Prevalence of occlusal pulpar exposure in 110 equine cheek teeth with apical infections and idiopathic fractures.

Examination of 110 cheek teeth (CT) that were clinically extracted (between 2004 and 2008) because of apical infection (n=79; mean dental age 3.5 years) or idiopathic CT fractures (n=31; median dental age 8.5 years), including examinations of transverse and longitudinal sections, showed the apical infections to be mainly (68%) due to anachoresis, with the residual cases caused by periodontal spread, infundibular caries spread, fissure fractures and dysplasia. The idiopathic fracture patterns were similar to previously described patterns. Occlusal pulpar exposure was found in 32% of apically infected CT, including multiple pulps in 27% and a single pulp in 5%. However, 10% of apically infected CT had changes to the occlusal secondary dentine, termed occlusal pitting, but did not have exposure of the underlying pulp. Multiple pulpar exposures occurred in some CT with apical infections, and the combination of pulp involvement reflects the anatomical relationships of these pulps. A higher proportion (42%) of CT extracted because idiopathic fractures had pulpar exposure (26% multiple, 16% single pulps), especially with midline sagittal maxillary and miscellaneous pattern mandibular CT fractures, but only (3%) had occlusal pitting.