Anatomy 100 outline

Anatomy 100 Outline

·        Bone   

1.  Composition

2.  Function

3.  Deposition and absorption

4.  Environmental adaption

5.  Fracture repair

6.  Endocrine regulation

7.  Periosteum

8. Types of Joints

9.  Temporomandibular Joint (anatomy and function)

10.  Hyoid apparatus  (anatomy and function)

11.  Skull wet lab (identification of the different bones of the head, location

of articulations, comparison of different aged skulls, and

biomechanics of the mandible.

• Tooth Structure

1.  Classification of teeth

2.  Types of tooth development

3.  Categories of tooth types or shapes

4.  Types of tooth anchorage

5.  Jaw occlusal overlay

6.  Animals classified by teeth

7.  Types of teeth

8.  Equine tooth identification

9.  Numbering systems

10.  Tooth roots and crown heights

11.  Tooth development

12.  Types of dentin, function, and dentinal tubule arrangements

13.  Enamel (types, function, composition, location, and development)

14.  Cementum (function, composition, location, development, and

adaptability)

15.  Pulp (composition, function, pulp cavity and chambers,  development,

and changes with age)

16.  Tooth structure differences

17.  Infundibula and enamel folds

18.  Periodontal ligaments (types and arrangements)

• Terminology
• Muscle

1. Types  of muscle tissue

2.  Tendons and Ligaments

3.  Muscle anatomy and histology (Micro anatomy)

4.  Neuromuscular junction

5.  Muscle contraction

6.  Muscles of mastication

• Nervous system

1.  Functions of the nervous system

2.  Components:

a.  Neurons

b.  Neuroglia

c.  Myelination

d.  Action potential

e.  Neurotransmitters

3.  Systems

a.   Central vs Peripheral

b.   Sensory vs Motor

c.   Somatic vs autonomic

d.  Sympathetic vs Parasympathetic

4.  Cranial nerves

• Fluids

1.  Composition and percentages of cardio vascular fluids

2.  Extra cellular fluids

3.  Lymph fluids

• Cardiovascular system

1.  Blood, plasma, red blood cells, proteins, white blood cells

2.  Anemia

3.  Homeostasis

4.  Capillaries

5.  Arteries, Arterioles

6.  Veins, Venules

7.  Systemic and pulmonary circulation

8.  Edema

9.  Shock and dehydration

10.  Lymphatic system

• Vessels and circulation

1.  Pulmonary vs systemic circulation

2.  Endothelium

3.  Arteries

4.  Arterioles

5. Capillaries

6.  Veins

7.  Venules

• Eye anatomy

1.  Eye lids (Palpebra)

2. Globe anatomy

3.  Focus

4.  Muscles of the eye

5.  Lacrimal glands

6.  Facial nerve innervations

7.  Conjunctiva

• Hearing and balance

1.  Parts of the ear

2.  Air pressure

3.  Hearing physiology

• Wet lab (cadaver dissection)

1.  Identification of gross structures

2.  Integument (skin)

3. Sub Q and fascia

4.  Insertion and origin of muscles

5.  Nerves and vessels

6.  Bone identification

7.  Salivary glands

8.  Lymph glands

9.  TMJ

10.  Hyoid apparatus

11.  Arcades and tooth sectioning

12.  Nerve blocks

13.  Sinuses and dental communication

2 year old QH with swollen maxilla

Case Report:

A 2 year old gelding with a swelling on the right side of the maxilla was brought to the clinic for dental evaluation.  The swelling was firm with no signs of a drain tract.  The owner said he noticed the bump two months ago and that it had been getting bigger slowly.  There are some scraps on his head which happened during a recent trailer ride.

Oral examination revealed a missing 507 and the 107 was beginning to erupt. There was some odor coming from this area and feed was packing on the buccal side of the 107.

Two radiographs were taken, a lateral oblique and a dorsal ventral with the mandible offset.

Evaluation:  The enlargement on the right maxilla is due to an abscessed 107.  The lateral oblique radiograph shows a blunted root with some deformity.  The 507 is missing but the remaining deciduous teeth look normal.  The dorsal ventral radiograph shows a increased radiolucent area around the 107 which indicates a increased periodontal space due to bone loss.  The radiolucent areas within the tooth are indication of lack of development of the tooth which expected in a 2 year old horse.

