Dentistry and Oral Surgery

Stem Cell Therapy for Feline Chronic Gingivostomatitis

Photo: Stem Cell Therapy for Feline Chronic Gingivostomatitis

Below, please find links to all of the clinical trials involving dentistry and/or oral surgery. The studies include a multitude of information, including (but not limited to) the study’s purpose, benefits for participating, and financial incentive information. If you have any questions, please contact the individual outlined at the end of each trial summary.

Please visit the Dentistry and Oral Surgery service webpage at the Veterinary Medical Teaching Hospital (VMTH) if you would like to learn more about the amazing things that our veterinarians can do for you and your animal.

Cats

Chronic Gingivostomatitis: Assessing Stem Cell Therapy in Cats that Have Not Had A Full Mouth Dental Extraction

Title: Fat-derived stem cells for treatment of feline gingivostomatitis

Purpose of Study: Feline chronic gingivostomatitis (FCGS) is a poorly defined disease characterized by inflammatory lesion, mostly ulcerative or proliferative in nature, affecting the gums and the back of the mouth. None of the treatments that are currently available are ideal, predictable and without possible complications. In our previous studies in over 20 cats, systemic (intravenous) administration autologous feline stem cells were shown to not only be safe, but, in most cases (about 70%), substantially improved or completely resolved the stomatitis. Therefore, the purpose of this study is use stem cells to treat cats diagnosed with chronic gingivostomatitis that have not had a full mouth extraction.

Contact: Dr. Boaz Arzi, DVM, DAVDC via phone (530-752-2470), fax (530-752-9620), or email (dosclinicaltrials@ucdavis.edu

Participation Requirements: Cats diagnosed with gingivostomatitis that have not had full mouth dental extractions

Initial Evaluation for Participation: The cats will be evaluated by the Dentistry and Oral Surgery Service to assess eligibility to be enrolled in the study.

Procedures and Owner Responsibilities: 

  • Full mouth radiographs, periodontal treatment and extraction of periodontally affected teeth at owner’s expense
  • Blood collection for analysis before the treatment and at the recheck appointments
  • Oral biopsy under general anesthesia performed at the first and last appointment (at 6 months)
  • Surgical collection of fat from the area under the belly for the production of stem cells
  • Administration of the stem cells (or placebo) to your cat systemically two times in 4 weeks interval (each treatment may be under sedation)
  • Hospitalization for 1-3 days after every stem cells administration
  • A small biopsy sample from the healed oral mucosa with your permission at the end of the study

Owner Responsibilities:

  • Bringing your cat to all scheduled appointments
  • Covering costs of full mouth dental radiographs, periodontal treatment, extraction of periodontally affected teeth, general anesthesia, take-home pain medication and any adverse events

Benefits: There is no cost to participate in this trial. If successful, your cat may not need additional treatment. This study may lead to the resolution of clinical signs that can change the quality of life of your cat. If this study will prove to be beneficial, it will have important clinical applications for other cats with the same condition and possibly even human medicine for similar indications.

Printable Flyers (PDF)

Chronic Gingivostomatitis: Assessing Stem Cell Therapy in Cats that Have Had a Full Mouth Dental Extraction

Title: Fat-derived stem cells for treatment of feline gingivostomatitis

Purpose of Study: Feline chronic gingivostomatitis (FCGS) is a poorly defined disease characterized by inflammatory lesion, mostly ulcerative or proliferative in nature, affecting the gums and the back of the mouth. None of the treatments that are currently available are ideal, predictable and without possible complications. In our previous studies in over 20 cats, systemic (intravenous) administration autologous feline stem cells were shown to not only be safe, but, in most cases (about 70%), substantially improved or completely resolved the stomatitis. Therefore, the purpose of this study is to treat cats for which all current treatment modalities have failed and have a poor quality of life.

Contact: Dr. Boaz Arzi, DVM, DAVDC via phone (530-752-2470), fax (530-752-9620), or email (dosclinicaltrials@ucdavis.edu

Participation Requirements: Cats diagnosed with gingivostomatitis that have failed to improve with all current treatments and have had full mouth dental extractions

Initial Evaluation for Participation: The cats will be evaluated by the Dentistry and Oral Surgery Service to assess eligibility to be enrolled in the study.

Procedures and Owner Responsibilities: Please contact Boaz Arzi, DVM, DAVDC via phone (530-752-2470), fax (530-752-9620), or email (dosclinicaltrials@ucdavis.edu) for details

Benefits: This study may lead to the resolution of clinical signs that can change the quality of life of your cat. If this study will prove to be beneficial, it will have important clinical applications for other cats with the same condition and possibly even human medicine for similar indications.

