Pearce C J
Equine Dental Clinic Ltd, Witchampton, Wimborne, UK.
N Z Vet J. 2020 May;68(3):178-186. doi: 10.1080/00480169.2020.1722971. Epub 2020 Feb 24.
Equine dentistry is a rapidly developing clinical specialty. It has benefitted from key advances in anatomical and physiological research, development of equipment and instrumentation, utilisation of standing sedation and anaesthesia protocols, a change towards minimally invasive surgical techniques, and the introduction of restorative and endodontic techniques translated from techniques used in human and canine dentistry. Anatomical research has provided further insight into the endodontic system of incisors and cheek teeth and how it changes throughout development with age. Studies of the periodontium have demonstrated a rich vascular supply and repair capacity. Routine dental visits are increasingly being performed utilising sedation and clinical instruments for routine examinations. Equipment has become more efficient, battery-operated and miniaturised giving benefits to both equine dental maintenance work and advanced techniques, assisting the transition to minimally invasive techniques, and the development of endodontic and restorative dentistry. Diagnosis has also benefitted from advances in equipment such as patient-side digital radiography systems, high definition oroscopy, and small diameter flexible fibrescopes that are capable of visualising inside a pulp canal. Dental units combining endodontic high- and low-speed drills, suction and air or water flush are becoming increasingly used and adapted for equine use. Sedative combinations and standing anaesthesia protocols have meant that revisions of traditional techniques, as well as novel techniques, can be performed with almost no requirement for general anaesthesia. Equine dentistry can only continue to advance in this way if there is early identification of dental disease through clinical oral examinations, leading to a system based on prophylaxis, as in human dentistry. This necessitates a change in attitude of the public and industry in general to a proactive approach, with early intervention based on examination and diagnostic findings of practitioners and not necessarily based on the clinical signs displayed by the patient.
马牙科是一个快速发展的临床专业。它受益于解剖学和生理学研究的重大进展、设备和仪器的开发、站立镇静和麻醉方案的应用、向微创外科技术的转变，以及从人类和犬类牙科技术翻译而来的修复和牙髓治疗技术的引入。解剖学研究进一步深入了解了切牙和颊齿的牙髓系统，以及它如何随着年龄的增长在整个发育过程中发生变化。牙周组织的研究表明其具有丰富的血管供应和修复能力。越来越多地利用镇静和临床仪器进行常规牙科检查。设备变得更加高效、电池供电且小型化，这对马牙科的维护工作和先进技术都有好处，有助于向微创技术的转变以及牙髓病学和修复牙科的发展。诊断也受益于设备的进步，如患者端数字射线摄影系统、高清口腔镜检查以及能够可视化牙髓管内部的小直径柔性纤维镜。结合牙髓高速和低速钻、抽吸以及空气或水冲洗功能的牙科治疗台越来越多地被使用并适用于马匹。镇静组合和站立麻醉方案意味着传统技术以及新技术的修订几乎无需全身麻醉即可进行。只有通过临床口腔检查早期发现牙齿疾病，从而建立一个像人类牙科那样基于预防的系统，马牙科才能以这种方式持续发展。这就需要公众和整个行业总体上改变态度，采取积极主动的方法，根据从业者的检查和诊断结果进行早期干预，而不一定基于患者表现出的临床症状。
