{"id":31604,"date":"2022-10-10T15:23:29","date_gmt":"2022-10-10T15:23:29","guid":{"rendered":"https:\/\/todaysveterinarypractice.com\/?p=31604"},"modified":"2024-07-09T17:55:03","modified_gmt":"2024-07-09T17:55:03","slug":"oral-surgery-to-remove-teeth-in-cats","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/","title":{"rendered":"Oral Surgery to Remove Teeth in Cats"},"content":{"rendered":"<p class=\"p1\"><span class=\"s1\">Exodontia, or extraction of teeth, is a commonly performed oral surgery procedure in cats. The objective with extractions is to remove the entire tooth and root without causing unnecessary damage to the surrounding soft tissue or bone.<sup>1<\/sup> Performing extractions in a consistent, orderly manner will decrease the incidence of complications.<sup>2<\/sup> <\/span><span class=\"s2\">The easiest way to avoid surgical complications is through adequate preparation, as described in the following tips:<\/span><\/p>\n<ul>\n<li class=\"p2\"><span class=\"s1\"><b>Always consider your skill and knowledge.<\/b>\u00a0If a procedure is beyond your capability based on your knowledge, skill, and\/or the pathology present, it is best to refer the patient to a board-certified veterinary dentist.<\/span><\/li>\n<li class=\"p2\"><span class=\"s1\"><b>Understand basic anatomy (<\/b><\/span><span class=\"s3\"><b>FIGURE 1<\/b><\/span><span class=\"s1\"><b>). <\/b>To<b> <\/b>avoid damaging key structures during extractions, you must be familiar with tooth anatomy and location of neurovascular bundles, the mandibular canal, nasal cavity, and the orbit.<\/span><\/li>\n<\/ul>\n<div id=\"attachment_31606\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig1.png\"><img fetchpriority=\"high\" decoding=\"async\" aria-describedby=\"caption-attachment-31606\" class=\" wp-image-31606\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig1.png\" alt=\"\" width=\"450\" height=\"333\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig1.png 858w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig1-300x222.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig1-768x568.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-31606\" class=\"wp-caption-text\">FIGURE 1. Foramina. The inferior alveolar neurovascular bundle exits the mandibular canal at the mental foramina. The middle mental foramen is in the interdental space between the mandibular canine tooth and third premolar tooth in the ventral half of the mandible beneath the lip frenulum (orange arrow). The caudal mental foramen is ventral to the mandibular third premolar (white arrow). The infraorbital neurovascular bundle exits from the infraorbital foramen, located apical to the maxillary third premolar where the zygomatic arch meets the maxilla (blue arrow).<\/p><\/div>\n<p>&nbsp;<\/p>\n<ul>\n<li class=\"p2\"><span class=\"s1\"><b>Always obtain full-mouth intraoral radiographs.<\/b>\u00a0Radiographs enable you to carefully evaluate the entire tooth, the periapical area, and the surrounding bone in order to formulate a treatment plan.\u00a0<\/span><\/li>\n<li class=\"p2\"><span class=\"s1\"><b>Consider all information.<\/b><i>\u00a0<\/i>To make an appropriate treatment decision for each tooth, combine what you see clinically, what you see radiographically, and clients\u2019 commitment to their pet\u2019s oral health care. <\/span><\/li>\n<li class=\"p2\"><span class=\"s1\"><b>Use preemptive multimodal pain management. <\/b>Doing so will provide oral surgery patients with a more comfortable intra- and postoperative period. <\/span><\/li>\n<li class=\"p2\"><span class=\"s1\"><b>Use controlled forces and a short finger stop (<\/b><\/span><span class=\"s3\"><b>FIGURE 2<\/b><\/span><span class=\"s1\"><b>). <\/b>Using a short finger stop prevents inadvertent penetration of the sublingual space, mandibular canal, nasal cavity, and orbit, should the elevator slip during extraction.<\/span><\/li>\n<\/ul>\n<div id=\"attachment_31607\" style=\"width: 310px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig2.png\"><img decoding=\"async\" aria-describedby=\"caption-attachment-31607\" class=\" wp-image-31607\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig2.png\" alt=\"\" width=\"300\" height=\"423\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig2.png 648w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig2-213x300.png 213w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-31607\" class=\"wp-caption-text\">FIGURE 2. Short finger stop, used to prevent inadvertent penetration of the sublingual space, mandibular canal, nasal cavity, and orbit if the elevator slips during extraction.<\/p><\/div>\n<ul>\n<li class=\"p2\"><span class=\"s1\"><b>Use appropriately sized, sharp instruments (<\/b><\/span><span class=\"s3\"><b>FIGURE\u00a03<\/b><\/span><span class=\"s1\"><b>).<\/b> Although the oral cavity is not considered a sterile surgical site, surgical instruments that are used to penetrate soft tissue or bone should always be sterilized before each use.<sup>3<\/sup> <\/span><\/li>\n<\/ul>\n<div id=\"attachment_31608\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig3A.png\"><img decoding=\"async\" aria-describedby=\"caption-attachment-31608\" class=\" wp-image-31608\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig3A.png\" alt=\"\" width=\"450\" height=\"330\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig3A.png 936w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig3A-300x220.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig3A-768x564.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-31608\" class=\"wp-caption-text\">Figure 3. Instruments for an oral surgery pack for a cat. (A) Top to bottom: 15 or 15C scalpel blade and scalpel handle (either flat or round), periosteal elevator. Left to right: iris scissors (some prefer LaGrange or Metzenbaum), small thumb forceps, small needle holder, small 1.3-mm dental luxator, wing-tipped elevators (sizes 2 and 3), small extraction forceps. Not shown: lip retractors, 5-0 absorbable suture with reverse cutting or taper needle and burs. Burs commonly used during extraction of cat teeth include round burs (Nos. 1\/2, 1, and 2), pear-shaped burs, and diamond burs.<\/p><\/div>\n<div id=\"attachment_31609\" style=\"width: 359px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig3B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31609\" class=\" wp-image-31609\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig3B.png\" alt=\"\" width=\"349\" height=\"566\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig3B.png 648w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig3B-185x300.png 185w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig3B-632x1024.png 632w\" sizes=\"(max-width: 349px) 100vw, 349px\" \/><\/a><p id=\"caption-attachment-31609\" class=\"wp-caption-text\">Figure 3. (B) Root tip pick and root tip extraction forceps (both useful for removing fractured root tips).