EOTRH and CT images questions Flashcards
Diagnosis
Three different manifestations of EOTRH previously reported are predominant
tooth resorption (A), predominant hypercementosis
Diagnosis
Three different manifestations of EOTRH previously reported are predominant
predominant hypercementosis (B)
Diagnosis
Three different manifestations of EOTRH previously reported are predominant
tooth resorption combined resorption and hypercementosis
marked radiographic changes, note advanced tooth resorption and hypercementosis radiographically
(C, D).
marked radiographic changes, note advanced tooth resorption and hypercementosis radiographically
(C, D).
Figure 1 Intraoral radiograph of the mandible of horse 19 showinghypercementosis and resorptive lesions in teeth 302, 303, 304, 401, 402 and403. Hypercementosis predominates in the teeth on the right side, whereasresorption is more evident on the left side. L, left in vet Records Rahmani 2019
Name the numbers
Fig. 4. (A) Dorsal, (B) sagittal, (C) transverse, and (D) closeup transverse images of the first
maxillary molar. Reference lines have been applied for the approximate level of the recon
on the dorsal (line of sagittal image) and sagittal (lines for dorsal and transverse images).
The arrowheads are highlighting the residual deciduous teeth (caps). 1. Periodontal space.
2. Dental pulp. 3. Enamel folds/dentin. 4. Pulp canal. 5. Infundibulum. in North america 2013 Barnatt
Fig. 8. (A) Transverse CT image at the level of the third maxillary premolar in an 11 year-old
donkey. Focal gas is present in the mesial medial tooth root (arrowhead). The nasolacrimal
duct has positive contrast infused. This is surrounded by soft tissue-attenuating material
and malformation of the conchal scrolls (arrow). (B) Dorsal CTimage of the equine skull immediately
dorsal to the apex of the maxillary teeth. There is focal gas secondary to a periapical
abscess in the mesial medial tooth root of the left maxillary second premolar (arrow). Note
the close proximity of the mesial medial tooth root of the left maxillary premolar to the nasolacrimal
duct (arrowheads). Barnat 2013 VNC
Fig. 10. (A) Transverse CT image at the level immediately cranial to the temporomandibular
joint and through the tympanic bulla (arrowhead) of a 6-year-old pony. (B) Dorsal CT image
at the level of the eye. A smooth well-demarcated dense mineral-attenuating structure
(dental origin tissue) is present in the left temporal bone and extends into the calvarial cavity
(arrows).
Fig. 25. Demonstration of the bisecting-angle technique for imaging the cheek tooth. The
x-ray beam (represented by the tensor light) is directed perpendicular to the plane that
bisects the angle between the tooth and the CR plate. The image (represented by the
shadow of the tooth) is equal in length to the actual tooth.
Fig. 35. Two examples of equine odontoclastic tooth resorption and hypercementosis
(EOTRH) in geriatric horses. The radiograph on the left is typical of those horses that present
with predominantly tooth resorption that affects the third incisors initially, and then involves
the second and first incisors sequentially over several years (arrows). The radiograph
on the right exemplifies those geriatric horses in which there is more predominant hypercementosis
and extrusion of the incisors, again affecting the lateral incisors initially and
progressing medially.
Fig. 36. EOTRH with pathologic fracture of the left mandibular second incisor (302). Note
that the left mandibular third incisor may also be fractured at the junction of the middle
and apical one-third in this view.
Fig. 39. Tooth resorption of the left mandibular canine (left) and the right maxillary canine
(right) teeth. Loss of the periodontal ligament space around the root of this tooth indicates
tooth resorption with bony replacement
Fig. 38. Oral photograph (left) of a right mandibular canine tooth with a deep periodontal
pocket. The radiograph in the center reveals a large area of mandibular bone lysis (arrows).
The photograph on the right was obtained intraoperatively, and reveals the large amount
of caseous purulent material present.
Fig. 42. Apical bone lysis (halo) and condensing osteitis associated with the right maxillary
third premolar (107) in a 5-year-old warmblood gelding. This horse presented with right
facial swelling rather than nasal discharge.
Fig. 44. Extraoral lateral DV maxillary oblique radiographs of a 4-year-old Clydesdale
gelding presented for right nasal discharge. There is periapical bone lysis (halo) and
condensing osteitis and widened periodontal ligament space of the right first and second
molars (109, 110). Compare with the radiograph on the right, the extraoral lateral DV
view of the left maxillary arcade
Fig. 47. Fluid lines demonstrated in a cadaver specimen. Note that the rostral maxillary sinus
(RMS) and caudal maxillary sinus (CMS) are separated by a bony septum and drain into the
nasomaxillary orifice into the middle nasal meatus. The RMS and the ventral conchal sinus
share a common space dorsal to the infraorbital canal, and are enclosed dorsally by the bulla
of the ventral conchal sinus.
Fig. 51. Lateral DV oblique radiograph (left) and DV radiograph (right) demonstrating an
ethmoidal hematoma in the left dorsal nasal conchus and nasal meatus (arrows).