Treatment options:  The only reasonable option in this case is extraction.  The root area is abscessed and is causing the maxilla enlargement.  The periodontal area is packing feed and is infected.  The tooth is dead and will not develop any further in this young horse.  The pain caused from these types of infection is substantial and will interfere with mastication and performance.

Oral extraction is preferred but the lack of a clinical crown makes this a difficult extraction.  However, this tooth was extracted using elevation with dental picks.  Surgical extraction is a reasonable option but requires surgical technique and instrumentation.  This type of surgical extraction can also be accomplished in a standing horse with sedation and local anesthesia.

Prognosis:  Removing a tooth from the arcade causes lack of integrity and drifting of teeth in the arcade.  The dental maintenance is always higher after an extraction because of lack of opposition which allows protuberances to develop.  The prognosis is good for resolving the infection and the maxilla enlargement. After care for this case should include a soft food diet for 4 weeks, twice daily flushes with large amounts of water, and antibiotics.

Discussion:  If a deciduous tooth is removed prematurely, the undeveloped permanent tooth is exposed and can become infected as in this case.  We do not know exactly what happened to the 507 but it was probably fractured or damaged, which caused premature shedding.

As our experience and techniques for oral extraction increases, we tend to prefer this method if applicable.  Surgical extraction of a 107 is not difficult and can be considered depending on the experience and ability of the practitioner.  The 107 does not communicate with Maxillary sinus which decreases the complications of this procedure.  Either approach should have a good outcome in this case.B.W Fletcher

Academy News 3-31-11

Students for the February 2011 class were welcomed with an informal gathering at the wet lab on Sunday evening, February 6^th, which happened to be Superbowl Sunday.  The game was available for those interested, and those who weren’t visited and got acquainted and reacquainted.  As usual, students came from all over the world.  One owner brought her horse from Arizona.  About 30 students from the Equine Science class from College of Southern Idaho, Twin Falls, visited one afternoon.  They were welcomed with a short introduction upstairs – thanks, Chad – and then spent about an hour observing in the wet lab.  This is an annual field trip for them and we always look forward to their visits.

Bernie Fletcher instructed Anatomy class with Nick Stuckman and Stephenie Carpenter assisting.  In attendance were 12 students, of which six were repeating the class.   Equine dental instructors were John Fortkamp, Troy Walck and Chad Sandifer.

There were six new students, nine second level, and 17 third and fourth level students.  Six students certified including one who reinstated certification.  Congratulations!  See biographies at the end of this post.

• Megan Knight, Lexington, KY
• Andrew Portch, South Africa
• Jeremy Spivey DVM, Platteville, CO
• T. J. Steele, Zolfo Springs, FL
• Romeo Vangoethemd, Belgium

In attendance for advanced class were 12 technicians; and three certified students completed the initial process of the examination level.  They passed the written exam and will attend two more sessions for the practical portion.  From now on, the maximum is two students at this level at any given class. If anyone is interested, please contact us for guidelines.

As well, if you have let your certification lapse and want to reinstate, let us know so we can help you with that process.  Attendance of both weeks is required at the fourth level tuition, presently $1,650, and attendance alone does not guarantee reinstatement.  Student must pass both written and practical exams.  We encourage attending Anatomy class; tuition for repeat students is $225.

Next class is scheduled for July 2011.  Contact the office to enroll.

• Anatomy: July 13 – 15, 2011
• Two-Week Dental: July 18 – 29, 2011
• One-Week Advanced: July 25 – 29, 2011

ATTENTION:  Certified Students

When you enroll for advanced class, consider attending the first week as well for updated lectures.  Tuition for first week is only $200; second week is $500. The website states that students are required to pass exams at each level prior to advancing to the next.  The Board voted at the February meeting to make this policy.  Written exams will be taken at the end of each session.  All first time students will advance to second level regardless of test results, but beginning with the second level, students must pass in order to advance to the third, and so on.

Pulp Capping Kits – Two left @ $150 each-Contact office to order!

After February class and the annual ski trip, Nick Stuckman and Stephenie spent time helping with projects at the office, including setting up new computers for Kathy and Elana, moving the old ones to the wet lab, moving the copy machine to another room and connecting it to the computers, and so on.  Thanks to both of you.  It’s like a new lease on life in the office.

