New study shows how cone-beam CT improves detection and surgical planning for canine oronasal communications

Enhanced characterization of acquired oronasal communications in dogs by cone-beam computed tomography: findings, risk factors, and clinical utility

Serena Bonacini; Stephanie Goldschmidt; Boaz Arzi; Janny Evenhuis; David Hatcher; Maria Soltero-Rivera

Background

Acquired oronasal communications (ONCs) in dogs are defects connecting the oral and nasal cavities, often resulting from advanced periodontal disease, trauma, tumors, or iatrogenic injury. Once chronic, these defects may develop epithelial lining and form permanent oronasal fistulas. Dogs with ONCs frequently exhibit chronic discomfort and respiratory signs such as nasal discharge or sneezing. Traditional diagnostic methods—including periodontal probing and intraoral radiographs—may inadequately evaluate palatal structures and surrounding anatomy. Cone-beam computed tomography (CBCT) provides high-resolution, three-dimensional imaging of maxillofacial structures and may improve diagnostic assessment and surgical planning. This study aimed to characterize CBCT findings of ONCs in dogs and identify associated risk factors and concurrent imaging findings.

Methods

A retrospective review was conducted using medical records from the Dentistry and Oral Surgery Service at the University of California–Davis Veterinary Medical Teaching Hospital. Dogs diagnosed with ONCs by dental probing and CBCT between December 2014 and November 2023 were included. Demographic information, clinical signs, ONC location and size, number of teeth involved, tooth presence or absence, and concurrent imaging findings were recorded. CBCT images were evaluated in multiple planes and 3-D reconstructions to measure ONC dimensions and calculate surface area. Statistical analyses included comparisons between Chihuahua and non-Chihuahua groups and modeling to identify predictors of ONC size and severity.

Results

Forty dogs met inclusion criteria, with a mean age of 10.8 years and mean body weight of 5.1 kg. Chihuahuas and related crosses had approximately twice the prevalence of ONCs compared with non-Chihuahua dogs (6.63% vs 2.72%) among dogs with periodontal disease. Periodontal disease was identified as the underlying cause in 97.5% of cases. The mean ONC area measured by CBCT was 15.57 mm², and 70% of dogs had bilateral disease. The number of teeth involved was positively associated with ONC severity relative to hard palate size. Age and body weight were associated with larger ONC area in one model, though these associations diminished when additional factors were considered. Clinical signs such as nasal discharge and sneezing were not reliable predictors of disease severity. Incidental findings were detected in approximately one-third of patients, including maxillofacial fractures, rhinitis, temporomandibular joint disease, and nasal foreign bodies.

Limitations

The study was retrospective and involved a small sample size from a tertiary referral center, introducing potential selection bias. The population consisted predominantly of small-breed dogs, which may limit generalizability to larger breeds. Additionally, comparisons with traditional imaging methods were not directly performed, limiting conclusions about diagnostic superiority relative to radiography.

Conclusions

CBCT enables detailed three-dimensional characterization of canine ONCs and can assist clinicians in surgical planning and detection of incidental craniofacial abnormalities. Periodontal disease remains the predominant cause of ONCs, and greater dental involvement correlates with increased defect severity. Chihuahuas and related crosses appear to have increased risk for developing ONCs, suggesting that early screening may be warranted in these breeds.

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