Feline Tooth Resorption: What to Extract, What to Amputate, What to Leave, and Why

Course overview

Feline tooth resorption is one of the most prevalent oral pathologies in cats and represents a significant source of chronic oral pain. Despite its frequency, the condition is often underdiagnosed due to subtle clinical presentation and reliance on visual examination alone. Many affected patients exhibit minimal outward signs despite advanced pathology, making accurate diagnosis dependent on a systematic approach that includes full-mouth intraoral radiography. Appropriate treatment planning requires a thorough understanding of disease classification, radiographic interpretation, and surgical decision-making. On physical examination, clinicians may observe gross changes that raise suspicion for tooth resorption, including gingival migration along the crown of the tooth, focal areas of gingival inflammation, or visible crown defects. In some cases, teeth may appear clinically absent due to advanced resorption, despite retained root structures within the alveolus. These findings, even in the absence of overt pain behaviors, support the need for anesthetized oral examination and diagnostic imaging. The course will emphasize how these clinical findings can be used to justify general anesthesia to clients as both a diagnostic and therapeutic necessity. This course provides a comprehensive review of feline tooth resorption, including current understanding of pathophysiology, classification systems, and disease progression. Emphasis is placed on case-based learning, application of extraction techniques, and critical evaluation of the limitations of dental radiography in diagnosis and treatment planning. While radiography remains essential, its limitations in early lesion detection and interpretation are addressed. The multifactorial and incompletely understood etiology is discussed in the context of current veterinary literature, including proposed roles of odontoclastic activity, chronic inflammation, periodontal disease, and age-related changes. Participants will develop a structured diagnostic approach with emphasis on identifying and differentiating Type 1, Type 2, and Type 3 lesions. Particular focus is placed on accurate delineation of the periodontal ligament space, as its presence or absence is critical in determining appropriate treatment. Radiographic indicators of ankylosis, replacement resorption, and inflammatory pathology will be reviewed, with correlation to clinical findings. Clinical decision-making is a primary focus of this course. Evidence-based indications for complete extraction, crown amputation with intentional root retention, and conservative monitoring will be outlined. Contraindications to crown amputation, including the presence of a discernible periodontal ligament space or evidence of inflammatory root pathology, will be emphasized. Step-by-step guidance on crown amputation technique will be provided, including appropriate case selection, removal of the clinical crown, reduction of remaining dental tissue to the level of surrounding alveolar bone, smoothing of sharp margins, and confirmation of complete crown removal. Surgical principles critical to successful outcomes are highlighted, including the creation of mucoperiosteal flaps that allow adequate visualization and access, preservation of surrounding structures, and achievement of tension-free primary closure. The importance of proper flap design, gentle tissue handling, and minimizing iatrogenic trauma is emphasized, particularly in cases involving ankylosed or structurally compromised teeth. By integrating current literature, radiographic interpretation, and practical surgical application, this course provides veterinarians with a structured, evidence-based framework for the diagnosis and management of feline tooth resorption. The goal is to improve diagnostic accuracy, support appropriate treatment selection, and enhance patient comfort and clinical outcomes.