Hope you liked the new format for our newsletter!  We are still post mailing about 100 letters, so if you have email and we don’t have your address, please let us know.

We ended our session with a party back at the Wet Lab immediately following class on Friday with tacos and beverages.  After a bite to eat or with a plate to go, several folks took off, anxious to get on the road, while others stayed for the evening, and still others wrapped it up downtown.

Sincerely,

Elana Gridley and Kathleen Stickney
Academy of Equine Dentistry Staff
Phone: 208/366-2315
Fax: 208/366-2340
academy@equinedentalacademy.com
www.equinedentalacademy.com

Newly Certified in Equine Dentistry

Megan Knight – I was born and raised in Washington state. I was in love with horses from a very young age, and I rode and showed in jumpers and pleasure horses as a kid. At 12 years old, my family and I moved to Alaska. We bought several horses up there and embarked on the exciting journey of owning horses in Alaska. I first became interested in dentistry when I watched a vet work on a mare of mine. Later in life, I moved to Oregon, and while I was working on a ranch there, I heard about the Academy.  I did some research and decided that I needed to check it out. I attended my first class in August of 2008, and achieved my certification in February 2011. I’d like to thank everyone at the Academy for all of their knowledge and support, my father for always believing in me, and Carter Wilson for his mentorship and patience over the last couple of years! – Lexington, Kentucky

Andrew Portch –  Andrew has been involved with horses most of his life, mainly for sports and show jumping, and has gentled and backed many young horses and re-schooled problem horses and ex-race horses.  He lives on a small stud farm in Pretoria, South Africa.    Before beginning his instruction at the Academy, he attended Ashton International College RSA and obtained IGCSE’s in 2006, AS levels in 2007 and A level geography in 2008.   He then attended an Equine Owners course at Onderstepoort Veterinary Academic hospital Pretoria and Bayer course on parasites and colic in horses and received an AEDP Certificate of Equine Dentistry in 2009.  Andrew was only 19 when he first attended the Academy in July 2010. – South Africa

Jeremy Spivey DVM – My interest in horses began at an early age, and like the rest of you, I am eternally interested in learning more about the horse.   I have shod horses professionally for the last 21 years and obtained my Certified Farriers designation from the American Farriers Association in 2003.  This led me to wanting to learn more about lameness and pathologies of the hoof, so I decided to attend veterinary school.  It was there in August of 2006 that I met Dr. Nick Moore.  I owe my involvement, interest, and certification in dentistry to him.  My deepest gratitude to you Nick for all you do.  Additionally, thanks to Dale Jeffrey, Dr. Fletcher, Troy Walck, John Fortkamp, Wil Croncich, Doug Jergens, and the rest of the staff at the Academy.  I owe you all a great debt.
Along the way I’d like to express my deepest thanks to those horsemen who have helped me.  Burney Chapman, CJF, is eternally missed by myself, farriers, and horses around the world.  Jim Quick, CJF, has taught me more about a horse’s foot than anyone else alive today.  Thank you for your patience as I learn.  Rod Taylor and Ben Vargas of Cimarron, NM, are two of the greatest cowboys and horsemen that I have ever had the chance to meet.  I owe my horsemanship to you both.  To Bob Marshall of Boulder, CO, thank you for your friendship over the years and for taking the time with me when a young roper wanted to learn more.
What we learn at the Academy is found nowhere else on earth.  It is truly a special place.  I have spent most of my life wanting to learn more about horses and am continually blown away by the uniqueness of what the Academy offers.  I hope to continue to help dental technicians, veterinarians, farriers, and ultimately the horse learn more about each other. – Platteville, Colorado

T. J. Steele – Before beginning my equine dental education at the Academy in November 2009, I had attended Farrier school and Edison Community College and been in the Marine Corp.  I took numerous classes while in the military and was a sergeant when I got out.   I have worked full-time as a farrier for five years now as Lucky S Farrier Services and have rodeoed just about my whole life.  My work experience includes assisting my wonderful wife Liz and my father in law, large animal veterinarians, in their practices Three Oaks Equine Reproduction Center and Ridge Large Animal Veterinarian Service.  I thank both of them for all the help and support with pursuing equine dentistry.  I also thank my mentor Wil Croncich for his kindness in passing on his wealth of equine dentistry knowledge, and all the instructors, stall leaders, and faculty at the Academy of Equine Dentistry for this amazing learning opportunity.  God Bless!- Zolfo Springs, Florida

Steinmann Pin Repulsion of Fractured 307

This 9 year old mare has a fractured 307 with part of the buccal crown missing and displacement of the lingual portion. Feed was packing into the fractured area and deep into the periodontal space. Radiographs revealed a distorted, blunted root with small root-like projections on the distal caudal portion of the fractured 307.