Fig. 50. Right lateral DV oblique view (left) of the maxillary cheek teeth in a geriatric horse
with dysphagia, weight loss, and bilateral nasal discharge. Note the absence of normal alveolar
bone detail and periodontal ligament space associated with the cheek teeth. A
computed tomography scan (right) confirmed the presence of a large invasive mass (paranasal
adenocarcinoma).
Fig. 52. Extraoral radiograph of the right mandibular premolars of a 3-year-old Arabian
mare. There is thinning of the ventral mandibular cortex and enlargement of the dental
sac of the third and fourth right mandibular premolars (407, 408), with normal appearance
of the developing tooth roots.
393 - Eruption cysts and apical
abscessation both can present as firm swellings of the ventral mandible. As in the
case of the maxillary cheek teeth, the eruption cysts tend to exhibit normal radiographic
appearance of the apical aspect of the developing roots, with a surrounding
cystic structure and thinning of the cortical bone ventrally (Fig. 52).
- This 8-year-old warmblood gelding has bilateral complicated crown fractures of the
mandibular fourth premolars. There is apical bone lysis (halo) evident, as well as thickening
of the underlying cortical bone.
Fig 22: Latero-45° ventral-lateral oblique radiograph taken from a
five-year-old horse with a unilateral mandibular swelling. The image
shows a lucent halo (arrows) around the rostral and caudal roots of
307, with some thickening and irregularity of the lamina dura denta.
The caudal root shows dentinal lysis. These changes are indicative of
apical pulpitis
Fig 23: Latero-30° dorsal-lateral oblique radiograph taken from
a nine-year-old horse that presented with a mildly painful left
maxillary swelling. The image shows a focal area of maxillary bone
lysis (arrows) around the caudal root of 207, which is indicative of
maxillary apical pulpitis
Fig. 2. The latero-lateral view is used primarily for evaluation of the paradental sinuses. This
is the right lateral view obtained by placing the sensor on the right side of the horse’s head
with the center of the plate and central beam on the rostral aspect of the facial crest, which is
about in the center of the maxillary arcade. In this view, the right and left infraorbital canals
(IFC) are superimposed. The right and left conchofrontal sinuses (CFS),caudal maxillary sinuses
(CMS), and rostral maxillary sinuses (RMS) are superimposed. Arrow indicates the maxillary
septum separating the RMS from the CMS. The RMS also is superimposed on the VCS.VNC
Fig. 3. A distinct fluid line present in the RMS (arrow), and a smaller volume of fluid in the
CMS (arrowhead). A 15-year-old warmblood gelding.
Fig. 6. DV view of an adult dry skull (top) and a 2-year-old miniature horse (bottom). The
maxillary septum is a well-defined bony septum between the RMS and the CMS
Fig. 8. To better isolate the cheek teeth in the DV views, the mandibles can be offset right
and left. Note that the clinician is holding the generator directly below her head so that the
central beam is perpendicular to the sensor. The assistants are pulling the mandible and
maxilla gently in opposite directions (top). Alternatively, a commercially available adjustable
gag (Juliuster, MXR Podoblock, USA) can be used (bottom).
RtV60-LeDO radiograph of a 3-year-old miniature horse mare. Note the prominent
apical alveolar bone lucency of all of the left mandibular cheek teeth (arrows). This so-called
eruption cyst is a normal radiographic feature of the immature permanent premolar and
molar associated with the presence of the dental sac (dental follicle).
Fig. 22. Demonstration of the bisecting angle technique. The central beam is directed
perpendicular to the plane that bisects the angle between to the tooth and the receptor.
This results in an image of the tooth that is neither foreshortened or elongated
A 22-year-old Dutch warmblood gelding. The use of an intraoral DR sensor improves
the ability to capture the entire maxillary canine tooth. These images are slightly obliqued
to better isolate the maxillary third incisors and canine teeth. There is marked external tooth
resorption (arrowheads) with inflammatory alveolar bone lysis (arrows) of the maxillary
third incisors 103 (left panel), and 203 (right panel).
Fig. 31. A 29-year-old Thoroughbred gelding with advanced tooth resorption in combination
with hypercementosis involving all incisors and canine teeth. In many cases of hypercementosis
is predominant, the tooth is extruded and there is minimal alveolar osteomyelitis.
Note that cervical inflammatory tooth resorption of the canine teeth (arrows, upper left and
lower right panels) can occur with replacement resorption of the apical portion of the tooth
(arrowheads, upper right and lower left panels). VNC 2020
Fig. 31. A 29-year-old Thoroughbred gelding with advanced tooth resorption in combination
with hypercementosis involving all incisors and canine teeth. In many cases of hypercementosis
is predominant, the tooth is extruded and there is minimal alveolar osteomyelitis.
Note that cervical inflammatory tooth resorption of the canine teeth (arrows, upper left and
lower right panels) can occur with replacement resorption of the apical portion of the tooth
(arrowheads, upper right and lower left panels). VNC 2020
Fig. 32. (A, B) Intraoral occlusal radiographs of a geriatric warmblood gelding with incisor
and canine tooth resorption and hypercementosis. (C) In the RtV45-LeDO view, there is
blunting of tooth roots with areas of decrease radiopacity (arrows).
