Liuti T, Smith S, Dixon P M
Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Roslin, UK.
Equine Vet J. 2018 Jan;50(1):41-47. doi: 10.1111/evj.12729. Epub 2017 Aug 29.
Equine maxillary cheek teeth apical infections are a significant disorder because of frequent spread of infection to the supporting bones. The accuracy of computed tomographic imaging (CT) of this disorder has not been fully assessed.
To compare the radiographic and CT findings in horses diagnosed with maxillary cheek teeth apical infections with pathological findings in the extracted teeth to assess the accuracy of these imaging techniques.
Observational clinical study.
Thirty-two maxillary cheek teeth (in 29 horses) diagnosed with apical infections by clinical, radiographic and principally by CT examinations, were extracted orally. The extracted teeth were subjected to further CT, gross pathological and histological examinations. Four normal teeth extracted from a cadaver served as controls.
Pulpar and apical changes highly indicative of maxillary cheek teeth apical infection were present in all 32 teeth on CT, but in just 17/32 teeth (53%) radiographically. Gross pulpar/apical abnormalities and histological pulpar/periapical changes were present in 31/32 (97%) extracted teeth. On CT, one tooth contained small gas pockets in the apical aspect of one pulp and adjacent periodontal space, however no pathological changes were found following its extraction.
The study is descriptive and is confined to a small number of cases.
This study showed a 97% agreement between CT diagnosis of maxillary cheek teeth apical infection and the presence of pathological changes in the extracted teeth, confirming the diagnostic accuracy of CT compared with radiography for this disorder.
马的上颌颊齿根尖感染是一种严重的病症,因为感染常常会扩散到支持骨。这种病症的计算机断层扫描成像(CT)的准确性尚未得到充分评估。
将诊断为上颌颊齿根尖感染的马的影像学和CT检查结果与拔除牙齿的病理检查结果进行比较,以评估这些成像技术的准确性。
观察性临床研究。
通过临床、影像学检查,主要是CT检查诊断为根尖感染的32颗上颌颊齿(来自29匹马)经口腔拔除。对拔除的牙齿进行进一步的CT、大体病理和组织学检查。从一具尸体上拔除的4颗正常牙齿作为对照。
CT检查显示所有32颗牙齿均有高度提示上颌颊齿根尖感染的牙髓和根尖改变,但影像学检查仅在17/32颗牙齿(53%)中发现。31/32颗(97%)拔除的牙齿存在大体牙髓/根尖异常和组织学牙髓/根尖周改变。CT检查发现,一颗牙齿的一个牙髓根尖部和相邻牙周间隙有小气泡,但拔除后未发现病理改变。
本研究为描述性研究,且病例数量有限。
本研究表明,CT诊断上颌颊齿根尖感染与拔除牙齿的病理改变之间的一致性为97%,证实了CT在该病症诊断方面相对于放射学检查的准确性。