Occlusal fissures in equine cheek teeth: μCT and histological findings

Pollaris, Elke; Staszyk, Carsten; Proost, Kirsten; Boone, Matthieu N.; Josipović, Ivan; Pardon, Bart; Vlaminck, Lieven

doi:10.1016/j.tvjl.2019.105421

Cited by 3 publications

(8 citation statements)

References 22 publications

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“…Furthermore, it was shown that type 2 fissures had the highest odds to evolve into a crown fracture with 13% observed to fracture followed by type 1b (10%) fissures. These findings support previous hypotheses that fissures with patterns in a more mesio-distal plane are more prone to develop into gross crown fractures (3,4,6,7,12). In contrast, fissures with a largely transverse orientation (type 1a) were also observed to develop into crown fractures (5%).…”

Section: Discussionsupporting

confidence: 90%

“…With the routine use of oral dental scopes by equine dental specialists, small dental anomalies are easily detected but subsequently raises more questions on the clinical importance of these observations. The presence of fine linear defects in the occlusal surface of equine cheek teeth is one of them and it has been demonstrated that these macroscopically visible fissures are in fact true microscopical cracks in the tooth (5,6). Some authors suggested that occlusal fissures might evolve to crown fractures (3,4,7), which is supported by the results of this study (7.4% of fissures evolved to a partial crown fracture in this study population).…”

Section: Discussionsupporting

confidence: 84%

“…However, in a previous study pulpitis was considered to be caused through existing occlusal fissures in 2 out of 79 (2.5%) apically infected cheek teeth (4). Oral bacteria might invade the space that is created by a fissure and colonize pulp tissue as was demonstrated by Wellmann and Dixon (5), and further supported by the findings of Pollaris et al (6). However, it was also concluded that healthy pulp should be able to deal with these noxious stimuli (6).…”

Section: Introductionmentioning

confidence: 84%

“…It has been suggested that occlusal fissures are induced by masticatory forces and that due to the interactive mechanical supportive role of the different dentinal tissues, some anatomical locations on the occlusal surface are more prone to mechanical trauma (3,6). The lingualside of equine maxillary cheek teeth is indeed the position where the masticatory forces are the highest in the maxilla.…”

Section: Discussionmentioning

confidence: 99%

“…Type 2 fissures were only recorded when they involved primary dentin. Small enamel cracks which were commonly observed in a cadaveric study (3) were not included due to the difficulty to observe them on video recordings and their minimal clinical importance as has been demonstrated in a high-resolution X-ray computed tomography study (6). The development of crown fractures was recorded during the follow-up period and their relationship with previously identified fissures was noted.…”

Section: Methodsmentioning

confidence: 99%

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Occlusal Fissures in Equine Cheek Teeth: A Prospective Longitudinal in vivo Study

2020

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Background: It has been suggested that fissures of the occlusal surface of equine cheek teeth may develop into crown fractures. Objectives: To examine the evolution of fissures present on the occlusal surface of cheek teeth. Furthermore, to investigate the presence of a fissure as a risk factor for the development of a subsequent crown fracture. Study Design: Observational longitudinal study. Methods: Bi-annual dental examinations were performed on 36 horses for 3 years. Video-recordings were made to evaluate the evolution of detected fissures. The effect of possible predictors on the development of tooth fractures was investigated by regression analysis. Results: The evolution of 785 fissures (467 type 1a, 271 type 1b, 47 type 2) was recorded. Fissure characteristics were observed to remain unchanged, disappear, become longer, shorter, change in configuration or change in color. Partial crown fractures (22 maxillary, 50 mandibular) were recorded in 52 cheek teeth in 22/36 horses. Fifty-nine of these fractures evolved from previously observed fissures (24 type 1a, 29 type 1b, 6 type 2). All fissure types proved to be a significant risk factor for the development of a crown fracture ( p < 0.001), with the highest odds for type 2 fissures ( OR = 14.27; 95% CI = 4.88–41.71). Other significant risk factors were the time of follow-up ( p < 0.001), mandibular teeth ( p < 0.001) and the lingual side of a tooth ( p < 0.001). All fractures were non-complicated. Main Limitations: Some horses were prematurely lost for follow-up, which perhaps influenced the results. A longer follow-up period would have also allowed an evaluation of the risk for pulp disease on the long term subsequent to partial crown fractures. Conclusions: The presence of a fissure of any type, mandibular cheek teeth, the lingual side of cheek teeth, and time of follow-up proved to be significant risk factors for development of a cheek tooth crown fracture. Type 2 fissures showed the highest odds followed by type 1b fissures. The observed partial crown fractures demonstrated a low clinical impact whereby no tooth showed signs of development of endodontal disease.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Occlusal Fissures in Equine Cheek Teeth: A Prospective Longitudinal in vivo Study

