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A review of equine dental disorders

机译：马牙疾病综述

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Equine dentistry is a very important but until recently rather neglected area of equine practice, with many horses suffering from undiagnosed, painful dental disorders. A thorough clinical examination using a full mouth speculum is a pre-requisite to performing any equine dental procedure. Common incisor disorders include: prolonged retention of deciduous incisors, supernumerary incisors and overjet--the latter usually accompanied by cheek teeth (CT) overgrowths. Overjet can be surgically corrected, but perhaps should not be in breeding animals. In younger horses, traumatically fractured incisors with pulpar exposure may survive by laying down tertiary dentine. Loss or maleruption of incisors can cause uneven occlusal wear that can affect mastication. Idiopathic fractures and apical infection of incisors are rare. The main disorder of canine teeth is the development of calculus of the lower canines, and occasionally, developmental displacements and traumatic fractures. The main indications for extraction of "wolf teeth" (Triadan 05s) are the presence of displaced or enlarged wolf teeth, or their presence in the mandible. Developmental abnormalities of the CT include; rostral positioning of the upper CT rows in relation to the lower CT rows--with resultant development of focal overgrowths on the upper 06s and the lower 11s. Displaced CT develop overgrowths on unopposed aspects of the teeth and also develop periodontal disease in the inevitable abnormal spaces (diastemata) that are present between displaced and normal teeth. Diastemata of the CT due to excessive developmental spacing between the CT or to inadequate compression of the CT rows is a common but under diagnosed problem in many horses and causes very painful periodontal disease and quidding. Supernumerary CT mainly occur at the caudal aspect of the CT rows and periodontal disease commonly occurs around these teeth. Eruption disorders of CT include prolonged retention of remnants of deciduous CT ("caps") and vertical impaction of erupting CT that may lead to large eruption cysts and possibly then to apical infections. Disorders of wear, especially enamel overgrowths ("enamel points"), are the main equine dental disorder and are believed to be largely due to the dietary alterations associated with domestication. If untreated, such disorders will eventually lead to more severe CT disorders such as shearmouth and also to widespread periodontal disease. More focal dental overgrowths will develop opposite any CT not in full opposition to their counterpart, e.g., following maleruption of or loss of a CT. Because of the great length of reserve crown in young (hypsodont) CT, apical infections usually cause infection of the supporting bones and depending on the CT involved, cause facial swellings and fistulae and possibly sinusitis. Diagnosis of apical infection requires radiography, and possibly scintigraphy and other advanced imaging techniques in some early cases. When possible, oral extraction of affected CT is advocated, because it reduces the costs and risks of general anaesthesia and has much less post-extraction sequelae than CT repulsion or buccotomy.
机译：马术是非常重要的，但直到最近，马术领域仍被忽略，许多马匹患有未经诊断的痛苦的牙齿疾病。使用全口窥镜进行彻底的临床检查是进行任何马牙手术的前提。常见的门牙疾病包括：乳牙门牙的长期保留，多余的门牙和过高的喷射-后者通常伴有颊齿（CT）过度生长。可以通过手术纠正过喷射，但在繁殖动物中可能不应该如此。在较年轻的马匹中，暴露于牙髓的外伤性切牙可通过放下第三牙质而幸存。门牙的脱落或断裂可能会导致咬合不均匀磨损，从而影响咀嚼。特发性骨折和切牙顶端感染很少见。犬齿的主要疾病是下犬牙结石的发展，偶尔还有发育移位和创伤性骨折。拔出“狼牙”（Triadan 05s）的主要迹象是狼牙移位或增大，或它们存在于下颌骨中。 CT的发育异常包括：上部CT排相对于下部CT排的水平位置-结果导致上部06s和下部11s上的焦点过度生长。移位的CT在牙齿的未对置部分上过度生长，并且在移位的牙齿与正常的牙齿之间不可避免的异常空间（渗血）中也发展为牙周病。在许多马匹中，由于CT之间过大的发育间隔或对CT行的压缩不充分而导致的CT异常是常见的，但在诊断中存在问题，并且会引起非常痛苦的牙周疾病和颤动。多余的CT主要发生在CT排的尾端，而牙周病通常发生在这些牙齿周围。 CT的爆发疾病包括长期保留乳腺CT残留物（“帽”）和垂直冲击CT可能导致大的囊肿性囊肿，进而可能导致顶端感染。磨损的疾病，特别是牙釉质的过度生长（“牙釉质点”）是马的主要牙齿疾病，并且被认为主要是由于与驯化有关的饮食变化。如果不加以治疗，这些疾病最终将导致更严重的CT疾病，例如剪口和广泛的牙周疾病。与CT完全相反的是，任何CT都会出现更多的局部牙齿过度生长，例如在CT破裂或丢失之后。由于年轻（假牙）CT的储备冠很长，根尖感染通常会引起支撑骨的感染，并且取决于所涉及的CT，会导致面部肿胀和瘘管，甚至可能引起鼻窦炎。顶端感染的诊断需要射线照相，在某些早期病例中可能需要闪烁显像和其他先进的成像技术。在可能的情况下，提倡口服提取受影响的CT，因为与CT排斥或开腹手术相比，它可降低全身麻醉的成本和风险，并且提取后遗症的可能性小得多。

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