<\/p><\/div>\n<ul>\n<li class=\"p2\"><span class=\"s1\"><b>Use magnification and lighting. <\/b>By<b> <\/b>preventing awkward postures and supporting a neutral spine, head-mounted lighting and magnification reduce the surgeon\u2019s eye, neck, and shoulder strain.<sup>4<\/sup> <\/span><\/li>\n<li class=\"p3\"><span class=\"s1\"><b>Be one with the periodontal ligament! <\/b>The periodontal ligament has fibers that attach to the cementum of the tooth root and to the alveolar bone surrounding the tooth root (<\/span><span class=\"s3\"><b>FIGURE 4<\/b><\/span><span class=\"s1\">). Stretching and breaking down the periodontal ligament is the key to successful tooth extraction.<sup>1<\/sup> For everything you do while extracting teeth from cats (creating flaps, removing alveolar bone, sectioning of multirooted teeth), the end goal is straight-line access to the periodontal ligament space with your dental elevator or luxator.<\/span><\/li>\n<\/ul>\n<div id=\"attachment_31610\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig4.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31610\" class=\" wp-image-31610\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig4.png\" alt=\"\" width=\"450\" height=\"339\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig4.png 850w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig4-300x226.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig4-768x578.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-31610\" class=\"wp-caption-text\">FIGURE 4. Periodontal ligament. The periodontal ligament (white arrow) has fibers that attach to the cementum and to the alveolar bone surrounding the tooth root. Courtesy Vica Combs.<\/p><\/div>\n<p class=\"p4\"><span class=\"s1\">For all but the simplest extractions, consider raising a gingival flap to increase visualization and allow for tension-free closure of the gingival tissues.<sup>1<\/sup> A surgical extraction involves creating a mucoperiosteal flap, removing buccal alveolar bone, sectioning multirooted teeth into single-root segments, and apposing the mucoperiosteal flap and the palatal or lingual gingival tissues after extraction of the tooth. <\/span><\/p>\n<h2 class=\"p5\">Steps for Surgical Extraction<\/h2>\n<p class=\"p6\"><span class=\"s1\">Following the same steps during all surgical extractions for all patients ensures consistent surgical outcomes. <\/span><\/p>\n<ol>\n<li><span class=\"s1\">To minimize contamination of the surgical site with calculus and bacteria, complete basic oral care (supragingival and subgingival scaling and polishing) before beginning the oral surgery.<sup>1<\/sup><\/span><\/li>\n<li>Obtain full mouth radiographs.<\/li>\n<li>Use preemptive multimodal pain management, including intraoral regional nerve blocks.<\/li>\n<li>Make an intrasulcular incision around the tooth or teeth to be extracted by using a 15 or 15C scalpel blade.<\/li>\n<li>Create a mucoperiosteal flap. A mucoperiosteal flap is a full-thickness flap, elevated beyond the mucogingival line to include the periosteum. Mucoperiosteal flaps improve visualization during extractions. Several principles of flap design must be considered when planning the mucoperiosteal flap (<span class=\"s3\"><b>BOX 1<\/b><\/span><span class=\"s1\">). The choice of flap\u2014envelope flap, triangular flap (1 vertical releasing incision), or broad-based pedicle flap (2 diverging vertical releasing incisions)\u2014depends on the location of the tooth to be extracted, the patient, and the surgeon\u2019s preferences.<\/span><\/li>\n<\/ol>\n<p><span class=\"s1\"><div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 1 Principles to Be Considered When Planning a Mucoperiosteal Flap<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\"><\/span><\/p>\n<ul>\n<li><span class=\"s1\">The apical portion of the flap must be wider than the coronal portion.<\/span><\/li>\n<li>The flap must be large enough to allow for adequate visualization of the surgical area.<\/li>\n<li>The flap should be gently handled.<\/li>\n<li>The flap should be approximated (sutured) over healthy bone without tension.<\/div><\/div><\/li>\n<li><b>Envelope flap (<\/b><span class=\"s3\"><b>FIGURE 5<\/b><\/span><span class=\"s1\"><span class=\"s1\"><b>):<\/b> The envelope flap provides the least amount of visualization and tissue for closure. It may be used for simple extractions or as the first step in crown amputation with intentional root retention. To create an envelope flap, make a horizontal incision in the gingival sulcus at the crestal bone, and elevate the attached gingival tissue with a periosteal elevator. The horizontal incision may extend only to the mesial and distal aspects of the tooth involved, or it may be extended to incorporate adjacent teeth and allow for greater flap reflection and exposure.<sup>5<\/sup> A vertical releasing incision is not made. If the envelope flap is not elevated beyond the mucogingival line, then it is considered a mucogingival flap, not a mucoperiosteal flap.<\/span><\/span><\/li>\n<\/ul>\n<div id=\"attachment_31611\" style=\"width: 459px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig5A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31611\" class=\" wp-image-31611\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig5A.png\" alt=\"\" width=\"449\" height=\"331\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig5A.png 783w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig5A-300x221.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig5A-768x566.png 768w\" sizes=\"(max-width: 449px) 100vw, 449px\" \/><\/a><p id=\"caption-attachment-31611\" class=\"wp-caption-text\">Figure 5. Envelope flap. (A) Planned flap elevation (black dashed line).<\/p><\/div>\n<div id=\"attachment_31612\" style=\"width: 461px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig5B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31612\" class=\" wp-image-31612\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig5B.png\" alt=\"\" width=\"451\" height=\"281\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig5B.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig5B-300x187.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig5B-768x479.png 768w\" sizes=\"(max-width: 451px) 100vw, 451px\" \/><\/a><p id=\"caption-attachment-31612\" class=\"wp-caption-text\">Figure 5. Envelope flap. (B) envelope flap after elevation.<\/p><\/div>\n<ul>\n<li><span class=\"s1\"><b>Triangular (3-cornered) mucoperiosteal flap (<\/b><\/span><span class=\"s3\"><b>FIGURE 6<\/b><\/span><span class=\"s1\"><b>):<\/b> Create an envelope flap and 1\u00a0vertical releasing incision that extends apical to the mucogingival line (<\/span><span class=\"s3\"><b>Figure 6A<\/b><\/span><span class=\"s1\">). Use a periosteal elevator to elevate the flap from the alveolar bone (<\/span><span class=\"s3\"><b>FIGURE 6B<\/b><\/span><span class=\"s1\"><span class=\"s1\">). The attached gingiva is tightly adhered to the underlying alveolar bone. Careful elevation in this area prevents tearing of the flap.