Equine odontoclastic tooth resorption and hypercementosis: Investigating individual incisor disease patterns using radiological classification.
Authors: Rehrl Sabine, Schulte Wiebke, Staszyk Carsten, Lischer Christoph
Journal: Equine veterinary journal
Summary
# EOTRH Distribution Patterns: Evidence for Age-Related Progression and Incisor-Specific Vulnerability Equine odontoclastic tooth resorption and hypercementosis (EOTRH) remains a significant diagnostic challenge because early pathological changes occur on clinically normal-appearing teeth, making radiographic assessment essential for thorough evaluation. This retrospective analysis of 142 horses aged 10 years and older examined individual incisor teeth using standardised radiological classification to determine whether EOTRH severity varied by tooth position and age. A strong positive correlation emerged between increasing age and disease progression (p<0.001, rho=0.48), with corner incisors consistently showing higher severity stages than central and intermediate incisors, and disease manifesting bilaterally in a symmetrical pattern across the arcade. For practitioners, these findings underscore that EOTRH warrants systematic radiographic screening in older horses presenting with even subtle clinical signs, and that corner incisors merit particular scrutiny as a reliable indicator of disease burden. The authors acknowledge limitations in differentiating mild EOTRH from age-related radiological changes, and difficulties imaging anatomically predisposed individuals, highlighting the need for careful technique standardisation when using incisor radiographs to inform clinical decisions about extraction timing and pain management strategies.
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Practical Takeaways
- •Radiographic examination is mandatory for all horses ≥10 years old to detect EOTRH, as clinical signs lag behind radiological changes; corner incisors warrant particular scrutiny
- •Expect bilateral symmetrical disease progression with age—when you identify EOTRH on one side, systematically examine the opposite side and expect worsening with each year of age
- •This is an underdiagnosed condition causing pain; elevated age-related prevalence means older horses presenting with behavioral or feeding issues warrant full radiographic incisor arcade evaluation
Key Findings
- •EOTRH shows bilateral symmetrical distribution pattern across the incisor arcade in horses aged 10 years and older
- •Significant positive correlation between horse age and EOTRH severity (p<0.001, rho=0.48, 95% CI 0.43-0.51)
- •Corner incisors are most severely affected, with disease severity increasing from central to middle to corner incisors
- •Radiography is essential for diagnosis as early EOTRH stages occur on clinically normal-appearing teeth