of regional and distant metastasis in cats with advanced oral squamous cell carcinoma (SCC) in a retrospective case series. Forty-nine cats with cytologically- or histopathologically-confirmed oral SCC presented to the Matthew J Ryan Veterinary Hospital of the University of Pennsylvania. History, clinical and laboratory results, diagnostic imaging findings and survival times were obtained from the medical records of patients who received diagnostic evaluation for metastasis. The prevalence of metastasis was assessed by means of mandibular lymph node cytology and three-view thoracic radiography. The prevalence of mandibular lymph node metastasis was 31% (15/49). Evidence of possible thoracic metastasis was seen in 10% (5/49) of cases. Of the patients with mandibular lymph node metastasis, 53% (8/15) were maxillary, 27% mandibular (4/15), 13% sublingual (2/15) and 7% caudal pharyngeal (1/15). Pulmonary metastasis was seen in three mandibular, one maxillary and one sublingual mass. Forty-one patients died or were euthanased owing to progression of local disease, and seven patients were lost to follow-up. The prevalence of regional metastasis in this study was more common than most previously reported studies, while the rate of pulmonary metastasis was higher than has previously been published. Although significant conclusions cannot be drawn, control of the primary tumor, regardless of tumor size at diagnosis, appears to be an important factor in improving survival time, and therefore treatment of metastasis may be important in those cases where long-term control of the primary tumor is possible.

A cadaveric study was performed to investigate the external mechanical forces required to fracture maxillary fourth premolar teeth in domestic dogs and describe a clinically relevant model of chewing forces placed on functionally important teeth in which fracture patterns are consistent with those defined by the American Veterinary Dental College (AVDC). Twenty-four maxillary fourth premolar teeth were harvested from dog cadavers. Samples consisted of teeth with surrounding alveolar bone potted in polycarbonate cylinders filled with acrylic. The cylinders were held by an aluminum device at an angle of 60° with respect to the ground. An axial compression test was performed, creating a force upon the occluso-palatal aspects of the main cusps of the crowns of the teeth. The highest compressive force prior to failure was considered the maximum force sustained by the teeth. Results showed the mean maximum force (± SD) sustained by the tested teeth at the point of fracture was 1,281 N (± 403 N) at a mean impact angle (± SD) of 59.7° (± 5.2°). The most common fracture type that occurred among all samples was a complicated crown fracture (n = 12), followed by an uncomplicated crown fracture (n = 6), complicated crown-root fracture (n = 5), and uncomplicated crown-root fracture (n = 1). There was no statistically significant correlation between dog breed, age, weight, impact angle, crown height or crown diameter, and the maximum force applied at the point of fracture. The only independent variable that remained significantly associated with maximum force was the crown height to diameter ratio (p = 0.005), suggesting that a decreased ratio increases tooth fracture resistance. The methodology described herein has been successful in creating a pattern of fracture of maxillary fourth premolar teeth consistent with that defined by the AVDC under angled compression at forces within the maximum chewing capability of the average domestic dog.