Q醬是一隻已節育的母巧克力貴賓犬，接受治療時為7歲10個半月

患犬有嚴重牙周病的病史，飼主在2022年發現狗的上顎右側犬齒脫落，原本的犬齒脫落處有一個缺口直通鼻腔，先至附近動物醫院就診，經友院轉介至本院就診評估治療，經陳重威獸醫師診斷為右側上犬齒(104)的齒槽廔管(口鼻廔管，oronasal fistula)。

由於該處的齒槽骨已完全流失、牙齦的厚度(thickness)也不足，若使用傳統的冠向移位翻瓣(coronally positioned flap)手術，可能會因為張力(tension)過大而造成皮瓣破裂、手術失敗，所以陳重威獸醫師經評估後決定採用「旋轉皮瓣(rotation flap)技術」進行手術，可以確實使用「無張力皮瓣(tension free flap)」進行縫合，讓癒合更加良好。

術後6個月回診追蹤，廔管處已完全封閉、癒合良好，口腔與鼻腔不再相通，沒有再感染的風險，狗的生活狀況良好，沒有打噴嚏、流鼻膿等症狀。

狗貓嚴重牙周病不只會造成牙齒掉光、口腔病變，甚至會誘發其他的併發症，影響身體其他器官等全身性疾病，例如：動脈粥狀硬化、血栓形成，增加心肌梗塞、中風、感染性心內膜炎、糖尿病、呼吸道疾病、失智症等發生的機率。

因此請飼主每日務必幫狗貓清潔牙齒，照護好口腔衛生，為狗貓健康做好把關。

Q-Chiang is a spayed female chocolate Poodle, at the time of treatment, she was 7 years and 10 and a half months old.

The patient has a history of severe periodontal disease. In 2022, the owner noticed that the maxillary right canine of her had fallen out, leaving a gap that communicated directly with the nasal cavity. The owner initially took the dog to a nearby animal hospital, and then was referred to our hospital for further evaluation and treatment. After examination by Dr. Chung-Wei Chen (Dr. Richard Chen), it was diagnosed as an oronasal fistula of the maxillary right canine (104).

Due to complete loss of alveolar bone in the affected area and insufficient thickness of the gingiva, the conventional coronally positioned flap surgery could result in excessive tension and lead to flap rupture and surgical failure. Therefore, after assessment, Dr. Chung-Wei Chen (Dr. Richard Chen) decided to perform the surgery using the “rotation flap” technique, which allows for the use of a “tension-free flap” for suturing and ensures better healing.

During the follow-up visit 6 months after the surgery, the oronasal fistula had completely closed, and the healing was excellent. The oral and nasal cavities were thoroughly separated, eliminating the risk of reinfection. The dog’s living condition is good, and there were no symptoms such as sneezing or nasal discharge.

Severe periodontal disease in dogs and cats not only leads to tooth loss and oral abnormalities but can also trigger other complications affecting various organs in the body. These systemic diseases include atherosclerosis, thrombosis, and increase the likelihood of developing the following diseases, including myocardial infarction (MI), stroke, infective endocarditis, diabetes, respiratory diseases, dementia (cognitive dysfunction syndrome, CDS), etc.

Therefore, it is essential for owners to clean their dogs’ and cats’ teeth daily and maintain good oral hygiene to safeguard their overall health.