Investigation and Management of Equine Idiopathic Cheek Teeth Fractures

Most horses with gross CT fractures have no history or evidence of trauma, and such fractures have been termed idiopathic CT fractures. These fractures involve maxillary CT in about 80% of cases, and the Triadan 09s are preferentially affected. The exact prevalence of these fractures is unknown, but a practice-based survey showed 0.4% of horses to be affected, with much higher levels detected by certain operators. Apart from midline sagittal infundibular fractures –where the fractures develop secondary to severe infundibular caries, the aetiopathogenesis of these fractures in usually unclear – and perhaps infundibular fractures should be removed from this classification. About 25% of fractured teeth have reduced thickness of secondary dentine, indicating long-term disease (or death) of some pulp horns that likely predispose these teeth to develop fractures, but no predispositions have been identified for most fracture CT. The fractures run through the anatomically weakest part of the tooth, i.e. the pulp horns or in maxillary CT with infundibular caries, sagittaly through both infundibula. The most common sites of idiopathic fractures are through the two lateral pulp chambers (1 and 2) of maxillary CT in what are termed “lateral slab fractures” (Fig 1). Midline sagittal infundibular fractures of maxillary CT are also a very common pattern. A variety of other less common fracture patterns can also occur in maxillary CT, involving one or more pulp chambers (Fig 1). Mandibular CT fractures (Fig 1), most commonly involve the two lateral pulp chambers, that have recently been renumbered as nos. 1 and 2. These two pulp chambers are more centrally located in mandibular CT and thus these fractures are sometimes erroneously described as midline fractures. […]