Fig. 32. (A, B) Intraoral occlusal radiographs of a geriatric warmblood gelding with incisor
and canine tooth resorption and hypercementosis. (C) In the RtV45-LeDO view, there is
blunting of tooth roots with areas of decrease radiopacity (arrows).(D) Multiplanar reconstruction
of the CT scan which is much more sensitive for identification of tooth resorption
(arrows) in cheek teeth. In this horse, there was evidence in the CT scan of tooth resorption
in nearly all of the cheek teeth.
Fig. 34. LeV15Cd15-RtDRO. (A) Dry skull, with (B) removal of the upper jaw and (C) in a
cadaver specimen. The arrow points to the right mandibular condyle in each image.
Fig. 35. Tangential views of the left TMJ compared. The left DV, caudo-rostral oblique view
is obtained with the sensor on the left side of the horse’s head (top photo and top radiograph),
whereas the left ventro-dorsal, rostro-caudal view is obtained with the sensor positioned
on the poll (bottom photo and bottom radiograph). Arrows indicate the TMJ, and
the asterisk indicates the mandibular condyle.
mare with facial over left maxillary swelling second premolar (206)
Fig. 37. (A) Intraoral and (B–D) extraoral views of a 15-year-old quarter horse mare with
facial swelling over the left maxillary second premolar (206). There was oral exposure of
the ventral aspect of the cementoma. No abnormal probing depths were noted and there
was no evidence of periodontal disease at this examination.
Fig 2: Latero-lateral (lateral) projection
Fig 3: Latero-45° ventral
open-mouthed oblique
projection
Fig 4: Latero-30° dorsal projection
Fig 5: Dorsoventral projection
Fig 7: Latero-15° ventral open-mouthed
oblique projection
Fig 8: Latero-10° dorsal open-mouthed
oblique projection
diagnosis
FIGURE 2 Radiograph of an apically infected mandibular Triadan
08 in a young horse where a thin metallic probe has been inserted
into a ventral draining tract. Note the extensive bone changes at
the caudal and apical aspects of the alveolus (arrows). Exodontia of
this tooth has an increased risk of post-extraction
problems as this
is a rostral mandibular cheek tooth, is apically infected and this is a
young horse.Dixon 2022
FIGURE 4 This radiograph of normal rostral mandibular cheek
teeth in a young horse has the periodontal space rostral to the
Triadan 07 indicated by a yellow arrow. The adjacent lamina dura
(bundle bone or cribriform plate) (white arrow) overlies the larger
expanse of spongy bone (SB). Dixon 2022
FIGURE 6 Left: This parasagittal CT image is of a horse with alveolar osteomyelitis and sequestration following exodontia of 408. Note
the gross soft tissue swelling overlying the affected alveolus (white arrow), alveolar thickening and remodelling and a large sequestrum of its
lateral wall (star). Right: This transverse CT image of the same case in a slightly different plane also shows the overlying soft tissue swelling
(white arrow), gross alveolar wall remodelling and an intra-alveolar
sequestrum (yellow arrow). The alveolus of (maxillary) Triadan 208 which
underwent exodontia the previous year is fully healed.Dixon 2022
FIGURE 8 This transverse CT image taken following exodontia
of 206 shows a large oro-nasal
fistula filled with food (arrows).
There also is almost total loss of the surrounding alveolus and of
some of its supporting bone that will make repair of this fistula very
problematic (figure courtesy of Dr Eric Parente
Fig 1: Transverse (a) and sagittal (b) CT planes of Case 1. On the transverse section left is to the right. The permanent maxillary 08s
have not developed and there are well-defined homogeneous soft-tissue attenuating structures (white arrows) within the space
between the 07s and the 09s. The deciduous teeth remain in place.
parotid anatomy in surgery resection - FIGURE 1 Right lateral (A) and transverse (B) views of the equine head. The skin has been removed and the parotidoauricular muscle
has been reflected dorsally. The cutaneous facei muscle has been removed. Outlined in green, red, purple, and yellow are the parotid salivary
gland, important arteries, veins, and nerves respectively.
It is located in the retromandibular fossa
between the vertical ramus of the mandible and the wing
of the atlas. Its dorsal border surrounds the base of the
auricular cartilage and the ventral border is dorsal to the
linguofacial vein. Rostrally, it attaches to the ramus of
the mandible and masseter muscle and caudally to the
strap muscles. The medial border overlies the maxillary
vein, the internal and external carotid arteries, the hypoglossal
and glossopharyngeal nerves, the vagosympathetic
trunk, and the lateral wall of the guttural pouch.1 The
The results of the report have not been presented at any meeting. facial nerve and its branches course through the parotid salivary gland (Figure 1).
tx?
Total or partial parotid sialoadenectomy
grade the caries
grade 0 grade 1.1 grade 1.2
grade the caries