<\/span><\/span><\/li>\n<\/ul>\n<div class=\"mceTemp\"><\/div>\n<div class=\"mceTemp\"><\/div>\n<div id=\"attachment_31613\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig6A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31613\" class=\" wp-image-31613\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig6A.png\" alt=\"\" width=\"450\" height=\"453\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig6A.png 780w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig6A-298x300.png 298w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig6A-150x150.png 150w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig6A-768x774.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-31613\" class=\"wp-caption-text\">Figure 6. Triangular (3-cornered) mucoperiosteal flap. (A) Planned flap elevation (black dashed line).<\/p><\/div>\n<div id=\"attachment_31614\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig6B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31614\" class=\" wp-image-31614\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig6B.png\" alt=\"\" width=\"450\" height=\"464\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig6B.png 792w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig6B-291x300.png 291w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig6B-768x791.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-31614\" class=\"wp-caption-text\">Figure 6. Triangular (3-cornered) mucoperiosteal flap. (B) triangular flap after elevation. Note the extension of the vertical releasing incision beyond the mucogingival line.<\/p><\/div>\n<ul>\n<li><span class=\"s1\"><b>Pedicle or broad-based (4-cornered) mucoperiosteal flap (<\/b><\/span><span class=\"s3\"><b>FIGURE 7<\/b><\/span><span class=\"s1\"><b>): <\/b>Make an intrasulcular incision around the tooth, and then make 2 diverging vertical releasing incisions at the mesial and distal aspects of the tooth\/teeth to be removed that extends beyond the mucogingival line (<\/span><span class=\"s3\"><b>FIGURE 7A<\/b><\/span><span class=\"s1\">). Use a periosteal elevator to elevate the flap from the alveolar bone (<\/span><span class=\"s3\"><b>FIGURE 7B<\/b><\/span><span class=\"s1\">)<\/span>. As with a triangula<span class=\"s1\"><span class=\"s1\">r flap, be careful when elevating the attached gingival tissue at the mucogingival line.<\/span><\/span><\/li>\n<\/ul>\n<div id=\"attachment_31615\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig7A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31615\" class=\" wp-image-31615\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig7A.png\" alt=\"\" width=\"450\" height=\"396\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig7A.png 780w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig7A-300x264.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig7A-768x676.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-31615\" class=\"wp-caption-text\">Figure 7. Pedicle or broad-based (4-cornered) mucoperiosteal flap. (A) Planned broad-based flap (black dashed line).<\/p><\/div>\n<div id=\"attachment_31616\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig7B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31616\" class=\" wp-image-31616\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig7B.png\" alt=\"\" width=\"450\" height=\"357\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig7B.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig7B-300x238.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig7B-768x609.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-31616\" class=\"wp-caption-text\">Figure 7. Pedicle or broad-based (4-cornered) mucoperiosteal flap. (B) broad-based flap after elevation. Note the extension of the vertical releasing incisions beyond the mucogingival line.<\/p><\/div>\n<p><span class=\"s1\">6. Perform alveolectomy (removal of buccal alveolar bone) (<\/span><span class=\"s3\"><b>FIGURE 8<\/b><\/span><span class=\"s1\">). To facilitate tooth extraction and identify the periodontal ligament space, remove buccal bone from the root surface. Use the alveolar juga (bony prominence over the root) to guide the removal of buccal alveolar bone overlying the tooth root. To remove the buccal bone, use a small round or pear-shaped bur in a high-speed handpiece in a light paintbrush or sweeping motion. Begin by removing the buccal bone from the coronal half of the root surface (approximately 50% of buccal bone). The width of the buccal bone removed should be the same width as the root. Extend the alveolar bone removal to expose the periodontal ligament space on either side of the tooth root. A very small round bur in a high-speed handpiece held perpendicular to the tooth root may be used to outline the periodontal ligament space. Clear <\/span>visualization of the periodontal ligament space allows<span class=\"s1\"><span class=\"s1\"> the surgeon to properly place the dental elevator or luxator. If elevation of a particular tooth root is difficult, consider removing more buccal bone.<\/span><\/span><\/p>\n<div id=\"attachment_31617\" style=\"width: 461px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig8.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31617\" class=\" wp-image-31617\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig8.png\" alt=\"\" width=\"451\" height=\"338\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig8.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig8-300x225.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig8-768x576.png 768w\" sizes=\"(max-width: 451px) 100vw, 451px\" \/><\/a><p id=\"caption-attachment-31617\" class=\"wp-caption-text\">Figure 8. Alveolectomy, right maxillary canine tooth.<\/p><\/div>\n<p><span class=\"s1\">7. Section multirooted teeth. To facilitate extraction, section multirooted teeth into single-rooted segments. To allow straight-line access into the periodontal ligament space with the dental elevator or luxator, use a round bur or cross-cut bur to section the tooth into the single-rooted segments. <\/span><\/p>\n<ul>\n<li><span class=\"s1\"><b>Sectioning 2-rooted premolars (<\/b><\/span><span class=\"s3\"><b>FIGURE 9<\/b><\/span><span class=\"s1\"><span class=\"s1\"><b>):<\/b> Identify the furcation of the tooth and make 2 diagonal cuts. Remove the diamond portion of the crown to allow straight-line access when placing the dental elevator or luxator into the periodontal ligament space of the tooth roots.