Dr Nicole du Toit BVSc MSc CertEP PhD Dipl EVDC (equine) Dipl
AVDC (equine)
Tulbagh Equine Dentistry
www.facebook.com/EquineVetDentistry
Introduction
– Wear disorders develop due to the hypsodont nature of equid teeth
– Any one abnormality will result in another if not treated
– ‘Normal’ age related wear changes
Sharp enamel points
– Develop due to anisognathia and masticatory action
– Buccal aspect maxillary cheek teeth
– Lingual aspect mandibular cheek teeth
– Often associated with buccal ulcers
– Do not float occlusal surface
Overgrown teeth
– Misaligned cheek teeth rows e.g. maxillary prognathism
– Most commonly upper 06s and Lower 11s
– Opposite missing or displaced teeth
– Mild, subtle bilateral overgrowths associated with eruption ‘dominance’?
Treatment of overgrown teeth
– Mild overgrowths can be floated/rasped level
– Severe overgrowths need to be floated 2-3 mm at 6-8 week intervals to avoid pulpar exposure
– If you see pink you are already in the pulp horn!
Exaggerated transverse ridges
– Transverse ridges normal
– More pronounced in younger horses
– Exaggerated
- May inhibit normal masticatory action
- May cause diastemata/ interdental periodontal disease
Displaced teeth
– Young horses: developmental
– Older horses: acquired
– Often bilateral
– May be associated with:
- Diastemata
- Cheek or tongue ulceration
– Mild cases: float edges smooth
– Severe cases: extraction – can be tricky
– Don’t forget potential opposing overgrowths
Wave mouth
– Uneven occlusal surface in rostro-caudal plane due to adjacent teeth worn and overgrown
– Float overgrown teeth only to normal crown height and NOT to level of worn teeth
– If severe need to do in stages
– Older horses unlikely to completely resolve
Worn teeth
– Age related
– Decreased enamel
– Reduced reserve crown
– If entire cheek teeth row or mouth – smooth mouth
– Manage opposing overgrowths
– If severe: Dietary management
Shear mouth
– Rare, any age
– Possibly related to tilted palate
– Horses only able to eat on opposing side
– Long term management – regular floating
Step mouth
– Opposite missing or displaced tooth
– Inhibits normal rostro-caudal mandibular movement
– Floating of overgrown tooth
Broken mouth
– Severe uneven occlusal surface due to multiple overgrown, worn and sharp teeth
Diastemata
– Abnormal space/ food impaction interdental space
– Most painful condition
– Periodontal pockets
– Most commonly involves caudal cheek teeth
– Important to use dental mirror not too miss them
– Very painful periodontal pockets
- Flush out food
- Antibiotic gel and packing material – conservative treatment
– Reduce oclussal surface of opposing teeth
- Reduce action of impacting food into diastemata
– Tooth extraction
- Associated tooth
– Burring to enlarge interdental space
Infundibular caries
– Most common in 09s
– Incomplete cementum formation
- Infundibular hypoplasia
– Advanced caries may lead to tooth fracture
– Burring and filling with dental material
- Reasonable success
Supernumerary cheek teeth
– Extra tooth/teeth
– Malocclusion, overgrowths and periodontal disease
Bit seats/rostral profiling
– Practice with no scientific evidence
– Risk of pulp exposure
– Loss of masticatory ability of front four teeth
– Owner education!!!
Canine rasping
– Danger of pulp exposure
– Justified to prevent tongue laceration or handler comfort
– Mild floating of sharp edges acceptable
Cheek teeth fractures
– Taylor and Dixon 2007
– Prevalence of 0.4%
– 39% not associated with clinical signs
– Quidding, halitosis, bitting and behavioural problems
Results
– 133 Maxillary cheek teeth
– 09s and 10s most common (46% of all farctured cheek teeth)
– 49 Mandibular cheek teeth
– Lateral slab fractures most common (48% maxillary and 57% mandibular cheek teeth fractures)
Results
(Dacre, Kempson and Dixon 2007)
– Teeth extracted at University of Edinburgh
– Maxillary 09s (64%)
– Mandibular 08s and 09s (80%)
– 30/35 involved pulp horns
– 5/35 coalescing infundibular caries
Fracture patterns
– Group 1: Maxillary slab fractues – throught pulp horns 1 & 2
– Group 2: Maxillary infundibular saggital fractures (through rostral and caudal infundibulae)
– Group 3: Miscellaneous maxillary fractures
– Group 4: Mandibular buccal slab fractures – through pulp hornes 4 & 5
– Group 5: Miscellaneous mandibular fractures
Treatment
(Taylor & Dixon 2007)
– Removal of loose fragment
– Floating sharp edges
– Tooth extraction
– 81% no clinical signs at follow up (half of these had no clinical signs at initial examination)
Dixon, Barakzai, Collins & Yates 2007
– Conservative – removal of fragments
– Extraction if apical infections
Aetiology
– Pulp horns are weakest anatomical area:
- Predisposed by pulp infections
- Reduced secondary dentine formation (25%)
- Pulp death/ pulpitis secondary to fracture
– Apical infections
- predisposing or secondary to fracture
– Severe infundibular caries
- weakens tooth
Conclusion
– All fractures through pulp cavities or infundibulae
– Predisposed by anatomical weakness
– All at risk for developing apical infection
– Conservative treatment successful unless apical infection
Sorry, comments are closed for this post.