Printable Flyers (PDF) - #1#2

Dental Disease: Assessing Better Diagnostics

Title: The diagnostic yield of dental radiographs and cone-beam computed tomography in cats with dental disorders

Purpose of Study: Because of the highly detailed images, cone-beam computed tomography (CBCT) scans are commonly used as diagnostic tools in human medicine with great success; however, these scans are only now being introduced to the veterinary field. Therefore, the purpose of this study is to establish CBCT scans as the ideal imaging modality for mesaticephalic and brachycephalic cats with dental disorders.

Contact: Dr. Colleen Geisbush in the Dentistry and Oral Surgery Service via phone (530-752-2470) or email (cmgeisbush@ucdavis.edu)

Participation Requirements: Cats diagnosed with dentoalveolar disease that are referred to or are currently being treated by the Dentistry and Oral Surgery service (DOSS) at the UCD Veterinary Medical Teaching Hospital (VMTH).

Initial Evaluation for Participation: Examination by DOSS

Procedures: As part of the diagnostic work-up, we will image your cat via CBCT scan under general anesthesia. The CBCT scan will be done during your scheduled appointment with DOSS.

Benefits: You will not be charged for the CBCT scan; however, you will be charged for the general anesthesia and dental treatment.

We cannot promise any benefits to your cat from your taking part in this clinical trial; however, we hope that this study will lead to better diagnostics techniques. This study may also benefit other species with the same condition in the future.

Owner Responsibilities: Participation in this study does not require any additional visits beyond your scheduled appointment with DOSS.

With the exception the CBCT scan, you will be responsible for bringing your cat to DOSS and paying for all other fees associated with your cat’s visit and treatment.

Dogs

Oral Melanoma: Finding the Best Technique to Identify Metastasis

Title: CT and PET/CT for staging of canine oral malignant melanoma

Purpose: Melanoma is the most common malignant tumor of the mouth in dogs. This tumor has a relatively high rate of metastasis (tumor spread) and detection of metastasis is important as it can impact prognosis. In human medicine, staging (looking for metastasis) for similar head and neck tumors regularly includes the functional imaging positron emission tomography (PET) combined with computed tomography (CT). Currently, there is no standardized approach in veterinary medicine to assess for metastasis in oral malignant melanoma in dogs. Previous research has found the feeling of lymph nodes on examination can be an inaccurate assessment for cancer spread as they can be normal in size and still contain tumor cells. Therefore, the purpose of this study is to compare lymph node palpation to the appearance of the local lymph nodes on CT scan and a combined PET/CT scan to histopathologic results to determine which method may be the most reliable for identification of metastatic (tumor filled) lymph nodes.

Contact: The Oncology Clinical Trial Coordinators via email (oncologyclinicaltrials@ucdavis.edu) or phone (530-752-0125)

Participation Requirements:

  • Dogs diagnosed with oral melanoma with gross measurable disease
  • Deemed healthy enough for anesthesia
  • You have an interest in imaging (CT scan) for surgical or radiation planning

Initial Evaluation for Participation:

  • Histologic (small piece of tumor) or cytologic (needle aspirate) diagnosis of oral or lip fold malignant melanoma
  • Bloodwork/urinalysis within two weeks
  • 3-view chest x-rays within 1 month
  • Initial required diagnostics can be performed elsewhere or with UC Davis, but are not covered by the study

Procedures: As part of this study, your dog will receive the same care and assessment as any dog with oral melanoma presented to the UC Davis VMTH.

  • Day 0: PET/CT scans, which involve an injection of a radioactive tracer and hospitalization for one night
  • ≤14 days after PET/CT scans: Mandibular lymph node (found under the chin) removal at UC Davis

Benefits: This study will cover costs associated with CT and PET scans, surgical removal of your dog’s mandibular lymph node(s), anesthesia, and up to $300 for study-related adverse events.

Your dog will receive the most advanced imaging techniques to assess their tumor as well as the local lymph nodes. Results from this study will hopefully improve medical knowledge about the capabilities of CT and PET scans, potentially limit unnecessary sampling and/or removal of lymph nodes, and better guide medical care for your dog and future dogs affected with the same disease.

Owner Responsibilities: If you allow your dog to participate in this study, you must agree to having your dog’s mandibular lymph nodes removed following the CT/PET scans and would be responsible for costs associated with therapy to address your dog’s tumor such as surgery, radiation and/or systemic treatment.

Printable Flyer (PDF)

Oral Melanoma: Assessing a Treatment

Title: OMX-4.80 (Zox) a novel protein oxygen transporter and radiation sensitizer for dogs with oral melanoma

Purpose: One reason tumors can be resistant to radiation therapy because of low levels of oxygen in the tumors. Another reason is that low levels of oxygen leads to local immune suppression. We anticipate that the treatment will carry oxygen to the tumor and hopefully restore normal oxygen levels to the tumor and make it more responsive to treatment.

Contact: The Oncology Clinical Trial Coordinators via email (oncologyclinicaltrials@ucdavis.edu) or phone (530-752-0125)

Participation Requirements: Dogs diagnosed with a biopsy confirmed melanoma

Initial Evaluation for Participation:  Prior to enrollment your dog must have a physical examination, a CBC, a Chemistry Panel and Chest X-rays to make sure they are eligible for the trial.

