Recognising and Managing Apical Infection

Apical infection in the horse can develop through traumatic fracture, iatrogenic pulpar exposure, spread from infundibular caries, or anachoresis – an inflammatory event within the vital pulp resulting in localised ischaemia and potentially secondary infection from blood borne bacteria¹ . Occlusal fissures of primary or secondary dentine may also be a potential source of ascending septic pulpitis, although this is not validated² . Age related variability in the volume and communications of the pulp canals dictate the extent of pulpitis with young horses invariably developing widespread pulpitis and apical infection³ .

The terms ‘apical infection’ and ‘apical abscess’ may be misleading, commonly being ‘catch-all’ terms used to describe all dental apical pathology including chronic apical periodontitis from chronic septic pulpitis and non-septic inflammatory reactions. In cases of chronic septic pulpitis there may be apical change noted radiographically however this may be historic with prior closure of the dental apex from reparative dentine and cementum formation sealing the dead pulp canal apically¹ . It is important to understand the aetiology of apical infection, or apical periodontitis and the potential for slow chronic development of apical change to guide decision making on appropriate therapy. [...]