DIAGNOSIS OF A PERIAPICAL ABSCESS IN A DOG: CASE REPORT

Adrián Sierra, eMVZ1; Diego F. Echeverry2; Edwin F. Buriticá2

1Estudiante De X Semestre de Medicina Veterinaria y Zootecnia, Universidad del Tolima.
2Grupo de Investigación en Medicina y Cirugía de Pequeños Animales, Universidad del Tolima

Introduction:
The periapical abscess is a pathology that involves the roots of the teeth and can be caused by caries, periodontal disease, and dental
fractures among others (Robaj & Shabani, 2017). The diagnosis of this pathology is usually carry out employing radiology, however,
the diagnostic utility of ultrasound has been described in humans. The aim of this case report is to present the first description of the
usefulness of ultrasound in the diagnosis of a periapical abscess of the 4th premolar in a dog .

Case presentation:
An 8-year-old mongrel male dog was referred to the Small Animal Clinic of our institution presenting a fistulous tract at the right
infra-orbital area from about a month (Fig.1A). Additionally the dog presented grade IV periodontal disease, gingivitis and halitosis.
An ultrasonographic study of the affected area was performed; as a result, maxillary bone lysis, and the presence of two hyperechoic
conical structures compatible with dental roots, surrounded by a hypoechoic halo without internal evidence of vascularization, were
observed (Fig.2). Additionally, a radiographic study was performed, evidencing loss of bone density at the periapical level of the
cranial and caudal 4th premolar roots of the right maxilla (Fig.1 B-C).
A B C

Figure 1. A. Image of the dog showing a fistulous tract at the right infra-orbital area. B. Radiographic image of oral cavity, evidencing loss of bone
density at the periapical level of the cranial and caudal 4th premolar roots of the right maxilla (yellow arrows). C. Enlarged image of B (yellow
arrows).
A B

ABSCESS ABSCESS

Cr * Cd
Cd Cr *
EA
O

R
F

Figure 2. Ultrasound scans images performed over the right fistulous tract using a 12 MHz probe A. Doppler scan showing poor vascularization
within the explore area B. B-mode images evidencing maxillary bone lysis (yellow arrowheads), and the presence of two hyperechoic conical
structures compatible with dental roots (yellow asterisks) surrounded by a hypoechoic halo, were observed.

Discussion:
Periapical abscess is a pathology that involves one or more teeth (usually premolars and molars) that can produce infra-
orbital fistulous tracts. These abscesses can be caused by caries, periodontal disease, and dental fractures among others
(Robaj and Shabani, 2017). The diagnosis is usually made with radiology, however, the diagnostic utility of ultrasound has
been described in humans. Prince et al. (2012) by the use of ultrasound, described the periapical abscess in humans
patients as a hypoechoic well-contoured cavity surrounded by reinforced bone walls, filled with fluid, without evidence of
internal vascularization on color Doppler examination. These ultrasonographic findings are compatible with those
observed in our patient. Conclusions: Ultrasonography could be a practical, non-invasive, and non-ionizing method for
the diagnosis of periapical lesions in dogs.

References:

• Robac A, Shabani, E. Radiological findings of common dental diseases in dogs and catas. Bulgarian journal of veterinary medicine.
2017;20:328-332.