<\/span><\/span><\/li>\n<\/ul>\n<div id=\"attachment_31618\" style=\"width: 459px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig9.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31618\" class=\" wp-image-31618\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig9.png\" alt=\"\" width=\"449\" height=\"506\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig9.png 851w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig9-266x300.png 266w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig9-768x865.png 768w\" sizes=\"(max-width: 449px) 100vw, 449px\" \/><\/a><p id=\"caption-attachment-31618\" class=\"wp-caption-text\">Figure 9. Sectioning plan for 2-rooted premolars.<\/p><\/div>\n<ul>\n<li><span class=\"s1\"><b>Sectioning the mandibular molar (<\/b><\/span><span class=\"s3\"><b>FIGURES 10 and 11<\/b><\/span><span class=\"s1\"><span class=\"s1\"><b>):<\/b> To allow straight-line access to the distal root, identify the furcation and make the first cut in line with the mesial side of the distal root. Make an additional horizontal cut in the distal crown and remove the rectangular piece of tooth crown. This additional cut decreases the incidence of breaking the distal root during elevation and extraction because it eliminates the long \u201clever arm\u201d of the distal crown and allows for easier access to the mesial portion of the distal root. Extract the distal root first, thereby providing clear access to the distal portion of the mesial root.<\/span><\/span><\/li>\n<\/ul>\n<div id=\"attachment_31619\" style=\"width: 461px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig10.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31619\" class=\" wp-image-31619\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig10.png\" alt=\"\" width=\"451\" height=\"571\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig10.png 858w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig10-237x300.png 237w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig10-808x1024.png 808w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig10-768x973.png 768w\" sizes=\"(max-width: 451px) 100vw, 451px\" \/><\/a><p id=\"caption-attachment-31619\" class=\"wp-caption-text\">Figure 10. Sectioning plan for mandibular molar.<\/p><\/div>\n<div id=\"attachment_31620\" style=\"width: 559px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig11.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31620\" class=\" wp-image-31620\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig11.png\" alt=\"\" width=\"549\" height=\"306\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig11.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig11-300x167.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig11-768x428.png 768w\" sizes=\"(max-width: 549px) 100vw, 549px\" \/><\/a><p id=\"caption-attachment-31620\" class=\"wp-caption-text\">Figure 11. Sectioned right mandibular premolars and molar.<\/p><\/div>\n<ul>\n<li><span class=\"s1\"><b>Sectioning the maxillary fourth premolar (<\/b><\/span><span class=\"s3\"><b>FIGURES 12 and 13<\/b><\/span><span class=\"s1\"><b>): <\/b>To separate the distal root from the 2 mesial roots, identify the furcation and make the first cut in line with the mesial side of the distal root (<\/span><span class=\"s3\"><b>FIGURE 12A<\/b><\/span><span class=\"s1\">). To separate the mesiobuccal and palatal roots, position the bur nearly parallel to the long axis of the tooth and perpendicular to the palate (<\/span><span class=\"s3\"><b>FIGURE 12B<\/b><\/span><span class=\"s1\"><span class=\"s1\">). Do not begin elevating roots until all 3 roots are distinct and separate. Elevate the distal root first, followed by the mesiobuccal root and finally the palatal root. Removing bone on the buccal side of the palatal root may improve visualization of the palatal root and facilitate extraction.<\/span><\/span><\/li>\n<\/ul>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d3fba6064dc\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig12A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 12. Sectioned right maxillary fourth premolar. (A) Section between the distal root and the 2 mesial roots (patient in lateral recumbency).\"><img loading=\"lazy\" decoding=\"async\" width=\"720\" height=\"813\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig12A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig12A.png 720w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig12A-266x300.png 266w\" sizes=\"(max-width: 720px) 100vw, 720px\" \/><span>Figure 12. Sectioned right maxillary fourth premolar. (A) Section between the distal root and the 2 mesial roots (patient in lateral recumbency).<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig12B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 12. Sectioned right maxillary fourth premolar. (B) section between the mesiobuccal root and the palatal root (patient in dorsal recumbency) (black dashed line).\"><img loading=\"lazy\" decoding=\"async\" width=\"860\" height=\"965\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig12B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig12B.png 860w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig12B-267x300.png 267w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig12B-768x862.png 768w\" sizes=\"(max-width: 860px) 100vw, 860px\" \/><span>Figure 12. Sectioned right maxillary fourth premolar. (B) section between the mesiobuccal root and the palatal root (patient in dorsal recumbency) (black dashed line).<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig13.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 13. Sectioned right maxillary premolars.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"619\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig13.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig13.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig13-300x184.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig13-768x472.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>Figure 13. Sectioned right maxillary premolars.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d3fba6064dc_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d3fba6064dc\"))}, 0);}var su_image_carousel_69d3fba6064dc_script=document.getElementById(\"su_image_carousel_69d3fba6064dc_script\");if(su_image_carousel_69d3fba6064dc_script){su_image_carousel_69d3fba6064dc_script.parentNode.removeChild(su_image_carousel_69d3fba6064dc_script);}<\/script>\n<div class=\"mceTemp\"><\/div>\n<p><span class=\"s1\">8. Elevate each tooth root segment (<\/span><span class=\"s3\"><b>FIGURE 14<\/b><\/span><span class=\"s1\"><span class=\"s1\">). When using the dental elevator or luxator, gently cradle the patient\u2019s head in your opposite hand so you can deliver controlled force and neutralize the pressure applied during tooth extraction. Work with the apex of the tooth away from you so the periosteal elevator, dental elevator, or luxator is directed away from you.