Equine Diagnostic Centre, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK.
Equine Vet J. 2010 Jan;42(1):30-6. doi: 10.2746/042516409X464104.
With the advent of detailed oral examination in horses using dental mirrors and rigid endoscopy, secondary dentinal lesions are observed more frequently. More information regarding the association of secondary dentinal defects with apical dental disease would improve the sensitivity of oral examination as a diagnostic aid for pulpitis.
To assess prevalence and severity of secondary dentinal defects observed on examination of occlusal surfaces of cheek teeth (CT) from horses showing clinical signs of pulpitis compared to asymptomatic controls.
Records from all cases of equine CT exodontia at the University of Bristol over a 4 year period were examined. Case selection criteria included the presence of clinical signs of pulpitis, an intact extracted tooth and availability of a complete history and follow up. Cases where coronal fracture or periodontal pocketing featured were excluded. CT from cadavers with no history of dental disease served as normal controls. Triadan positions and eruption ages of control teeth were matched with those of teeth extracted from cases. CT from selected cases and control teeth were examined occlusally. Secondary dentinal defects were identified and graded. Prevalence of occlusal lesions in CT with pulpitis and controls was compared.
From the records of 120 horses where exodontia was performed, 40 cases matched selection criteria. Twenty-three mandibular and 21 maxillary CT were extracted from cases. The controls consisted of 60 mandibular and 60 maxillary CT from 7 cadaver skulls. Secondary dentinal defects were significantly over-represented in CT extracted from cases of pulpitis (P < 0.001). Of diseased mandibular CT, 56.5% had defects compared to none of the controls. Of diseased maxillary CT, 57% had defects compared with 1.6% of controls. Multiple defective secondary dentinal areas and severe lesions were more prevalent in diseased mandibular CT compared with diseased maxillary CT. CONCLUSIONS AND PRACTICAL SIGNIFICANCE: Careful examination of occlusal secondary dentine is an essential component in investigation of suspected pulpitis in equine CT.
随着使用牙镜和刚性内窥镜对马进行详细的口腔检查的出现,更频繁地观察到继发性牙本质病变。更多关于继发性牙本质缺陷与根尖牙病之间关联的信息将提高口腔检查作为牙髓炎诊断辅助的敏感性。
评估与无症状对照相比,表现出牙髓炎临床症状的马的颊齿(CT)咬合面检查中观察到的继发性牙本质缺陷的患病率和严重程度。
检查了布里斯托大学在 4 年期间所有马 CT 拔牙病例的记录。病例选择标准包括存在牙髓炎的临床症状、完整拔出的牙齿以及完整的病史和随访。排除了有冠部骨折或牙周袋形成的病例。没有牙科疾病史的尸体 CT 作为正常对照。对照牙齿的 Triadan 位置和出牙年龄与从病例中提取的牙齿相匹配。选择性病例和对照牙齿的 CT 进行了咬合检查。确定并分级了继发性牙本质缺陷。比较了牙髓炎和对照 CT 中咬合病变的患病率。
从 120 例进行拔牙的马的记录中,有 40 例符合选择标准。从病例中提取了 23 个下颌和 21 个上颌 CT。对照组由 7 具尸体头骨中的 60 个下颌和 60 个上颌 CT 组成。从牙髓炎病例中提取的 CT 中,继发性牙本质缺陷明显更为普遍(P <0.001)。患病下颌 CT 中有 56.5%有缺陷,而对照中无一例。患病上颌 CT 中有 57%有缺陷,而对照中只有 1.6%。与患病上颌 CT 相比,患病下颌 CT 中更普遍存在多个有缺陷的继发性牙本质区域和严重病变。
仔细检查咬合继发性牙本质是调查马 CT 疑似牙髓炎的重要组成部分。