Oral extraction is the treatment of choice, which was attempted but was not successful.Several tooth fragments were removed but the distorted root could not be extracted. The horse was prepped for surgical repulsion.

A 16 gauge needle was inserted in the proposed surgical site under the 307 and then radiographed to determine the exact location of entry for repulsion. It is necessary for the placement of the stieman to be directly in the middle of the root fragment for successful repulsion. The horse was sedated and the inferior alveolar nerve was blocked. This nerve block desensitizes all of the teeth and immediate surrounding structures only. Lidocaine was infused into the cheek and distal mandible in the area of the 307 to complete the nerve block for this standing procedure. A small biopsy punch was used to remove the skin and under lying tissue, including the periosteum. An 1/8th inch stieman pin with a trocar point was tapped through the distal mandible at the exact location under the 307 with a surgical mallet. A full mouth speculum is used to open the mouth to allow an assistant to place a finger on the root fragment while the stieman pin is advance to confirm proper positioning of the pin and to communicate with the surgeon concerning movement of the fragment during the procedure. Once the pin contacts the center of the fragment, a vibration will be noted by the assistant as the pin is tapped. In this case, the tooth root was repulsed intact without any portion of the root being fractured during the procedure. Post radiographs were taken to confirm complete extraction of the tooth.

The alveolus was flushed with diluted chlorhexidine solution after repulsion. Furacin powder was packed in alveolus and left to dissolve. The owner was instructed to feed only soft feeds for two weeks and flush the mouth out daily with large quantities of water using a garden hose placed in the interdental space. The horse was given tetanus toxoid, 500mg of Flunixin Meglumne, and dispensed Trimethroprim and Sulfadazine B.I.D. for 10 days.

Discussion:

Extractions of equine cheek teeth can be difficult and every case is unique. There are several different extraction techniques that may be employed and choosing the correct technique will depend on the clinical exam, radiographic findings, age of horse, anatomical location of tooth, and economics. Oral extraction is economical and the least traumatic procedure which can be accomplished in the standing horse with sedation and local anesthesia. However, this technique is not always successful and surgical methods may be required to complete the extraction. In this case, a small Steinmann Pin was used which has several advantages. The pin is small and strong enough to penetrate the mandible with out disruption of the vessels in the mandibular canal distal to the root. Careful advancement of the trocar point at the level of the canal usually slides past the major vessel thus reducing trauma and hemorrhage. The resulting hole in the mandible is very small, heals quickly, and is cosmetically acceptable. Instrumentation for this procedure is simple, available , and economical. This method of extraction can be accomplished on a standing horse with sedation and effective nerve blocks.
B.W. Fletcher, DVM

Academy news December 2010

GREETINGS!

November’s Anatomy class consisted of 16 students at all levels of equine dentistry, instructed by Dr. Bernie Fletcher and Nick Stuckman RVT, CEqD, with assistance from Stephenie Carpenter.  Dental class unofficially began Sunday night with a Welcome Party at the Wet Lab, which was really a great way to get acquainted and reacquainted.  Dental class was attended by 11 PG-1, 13 PG-2, and 13 PG-3 & PG-4 students.  Eight Certified students returned for continuing education.  As usual, they were from all over the United States and the world; Canada, Caribbean, Czech Republic, Belgium, France, Spain, Germany, The Netherlands, United Kingdom, Iceland, and South Africa. Instructor John Fortkamp ACEqD was assisted by advanced instructor Troy Walck ACEqD and two-week instructor Chad Sandifer CEqD.  Students are now preparing their own power point presentations. A computer station with six computers in the Wet Lab classroom was organized prior to November class to facilitate this process and it worked very well.  Most students brought their own laptops.  We closed session with a get together after class Friday afternoon, which worked out well for those anxious to hit the road!

