A Comparison of Computed Tomographic, Radiographic, Gross and Histological, Dental, and Alveolar Findings in 30 Abnormal Cheek Teeth from Equine Cadavers

Abstract

Background Equine cheek teeth disorders, especially pulpar/apical infections, can have very serious consequences due to the frequent extension of infection to the supporting bones and/or adjacent paranasal sinuses. Limited studies have assessed the accuracy of computed tomographic (CT) imaging in the diagnosis of these disorders, and no study has directly compared imaging and pathological findings of the alveoli of diseased equine cheek teeth. Objective To validate the accuracy of CT and radiographic imaging of cheek teeth disorders by comparing CT and radiographic imaging, gross and histological findings in abnormal cheek teeth and their alveoli extracted from equine cadaver heads. Study design Ex vivo original study. Methods Fifty-four cadaver heads from horses with unknown histories that had died or been euthanized on humane grounds obtained from a rendering plant had radiography, CT imaging, and gross pathological examinations performed. Based on imaging and gross examination findings, 30 abnormal cheek teeth (26 maxillary and 4 mandibular) identified in 26 heads were extracted along with their dental alveoli where possible, and further CT imaging, gross, and histological examinations were performed. Eight maxillary cheek teeth (including four with attached alveolar bone) from these heads, that were normal on gross and CT examinations, were used as controls. Results Gross pathological and histological examinations indicated that 28/30 teeth, including two supernumerary teeth, had pulpar/apical infection, including pulpar and apical changes. A further supernumerary and a dysplastic tooth were also identified. Abnormal calcified tissue architecture was present in all three supernumerary and in the dysplastic tooth. CT imaging strongly indicated the presence of pulpar/apical infection in 27 of the 28 (96.4%) pulpar/apically infected teeth, including the presence of intrapulpar gas ( N = 19/28), apical clubbing ( N = 20), periapical halo ( N = 4), root lysis or fragmentation ( N = 7), and periapical gas ( N = 2). Also present were alveolar bone sclerosis ( N = 20), alveolar bone thickening ( N = 3), and lytic/erosive changes ( N = 8). Radiographic abnormalities strongly indicative of pulpar/apical infection including periapical sclerosis ( N = 8/28) and apical clubbing ( N = 14/28) were found in 14/28 (50%) of apically infected teeth. Histological changes were present in alveolar bone of all 21 cases of apical infection where alveolus remained attached to the tooth and was marked in 16 cases, all which had CT alveolar changes. Histological changes included disruption of the normal trabecular pattern, in...

Standing CT of the equine head: Reducing radiation dose maintains image quality

“…Each head was subsequently scanned three times from the nares to the level of the occipital condyles. Heads were scanned at mAs 300, following the accepted previously published standard‐of‐care radiation dose . Each head was also scanned at mAs 225 (25% tube current reduction) and mAs 150 (50% tube current reduction).…”

“…Heads were scanned at mAs 300, following the accepted previously published standard-of-care radiation dose. 5,8,9,24,25 Each head was also scanned at mAs 225 (25% tube current reduction) and mAs 150 (50% tube current reduction…”

“…Radiographs of the equine skull can be difficult to interpret, despite optimal positioning, due to the anatomic complexity and superimposition of osseous, dental, and soft tissue structures . Computed tomographic examination of the equine head, particularly in cases of dental and paranasal sinus disease, yields additional clinically useful information compared to multiple radiographic projections . Computed tomography eliminates the inherent problem of superimposition of structures in conventional radiography of the head .…”

Computed Tomographic Assessment of Individual Paranasal Sinus Compartment and Nasal Conchal Bulla Involvement in 300 Cases of Equine Sinonasal Disease

“…In particular CT imaging has allowed accurate identification of cheek teeth periodontal, apical and endodontic disease (12,15,(17)(18)(19).…”

Maxillary Incisors of the Horse before and at the Beginning of the Teeth Shedding: Radiographic and CT Study

“…To accurately diagnose and formulate a treatment plan, evaluation of dental disorders requires a complete maxillofacial–oral examination and supplemental imaging means [ 21 ]. Some authors have compared and validated the accuracy of CT and radiographic imaging in detecting cheek teeth disorders in horses [ 24 ]. As stated above, in horses, there is a lack of radiographic data on deciduous incisors and dental germs of permanent incisors in the period before and at the beginning of the teeth shedding.…”