Two- and three-dimensional computed tomographic anatomy of the enamel, infundibulae and pulp of 126 equine cheek teeth. Part 2: Findings in teeth with macroscopic occlusal or computed tomographic lesions.
Authors: Windley Z, Weller R, Tremaine W H, Perkins J D
Journal: Equine veterinary journal
Summary
# Editorial Summary Dental pathology in horses remains notoriously difficult to diagnose and characterise, yet understanding the internal anatomy of cheek teeth lesions is essential for developing effective treatment strategies. Windley and colleagues examined 126 extracted cheek teeth using two- and three-dimensional CT imaging alongside direct anatomical sectioning, focusing specifically on teeth displaying either visible occlusal damage or CT-identified lesions, and categorising infundibular pathology into six distinct classifications. The findings revealed that whilst only 65% of infundibular lesions were detectable on gross occlusal examination, CT imaging identified lesions in 90% of infundibulae, with all teeth more than six years post-eruption showing detectable pathology; peripheral enamel hypoplasia and enamel prolapses occurred in 10% and 1.6% of specimens respectively, and pulp infections presented with variable CT appearances depending on the underlying pathological process. For practitioners managing equine dental disease, these results underscore the considerably higher diagnostic sensitivity of CT over clinical assessment alone, suggesting that seemingly minor or inapparent lesions may represent significant pathology, whilst the detailed anatomical classification system provides a framework for understanding disease progression and selecting appropriate interventions based on lesion type and severity.
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Practical Takeaways
- •CT imaging should be considered the gold standard for evaluating equine cheek teeth disease, as conventional occlusal examination misses the majority of infundibular lesions (25% missed in this study)
- •Expect infundibular involvement in all horses over 6 years of age post-eruption; the high prevalence suggests these lesions warrant clinical attention rather than dismissal as incidental findings
- •When diagnosing equine dental disease, rely on 2D/3D CT rather than external assessment alone to guide appropriate treatment protocols and prognosis
Key Findings
- •Infundibular lesions were detected on CT in 90% (115/128) of infundibulae, but only 65% (83/128) were visible on occlusal surface examination alone
- •All infundibulae over 6 years post-eruption had detectable lesions, demonstrating age-related progression
- •Peripheral enamel hypoplasia occurred in 10% of teeth and enamel prolapses in 1.6%, with variable CT appearances in pulp infections
- •2D and 3D CT imaging proved highly superior to occlusal surface examination for detecting dental lesions within enamel, infundibulae, and pulp structures