<sup>1<\/sup> Grasp the handle of the dental elevator or luxator in the palm of your hand and extend your index finger down the shaft of the instrument to within a few millimeters of its tip. Use a short finger stop to prevent inadvertent penetration of the sublingual space, orbital region, or nasal cavity if the elevator slips. Introduce the dental elevator into the space between the tooth and alveolar bone that is occupied by the periodontal ligament. To facilitate stretching and tearing the periodontal ligament, rotate the elevator and hold steady pressure for 15 to 30\u00a0seconds. As space allows, place the elevator further apically and repeat the elevation. Continue elevating circumferentially around the tooth until the tooth is loose. Alternatively, a dental luxator may initially be placed in the periodontal ligament space and moved side to side to create a cutting action at the luxator tip. The luxator is then pressed apically to sever the periodontal ligament, creating a wedging force.<sup>6<\/sup> Note that luxators are made of softer metal and should not be rotated because the thin tip of the instrument will bend and break.<sup>1<\/sup><\/span><\/span><\/p>\n<div id=\"attachment_31624\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig14.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31624\" class=\" wp-image-31624\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig14.png\" alt=\"\" width=\"450\" height=\"441\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig14.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig14-300x294.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig14-768x753.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-31624\" class=\"wp-caption-text\">Figure 14. Placing the elevator into the periodontal ligament space of the mesial root of the left mandibular fourth premolar of a cat in right lateral recumbency. Working with the apex of the tooth away from you, introduce the dental elevator or luxator into the periodontal ligament space while using a short finger stop.<\/p><\/div>\n<p><span class=\"s1\">9. Extract each tooth root segment (<\/span><span class=\"s3\"><b>FIGURE 15<\/b><\/span><span class=\"s1\"><span class=\"s1\">). After the tooth is very mobile, use extraction forceps and grasp the tooth near the cementoenamel junction as close to the root as possible. Gently rotate the extraction forceps along the long axis of the tooth root while pulling the tooth root segment coronally. Pushing the tooth toward the apex with the extraction forceps may help break down the periodontal ligament fibers. Applying excessive force with the extraction forceps may lead to root fracture. After tooth removal,\u00a0always\u00a0inspect the extracted root to be sure the apex is smooth and round. A rough or jagged root edge indicates that a root remnant probably remains in the alveolus.<sup>2<\/sup><\/span><\/span><\/p>\n<div id=\"attachment_31625\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig15.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31625\" class=\" wp-image-31625\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig15.png\" alt=\"\" width=\"450\" height=\"359\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig15.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig15-300x239.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig15-768x612.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-31625\" class=\"wp-caption-text\">Figure 15. Extraction forceps positioned at the cementoenamel junction of the left mandibular canine tooth.<\/p><\/div>\n<p><span class=\"s1\">10. Perform alveoplasty (bone recontouring). To remove any diseased bone and to smooth rough alveolar bone edges, use a medium-grit football diamond bur in a high-speed handpiece with water coolant. Palpate the extraction site to confirm that no sharp bony projections remain.<\/span><\/p>\n<p><span class=\"s1\">11. Debride, curette, and flush the alveolus. Debride the soft tissue edges of the extraction site. Introduce a curette into the alveolus to remove granulation tissue, debris, necrotic bone, and bone fragments from the alveolus. Flush the empty alveolus with saline to remove any persistent debris. <\/span><\/p>\n<p><span class=\"s1\">12. Release the periosteum (<\/span><span class=\"s3\"><b>FIGURE 16<\/b><\/span><span class=\"s1\">). To eliminate tension on the mucoperiosteal flap before closure, incise the periosteum along the entire width of the flap. Use a blade or scissors to incise the periosteum on the alveolar side of the mucoperiosteal flap just apical to the mucogingival line. The tissue coronal to the mucogingival line is the attached gingiva and is 1\u00a0layer thick. If you try to cut the attached gingival tissue, you will cut a portion of your flap off. Place the scissors between the mucosa (away from you in <\/span><span class=\"s3\"><b>FIGURE 16A<\/b><\/span><span class=\"s1\">) and periosteum (toward you in <\/span><span class=\"s3\"><b>FIGURE 16A<\/b><\/span><span class=\"s1\"><span class=\"s1\">), and undermine to separate the 2 layers. Place 1 blade of your scissors into the \u201ctunnel\u201d that you created with undermining and then cut the periosteum. When the periosteum is properly released, the mucoperiosteal flap will cover the empty alveolus without tension. To allow for easier placement of the suture needle and to minimize tearing of the tissues when suturing, elevate the lingual or palatal mucosa and 2 mm of the attached gingival tissue on the mesial and distal sides of the extraction site. Periosteum release can be completed when elevating the flap or after tooth extraction.<\/span><\/span><\/p>\n<div class=\"mceTemp\"><\/div>\n<div id=\"attachment_31626\" style=\"width: 459px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig16A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31626\" class=\" wp-image-31626\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig16A.png\" alt=\"\" width=\"449\" height=\"431\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig16A.png 853w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig16A-300x288.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig16A-768x736.png 768w\" sizes=\"(max-width: 449px) 100vw, 449px\" \/><\/a><p id=\"caption-attachment-31626\" class=\"wp-caption-text\">Figure 16. Releasing the periosteum. (A) Undermine the tissue plane between the alveolar mucosal tissue and the periosteum. These tissues are apical to the mucogingival line (white dashed line). The attached gingival tissue is coronal to the mucogingival line (yellow asterisk).