The association between oral examination findings and computed tomographic appearance of the equine temporomandibular joint.
Authors: Carmalt J L, Simhofer H, Bienert-Zeit A, Rawlinson J E, Waldner C L
Journal: Equine veterinary journal
Summary
# The association between oral examination findings and computed tomographic appearance of the equine temporomandibular joint Whilst masticatory biomechanics in horses have received considerable research attention, the relationship between dental and oral pathology and temporomandibular joint (TMJ) structure remains poorly understood—a gap this 2017 study aimed to address. Carmalt and colleagues conducted a retrospective cross-sectional analysis of 201 horses from three practices, each with complete oral examination and CT imaging of the skull or upper cervical region, using logistic regression to identify associations between specific oral findings and CT-detected TMJ abnormalities (alterations in mandibular condyle contour/density, mandibular fossa morphology, and intra-articular disc appearance). Notably, horses with infundibular caries were significantly more likely to present with TMJ anatomical abnormalities, whereas those with periodontal disease actually showed fewer TMJ changes; additionally, horses with abnormal TMJs were older than those with normal joints. However, the authors acknowledge that their cross-sectional design cannot establish causality or temporal relationships—we cannot determine whether oral pathology drives TMJ changes or vice versa, nor can we yet establish whether the observed anatomical variations carry clinical significance. For practitioners, this suggests infundibular disease warrants closer attention to TMJ function and that routine oral examination should inform assessment decisions; nevertheless, further prospective research is needed to clarify whether TMJ interventions should be integrated into treatment protocols for specific dental conditions.
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Practical Takeaways
- •TMJ abnormalities are more common in older horses; consider age-related screening in geriatric patients with mastication issues
- •Infundibular disease appears linked to TMJ changes—investigate TMJ status in horses presenting with infundibular pathology
- •Periodontal disease alone may not drive TMJ pathology; focus diagnostic workup accordingly when assessing mastication problems
Key Findings
- •Horses with abnormal TMJ findings were significantly older than those with normal TMJ anatomy
- •Periodontal disease was associated with lower likelihood of abnormal TMJ findings on CT
- •Infundibular disease was associated with higher likelihood of TMJ abnormalities
- •Cross-sectional study design prevented establishment of causality between oral pathology and TMJ changes