Dixon P M, Ceen S, Barnett T, O'Leary J M, Parkin T D, Barakzai S
Department of Clinical Veterinary Studies, Royal (Dick) School of Veterinary Studies and Roslin Institute, Easter Bush Veterinary Centre, University of Edinburgh, UK.
Equine Vet J. 2014 Jan;46(1):76-80. doi: 10.1111/evj.12085. Epub 2013 Jun 28.
Cheek teeth diastemata are a common cause of painful periodontal disease in horses, but there is limited objective information on their treatment.
To assess the long-term response to diastema widening in clinically affected horses.
Retrospective study.
Medical records from cases of cheek teeth diastemata treated by diastema widening referred to the University of Edinburgh Equine Hospital from 2008 to 2011 were analysed.
During this period, 302 horses were diagnosed with clinically significant cheek teeth diastemata, of which 202, median age 11 years, with severe associated periodontitis were treated by widening of 674 problematic diastemata; 89.8% between mandibular cheek teeth and 10.2% between maxillary cheek teeth, with a mean of 1.5 treatments performed per case. These 202 cases showed quidding in 76.2%; weight loss in 33.2%; bitting problems in 20.1% and halitosis in 10.9%, with 5.4% being asymptomatic. Follow-up of 92% of treated cases, a mean of 20.8 months after their initial treatment, showed that 72.6% had complete remission of clinical signs that was permanent (for the duration of this study) in 50.5% and temporary in 22%. A partial response was obtained in 17.2%, no response was obtained in 4.3%, and owners were unsure of response in 5.9%. Clinical improvement was sometimes delayed, with 19% taking >4 weeks following treatment for improvement. Inappropriate sites were burred in individual teeth of 6 horses, causing iatrogenic pulpar exposure in 2 cases, but following treatment none developed clinical signs of apical infection.
Diastema widening is an effective but potentially invasive treatment for horses with cheek teeth diastemata with severe periodontitis.
Diastema widening by trained personnel is suitable for advanced cases of cheek teeth diastema, but many cases require repeated treatments.
颊齿间隙是马牙周病疼痛的常见原因，但关于其治疗的客观信息有限。
评估临床患病马对间隙增宽治疗的长期反应。
回顾性研究。
分析2008年至2011年转诊至爱丁堡大学马医院接受间隙增宽治疗的颊齿间隙病例的病历。
在此期间，302匹马被诊断患有具有临床意义的颊齿间隙，其中202匹（中位年龄11岁）伴有严重牙周炎，对674个问题间隙进行了增宽治疗；下颌颊齿间隙占89.8%，上颌颊齿间隙占10.2%，每例平均进行1.5次治疗。这202例病例中，76.2%有咀嚼障碍；33.2%体重减轻；20.1%有咬嚼问题；10.9%有口臭，5.4%无症状。对92%的治疗病例进行随访，初始治疗后平均20.8个月，结果显示72.6%的病例临床症状完全缓解，其中50.5%为永久性缓解（在本研究期间），22%为暂时性缓解。部分缓解的占17.2%，无反应的占4.3%，主人不确定反应情况的占5.9%。临床改善有时会延迟，19%的病例在治疗后>4周才出现改善。6匹马的个别牙齿出现去钻磨部位不当，导致2例医源性牙髓暴露，但治疗后均未出现根尖感染的临床症状。
间隙增宽是治疗患有严重牙周炎的颊齿间隙马的一种有效但具有潜在侵入性的治疗方法。
由训练有素的人员进行间隙增宽适用于颊齿间隙的晚期病例，但许多病例需要重复治疗。