<\/p><\/div>\n<div id=\"attachment_31627\" style=\"width: 461px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig16B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-31627\" class=\" wp-image-31627\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig16B.png\" alt=\"\" width=\"451\" height=\"317\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig16B.png 860w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig16B-300x211.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig16B-768x540.png 768w\" sizes=\"(max-width: 451px) 100vw, 451px\" \/><\/a><p id=\"caption-attachment-31627\" class=\"wp-caption-text\">Figure 16. Releasing the periosteum. (B) Periosteum partially released on the right side of the flap (white dashed lines).<\/p><\/div>\n<p><span class=\"s1\">13. Obtain a postoperative radiograph. Always document complete extraction of the entire tooth root without unnecessary damage to the surrounding bone. <\/span><\/p>\n<p><span class=\"s1\">14. Suture the mucoperiosteal flap<i>. <\/i>If an envelope flap was used, place sutures to appose the gingival tissue only in the interdental papilla. If a triangular or broad-based flap was used, the suture line should be supported by intact healthy bone. With the flap in normal position, the mucoperiosteal flap is apposed to the palatal or lingual mucosal tissue by using 5<\/span><span class=\"s4\">\u2010<\/span><span class=\"s1\">0 absorbable sutures and a reverse cutting or tapered needle in the surgeon\u2019s choice of pattern. Closing oral surgery sites allows for primary intention healing, which lessens the amount of re-epithelialization, collagen deposition, contraction, and remodeling needed for healing.<sup>7<\/sup><\/span><\/p>\n<h2 class=\"p5\">Coronectomy (Modified Extraction)<\/h2>\n<p class=\"p4\"><span class=\"s1\">A coronectomy, or modified extraction technique (<\/span><span class=\"s3\"><b>FIGURE 17 and BOX 2<\/b><\/span><span class=\"s1\">), has been described as a treatment for root replacement resorption, commonly referred to as type 2 tooth resorption, in cats.<sup>8<\/sup> Using this technique requires preoperative dental radiographs to confirm type 2 resorption. If radiographs confirm type 1 tooth resorption, proceed with surgical extraction as described above. If the radiographs confirm type 2 tooth resorption, the periodontal ligament space is not visible, the root structure is not clearly defined, and the root structure is similar in density to the surrounding alveolar bone, then a coronectomy may be completed. Teeth with concurrent endodontic or periodontal pathology or teeth in a patient with feline chronic gingivostomatitis cannot be treated with coronectomy.<\/span><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-3 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d3fba606e01\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17A.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 17. Coronectomy of the right mandibular fourth premolar tooth in a cadaver specimen. Note that the tooth did not have a tooth resorption lesion and was used for demonstration purposes only. (A) Create a small envelope flap. The gingiva is minimally reflected to expose the tooth and marginal alveolar bone. If more exposure is needed, a triangular or pedicle flap may be used.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"622\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17A.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17A.png 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17A-300x185.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17A-768x474.png 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>Figure 17. Coronectomy of the right mandibular fourth premolar tooth in a cadaver specimen. Note that the tooth did not have a tooth resorption lesion and was used for demonstration purposes only. (A) Create a small envelope flap. The gingiva is minimally reflected to expose the tooth and marginal alveolar bone. If more exposure is needed, a triangular or pedicle flap may be used.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17B.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 17. (B) Amputate the tooth at or slightly below the alveolar bone margin. Retract the gingiva and use a No. 2 round bur in a high-speed handpiece with water coolant to amputate the affected tooth at or slightly below the alveolar crest. Remove all visible tooth structure. Cut almost all the way through the tooth, but avoid cutting all the way through the tooth to avoid inadvertent damage to the lingual or palatal mucosal tissue.\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"758\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17B.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17B.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17B-300x263.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17B-768x674.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 17. (B) Amputate the tooth at or slightly below the alveolar bone margin. Retract the gingiva and use a No. 2 round bur in a high-speed handpiece with water coolant to amputate the affected tooth at or slightly below the alveolar crest. Remove all visible tooth structure. Cut almost all the way through the tooth, but avoid cutting all the way through the tooth to avoid inadvertent damage to the lingual or palatal mucosal tissue.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17C.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 17. (C) Use extraction forceps to \u201cbreak\u201d the crown off.\"><img loading=\"lazy\" decoding=\"async\" width=\"792\" height=\"925\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17C.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17C.png 792w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17C-257x300.png 257w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17C-768x897.png 768w\" sizes=\"(max-width: 792px) 100vw, 792px\" \/><span>Figure 17. (C) Use extraction forceps to \u201cbreak\u201d the crown off.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17D.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 17. (D) Elevate the lingual or palatal mucosa from the bone with a periosteal elevator.\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"805\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17D.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17D.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17D-300x280.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17D-768x716.png 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 17. (D) Elevate the lingual or palatal mucosa from the bone with a periosteal elevator.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17E.png\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 17. (E) Use a medium-grit diamond bur to remove the remaining tooth structure and smooth sharp bony projections.