Clinical, Diagnostic and Histological Findings Involving Cheek Teeth Hypercementosis in Nine Horses.

The research paper explores the characteristics, diagnosis, and outcomes of hypercementosis in the cheek teeth of nine horses, tracing the link between this condition and chronic inflammatory conditions such as caries, fractures and pulpitis.

Research Objective and Scope

• The study aims to delve into the infrequent but integral condition of hypercementosis that affects the cheek teeth in horses. The condition is marked by the accumulation of mineral deposits in the tooth-bearing region, with the nature and extent of these deposits varying across cases. In some, they are peripherally attached, while in others, they present themselves as separate nodular structures.
• It attempts to distinguish hypercementosis from related conditions, including cementoma and equine odontoclastic tooth resorption and hypercementosis (EOTRH), given their similar radiological and histological presentations.
• The researchers analyzed the clinical presentation, imaging features, surgical management, and histological findings of nine horses presenting with dental lesions associated with hypercementosis.

Clinical Presentation and Diagnostic Techniques

• Of the horses examined, their ages ranged from 4-15 years, with primary symptoms being nasal discharge or facial swelling.
• Diagnostic tools included radiographs or computed tomography (CT), which identified peripheral and nodular mineral structures in six and three horses, respectively.
• The condition predominantly affected the maxillary cheek teeth, as observed in eight of the nine cases.

Surgical Management

• In six cases, the apical cross-sectional area was enlarged beyond the coronal cross-sectional area due to peripheral hypercementosis, thereby making normal extraction difficult. This required sectioning in two cases and repulsion in another.
• In four out of five cases with nodular hypercementosis, extraction of the lesions was performed.
• Post-extraction complications occurred in five cases, necessitating additional procedures in four of those cases.

Histological Findings

• The extracted dental and proliferative mineral material showed characteristic hypercementosis. This was noted by large sheets of eosinophilic matrix with lacunae and frequent, irregular, basophilic cement lines.
• All the examined cases displayed chronic inflammation, indicated by caries, chronic fractures, and/or pulpitis.
• These findings align with previous descriptions of cementoma and histological findings of hypercementosis lesions of EOTRH.

Conclusion and Further Studies

• Despite the complications, all the horses were able to return to their intended use, either riding or pasture.
• The research indicates the need for further investigation to distinguish between hypercementosis, cementoma, and EOTRH, given their overlapping traits.