Congratulations to those newly Certified in Equine Dentistry!!!

* Dr. Gunter Gebbe CEqD- Germany
* Kelvin Willams CEqD – United Kingdom

Remember to visit Facebook for class photos and updated information!

 Anatomy Class

BOARD MEETING

Board members met Sunday night, November 14, 2010, to conduct regular business.

• The Advanced program has been upgraded to an Examination Level.  Please inquire for guidelines regarding certification requirements and testing.
• Proper attire is essential for appearing professional.  Instructors and stall leaders, and students as well, are expected to dress appropriately in the classroom and especially the wet lab.  Scrubs or smocks would be acceptable, and for those giving lectures, we suggest polo shirts or dress shirts, sweaters or blouses.  And, extra long tops are a must if you wear low rise jeans!!!
• Presently, our website states students are required to pass exams at each level prior to advancing to the next.  This is not policy and was not acted upon, but may be considered a requirement in the future.
• Guests are welcome!  Our policy allows for a two-day audit for observation only – no tuition, no credits, no participation!  Application and acceptance are required prior to attending.
• The Introduction to Equine Dentistry CD is no longer available.  It will be replaced by a Horse Owner Educational CD, primarily for students to share with their clients and others.
• We try to keep you updated with these periodic newsletters.  We will be changing our email format, which will allow for including pictures and links to the website and facebook, etc. We prefer to communicate this by email, but for those of you who don’t use email, certainly we will post them to you.

                                                                             Advanced Class

 

Certified in Equine Dentistry – November 2010

Dr. Gunter Gebbe CEqD  – I was born on September 19, 1965, as the fourth son of a farmer. I have studied Veterinary medicine in Hannover up to 1993.  I started working as a veterinarian in “Landgestüt Celle” and then different Praxis and Clinics.  These were my first contacts with equine dentistry.  Since 1998 I have been a partner in a veterinary praxis, and equine dentistry was my hobby. I had a lot of continuing education in this part of medicine and heard about the school in Glenns Ferry.  In 2008 I started at the Academy of Equine Dentistry and in November 2010 I was Certified.- Germany

Kelvin Williams CEqD – I originally trained as a mechanic, specializing in heavy plant machinery.  The only horse power I was involved with had an engine and wheels; that is until meeting my future wife Sarah in 1995. After meeting Sarah who has been involved with and owned horses all of her life, I purchased Kizzie, a 16.3hh Warmblood mare.  Although she was very big and sometimes very stubborn – Kizzie, not Sarah – we made a great partnership and my love affair with the horse was born. There followed various courses in Natural Horsemanship.  I attained Parelli Level 1 and also various Monty Roberts courses, mainly because of my stubborn mare.   We operate a very successful Miniature Donkey Stud in the UK where we breed and show the finest Miniature donkeys. www.miniature-donkey.co.uk It was a problem with one of my horse’s wolf teeth and the complete lack of expert dental technicians in the area that led me to my first thoughts about becoming an EDT. After scouring the internet and researching what the course would entail, I was directed to the Academy of Equine Dentistry in Idaho.  It was here, with the skills and help of the Academy staff and trainers, and in particular just being part of a professional caring team that always puts the horse’s comfort first, that I Certified in Equine Dentistry. – United Kingdom

Academy News

              Universal School of Horse Dentistry, Inc.

                   dba Academy of Equine Dentistry

P.O. Box 999, 242 E. 1^st Ave.

Glenns Ferry, Idaho 83623

         October 10, 2010

GREETINGS!      

We had a great class in July attended by 16 PG-1, 7 PG-2, three PG-3 and three PG-4 students, and 15 Certified technicians attended advanced class.  Instructor John Fortkamp was assisted by advanced instructor Ben Koertje and two-week instructor Troy Walck and assistant Carter Wilson. 15 were in attendance for Anatomy, instructed by Dr. Bernie Fletcher, Nick Stuckman, and Stephenie Carpenter. We wrapped up the session by celebrating at the Three Island State Park on Friday night.  It was a lovely evening and setting, and most of us were there until after dark, visiting and saying our good-byes.   

Congratulations to our students who certified in July!

