Page 765 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

740 CHAPTER 4

VetBooks.ir result in displacement during eruption, with subse- Management
Treatment of the secondary consequence is often indi-
quent misalignment of the tooth arcade, or predis-
pose to apical compression with resultant hypoxic
teeth may be a component of the management.
ischaemia. cated although extraction of individual malerupted
Clinical presentation ACQUIRED DENTAL DISEASES
Maleruption resulting in misalignment is imme-
diately obvious on oral examination and it is com- DIASTEMA LEADING TO PERIODONTITIS
monly bilateral. Careful inspection for early signs
of misalignment should be performed at each dental Definition/overview
examination. The consequences of misalignment are A diastema is defined as an inappropriate space
malocclusion with the opposing arcade, resulting in between two teeth of the same type, which can be
the development of focal overgrowths and diastema, pathologically significant in Equidae if it results
or gaps, between the adjacent teeth in the row. This in food retention and periodontitis. Diastemata
results in loss of the close association between adja- often occur in multiple sites, especially between
cent teeth and enables accumulation of food adjacent the mandibular cheek teeth. Periodontitis is
to the gingival sulcus and destructive bacteria in defined as inflammation of the periodontal tissues,
periodontal pockets. This causes gingivitis, gingival including the periodontium, and may also include
recession and peripheral cemental caries. This condi- gingivitis.
tion appears to be painful, with affected horses often
exhibiting signs including slow eating and quidding Aetiology/pathophysiology
(oral dysphagia) and, in chronic cases, development Primary periodontitis is rare in the horses and
of periodontitis. plaque accumulation has not been identified as a
major factor in this species. Extensive periodonti-
Diagnosis tis usually accompanies the presence of diastemata,
Oral examination will reveal the presence of mal- possibly due to misalignment or age-related loss of
eruptions. Radiography may be indicated to dem- mesiodistal compression, which allow the develop-
onstrate secondary consequences such as impacted ment of periodontal food pockets. This facilitates
teeth (Fig. 4.38) or deep periodontal disease or pathogenic bacteria to accumulate in the gingi-
caries. val sulcus resulting in gingivitis and periodontitis
(Figs. 4.39–4.41).

Clinical presentation
4.38
The clinical history may include slow eating, spilling
food, difficulty with mastication of long-fibre diets
and even weight loss.

Diagnosis
An oral examination, including using a dental
mirror to identify the presence of food trapped in
periodontal pockets will enable diagnosis of this
condition. The condition is common in aged horses,
which have reduced areas of periodontal attachment
and short reserve crowns, resulting in a physiologi-
cal reduction in the mesiodistal compression. In
chronic cases multiple teeth may be digitally loose.
Fig. 4.38 306 is displaced in this radiograph and its Advanced cases will reveal chronic sclerosis of the
maleruption could impede the normal eruption of 307. dental alveolus on radiography or CT.