Background: Sagittal fractures of equine cheek teeth are commonly observed during oral examination. There are few reports on the apical and endodontic pathology associated with such fractures seen during computed tomographic (CT) examination.
Accepted ArticleThis article is protected by copyright. All rights reserved Objectives: To document the prevalence of CT changes indicative of apical disease in equine cheek teeth which have suffered a sagittal fracture involving the clinical +/-reserve crown.
Study design: Retrospective case series.Methods: CT examinations of equine heads with sagittal fractures of cheek teeth present were reviewed: 81 teeth from 49 horses were identified to have a sagittal cheek tooth fracture. The images were evaluated for apical pathology including gas (in the endodontic system and periapically), widened periodontal space, periapical sclerosis, apical clubbing, cementoma/hypercementosis, lamina dura loss, associated sinusitis and sinus mucosal swelling.An apical infection grading system was created to give each tooth a score. Hounsfield units were used to measure the density of the endodontic, apical and periapical regions. The fracture length ratio was recorded. Statistical analysis was performed using a generalised estimating equation to evaluate predictors of apical infection and associations between clinical signs and CT abnormalities.Results: 87 sagittal fractures (56 buccal, 17 palatal/lingual and 14 midline) from 81 teeth were recorded (74 maxillary and 7 mandibular). Apical infection was diagnosed in 73% (37/51, P = 0.05) of buccal, 55% (6/11, P =0.07) of palatal/lingual, 100% (13/13) of midline, 100% (6/6) with multiple fractures and 96% (23/24, P =0.008) of fractures involving infundibula. There was no significant relationship between apical infection and the presence of clinical signs associated with dental pathology (P = 0.4). There was no significant association between fracture length ratio and apical infection (P = 1.0). Midline sagittal fractures were significantly associated with sinusitis when compared to all other maxillary fractures (OR 5.92, 95% CI 186 1.67-20.83, P=0.006). Loss of the lamina dura was not significantly associated with apical infection (P=0.5) Main limitations: Maxillary tooth bias and subjective grading system.
Conclusions:A large proportion of fractured cheek teeth have evidence of apical infection on CT examination and therefore warrant treatment.
This case report describes the successful surgical management of a sinonasal angiomatous polyp involving the dorsal conchal bullae, dorsal conchal sinus, ventral conchal sinus, ventral conchal bullae and ventral conchal recess of the left nasal cavity resulting in a secondary sinusitis and compression of the nasal passage.
anaesthesia and recovery data were also recorded. Comparisons were made using the chi square, Wilcoxon rank sum, or Welch-Satterthwaite two-sample t-test (P < 0.05).Results: There were no differences between groups except mean AE standard deviation (s.d.) end-tidal sevoflurane (FE´Sevo) concentration (2.9 AE 0.4 D vs. 2.5 AE 0.3% R, P < 0.001). Using FE´Sevo as a covariate, no differences were found for any recovery variables.
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