John Comerford CEqD –  Co. Kilkenny, Ireland

James Miller CEqD – Sweetwater, Tennessee

Scott Vaughn CEqD – Lodi, California

Remember to visit Facebook and the website link for photos, class dates, updates, cases and more information!

 

Upcoming Class

We are busy preparing for November class!

 Please consider continuing education!   There’s still time to enroll!

Anatomy                      November 3 – 5, 2010

                                                            Two-Week Dental        November 8-19, 2010

                                                            One-Week Advanced  November 15-19, 2010

Students are now preparing their own power point presentations,

and we are setting up computer stations at the Wet Lab to facilitate this process.

 

BOARD MEETING

Board members met July 25, 2010, to conduct regular business.

The Advanced program has been upgraded to an Examination Level. 

Please inquire for guidelines regarding certification requirements and testing.

Field Trips

The Memorial Day Weekend field trip was moved from Bishop to Sonora due to flooding.  Three students only were in attendance; one newly enrolled for July, one PG-3 student and one who certified in July; and all benefitted from the one-on-one learning experience, working with Ben Koertje and Darrin Baker.   The September Mammoth Lakes field trip was cancelled due to lack of enrollment.  We have instructors who are eager and willing to provide these trips, and we will continue to sponsor them if there is enough participation.   Let us know if you are interested!

We hope all of you are doing well.  We encourage you to come back any time for continuing education!!!

  

Sincerely, Academy of Equine Dentistry

Office Staff:  Kathleen Stickney and Elana Gridley 

 

Phone: 208/366-2315

Fax: 208/366-2340

academy@equinedentalacademy.com

www.equinedentalacademy.com

 

 

 

 

 

 

Newly Certified Articles

 

JULY 2010

John Comerford CEqD  –   I attended Irish National Stud Farrier School and have spent 25 plus years working as a farrier with showjumpers, racehorses, eventers, polo poines, hunters and driving horses.  I have participated in Showjumping, Hunting, Pony Club, Eventing and Raceriding, and have had experience breaking horses and training racehorses.  I attended my first course at the Academy in May 2006 and certified in July 2010.

                                                                                                                                    -Co. Kilkenny, Ireland           

           

James Miller CEqD – I grew up in south Florida and currently live in Sweetwater, Tennessee.  I have been in the horse industry most of my life. During high school I rode cutting horses in the southeast including Florida High School Rodeo. I graduated from Texas Christian University and during my summers I worked for world champion cutting horse trainer Greg Welch, son of Buster Welch. During this time I started a lot of colts on cattle. Shortly after college, I began getting into team roping. I travel all over competing in rodeos and USTRC ropings.  I had met some certified equine dentists who attended the Academy and had one of them work on a rope horse of mine. I noticed the difference it made on my horse and was very impressed and wanted to learn more about this field. I have always enjoyed working with horses and horse owners. I now have a great practice that allows me to travel all over and make a difference in horses. I would like to thank John Fortkamp for allowing me to travel with him and giving me pointers. I would also like to thank Carter Wilson and Roger Kelsey.

 

-Sweetwater, Tennessee                                                   

Scott Vaughn CEqD –  I have been around horses all my life.  Team Roping has always been a passion and training just goes with the roping.  I have been blessed with the opportunity to work with some of the best trainers, vets and farriers in our area.  There is always something new to learn.

I have worked in the automotive industry as a technician, a foreman and in management.  I carry 14 automotive masters and still work as a Technical Operations Supervisor on the West Coast for VW Credit and Audi finance (VWOA).

I became interested in Equine Dentistry when I had to call a friend of mine (who came to this school) to do some dentistry on our own horses.  After watching and listening to him, I thought, “I need to learn this” and I became hooked.  The more I learned, the more I wanted to learn. I have always wanted to do something that included horses besides roping and THIS was IT. The gratification I get from working on horses and helping them out is beyond words.

I had a lot of help from my wife Kathi who supports me greatly and is my biggest fan.  I also would like to thank Ben Koertje and Darrin Baker along with the great people I have met along the way at the Academy. My appreciation goes out to the instructors and staff of the Academy of Equine Dentistry.                                     

