Written by Dr. Travis Henry

Computed tomography (CT) imaging continues to revolutionize equine dentistry, offering unparalleled diagnostic capabilities and becoming the gold standard for assessing dental disease and skull conditions. Recent advancements in equine CT technology have enhanced its ability to provide detailed, high-resolution images of both bone and soft tissue structures, allowing veterinarians to diagnose and treat equine dental issues with greater precision.

Enhanced Diagnostic Capabilities

Equine CT imaging delivers superior detail compared to traditional X-rays, offering the ability to manipulate images tridimensionally. This feature allows for a more comprehensive evaluation of the equine skull and teeth, improving diagnostic accuracy and treatment planning. The bone window is primarily used in dental cases, while the soft tissue window proves invaluable for assessing conditions such as sinus cysts and soft tissue masses. For instance:

• Figure 1: A nasal conchal bulla containing inspissated purulent material and sinusitis demonstrates how CT can clearly define complex structures.

• Figure 2: A sinus cyst showing distinct patterns of density, enabling the assessment of lining thickness and fluid characteristics.
  

The Power of 3D Imaging

One of CT’s most significant advantages is its ability to provide tridimensional evaluations through multiplanar reconstructions (MPR). This is particularly beneficial for correcting defects in positioning during scans of standing horses.

Equine teeth are complex structures:

• Each tooth typically has five pulp horns, a common pulp chamber, and root canals associated with each root.

• Maxillary teeth have three roots and infundibula, while mandibular cheek teeth have two roots.

With CT imaging, veterinarians can examine transverse, sagittal, and dorsal views of each tooth. This level of detail eliminates uncertainty, ensuring the correct tooth is identified and treated. This precision reduces the risk of complications, such as removing the wrong tooth.

Applications in Trauma and Infection

CT is invaluable for assessing skull fractures and facial injuries, offering detailed insights into the extent of trauma. For example:

• Figure 3: A methicillin-resistant Staphylococcus aureus (MRSA) case with chronic sinusitis highlights the utility of CT in monitoring disease progression and guiding treatment. In this instance, the infection spread across the frontal suture and beneath the opposite orbit. CT imaging enabled timely adjustments to the treatment plan, leading to a successful outcome.

Advancements in Dental Disease Management

CT imaging excels in diagnosing dental conditions such as periodontal disease (figure 4), draining tracts, and tooth fractures. Recent studies emphasize its role in:

• Early Detection: Identifying subtle changes in bone density or soft tissue before clinical symptoms become apparent.

• Treatment Planning: Facilitating precise surgical planning, such as for tooth extractions or addressing apical infections.

The ability to perform a CT scan in approximately 15 minutes and transition seamlessly to treatment under the same sedation protocol is transformative. This efficiency reduces costs, minimizes stress for elderly or high-risk patients, and allows immediate implementation of a tailored treatment plan.

A Bright Future for Equine Dentistry

Equine CT imaging is advancing rapidly, with systems like the Equina® by Asto CT offering faster scan times, improved resolution, and enhanced image reconstruction software. This technology has revolutionized equine dentistry by providing high-resolution, multi-slice CT images that allow for the detection of early signs of subtle stress responses in both bone and soft tissue. By delivering superior detail and three-dimensional views of the equine skull and teeth, CT imaging ensures accurate diagnoses and optimal outcomes for our equine patients.

Dr. Travis Henry is a graduate of Michigan State and completed his residency from UC Davis. He’s unique in the sense that he’s received board certification in both small and large animal dentistry. He has owned Midwest Veterinary Dental Services for over 15 years and recently has become an adjunct faculty member at the University of Wisconsin-Madison. He’s known internationally for his expertise in animal dentistry. Currently Dr. Travis Henry uses the Equina by Asto CT at the University of Wisconsin-Madison for his equine dental cases.