Computed tomography and scintigraphy for evaluation of dental disease in the horse
Authors: Barakzai S. Z., Barnett T. P.
Journal: Equine Veterinary Education
Summary
# Editorial Summary: CT and Scintigraphy in Equine Dental Diagnosis Conventional radiography of the equine head is fundamentally limited by superimposition of overlapping anatomical structures, making subtle dental and periapical pathology difficult to detect reliably. This 2015 review examines two advanced imaging modalities—computed tomography (CT) and nuclear scintigraphy—as diagnostic tools for equine dental disease. CT offers superior soft tissue contrast resolution and allows multi-planar and three-dimensional reconstruction, enabling precise assessment of dental tissues, periodontal structures, alveolar bone, and paranasal sinuses without the spatial ambiguity inherent in conventional radiography. Scintigraphy with technetium-99m methylene diphosphonate detects changes in bone metabolism before radiographic signs become apparent, making it particularly valuable for identifying early periapical infections and clarifying equivocal cases involving supernumerary or dysplastic teeth where CT findings may be inconclusive. For practitioners managing horses with chronic sinusitis, quidding, or suspected cheek tooth pathology unconfirmed by standard imaging, these advanced modalities provide substantially greater diagnostic accuracy—though availability and cost remain practical considerations in clinical decision-making.
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Practical Takeaways
- •Use CT imaging when detailed assessment of dental anatomy and pathology is needed, as it provides clearer visualization of individual teeth and surrounding structures than radiography alone
- •Consider scintigraphy for suspected early periapical infections before radiographic changes become evident, improving diagnostic sensitivity
- •For complicated cases involving supernumerary or dysplastic teeth, combine imaging modalities (CT and scintigraphy) rather than relying on conventional radiography alone
Key Findings
- •CT imaging provides superior contrast resolution and 3D reconstruction compared to conventional radiography, eliminating superimposition artifacts in equine head imaging
- •Scintigraphy with 99mTc-MDP can detect bone changes preceding radiographic findings, making it valuable for early diagnosis of periapical infections
- •Scintigraphy is particularly useful for imaging supernumerary or dysplastic teeth where radiography or CT results are equivocal