Procedures:  It is important to note that radiotherapy treatments are being done as part of the normal treatment of this disease. If your dog is enrolled in the study, the following will be done:

  • On Day 1, On Day 1, we will administer a drug to mark oxygen levels, collect and analyze blood, biopsy your dog’s tumor under anesthesia, and do a CT scan to plan for radiation therapy and administer the oxygen carrier.
  • On Day 2, we will administer another oxygen marker and biopsy of your dog's tumor under anesthesia.
  • On Day 4, we will take blood, anesthetize your dog for an additional biopsy and begin your dog’s radiation treatment which will be once a week for four weeks.
  • After the second radiation treatment, we will collect another biopsy.
  • We will collect blood after the third and fourth radiation therapy session (each one week apart as part of the normal course of treatment).
  • In the event of death, we would strongly encourage you to allow a necropsy to be performed so we can try to determine the cause of death.

Benefits: The study will cover costs associated with study drugs, drug administration, day hospitalizations for the study, the radiation planning CT scan and the associated anesthesia, blood work for the study, and biopsies.  Additionally, the study will also cover up to $2,000 in medical costs if there is an unanticipated side effect from the study and up to $2,000 credit onto your dog’s medical bill at the end of the study to be used for the cost of radiation therapy.

Results from this study may lead to an improvement of your dog’s response to treatments such as radiotherapy.

Owner Responsibilities: We expect that participation in this clinical trial will take 5 weeks and anticipate each visit taking 6-8 hours. If you decide to have your dog participate in the trial, you will be responsible for keeping each scheduled appointment, ensuring that your dog has not eaten food for at least 12 hours prior to any anesthetic procedure, and covering costs associated with the radiation therapy required to enter the study.

Printable Flyer (PDF)

Oral Tumors: Optimizing the Identification of Tumor Spread To Lymph Nodes

Title: Preoperative sentinel lymph node mapping in dogs

Purpose of Study: Successful treatment of many cancers depends on the extent of disease present at the time of diagnosis, and on accurate detection of that disease. Some oral cancers commonly spread from the mouth to nearby lymph nodes. Lymph node metastasis, if present, can influence the prognosis and treatment recommendations made for a patient. Currently, however, our standard veterinary staging protocol (aspiration cytology of the geographically nearest lymph node) misses a diagnosis of lymph node metastasis in a concerning number of patients. Because lymphatic pathways and lymph nodes of the head are very complicated and the closest lymph node is not necessarily the most likely to show disease, it is possible to miss disease because we do not know which is the best lymph node to evaluate. Lymph node mapping, a technique to visualize the lymphatic drainage of tumors, is increasingly used to improve cancer staging and treatment protocols in the treatment of cancer in people. Mapping allows identification of the “sentinel lymph node,” or lymph node that is most likely to demonstrate evidence of metastatic disease. This lymph node can then be aspirated or surgically removed with the primary tumor to be evaluated microscopically for spread of cancer. This trial is being performed to optimize a method of sentinel lymph node mapping that can be accessible to a greater number of veterinary practitioners in an effort to improve the accuracy of cancer diagnoses and treatment recommendations we make for our veterinary patients, improving their quality of life and length of time with us following diagnosis with this cancer.

Contact: If you are interested in determining whether your dog is eligible for the trial, please schedule an appointment for evaluation with one of the participating clinical services by calling the Small Animal Clinic at (530) 752-1393 and following the prompts for either Soft Tissue Surgery, Dentistry and Oral Surgery or Oncology. For general questions not related to your own dog’s eligibility, please contact Dr. Steffey (530-752-3799, masteffey@ucdavis.edu).

Participation Requirements:

  • Dogs diagnosed with an oral tumor with owners that have elected to surgically remove the tumor.
  • Ineligible: Dogs with pre-existing, palpably very large lymph nodes

Initial Evaluation for Participation: If you choose to enroll your dog, your dog will receive two CT scans on separate days: the first done for standard diagnostic/surgical planning, and the second done immediately prior to surgery. Both CT scans will be performed with contrast while under general anesthesia.

Benefits: All costs associated with this study, including the second CT scan and the 1 hour of extra anesthesia time associated with each CT scans will be paid by the sponsor. Additionally, a financial benefit of $500 will be credited to your VMTH account after your dog completes the second CT scan on the day of his/her surgery.

Owner Responsibilities: If you allow your dog to participate in this study, you will be responsible for bringing your dog to the UC Davis VMTH for his/her scheduled appointments, covering costs associated with the standard diagnostic workup of your dog’s tumor, the first (diagnostic/surgical planning) CT scan, and standard costs associated with surgical removal of the oral tumor, and allowing him/her to be hospitalized for the required length of time pre- and postoperatively.

Printable Flyer (PDF)