Windley Z, Weller R, Tremaine W H, Perkins J D
Department of Veterinary Clinical Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
Equine Vet J. 2009 May;41(5):441-7. doi: 10.2746/042516409x391033.
Dental disease often presents a diagnostic challenge in the horse. Computed tomography (CT) is increasingly used in the evaluation of head related disease in the horse, but the CT appearance of the most common dental diseases of horses has not yet been fully described.
To describe the CT appearance of the peripheral enamel, pulp, infundibular enamel and cement in equine cheek teeth with macroscopic occlusal or CT lesions.
In this study, 126 cadaveric cheek teeth with eruption ages of between 05 and 19 years were evaluated for lesions of their infundibulae, pulp and enamel using occlusal surface morphology, 2- (2D) and 3-dimensional (3D) CT and anatomical sectioning. Variations in teeth with no macroscopic lesions have been described in a previous study. The infundibular lesions were categorised further into one of 6 classifications.
Infundibular lesions were identified on CT in 90% (115/128) of infundibulae. Of these, 65% (83/128) had infundibular lesions on occlusal surface examination. The extent of infundibular lesions observed varied with age group. All infundibulae over 6 years post eruption had detectable lesions. Peripheral enamel hypoplasia and enamel prolapses, were observed in 10% (12/126) and 1.6% (2/126) of teeth, respectively. The CT appearance of teeth with pulp infections was seen to vary with differing pathologies.
The high prevalence of infundibular lesions should encourage consideration of their clinical significance, in addition to the role of infundibulae in dental disease of the horse. Two-dimensional and 3D CT proved to be highly valuable imaging modalities for dental disease, enabling lesions within the enamel, infundibulae and pulp of equine cheek teeth to be easily detected. The results of this study will facilitate the use of 2D and 3D CT as clinical diagnostic tools for dental disease and aid in the selection of the most appropriate treatment protocol.
牙齿疾病在马匹中常常带来诊断挑战。计算机断层扫描（CT）越来越多地用于评估马匹头部相关疾病，但马匹最常见牙齿疾病的CT表现尚未得到充分描述。
描述患有宏观咬合或CT病变的马颊齿外周釉质、牙髓、漏斗状釉质和牙骨质的CT表现。
在本研究中，对126颗萌出年龄在5至19岁之间的尸体颊齿，使用咬合面形态学、二维（2D）和三维（3D）CT以及解剖切片评估其漏斗状结构、牙髓和釉质的病变情况。先前的一项研究已描述了无宏观病变牙齿的变异情况。漏斗状病变进一步分为6种分类中的一种。
在90%（115/128）的漏斗状结构中通过CT发现了漏斗状病变。其中，65%（83/128）在咬合面检查时有漏斗状病变。观察到的漏斗状病变程度随年龄组而异。所有萌出后超过6年的漏斗状结构都有可检测到的病变。分别在10%（12/126）和1.6%（2/126）的牙齿中观察到外周釉质发育不全和釉质脱垂。牙髓感染牙齿的CT表现因不同病理情况而异。
漏斗状病变的高发生率应促使人们考虑其临床意义，以及漏斗状结构在马匹牙齿疾病中的作用。二维和三维CT被证明是用于牙齿疾病的极具价值的成像方式，能够轻松检测出马颊齿釉质、漏斗状结构和牙髓内的病变。本研究结果将有助于将二维和三维CT用作牙齿疾病的临床诊断工具，并有助于选择最合适的治疗方案。