-Lodi, California

 

 

 

 

 

 

 

Abscessed 406

Case History:

This 3 year old QH gelding was brought to the wet lab in February 2010 to evaluate a swollen mandible with a large open abscess.  This horse was kicked by another pasture horse and shortly after a swelling in the left mandible was noticed.  This area continued to enlarge over a 2 week period before rupturing and draining purulent material.   The horse was transported to the wet lab for evaluation and treatment, two weeks after the abscess ruptured.  Fig 1 shows the open draining abscess prior to evaluation. 

The area was surgically prepped and probed for any foreign body or bone fragments.  A bone chip can be seen in the radiograph in figure 5, which was removed.  Figure 4 shows the bone chip after removal which was directly under the caudal root of the 406.  The oral cavity did not show any of signs of infection and the horse was eating normally.  The root structure of the 406 in the radiograph (fig. 5) looked normal at this time, so the abscess was flushed and treated locally along with antibiotic therapy which was to be administered orally by the owner.

The horse returned in July 2010 for follow-up evaluation.  At this time the mandible was slightly enlarged distal to the 406 and there was a drain tract presents exuding a small amount of odiferous pustular discharge (fig. 8).  Radiographs taken at this time did show an opening in the mandible distal to the caudal root of the 406 along with radiographic signs of distortion of the apical root.   The oral cavity appeared normal and the horse was eating well.

Evaluation:

Along with case history and clinical exam, radiographs confirm an infectious tract that communicates with the caudal apical root and possibly the anterior root of the 406.  This tract was not visible in radiographs taken in Feb. and there were no abnormal root formation involving the 406.  Thus, contamination and infection of the root structure of the 406 occurred shortly after trauma caused a fracture of the mandible distal to this premolar.  A dorsal ventral radiographic view (fig. 6) shows a radiolucent area on the buccal side of the 406 indicating the drain tract is positioned laterally which can also be seen clinically by the location of the exiting drain tract. The bone fragment removed in Feb. was located on the lateral side in the same location as the drain tract.  Abscesses tend to take the path of least resistance for drainage which would logically be this damaged area of bone. 

Treatment:

This apical root infection due to blunt force trauma and contamination from a wound on the lateral distal area of the mandible did not resolve with conservative medical treatment consisting of debridement and antibiotic therapy.  Even though the clinical and reserve crown of this tooth appear normal, a root canal procedure is not advisable in this 3 year old horse due the large pulp cavities and the lack of dense root structure.  This tooth was infected approximately 6 months after eruption compromising viability and further maturation of this tooth.  Obturation of the pulp cavities and sealing the apical roots would be difficult and structurally questionable for any extended period of time.  The most reasonable option for this case is oral extraction.   However, in this case, the clinical crown was fractured leaving only the distal portion of the reserve crown and root.  A 1 cm section of bone was removed distal to the 406 using a osteotome and mallet allowing access to the apical root.  A  Steinman Pin was used to loosen and repulse the remaining portion of the 406.  The distal alveolus and drain tract were debrided thoroughly with a small spoon curette and the opening was left open for drainage and aftercare flushing.  Packing the alveolus is not necessary and can delay healing.  If packs are left in place to long, complete healing around the pack can occur leaving a cavity in the arcade where food can pack causing periodontal infections.

Aftercare

The horse was sent home with instructions to flush the area daily through the opening on the outside of the mandible and also to flush the inside of the mouth out with a garden hose for 1 minute per day.  A soft feed diet was recommended for 2 weeks and the horse was prescribed oral antibiotics for 10 days. The owner is advised that drainage from the wound should decrease progressively over a 2-4 week period along with foul odor from the draining area and mouth.  Granulation of the open alveolus is fairly quick but complete healing of the skin and gingiva may take several weeks.

B.W Fletcher

Mammoth Lakes- Field Trip

September 13 -17, 2010

All Academy Equine Dental Practitioners Welcome, Including newly Enrolled Students!

$600.00 Tuition – Worth 50 Credits!

Organizers: Ben Koertje ACEqDT and Darrin Baker CEqDT

Veterinarian: Dr. Dave Curd

Participants will be responsible for transportation, lodging and food. 

Limited free lodging available!

Very beautiful area of California near Mono Lake and Yosemite National Park

and Bodie Ghost Town, which includes many summer recreation activities.

Bring clothing for both warm and cool weather!

Sponsored by the Academy of Equine Dentistry

Contact (208)366-2315 or academy@equinedentalacademy.com to enroll!

