Update on Equine Odontoclastic Tooth Resorption and Hypercementosis.

Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a progressive, painful disease, affecting incisors, canines, and cheek teeth. Examination findings include gingival inflammation, gingival recession and/or hyperplasia, subgingival swelling, bulbous enlargement of teeth, associated periodontal disease, pathologic tooth fracture, and/or tooth mobility and loss. Current hypotheses include biomechanical stresses and secondary bacterial involvement. Early recognition allows case management, but it is a progressive disease. Owner education is crucial; horses with complete or multiple extractions have a favorable prognosis. Human oral and dental health may be affected by bisphosophonate use; long-term effects of these drugs are currently unknown in horses.

Clinical treatment and prognosis of equine odontoclastic tooth resorption and hypercementosis.

REASONS FOR PERFORMING STUDY: Equine odontoclastic tooth resorption and hypercementosis is an infrequent and underdiagnosed form of severe dental disease in horses that can affect quality of life. The study was performed to compare the clinical, radiographic, histological and prognostic findings specific to equine odontoclastic tooth resorption and hypercementosis in horses. Removal of affected teeth is currently the best treatment. OBJECTIVES: The goals are to report salient clinical and histological features of the disease and its management in a case series describing an under-reported syndrome in horses and the long-term prognosis. STUDY DESIGN: Retrospective case series. METHODS: Medical records from New Bolton Center, University of Pennsylvania from January 2000 to December 2012 were reviewed from horses that had a diagnosis of 'cementoma' or 'hypercementosis' and any associated dental-related diagnosis affecting the teeth and oral cavity. Radiographic, surgical and histological reports were collated and the clinical cases compared and tabulated to provide a better description of the equine disease. RESULTS: A total of 18 cases were identified, 17 of which were geldings and one of which was a nonbreeding stallion; no mares had the disease. The mean age at diagnosis was 24 years, with a range of 17-29 years. There was no breed predilection, and varied clinical signs relating to the mouth were found. Some teeth involved had only radiographic changes of disease and not gross clinical evidence. The mandibular incisors were generally affected earlier than the maxillary incisors, but the disease is progressive, and eventually, all of the incisors and sometimes the canines are involved. No premolars or molars were affected in this case series. CONCLUSIONS: Based on this case series, all teeth, and particularly the incisors, should be examined for signs of gingivitis and hypercementosis and subsequently radiographed for an early diagnosis and management. When compared with our hospital population, older geldings were more likely to be affected with cementoma formation and its accompanying resorptive process. Removal of clinically and radiographically affected teeth carries a good prognosis for improved quality of life.

A new understanding of oral and dental disorders of the equine incisor and canine teeth.

This article discusses the classification systems for dental fractures and how the assessment affects treatment options. Diagonal incisor malocclusion is discussed in relation to skull asymmetry and how this commonly relates to premolar and molar occlusion. Oral and radiographic assessment of incisive bone fracture and incisor avulsion is reviewed for determining treatment options. A summary of incisor and canine resorption and hypercementosis is presented. Clinical presentations, staging, and classifications of tooth resorption as well as canine odontoplasty are discussed. Excessive plaque and calculus formation on lower canines leading to periodontal disease and abscess is examined.

Advances in the treatment of diseased equine incisor and canine teeth.

Dental therapies for equid incisor and canine teeth have modernized significantly over the last 2 decades. Basic principles in incisor reduction have become more conservative, and extraction procedures more exacting. Periodontal and endodontic treatments are described to save teeth that would have succumbed to extraction in the past. Pathologic impacts on treatment decisions for equine odontoclastic tooth resorption and hypercementosis are significant, and veterinarians and owners need to be aware of treatment options and outcomes. Easy access to equid incisor and canine teeth offers a variety of therapeutic options, and this article reviews some of the practical procedures available.

Lesiones radiopacas periapicales de los maxilares: diagnóstico diferencial y plan de tratamiento / Radiopaque periapical jaw lesions: differential diagnosis and treatment planning

Se describen las patologías periapicales de los maxilares, para lo cual se expone una clasificación con fines didácticos tomando en cuenta el origen y comportamiento de dichas entidades patológicas. Se exponen la clínica, radiología e histopatología de las mismas con el fin de conocerlas y así poder llegar a realizar un diagnóstico diferencial correcto de ellas. Por último, se sugiere el enfoque terapéutico para cada una de ellas (AU)

Lesiones radiopacas periapicales de los maxilares: diagnóstico diferencial y plan de tratamiento / Radiopaque periapical jaw lesions: differential diagnosis and treatment planning

Se describen las patologías periapicales de los maxilares, para lo cual se expone una clasificación con fines didácticos tomando en cuenta el origen y comportamiento de dichas entidades patológicas. Se exponen la clínica, radiología e histopatología de las mismas con el fin de conocerlas y así poder llegar a realizar un diagnóstico diferencial correcto de ellas. Por último, se sugiere el enfoque terapéutico para cada una de ellas