\"><img loading=\"lazy\" decoding=\"async\" width=\"792\" height=\"806\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17E.png\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17E.png 792w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17E-295x300.png 295w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_Fig17E-768x782.png 768w\" sizes=\"(max-width: 792px) 100vw, 792px\" \/><span>Figure 17. (E) Use a medium-grit diamond bur to remove the remaining tooth structure and smooth sharp bony projections.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d3fba606e01_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d3fba606e01\"))}, 0);}var su_image_carousel_69d3fba606e01_script=document.getElementById(\"su_image_carousel_69d3fba606e01_script\");if(su_image_carousel_69d3fba606e01_script){su_image_carousel_69d3fba606e01_script.parentNode.removeChild(su_image_carousel_69d3fba606e01_script);}<\/script>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 2 Steps for Coronectomy<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">\n<ol>\n<li>Create a flap <strong>(FIGURE 17A)<\/strong><\/li>\n<li>Amputate the tooth at or slightly below the alveolar bone margin <strong>(FIGURE 17B)<\/strong><\/li>\n<li>Remove the tooth crown <strong>(FIGURE 17C)<\/strong><\/li>\n<li>Elevate the lingual or palatal mucosal tissue <strong>(FIGURE 17D)<\/strong><\/li>\n<li>Perform alveoplasty <strong>(FIGURE 17E)<\/strong><\/li>\n<li>Take a postoperative radiograph<\/li>\n<li>Suture the flap<\/div><\/div><\/li>\n<\/ol>\n<h2 class=\"p5\">Postoperative Care<\/h2>\n<p class=\"p4\"><span class=\"s1\">Discharge patients with postoperative analgesics that are customized for each patient. Instruct clients to feed the cat a soft diet (either softened kibble or canned food) for 7 to 14 days and to not allow the cat access to treats or toys that may affect the sutures during the postoperative period. A 2-week complimentary recheck examination allows the surgeon to recheck the oral surgery sites and provides the staff an opportunity to review the patient\u2019s preventive oral healthcare plan with the client.<sup>1<\/sup> <\/span><\/p>\n<h2 class=\"p5\">Conclusion<\/h2>\n<p class=\"p4\"><span class=\"s1\">To minimize extraction complications and decrease surgeon stress, be aware of anatomy and the relationship of the tooth roots to other structures of the head, formulate a plan, use intraoral radiographs, use proper instrumentation and technique, apply controlled forces, and be patient. Completing extractions in a consistent, orderly manner will decrease the incidence of complications.<sup>2<\/sup> <\/span><\/p>\n<p class=\"p4\"><span class=\"s1\">The best way to gain confidence and improve your oral surgery skills and knowledge is to participate in a wet lab for tooth extraction in cats. If a particular case or circumstance is beyond your ability, referral to a board-certified veterinary dentist is in the best interest of the patient.<sup>2<\/sup> <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p> Preparation and organization are important factors in tooth extraction, as completing extractions in a consistent, orderly manner will decrease the incidence of complications.<\/p>\n","protected":false},"author":236,"featured_media":31633,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":10958,"footnotes":""},"categories":[409],"tags":[13],"class_list":["post-31604","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-november-december-2022","tag-peer-reviewed","column-insights-in-dentistry","clinical_topics-dentistry"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Oral Surgery to Remove Teeth in Cats | Today&#039;s Veterinary Practice<\/title>\n<meta name=\"description\" content=\"Completing feline tooth extractions in a consistent, orderly manner will decrease the incidence of complications.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Oral Surgery to Remove Teeth in Cats\" \/>\n<meta property=\"og:description\" content=\"Completing feline tooth extractions in a consistent, orderly manner will decrease the incidence of complications.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/\" \/>\n<meta property=\"og:site_name\" content=\"Today&#039;s Veterinary Practice\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/todaysveterinarypractice\" \/>\n<meta property=\"article:published_time\" content=\"2022-10-10T15:23:29+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-07-09T17:55:03+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_MainImage.png\" \/>\n\t<meta property=\"og:image:width\" content=\"990\" \/>\n\t<meta property=\"og:image:height\" content=\"419\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Marissa Delamarter\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Marissa Delamarter\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"19 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/\"},\"author\":{\"name\":\"Marissa Delamarter\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#\\\/schema\\\/person\\\/aae8b57232625dd9c50c1f00d261e1de\"},\"headline\":\"Oral Surgery to Remove Teeth in Cats\",\"datePublished\":\"2022-10-10T15:23:29+00:00\",\"dateModified\":\"2024-07-09T17:55:03+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/\"},\"wordCount\":3211,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2022\\\/10\\\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_MainImage.png\",\"keywords\":[\"Peer Reviewed\"],\"articleSection\":[\"November\\\/December 2022\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/#respond\"]}]},{\"@type\":[\"WebPage\",\"MedicalWebPage\"],\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/\",\"url\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/\",\"name\":\"Oral Surgery to Remove Teeth in Cats | Today&#039;s Veterinary Practice\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2022\\\/10\\\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_MainImage.png\",\"datePublished\":\"2022-10-10T15:23:29+00:00\",\"dateModified\":\"2024-07-09T17:55:03+00:00\",\"description\":\"Completing feline tooth extractions in a consistent, orderly manner will decrease the incidence of complications.