Chronic gingivostomatitis in cats: full-mouth vs partial (premolar–molar) extraction — MAYBE (weak evidence) (the treatment made no difference)

In cats with chronic gingivostomatitis, does full-mouth extraction vs partial (premolar–molar) extraction give equal remission rates?

Shelf #756 · gate-verified and approved by the developer

MAYBE (weak evidence) (the treatment made no difference): Two retrospective case series — the only records that compare extraction extent in cats with chronic gingivostomatitis/stomatitis — both found no association between how many teeth were extracted and the outcome, but neither was designed or powered to prove the remission rates equal, so the honest stamp stays weak. In Jennings 2015 (PMID: 25719848; retrospective case series, 95 cats with stomatitis treated by tooth extraction, median follow-up 231 days, range 33–2,655), 6 cats (6.3%) had no improvement and 25 (26.3%) little improvement, while 37 (39.0%) had substantial clinical improvement and 27 (28.4%) complete resolution — substantial improvement or resolution in 64 of 95 cats (67.4%) — and extent of extraction (partial-mouth vs full-mouth) was not associated with overall response to treatment; of the 64 improved cats, 44 (68.8%) required extended medical management for a finite period to achieve their outcome. In Druet 2017 (PMID: 29270412; retrospective study, 104 feline calicivirus-positive caudal-stomatitis cats, of whom 56 had recheck examinations and form the outcome cohort), extraction type was full-mouth in 3 of 56 cats, subtotal (at least all premolar and molar teeth but not all teeth — the partial extent this shelf asks about) in 47 of 56, and selective partial in 6 of 56; clinical cure (absence of pain and completely healed lesions) was achieved in 18 of 56 cats (32.1%) within a median of 33.5 days, and cure or very significant improvement in 51.8% overall, and the type/extent of extraction was not found to influence the clinical outcome (P > 0.05) — with the authors themselves noting the very low full-mouth numbers may have resulted in low statistical power (PMC full text). Design class (c): randomisation is not established — both records are retrospective case series in which extraction extent was chosen clinically, so confounding by indication (more severely affected mouths plausibly receiving more extensive extraction) cannot be excluded, and neither record reports remission rates broken down by extent with an equivalence analysis. The null suffix records that in both series the more extensive operation made no observed difference; the MAYBE (weak evidence) grade records that 'no difference found' in underpowered retrospective data is not proof of equal remission. One-home boundary: ciclosporin for gingivostomatitis refractory to extraction homes on shelf #757 (Lommer 2013, PMID: 23757820) and is not re-carded here — this shelf is about the extraction comparison itself, in cats not selected for refractoriness. Tier C is not engaged: no mortality or survival claim is made. Drafted Nov 10, 2026 (VetMed build, topic #756); figures from the abstracts and, for Druet 2017, the PMC full text, fetched and verified at drafting.

Jennings 2015: in 95 cats with stomatitis, substantial improvement (39.0%) or complete resolution (28.4%) followed extraction in two-thirds of cats, and extent of extraction (partial-mouth vs full-mouth) was not associated with overall response

Retrospective case series (record's own wording; publication type: Journal Article)

Who: Cats: 95 cats with stomatitis treated with tooth extraction over a 14-year period (2000–2013), in a retrospective case series. Medical records were reviewed for demographics, diagnostics, surgical procedure — including full-mouth extraction (FME) versus partial-mouth extraction (PME) — and specifics of medical management; patients were categorised by response to treatment. Median postoperative follow-up was 231 days (range, 33 to 2,655 days). The record's abstract does not report how many cats received FME vs PME, nor response rates within each extent group.

