Endodontics in horses and the future

Endodontics refers to the treatment of root canals in the tooth. In humans this primarily concerns the treatment of bacterial infection of the pulp, while attempting to salvage the tooth. The role of bacteria in human pulp necrosis was demonstrated only as recently as 1966, and subsequently predominantly anaerobic bacteria have been implicated as the aetiological agents. Bacteria enter the dentino-pulp complex via advanced caries, via periodontal inoculation, via dental fractures that traverse the dentine of via anachoretic (haematogenous). Direct comparison between pulpitis in humans and horses diverges significantly at this point. In horses the aetiopathological mechanism is unproven but anachoretic inoculation is suspected to be the most commonly involved route of transmission. Risk factors hypothesised include firstly the age of the horse, with a degree of dental eruption impaction occurring that could compromise the apical vasculature between 2 and 5 years that coincides with the highest prevalence of pulpitis, and secondly the proximity of the maxillary dental vasculature to the vasculature of the paranasal sinuses that frequently harbour bacteria. In humans acute or reversible pulpitis is recognised by temporary pain only on stimulation and normal periapical radiographic appearance. Chronic or nonreversible pulpitis is recognised by spontaneous pain, involvement of the periodontal ligament, and periapical periodontal ligament changes on radiographs. In all probability when diagnosed all equine cases are chronic. In humans, pulp and root canal varies greatly between individuals. […]