126


EQUINE VETERINARY EDUCATION / AE / MARCH 2016


a)


d)


b)


e)


c)


f)


Fig 5: EOTRH in cheek teeth of a 20-year-old Arabian gelding (Case 1). a) Extracted 309, mesiolingual view. The tooth is covered by irregular cementum (irC). Brown staining and pitting indicate presence of necrotic tissue. b) Extracted 309, mesial half, horizontal section 30 mm sub-occlusally. Dentin (D) and enamel (E) show normal outline, texture and coloration. Red coloration in pulp horn 2 (black arrowhead) indicates vital pulpal tissue. The tooth is surrounded by large amounts of irregular cementum (irC) causing hypercementosis. c) Extracted 309, mesial half, horizontal section 40 mm sub-occlusally. Irregular cementum surrounding the dental root. d), e), f) Extracted 309, histological sections demonstrating typical microscopical features of EOTRH: d) Odontoclastic resorption (red arrowheads). e) Reactive deposition of reparative/irregular cementum indicated by presence of wavy reverse and incremental lines (blue arrowheads). Green arrow heads indicate lacunae of cementoblasts. The adjacent periodontal ligament (PDL) is characterised by leucocyte infiltrations and numerous capillaries. f) Irregular cementum has been deposited on the previously resorbed dentinal surface. The irregular cementum contains vascular channels (yellow arrowheads). Blue arrowheads: reversal and incremental lines.


and the mineralised tissue was dominated by cementoblast- like cells producing new (irregular) cementum. In some positions odontoclasts were present causing ongoing tooth resorption (Fig 5). The histopathological features described confirmed the diagnosis of a hypercementotic form of EOTRH.


Case 2 A 38-year-old Shetland pony mare was referred to the equine teaching hospital of the Freie Universit€


at Berlin


emergency service for evaluation of inappetance that had persisted for several days. The referring veterinarian suspected dental disease may have been responsible for the prolonged loss of appetite and reported a foul odour originating from the mouth as well as ptyalism during mastication. According to the owner, the pony had been losing weight recently even though her diet consisted of a mash and soaked hay cubes. The horse had not received regular dental care in the 34 years she had lived with the current owner. Haematology


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and serum biochemistry revealed hyperlipidaemia and leucocytosis all of the other blood parameters were within normal limits. Following treatment and resolution of the


hyperlipidaemia, a complete oral examination was performed with the horse sedated and revealed severe bulbous enlargement of reserve crown and roots, severe gingivitis, periodontitis and gingival recession affecting all incisors (Fig 6). The maxillary 03s were displaced horizontally (Fig 6). Additionally, erythema affecting the mucosa of the lower lip was noted (Fig 6). A pronounced step and wave mouth were present in


the CT dentition but only a few margins of the mandibular and maxillary teeth were sharp. Further inspection by using an intraoral mirror revealed that all CT were wider than usual due to an increase in the peripheral cementum. All CT were also found to be mobile by digital pressure. The 206 CT was missing and the 411 was displaced rostrally and very loose.


Mild gingivitis and periodontitis around some of the CT were noted.


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