Diagnostic imaging in veterinary dental practice. Supernumerary molars in a horse.

The study presents the case of a horse suffering from mild dysphagia, a fractured left molar, and an abnormally large first molar, and how veterinarians were able to diagnose and evaluate these conditions through diagnostic imaging in veterinary dental practice.

History and Physical Examination Findings

• The horse that was studied was a 4-year old castrated male warmblood weighing 575 kg. The horse was evaluated due to symptoms of mild dysphagia (difficulty in swallowing), a fractured left maxillary third molar tooth, and a left maxillary first molar tooth that had an abnormally large occlusal (biting) surface.
• A general physical examination showed that all other health indicators including rectal temperature, heart rate, respiratory rate, and results of a complete blood count (CBC) and serum biochemical analysis were within the normal limits. In terms of athletic condition, the horse had a body condition score of 6 out of 9.

Oral Examination and Dental Charting

• The horse was sedated and a complete oral examination along with dental charting was performed. The examination revealed the presence of minor sharp enamel points on the outer surface of the upper cheek teeth and inner surface of the lower cheek teeth.
• The left dental quadrant had 7 cheek teeth with a suspected supernumerary (extra) third molar tooth in the farthest part of the quadrant. The presence of food impacted in the space between the first and second left molar teeth was observed.
• Furthermore, the tooth in the normal left maxillary third molar position had a complicated crown root fracture, with part of the tooth displaced into the cheek’s mucosa. Another irregularity was an abnormally large left maxillary first molar tooth, about 25% larger than the tooth on the opposite side. The molar had an abnormal shape including the appearance of 4 infundibula (funnel-like structures) and absence of the expected pulp horn arrangement.

Diagnostic Imaging

• A series of radiographs using different projection angles was taken of the right and left maxillary quadrants, and the superimposed right and left maxillary and mandibular quadrants for further evaluation of the dental health of the horse. This technique in veterinary dental practice enables an inside view of dental structures and helps to confirm the diagnosis.