“Hematologic, Biochemical, and Endocrine Parameters in Horses With Tooth Resorption and Hypercementosis”. Earley. JVD. 2017:34(3).
what was the endocrine abnormality found in half the horses suffering from EOTRH?
Dentigerous cysts in horses. Where are they most often located? What are the symptoms? How are they treated?
A dentigerous cyst, or ectopic tooth, in horses is most commonly attached to the temporal bone (AKA temporal teratoma, ‘ear tooth’, or ‘aural fistula’).
Diagnosed by signalment, history, and physical examination.
The most common presentation is a swelling at the base of the pinna with an associated chronic draining tract.
Treatment consists of surgical removal of the dentigerous cyst and any related draining tract.
DDs for dentigerous cysts include abscessation, hematoma/seroma, bony sequestra, or foreign body.
“Heterotopic Polyodontia Diagnosis and Surgical Removal of a Dentigerous Cyst Comprising 2 Dental Structures in a 14-Year-Old Horse”. Platt et al. JVD 2021.
JVD 2023. Hunt et al. “Intraoral formation of a rigid obturator for the treatment of dental fistulae and draining tracts in the horse”.
treated ONFs in horses by plugging the hole with a layer of borate fiber that was then covered in bis-acryl.
what percentage of horses had complete resolution of clinical signs?
what were the complications?
complete resolution of clinical signs in 21/22 (95.5%) horses.
31.8% (7/22) had complications, all related to the plug fracturing/being displaced/not sealing the defect completely. all complications were solved by replacing the plug.
JVD 2021. Turner et al. Tooth elongation of maxillary second premolars and mandibular third molars and associated periodontal disease in horses a retrospective study.
Prevalence of periodontal disease in horses? How does elongation lead to PD?
PD in horses has a prevalence of up to 75% and is a leading cause of tooth loss.
This article found a significant positive correlation between tooth elongation and PD.
Equine cheek teeth arcades function as a whole unit to masticate rough feedstuffs. The forces acting upon cheek teeth have been measured between 964-1956N during the power stroke of the chewing cycle. Elongations of clinical crowns that occur as a result of malocclusion may lead to shift of teeth within the rank of the arcade, causing diastemata formation. Early PD likely occurs with initial formation of overgrowths and resultant diastemata formation.
JVD 2022. James A. Brown, Brian G. Murphy, Kemba S. Clapp, Elise E. B. LaDouceur. “Clinical, Diagnostic and Histological Findings Involving Cheek Teeth Hypercementosis in Nine Horses”.
According to Chinkangsadarn T, Wilson GJ, Greer RM, Pollitt CC, Bird PS. Aust Vet J 2015. “An abattoir survey of equine dental abnormalities in Queensland, Australia”.
What were the 4 most common abnormalities identified, in order of prevalence?
According to Chinkangsadarn T, Wilson GJ, Greer RM, Pollitt CC, Bird PS. in “An abattoir survey of equine dental abnormalities in Queensland, Australia”.
Identify the equine abnormality in b (arrows and star), c and d.
a. normal
b. hook (star) and sharp enamel points (arrows)
c. step
d. diastemata and periodontal pockets with visible soft tissue and bone loss
N.B. Wave mouth not shown
“A comparison of CT, radiographic, gross and histological, dental, and alveolar findings in 30 abnormal cheek teeth from equine cadavers” by Liuti, Smith, Dixon. FVETS 2017.
what was the point of this study and what were the findings?
validate accuracy of CT and radiographic imaging of cheek teeth disorders by comparing CT and rad imaging, gross and histo findings of abnormal cheek teeth and there alveoli extracted from equine cadaver heads.
54 heads from euthanized horses (no breed/age info) had 26 maxillary cheek teeth and 4 mandibular disease extracted (30) with alveoli for imaging and histo comparisons.
gross pathological and histo exam confirmed 28/30 had pulpar/apical infection or changes
* CT indicated the presence of pulpar/apical infection in 27/28 (96%)
* Rads indicative of pulpar/apical infection in 14/28 (50%)
* histo 21/28 (some missing bone)
EXCELLENT CORRELATION ON CT!
JVD 2022. James. “Equine Odontoclastic Tooth Resorption and Hypercementosis”.
What is EOTRH? What causes it?
EOTRH: painful, progressive dental disease affecting mainly the incisor and canine teeth of middle-aged and geriatric horses, typically over 15 years of age. It involves tooth resorption and excessive cementum production.
Etiology unknown, suggested:
* biomechanical stress on aging teeth
* bacterial infiections, especially Treponema and Tannerella spp.
* Immune-mediated responses
* Iatrogenic dental treatments
* nutritional or endocrine factors
JVD 2022. James. “Equine Odontoclastic Tooth Resorption and Hypercementosis”.
