History, clinical findings and outcome of horses with radiographical signs of equine odontoclastic tooth resorption and hypercementosis

Abstract

The progression of equine odontoclastic tooth resorption and hypercementosis (EOTRH) has not been completely evaluated, and currently, the only effective treatment is extraction of severely affected teeth. We aim to describe how the disease relates to the history and clinical findings and to report on the outcome in individual horses. This case series comprises data collected from 20 horses (age 14–29 years old) with radiographic findings of EOTRH in their incisor and/or canine teeth. Most horses affected with EOTRH in this study were admitted for dental problems, but some for other complaints such as colic. Of the 288 teeth evaluated radiographically, 224 teeth were abnormal. Radiographic findings were most frequently located in the apical aspect and reserve crown of the teeth, and lesions were also commonly found in clinically normal teeth. Histopathology of extracted teeth showed inflammation in the periodontal ligament and revealed that resorption often extended to the dentine. Some owners were unwilling to allow extraction of their horses’ severely affected teeth, even though this treatment has been shown to increase the wellbeing of the horse. As EORTH is a life-long condition, the progression of the disease has to be continuously monitored and the treatments adjusted accordingly.

The Role of Computed Tomography in Imaging Non-neurologic Disorders of the Head in Equine Patients

“…Despite this being a painful disease, it is often undiagnosed. The etiology of the disease is unknown ( 50 , 51 ). EOTRH is characterized by either the predominately resorptive or hypercementosis pattern, or by a combination of both patterns.…”

“…EOTRH is characterized by either the predominately resorptive or hypercementosis pattern, or by a combination of both patterns. Typically, on radiographs, a bulbous enlargement of the intraalveolar crown root, resorption of the reserve crown, root and apex with widening of the peridontal ligament space as well as tooth fractures are noted ( 51 ). Teeth affected by EOTRH frequently have endodontic disease with inflammation, lysis, necrosis and fibrosis of the pulp ( 51 ).…”

Equine Incisor Lesions: Histologic Confirmation of Radiographic, Macroscopic, and Micro-Computed Tomographic Findings

“…Hitherto, palliative therapies, such as tooth brushing and oral irrigation, dietary modifications, floating and incisor reduction, anti-inflammatory and/or antibiotic drugs, corticosteroids, surgical curettage, and debridement [ 3 , 9 , 10 ], show limited to no success in stopping the disease progression [ 10 , 11 ]. Thus, extraction of the affected teeth, oftentimes the complete incisor dentition, is recommended [ 12 , 13 ].…”

Equine Odontoclastic Tooth Resorption and Hypercementosis

“…Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a recently described painful and progressive condition with unknown etiology that affects middle-aged and geriatric equines. It predominantly affects the permanent incisor and canine teeth [1][2][3][4][5][6] and less commonly, the premolar and molar teeth. 7 EOTRH is characterized by external odontoclastic tooth resorption, progressive proliferation of irregular cementum, and osteoclastic resorption of the surrounding alveolar bone.…”

“…8 Tooth resorption may occur with or without hypercementosis, which is considered a reparative mechanism rather than being part of the primary pathological process. [4][5][6] This condition was first published in 2008 where it was described as a painful, uncommon, and possibly under-recognized disorder. 9 Several etiologic theories for EOTRH have been suggested; however, no single cause has been established.…”