EOTRH and CT images questions

Question 1

Diagnosis

Answer 1

Three different manifestations of EOTRH previously reported are predominant
tooth resorption (A), predominant hypercementosis

Question 2

Diagnosis

Answer 2

Three different manifestations of EOTRH previously reported are predominant
predominant hypercementosis (B)

Question 3

Diagnosis

Answer 3

Three different manifestations of EOTRH previously reported are predominant
tooth resorption combined resorption and hypercementosis

Question 4

Answer 4

marked radiographic changes, note advanced tooth resorption and hypercementosis radiographically
(C, D).

Question 5

Answer 5

marked radiographic changes, note advanced tooth resorption and hypercementosis radiographically
(C, D).

Question 6

Answer 6

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

Question 7

Name the numbers

Answer 7

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

Question 8

Answer 8

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

Question 9

Answer 9

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).

Question 10

Answer 10

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.

Question 11

Answer 11

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.

Question 12

Answer 12

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.

Question 13

Answer 13

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

Question 14

Answer 14

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.

Question 15

Answer 15

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.

Question 16

Answer 16

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

Question 17

Answer 17

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.

Question 18

Answer 18

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).

Question 19

Answer 19

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).

Question 20

Answer 20

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).

Question 21

Answer 21

54. 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.

Question 22

Question 23

Answer 23

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

Question 24

Answer 24

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

Question 25

Answer 25

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

Question 26

Answer 26

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.

Question 27

Answer 27

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

Question 28

Answer 28

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).

Question 29

Answer 29

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).

Question 30

Answer 30

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

Question 31

Answer 31

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).

Question 32

Answer 32

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

Question 33

Answer 33

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

Question 34

Answer 34

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).

Question 35

Answer 35

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.

Question 36

Answer 36

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.

Question 37

Answer 37

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.

Question 38

mare with facial over left maxillary swelling second premolar (206)

Answer 38

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.

Question 39

Answer 39

Fig 2: Latero-lateral (lateral) projection

Question 40

Answer 40

Fig 3: Latero-45° ventral open-mouthed oblique projection

Question 41

Answer 41

Fig 4: Latero-30° dorsal projection

Question 42

Answer 42

Fig 5: Dorsoventral projection

Question 43

Answer 43

Fig 7: Latero-15° ventral open-mouthed oblique projection

Question 44

Answer 44

Fig 8: Latero-10° dorsal open-mouthed oblique projection

Question 45

diagnosis

Answer 45

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

Question 46

Answer 46

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

Question 47

Answer 47

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

Question 48

Answer 48

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

Question 49

Answer 49

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.

Answer 50

Fig 3: Transverse CT sections of Case 2 at the level of the maxillary 08s (a) and 09s (b). Left is to the right. a) There is complete absence of the permanent maxillary 08s bilaterally, with the space between the 07s and 09s filled by trabecular bone. Similarly, the permanent 308 is also absent and there is moderate asymmetry of the mandible branches secondary to tooth agenesis. The deciduous caps are retained. b) There is widening of the periapical space of 209 with moderate root blunting and moderate thickening of the surrounding alveolar bone.

Question 51

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.

Answer 51

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).

Question 52

tx?

Answer 52

Total or partial parotid sialoadenectomy

Question 53

grade the caries

Answer 53

grade 0 grade 1.1 grade 1.2

Question 54

grade the caries