How accurate are radiographs in diagnosing EOTRH?
may underestimate early lesions (low sensitivity).
in one study 58% of radiographically “healthy” teeth had lesions on micro-CT.
JVD 2022. James. Equine Odontoclastic Tooth Resorption and Hypercementosis.
What are the histological features?
James A. Brown, Brian G. Murphy, Kemba S. Clapp, Elise E. B. LaDouceur. JVD 2022. “Clinical, Diagnosis and Histological Findings Involving Cheek Teeth Hypercementosis in Nine Horses”.
Is there a known link between EOTRH and systemic disease?
some shown altered parathyroid hormone or vit D levels and hypoalbuminemia
According to Marshall R, Shaw DJ, Dixon PM. “A study of sub-occlusal secondary dentine thickness in overgrown equine cheek teeth”. The Veterinary Journal. 2012;193(1):53-57.
Is this a maxillary or mandibular tooth and which number?
Number the pulp horns.
Mandibular 06
A sub-occlusal transverse section of a mandibular 06 equine cheek tooth placed with its apical aspect facing upwards. All six pulp horns have open pulp horns containing viable pulp (that has caused pink staining of the adjacent dentine during sectioning).
According to Marshall R, Shaw DJ, Dixon PM. A study of sub-occlusal secondary dentine thickness in overgrown equine cheek teeth. The Veterinary Journal. 2012;193(1):53-57.
This tooth is an 09. is it maxillary or mandibular? How do you know?
number the pulp horns
mandibular.
No infundibulae, no cingulae.
Marshall R, Shaw DJ, Dixon PM. “A study of sub-occlusal secondary dentine thickness in overgrown equine cheek teeth”. The Veterinary Journal. 2012;193(1):53-57.
This is a mandibular 11. How many pulp horns are there?
6 pulp horns (no horn 6 skip 5 to 7)
Marshall R, Shaw DJ, Dixon PM. “A study of sub-occlusal secondary dentine thickness in overgrown equine cheek teeth”. The Veterinary Journal. 2012;193(1):53-57.
This tooth is an 06. is it maxillary or mandibular? Number the pulp horns
Maxillary - has infundibulae and has cingulae
Marshall R, Shaw DJ, Dixon PM. A study of sub-occlusal secondary dentine thickness in overgrown equine cheek teeth. The Veterinary Journal. 2012;193(1):53-57.
This is a maxillary 09. What are the two unlabelled black spots in the centre of the tooth? what disease process occurs here number the pulp horns
black spots are centre of infundibulae where arteries supply cementum with blood during development. Infundibular caries can occur here
Marshall R, Shaw DJ, Dixon PM. A study of sub-occlusal secondary dentine thickness in overgrown equine cheek teeth. The Veterinary Journal. 2012;193(1):53-57.
Is this a maxillary or mandibular tooth? What number? Number the pulp horns.
maxillary 11.
* you can tell because there are 7 pulp horns and no other tooth has that.
* number goes up to 8 but there is no 6 (only on 06’s is there a 6)
Marshall R, Shaw DJ, Dixon PM. A study of sub-occlusal secondary dentine thickness in overgrown equine cheek teeth. The Veterinary Journal 2012.
Describe the number of pulp horns each tooth has?
Here is the pulp horn numbering system: Here it is again! Here are some tricks -
My best bet:
* Memorize the basic pattern for a maxillary and mandibular 09.
* for all 06’s add a pulp horn 6 at the most mesial extent.
* For a maxillary 11 add a 7 bucally and an 8 palatally.
* For mandibular 11’s add a 7 at the most distal extent.
Sigh.
According to Jens Arnbjerg. JVD 2014. Generalized Hypercementosis in Geriatric Horses.
Which tooth had the worst hypercementosis?
lateral incisors - 03’s
According to Jens Arnbjerg. Generalized Hypercementosis in Geriatric Horses
What was theorized to lead to the hypercementosis?
occlusal pressure or stress
Jens Arnbjerg. JVD 2014. Generalized Hypercementosis in Geriatric Horses.
what was different about the incisor angles of teeth with hypercementosis?
horses with a more acute incisor angle had greater cementum deposition
Jens Arnbjerg. JVD 2014. Generalized Hypercementosis in Geriatric Horses.
on which sides of the teeth was the excess cementum usually deposited?
Cementum deposition was usually more concentrated on the axial and lingual aspects of the roots compared with the abaxial and labial aspects
Jens Arnbjerg. JVD 2014. Generalized Hypercementosis in Geriatric Horses.
What is the composition and hounsfield units of cementum? dentin? enamel?
Cementum:
* 65% inorganic, 35% organic and water
* 1200-1500 HU
Dentin:
* 70% inorganic, 30% organic and water
* 1600-1800 HU.
Enamel:
* 96-98% inorganic
* 2400-2600 HU (due to its lower water content)