Call Ben (925)250-8272 or Darrin (209)743-6042 for all other detailsMammoth Lakes – Field Trip

Orthodontic Treatment of Entrapped 308

There is a wide variety of orthodontic appliances used for different situations to move teeth. The device shown in figure 183 was developed to spread the 307 and 309 to create room for the eruption of a trapped 308.

Fig.183

It is basically a metal spring positioned in a plastic cylinder with a washer and stud on each end to maintain placement between the teeth. The tension produced by the spring is adjustable, depending on the compression of the spring in regard to the space provided between the teeth. The tension is continuous and will move teeth gradually in a short period of time. In this case, adequate room for eruption of the 308 was obtained in a few weeks. Because tension is only placed on the proximal crown, the teeth are actually being tipped as can be verified by the steps produced on the occlusal surface(Fig. 182).

Fig.181

Fig.182

This is an ideal situation for providing space for a trapped cheek tooth where only increased space is required above the gum line. This horse is 5 years of age which means that this tooth has been trapped since he was 3 1/2. Unfortunately, this tooth did not erupt after the necessary space was provided at the crown level by the orthodontic device.

Fig.184

Weekly exams over a 3-month period showed no signs of any eruption of this tooth. Radiographs show that there are disturbing root changes consisting of distortion and blunting that may be hindering the eruption of this 308. A decision was made to surgically remove that distal potion of the root, followed by a root canal. An apicoectomy was performed on the 308 by removing a section of bone from the lateral mandible to expose the root. The skin and periosteum were elevated away from the bone, which created a proximal flap that would be sutured back into place after the apicoectomy and root canal were completed. The distal portion of the root was cut off just above the distorted area with a diamond cut off wheel. The cut was angled to allow better exposure of the pulp chambers for the root canal. Post surgical x-rays show the portion of root removed and the composite placed in the pulp cavities.
This surgical procedure was performed with the horse standing, using sedation and local anesthesia. This horse was difficult to handle and was reluctant to be caught prior to the surgery. He noticeably had an immediate change in disposition, which indicates relief of pain. The distorted root was caused by pressure from the inability of normal eruption to occur, which creates inflammation and pain. In my experience, most trapped premolars eventually abscess and form a drain tract through the distal mandible below the root if they are not extracted. Figures 185, 186, 187

Fig.185

Fig.186

Fig.187

The spring type orthodontic device was replaced immediately after the completion of the apicoectomy and root canal, to ensure space for eruption of the 308. Followup exams and radiographs show that the 308 is indeed erupting, but slowly. Normal eruption time would be approximately 6 months for a premolar to be in wear after erupting through the gum line. The 308 in this case erupted in wear in approximately 9 months post surgery. The orthodontic device was removed 3 months post surgery. This is an experimental procedure, but it does show promise as an alternative to extraction of trapped premolars. Early detection of a problematic eruption of a premolar would increase the chances for success and may only require an orthodontic device to provide the space necessary for eruption. Relief cuts on the crowns of the adjacent teeth are also an option that has been successful in certain cases if performed early enough. I prefer not to extract these premolars on young horses if at all possible, because of the disruption of the integrity of the arcade, however, extraction is still a reasonable treatment for this problem if no other options are available. Figures 188, 189

Fig. 189

Fig.188

Retained Premolar Caps

Case History:

 

This is a 6-year-old horse with foul odor from feed packing in the buccal 108 and 208 area.

The horse was difficult to handle while examining the oral cavity. There was no history of prior dentistry on this horse.

Evaluation:

 

Initially when examined, it looked like there were bilateral sagittal fractures of the 108 and 208. After closer examination, we could see that the 108 and 208 were intact but displaced toward the palate, and the piece of fractured tooth retained on the buccal side was part of the 508 and 608.

Treatment:

 

Removal of these retained deciduous fragments will resolve this problem and is not a difficult procedure.

Discussion:

 

Eruption can be a problematic process if the teeth are misaligned. It is important that the permanent tooth erupts directly underneath the deciduous tooth, which causes dissolution of the deciduous roots and normal shedding. In this case the permanent 8’s are displaced, causing pressure only on the medial portion of the deciduous tooth during eruption. The buccal side remained connected to the gingiva due to the pressure of the buccal cheek which kept it in place.

B.W. Fletcher