Result: Of 95 cats, 6 (6.3%) had no improvement and 25 (26.3%) had little improvement in stomatitis following tooth extraction and extended medical management (EMM). Following tooth extraction, 37 cats (39.0%) had substantial clinical improvement and 27 (28.4%) had complete resolution of stomatitis — 64 of 95 cats (67.4%) in the two better categories; of these 64 cats, 44 (68.8%) required EMM for a finite period to achieve their positive outcomes. Extent of tooth extraction (PME vs FME) was not associated with overall response to treatment. At initial recheck, a better long-term response was observed in patients with resolution of abnormal behavior (OR, 7.2), decrease in oral inflammation (OR, 3.5), and lack of need for follow-up medical management with antimicrobials (OR, 3.7) — prognostic associations, not effects of extraction extent. The authors conclude that extraction of teeth in areas of oral inflammation provided substantial improvement or complete resolution in more than two-thirds of affected cats, that full-mouth extraction did not appear to provide additional benefit over PME, and that most cats may require EMM to achieve substantial improvement or complete resolution.

Watch out: Retrospective and non-randomised: which cats received full-mouth vs partial-mouth extraction was a clinical decision, so the extent groups almost certainly differed in lesion distribution and severity at baseline (confounding by indication), and the abstract gives neither the group sizes nor remission rates by group — only the overall rates and the statement that extent was not associated with response. 'Not associated' in a series of this size is not an equivalence result. Outcomes were also achieved with extended medical management in most improved cats (44 of 64), so the remission figures are for extraction plus medical management, not extraction alone. The population is cats with 'stomatitis' as recorded over 2000–2013, not a uniformly defined chronic gingivostomatitis cohort.

Jennings MW, Lewis JR, Soltero-Rivera MM, Brown DC, Reiter AM. Effect of tooth extraction on stomatitis in cats: 95 cases (2000-2013). J Am Vet Med Assoc. 2015;246(6):654-60. PMID: 25719848. Registry ID: none in the record. MeSH: Animals · Cat Diseases/therapy* · Cats · Female · Male · Retrospective Studies · Stomatitis/therapy/veterinary* · Tooth Extraction/veterinary*

Druet 2017: in 56 rechecked cats with calicivirus-positive caudal stomatitis, cure was 32.1% and cure-or-better 51.8% after extraction, and the type of extraction (full-mouth 3 cats, subtotal premolar–molar 47, selective partial 6) did not influence outcome

Retrospective study in two parts (record's own title wording; publication type: Journal Article) — outcome part restricted to the 56 of 104 cats with in-department recheck examinations

Who: Cats: 104 cats with feline chronic gingivostomatitis (caudal stomatitis) testing positive for feline calicivirus (FCV) by real-time RT-PCR on oropharyngeal swab, seen at a veterinary referral centre (Advetia, Paris, France; records January 2011–February 2016), formed part 1 of this retrospective study; the 56 cats with post-extraction recheck examinations in the department formed part 2, the outcome cohort (PMC full text). Extraction was performed according to severity of inflammation and dental disease: full-mouth extraction (FME), subtotal mouth extraction (SME — at least all premolar and molar teeth but not all teeth), or partial mouth extraction (PME — extraction of a selective number of teeth) (PMC full text). In part 2, 3 of 56 cats (5%) underwent FME, 47 of 56 (84%) SME, and 6 of 56 (11%) PME (PMC full text).

Result: Clinical cure — defined as absence of pain and completely healed oral lesions — was observed in 18 of 56 cats (32.1%) within a median time of 33.5 days (range 14–189 days); together with very significant improvement, cure or very significant improvement was achieved in 51.8% of cats (PMC full text: 29 of 56 cats showed significant improvement or cure within a median of 38 days). Owners considered their cat cured in 41.1% of cases or significantly improved in 19.6% (60.7% combined). Extent/type of teeth extraction was not found to influence the clinical outcome (abstract: P > 0.05), and the authors note in the full text that the low numbers in the full-mouth and partial categories may have resulted in low statistical power. FCV load was likewise not correlated with outcome: presence of lingual ulcers was the only variable significantly correlated with FCV load (P = 0.0325), and cats with less severe alveolar/buccal stomatitis improved significantly more rapidly (P = 0.0294, PMC full text).

