Two‐ and three‐dimensional computed tomographic anatomy of the enamel,infundibulae and pulp of 126 equine cheek teeth. Part 2: Findings in teeth with macroscopic occlusal or computed tomographic lesions

Reasons for performing study: Dental disease often presents a diagnostic challenge in the horse. Computed tomography (CT) is increasingly used in the evaluation of head related disease in the horse, but the CT appearance of the most common dental diseases of horses has not yet been fully described. Objective: To describe the CT appearance of the peripheral enamel, pulp, infundibular enamel and cement in equine cheek teeth with macroscopic occlusal or CT lesions. Methods: In this study, 126 cadaveric cheek teeth with eruption ages of between 0.5 and 19 years were evaluated for lesions of their infundibulae, pulp and enamel using occlusal surface morphology, 2‐ (2D) and 3‐dimensional (3D) CT and anatomical sectioning. Variations in teeth with no macroscopic lesions have been described in a previous study. The infundibular lesions were categorised further into one of 6 classifications. Results: Infundibular lesions were identified on CT in 90% (115/128) of infundibulae. Of these, 65% (83/128) had infundibular lesions on occlusal surface examination. The extent of infundibular lesions observed varied with age group. All infundibulae over 6 years post eruption had detectable lesions. Peripheral enamel hypoplasia and enamel prolapses, were observed in 10% (12/126) and 1.6% (2/126) of teeth, respectively. The CT appearance of teeth with pulp infections was seen to vary with differing pathologies. Conclusions and potential relevance: The high prevalence of infundibular lesions should encourage consideration of their clinical significance, in addition to the role of infundibulae in dental disease of the horse. Two‐dimensional and 3D CT proved to be highly valuable imaging modalities for dental disease, enabling lesions within the enamel, infundibulae and pulp of equine cheek teeth to be easily detected. The results of this study will facilitate the use of 2D and 3D CT as clinical diagnostic tools for dental disease and aid in the selection of the most appropriate treatment protocol.