ISSN 2398-2977      

Teeth: caries - infundibular cement

pequis

Synonym(s): Infundibular necrosis, dental decay, dental caries


Introduction

  • Cause: defective/hypoplastic cementum in the infundibula of a maxillary cheek tooth.
  • Signs: none; secondary signs associated with secondary infection of surrounding tissues; depend on which tooth affected. Can affect any tooth, 109, 209 appear to be most commonly involved; deep caries of caudal cheek teeth may   →   nasal discharge and sinus infection. Advanced lesions may   →    fracture of tooth.
  • Diagnosis: oral examination, radiography.
  • Treatment: early cases - none; advanced cases - extraction   Teeth: extraction  , curettage and irrigation, infundibula resoration possible but more research required, re long-term success.
  • Prognosis: good.

Pathogenesis

Etiology

  • Defective cementum.

Predisposing factors

General
  • Unknown at present - maxillary cheek teeth only affected.

Pathophysiology

  • Hypoplasia of infundibular cementum.
  • Normal tooth wear   →   hypoplastic cementum exposed.
  • Impacted feed within infundibulum ferments   →   acid production   →   dissolution of surrounding cementum, enamel and dentine   →   caries formed.
  • Irregular secondary dentine formation may protect pulp from infection.
  • Advanced cases   →    rostral and caudal infundibular caries   →    coalescence of infundibulae   →    dental fracture.
  • Enamel loss   →   inflammation and infection of surrounding tissues may    →   alveolar sepsis   Teeth: periodontal disease  , sinus empyema   Paranasal sinuses: bacterial sinusitis  or nasal discharge.
  • Note: decay in first three cheek teeth may   →   swelling, rarely a discharging sinus tract; decay in PM4 and molars   →   sinus infection and nasal discharge.
  • Note: many cases do not result in apical infections; dental fractures most likely.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Tremaine H & Pearce C (2012) A modern approach to equine dentistry 4. Routine treatments. In Pract 34 (6), 330-347 VetMedResource.
  • Weller R, Livesey L et al (2001) Comparison of radiography and scintigraphy in the diagnosis of dental disorders in the horse. Equine Vet J 33 (1), 49-58 PubMed.
  • Dixon P M, Tremaine W H, Pickles K et al (1999) Equine dental disease Part 1 - a long-term study of 400 cases - disorders of incisor, cannie and first premolar teeth. Equine Vet J 31 (5), 369-377 PubMed.
  • Dixon P M et al (1999) Equine dental disease Part 2 - a long-term study of 400 cases - disorders of development and eruption and variations in position of the cheek teeth. Equine Vet J 31 (6), 519-528 PubMed.
  • Crabhill M R et al (1998) Pathophysiology of acquired dental diseases of the horse. Vet Clin North Am Equine Pract 14 (2), 291-307 PubMed.
  • Mueller P O et al (1998) Dental sepsis. Vet Clin North Am Equine Pract 14 (2), 349-363 PubMed.
  • Baerg S D et al (1996) Endotonic therapy and surgical excision of a chronic suppurative osteomyelitic lesion in a horse, a case report. J Vet Dent 13 (4) ,145-148 PubMed.
  • Lane J G (1994) A review of dental disorders of the horse, their treatment and possible fresh approaches to management. Equine Vet Educ (1), 13-21 Wiley Online Library.
  • Baker G J et al (1974) Some aspects of equine dental decay. Equine Vet J (3), 127-130 PubMed.

Other sources of information

  • Dacre (2005) Equine Dental Pathology. In: Equine Dentistry. Eds: Baker & Easley. 2nd edn. Saunders, USA. pp 87-107.

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