2020

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The facultative human oral pathogen Prevotella histicola in equine cheek tooth apical/ periapical infection: a case report

et al. 2021

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Background Prevotella histicola is a facultative oral pathogen that under certain conditions causes pathologies such as caries and periodontitis in humans. Prevotella spp. also colonize the oral cavity of horses and can cause disease, but P. histicola has not yet been identified. Case presentation A 12-year-old Tinker mare was referred to the clinic for persistent, malodorous purulent nasal discharge and quidding. Conservative antibiotic (penicillin), antiphlogistic (meloxicam), and mucolytic (dembrexine-hydrochloride) treatment prior to referral was unsuccessful and symptoms worsened. Oral examination, radiography, sino-/ rhinoscopy, and standing computed tomography revealed severe apical/ periapical infection of the upper cheek tooth 209 with accompanying unilateral sinonasal inflammation and conchal necrosis. The tooth exhibited extensive subocclusal mesial infundibular cemental hypoplasia and caries, and an occlusal fissure fracture. After mechanical debridement and thermoplastic resin filling of the spacious subocclusal carious infundibular lesion, the tooth was extracted intraorally. The sinusitis and conchal necrosis were treated transendoscopically. Selective bacteriological swab cultures of affected tooth roots and subsequent matrix-assisted laser desorption ionization-time of flight mass spectrometry showed an infection with the obligate anaerobic, Gram-negative bacterium P. histicola. Surgical intervention and adapted antibiotic therapy led to normal healing without complications. Conclusions This study provides the first documented case of dental infection in a horse caused by P. histicola at once indicating necessity of more sufficient microbiological diagnostics and targeted antibiotic treatment in equine dental practice. This finding is also conducive to understand species-specific Prevotella diversity and cross-species distribution.

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Fracture Resistance of Equine Cheek Teeth With and Without Occlusal Fissures: A Standardized ex vivo Model

et al. 2021

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Background:Ex vivo fracture models are frequently used in human dentistry to provide insights in the fracture mechanisms of teeth. Equine cheek teeth fractures are an important dental pathology, but there has been no research performed to examine the fracture resistance ex vivo.Objective: To evaluate the fracture resistance of equine cheek teeth and identify anatomical predictors that might influence fracture resistance in healthy teeth. It was further evaluated if the presence of a fissure caused a decrease in fracture resistance.Study design:Ex vivo experimental design.Methods: Individual cheek teeth were subjected to a compression load in a universal testing machine until fracture occurred. Testing was performed in two study groups. A first group of healthy cheek teeth was tested to examine anatomical predictors on fracture resistance. A second group comprised cheek teeth with occlusal fissures and an equal number of age- and size-matched fissure-free teeth as controls. The effect of possible predictors on fracture resistance was investigated by regression analysis.Results: In the first group, fracture resistance was significantly influenced by the location on the tooth where testing was performed in both maxillary (p < 0.001) and mandibular teeth (p < 0.001). Additional significantly associated factors were Triadan number in mandibular (p = 0.009) and the mesiodistal length of the occlusal surface of maxillary teeth (p = 0.01). Experimentally induced crown fractures that extended below the simulated bone level were more frequently associated with pulp horn exposure (p < 0.001). In the second group, significant lower fracture loads were recorded in teeth with fissures (mandibular p = 0.006; maxillary p < 0.001), compared to fissure-free teeth.Main limitations: This ex vivo model does not imitate the in vivo masticatory forces and lacks the shock-absorbing properties of the periodontal ligament.Conclusions: The methodology used in this study provides an ex vivo experimental set-up to test fracture resistance of equine cheek teeth enabling evidence-based research to examine the potentially weakening effects of tooth pathology and its treatments. Crown resistance to fracture differed along the occlusal surface of healthy equine cheek teeth, and the presence of fissures further decreased fracture resistance.

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Occlusal fissures in equine cheek teeth: μCT and histological findings

Cited by 3 publications

References 22 publications

Occlusal Fissures in Equine Cheek Teeth: A Prospective Longitudinal in vivo Study

Occlusal Fissures in Equine Cheek Teeth: A Prospective Longitudinal in vivo Study

The facultative human oral pathogen Prevotella histicola in equine cheek tooth apical/ periapical infection: a case report

Fracture Resistance of Equine Cheek Teeth With and Without Occlusal Fissures: A Standardized ex vivo Model

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