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/#primaryimage\",\"url\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2022\\\/10\\\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_MainImage.png\",\"contentUrl\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2022\\\/10\\\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_MainImage.png\",\"width\":990,\"height\":419},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/dentistry\\\/oral-surgery-to-remove-teeth-in-cats\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Oral Surgery to Remove Teeth in Cats\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#website\",\"url\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/\",\"name\":\"Today's Veterinary Practice\",\"description\":\"Peer-Reviewed Veterinary Journal\",\"publisher\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#organization\",\"name\":\"Today's Veterinary Practice\",\"url\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2022\\\/01\\\/tvp-logo.png\",\"contentUrl\":\"https:\\\/\\\/todaysveterinarypractice.com\\\/wp-content\\\/uploads\\\/sites\\\/4\\\/2022\\\/01\\\/tvp-logo.png\",\"width\":179,\"height\":89,\"caption\":\"Today's Veterinary Practice\"},\"image\":{\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/todaysveterinarypractice\",\"https:\\\/\\\/www.youtube.com\\\/thenavc\"],\"email\":\"info@navc.com\"},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/#\\\/schema\\\/person\\\/aae8b57232625dd9c50c1f00d261e1de\",\"name\":\"Marissa Delamarter\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/5dc090334d16394e7b167a6ab8f68423224f6269541503e96e9c22dec0425e6a?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/5dc090334d16394e7b167a6ab8f68423224f6269541503e96e9c22dec0425e6a?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/5dc090334d16394e7b167a6ab8f68423224f6269541503e96e9c22dec0425e6a?s=96&d=mm&r=g\",\"caption\":\"Marissa Delamarter\"},\"url\":\"https:\\\/\\\/navc.sitepreview.app\\\/todaysveterinarypractice.com\\\/author\\\/mdelamarter\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Oral Surgery to Remove Teeth in Cats | Today&#039;s Veterinary Practice","description":"Completing feline tooth extractions in a consistent, orderly manner will decrease the incidence of complications.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Oral Surgery to Remove Teeth in Cats","og_description":"Completing feline tooth extractions in a consistent, orderly manner will decrease the incidence of complications.","og_url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/","og_site_name":"Today&#039;s Veterinary Practice","article_publisher":"https:\/\/www.facebook.com\/todaysveterinarypractice","article_published_time":"2022-10-10T15:23:29+00:00","article_modified_time":"2024-07-09T17:55:03+00:00","og_image":[{"width":990,"height":419,"url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_MainImage.png","type":"image\/png"}],"author":"Marissa Delamarter","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Marissa Delamarter","Est. reading time":"19 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/#article","isPartOf":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/"},"author":{"name":"Marissa Delamarter","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#\/schema\/person\/aae8b57232625dd9c50c1f00d261e1de"},"headline":"Oral Surgery to Remove Teeth in Cats","datePublished":"2022-10-10T15:23:29+00:00","dateModified":"2024-07-09T17:55:03+00:00","mainEntityOfPage":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/"},"wordCount":3211,"commentCount":0,"publisher":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#organization"},"image":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/#primaryimage"},"thumbnailUrl":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_MainImage.png","keywords":["Peer Reviewed"],"articleSection":["November\/December 2022"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/#respond"]}]},{"@type":["WebPage","MedicalWebPage"],"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/","url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/","name":"Oral Surgery to Remove Teeth in Cats | Today&#039;s Veterinary Practice","isPartOf":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/#primaryimage"},"image":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/#primaryimage"},"thumbnailUrl":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_MainImage.png","datePublished":"2022-10-10T15:23:29+00:00","dateModified":"2024-07-09T17:55:03+00:00","description":"Completing feline tooth extractions in a consistent, orderly manner will decrease the incidence of complications.","breadcrumb":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/#primaryimage","url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_MainImage.png","contentUrl":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/10\/Charlier_TVPNOvDec22_FelineDentalOralSurgery_MainImage.png","width":990,"height":419},{"@type":"BreadcrumbList","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/oral-surgery-to-remove-teeth-in-cats\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/"},{"@type":"ListItem","position":2,"name":"Oral Surgery to Remove Teeth in Cats"}]},{"@type":"WebSite","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#website","url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/","name":"Today's Veterinary Practice","description":"Peer-Reviewed Veterinary Journal","publisher":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#organization","name":"Today's Veterinary Practice","url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#\/schema\/logo\/image\/","url":"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/01\/tvp-logo.png","contentUrl":"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/01\/tvp-logo.png","width":179,"height":89,"caption":"Today's Veterinary Practice"},"image":{"@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/todaysveterinarypractice","https:\/\/www.youtube.com\/thenavc"],"email":"info@navc.com"},{"@type":"Person","@id":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/#\/schema\/person\/aae8b57232625dd9c50c1f00d261e1de","name":"Marissa Delamarter","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/5dc090334d16394e7b167a6ab8f68423224f6269541503e96e9c22dec0425e6a?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/5dc090334d16394e7b167a6ab8f68423224f6269541503e96e9c22dec0425e6a?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/5dc090334d16394e7b167a6ab8f68423224f6269541503e96e9c22dec0425e6a?s=96&d=mm&r=g","caption":"Marissa Delamarter"},"url":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/author\/mdelamarter\/"}]}},"_links":{"self":[{"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/posts\/31604","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/users\/236"}],"replies":[{"embeddable":true,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/comments?post=31604"}],"version-history":[{"count":14,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/posts\/31604\/revisions"}],"predecessor-version":[{"id":34287,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/posts\/31604\/revisions\/34287"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/media\/31633"}],"wp:attachment":[{"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/media?parent=31604"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/categories?post=31604"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-json\/wp\/v2\/tags?post=31604"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}