Page 772 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Gastrointestinal system: 4.1 The upper gastrointestinal tr act 747

VetBooks.ir Clinical presentation discolouration of dentine is probably structurally
significant. As such there is an argument for treat-
Affected teeth may be asymptomatic. Caries results
in sequential demineralisation of peripheral and
lead to pathological dental fractures. Debridement
occlusal cementum, progressing into enamel and ing grade 2 lesions, to prevent progression that can
eventually into dentine (Fig. 4.55). Caries can of diseased tissues using high-speed burrs, files
be graded according to a modified Honma scale. and abrasion, combined with full etch and bonding
Structural weakening will eventually occur once with restoration dental composites, is currently an
enamel is affected and can lead to dental frac- attempt to achieve this. The efficacy of this tech-
ture when subjected to normal masticatory forces. nique in the long term is currently unproven. Teeth
Penetration into the dentine, which is porous, can with peripheral caries may benefit from debridement
result in pulpitis. The rate of progression is highly in association with dietary management and concur-
variable but advanced grade 3 caries (involving den- rent treatment of periodontitis.
tine) is clinically significant.
DENTAL FRACTURE
Diagnosis
Occlusal and peripheral dental observation for signs Definition
of pitting, discolouration and demineralisation of Fracture involving a tooth.
dental tissues. Oroscopic examination will reveal
greater detail of any damage, particularly if used in Aetiology
combination with a fissure probe (Fig. 4.56). Dental fractures result from trauma (usually inci-
sors) or are pathological fractures of teeth pre-
Differential diagnoses disposed by affliction with overgrowths, caries or
Dental fracture, normal wear patterns. pulpitis. Traumatic fractures can involve transverse
fractures to incisors or avulsion injuries involving
Management the rostral mandible or incisive bones. Simple frac-
Indications for management of caries are cur- tures involving peripheral cementum and enamel
rently poorly defined. Grade 3 caries that involves may be clinically asymptomatic. Complex fractures

4.55 4.56

Fig. 4.55 This tooth has grade 3 infundibular caries Fig. 4.56 Oroscopic view of a tooth afflicted with
that can structurally weaken the tooth, leading to grade 2 infundibular cemental caries.
parasagittal fracture.