Watch out: The full-mouth group is 3 cats: this record has almost no power to detect an extent effect, as its authors state, so 'did not influence outcome' is a very weak null for the full-vs-partial contrast specifically; the bulk of the cohort (47 of 56) received the subtotal premolar–molar extent. Population is restricted to FCV-positive cats with caudal stomatitis at one referral centre, and 48 of the 104 part-1 cats had no in-department recheck and are absent from the outcome cohort, so loss to follow-up could bias the cure figures in either direction. Extent was chosen by lesion severity (confounding by indication), and postoperative medical treatment was not standardised across cats (of the 38 cats not clinically cured, 27 of 38, 71.1%, were on medical treatment, PMC full text table).

Druet I, Hennet P. Relationship between Feline calicivirus Load, Oral Lesions, and Outcome in Feline Chronic Gingivostomatitis (Caudal Stomatitis): Retrospective Study in 104 Cats. Front Vet Sci. 2017;4:209. PMID: 29270412. Registry ID: none in the record. MeSH: none in the record

Synthesis: two retrospective series (95 and 56 outcome cats) both found no association between extraction extent and remission, but neither can prove the rates equal — MAYBE (weak evidence) (the treatment made no difference)

Synthesis

Who: Synthesis of the two cards above (Jennings 2015, 95 cats; Druet 2017, 56 outcome cats from a 104-cat FCV-positive cohort) and of the near-miss records documented in the result, fetched at drafting and deliberately not carded as claim-carriers.

Result: (1) Agreement on the comparison: Jennings 2015 found extent of extraction (PME vs FME) not associated with overall response in 95 cats, with substantial improvement in 39.0% and complete resolution in 28.4% overall; Druet 2017 found the type of extraction did not influence clinical outcome in 56 rechecked cats, with clinical cure in 32.1% and cure-or-very-significant-improvement in 51.8% overall. Neither record reports remission rates by extent group, and neither performs an equivalence analysis. (2) Why the stamp stays weak: both are retrospective (design class (c)), extent was clinician-chosen, Druet's full-mouth arm is 3 cats, and Jennings' abstract withholds the extent-group sizes — the data are consistent with equal remission and also with a moderate difference in either direction that these series could not detect. (3) Near-misses not carded: Silva 2021 (PMID: 34828037), a retrospective series of 111 FCGS cats comparing outcomes by retroviral status (FeLV-positive cats had a significantly worse outcome after dental extractions, with 7.5 times the chance of no improvement), does not compare extraction extents and cannot carry this shelf's comparison. Arzi 2020 (PMID: 33118849) studied stem-cell therapy given BEFORE full-mouth extraction in 5 cats — a different intervention with no partial-extraction arm. (4) Design class (c): no randomised or prospective record comparing extraction extents exists in the fetched literature; remission after extraction (with medical management) is common — roughly two-thirds substantially improved or resolved in Jennings — but the full-vs-partial equality rests on two underpowered retrospective nulls.

Watch out: One-home check at drafting: none of PMIDs 25719848, 29270412, 34828037 or 33118849 appears in any other pack on disk. Boundary honoured: shelf #757 (ciclosporin in gingivostomatitis refractory to extraction, Lommer 2013, PMID: 23757820) is a different question — treatment after extraction has failed — and none of its figures are carried here; conversely, these extraction-outcome records do not home on #757. Do not state the remission rates as 'equal': the records found no association between extent and outcome, which is weaker. Do not merge the two series' headline percentages — Jennings counts substantial improvement plus complete resolution (67.4% of 95) after extraction with extended medical management, while Druet counts clinical cure (32.1% of 56) or cure with very significant improvement (51.8%) in an FCV-positive caudal-stomatitis cohort; the definitions and populations differ.

Synthesis of Jennings MW et al. PMID: 25719848; Druet I et al. PMID: 29270412; Silva M et al. PMID: 34828037; Arzi B et al. PMID: 33118849. Registry IDs as on the individual cards (none in the records).

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