or if positioning is not optimal. The addition of offset mandible and intraoral views of the incisors and canine teeth is case-dependent.1 The use of all 6 of these views allows for evalua-
Fig. 8. RV45LDO radiograph of a 22-year-old Tennessee Walk- ing Horse mare. There was feed packing in diastemata between the left and right maxillary 3rd and 4th premolars and 1st mo- lars. Periapical bone lysis (arrow) is evident on the distal buccal root of the left maxillary 3rd premolar (207). Note the short roots of the maxillary cheek teeth in comparison to the mandib- ular cheek teeth.
tion of each cheek tooth from several angles and is analogous to obtaining 4 to 5 views in a fetlock joint study with the same views of the contralateral limb for comparison. Standardization of the study has the benefit of permitting the radiologist to readily recognize when the view is appropriately positioned, speeds up the radiographic examination, and en- hances the ability to obtain a diagnosis or seek a consultation from a specialist. Digital systems al- low the radiologist to obtain this study quickly. The author recommends presenting this service as a study billed similarly to a distal extremity study in a lameness examination (Equine dental radiographic study: $200–300) rather than billing by the image, which tends to result in the client requesting fewer images than are needed for a complete assessment and treatment planning.
Fig. 9. An 8-year-old Holsteiner gelding with a complicated crown fracture of 408 associated with right ventral mandibular swelling and a draining tract. There is periapical sclerosis and apical bone lysis (arrows) associated with the fractured 408 (A) as compared with the contralateral 308 (B). Courtesy of Leah Limone, DVM.
