Equine “Idiopathic” and Infundibular Caries-Related Cheek Teeth Fractures: A Long-Term Study of 486 Fractured Teeth in 300 Horses

Paddy Dixon, Rebekah Kennedy, Richard Reardon

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Limited objective information is available on the prevalence of non-traumatic equine cheek teeth fractures, the signalment of affected horses and on the clinical features and treatment of these fractures.

Objectives
To document patterns of idiopathic and infundibular caries-related cheek teeth fractures in a referral population. Evaluate associations between fracture patterns and: horse age, Triadan position of affected teeth, clinical signs, and deemed necessity for treatment.

Study design
Retrospective case review.

Methods
The clinical records at Edinburgh University Veterinary School (2010-2018) were examined for the presence of non-traumatic equine cheek teeth fractures. Variations in the frequencies of different fracture patterns were compared between horse ages, Triadan tooth positions, clinical signs and deemed necessity for treatment.

Results
Records of 300 horses with 486 non-traumatic cheek teeth fractures including 77% maxillary and 23% mandibular teeth with a mean of 1.6 (range 1-10) fractured teeth/horse were available. Fracture patterns included maxillary 1st and 2nd pulp horn (“slab”) cheek teeth fractures (n=171); caries-related infundibular fractures (n=88); other maxillary teeth fracture patterns (n=92); mandibular 1st and 2nd pulp horn (“slab”) fractures (n=44); other mandibular fracture patterns (n=62) and complete clinical crown loss (n=29; including 23 maxillary and 6 mandibular cheek teeth).
The median age of affected horses ranged from 11 years with maxillary “slab” fractures to 15 39 years with infundibular caries-related fractures.
The 4th premolar and 1st and 2nd molars (Triadan 08s-10s) were the most commonly (86%) fractured maxillary teeth. The 4th premolar and 1st molar (Triadan 08 and 09) positions were the most commonly (64%) fractured mandibular teeth.
No clinical signs were noted in horses with 48% of the fractured teeth; oral pain/quidding was recorded with 26%, clinical apical infection with 23% and bitting/headshaking problems with 6%. 46
Treatments included extraction of 40% of fractured teeth, extraction of small/loose fragments (10%) and odontoplasty. The stable remnants of 60% of fractured teeth were left in horses without clinical signs.

Main Limitations
Imaging and long-term follow up information was not available for all cases.

Conclusions
There is increasing recognition of equine non-traumatic cheek teeth fractures, with about half of these fractures not causing clinical signs. Teeth with apical infection; multiple fractures, looseness or advanced caries require extraction. Other fractured teeth with subclinical endodontic disease may not need exodontia unless they later cause clinical signs.
Original languageEnglish
Article number646870
JournalFrontiers in Veterinary Science
Volume8
DOIs
Publication statusPublished - 28 May 2021

Keywords

  • Horse
  • Equine dental disease
  • Equine dental fracture
  • Equine cheek teeth non-traumatic fracture
  • Idiopathic
  • Cheek teeth fracture
  • Infundibular caries-related fracture.

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