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Fracture Resistance of Equine Cheek Teeth With and Without Occlusal Fissures: A Standardized ex vivo Model.

ABSTRACT: Background: Ex vivo fracture models are frequently used in human dentistry to provide insights in the fracture mechanisms of teeth. Equine cheek teeth fractures are an important dental pathology, but there has been no research performed to examine the fracture resistance ex vivo. Objective: To evaluate the fracture resistance of equine cheek teeth and identify anatomical predictors that might influence fracture resistance in healthy teeth. It was further evaluated if the presence of a fissure caused a decrease in fracture resistance. Study design: Ex vivo experimental design. Methods: Individual cheek teeth were subjected to a compression load in a universal testing machine until fracture occurred. Testing was performed in two study groups. A first group of healthy cheek teeth was tested to examine anatomical predictors on fracture resistance. A second group comprised cheek teeth with occlusal fissures and an equal number of age- and size-matched fissure-free teeth as controls. The effect of possible predictors on fracture resistance was investigated by regression analysis. Results: In the first group, fracture resistance was significantly influenced by the location on the tooth where testing was performed in both maxillary (p < 0.001) and mandibular teeth (p < 0.001). Additional significantly associated factors were Triadan number in mandibular (p = 0.009) and the mesiodistal length of the occlusal surface of maxillary teeth (p = 0.01). Experimentally induced crown fractures that extended below the simulated bone level were more frequently associated with pulp horn exposure (p < 0.001). In the second group, significant lower fracture loads were recorded in teeth with fissures (mandibular p = 0.006; maxillary p < 0.001), compared to fissure-free teeth. Main limitations: This ex vivo model does not imitate the in vivo masticatory forces and lacks the shock-absorbing properties of the periodontal ligament. Conclusions: The methodology used in this study provides an ex vivo experimental set-up to test fracture resistance of equine cheek teeth enabling evidence-based research to examine the potentially weakening effects of tooth pathology and its treatments. Crown resistance to fracture differed along the occlusal surface of healthy equine cheek teeth, and the presence of fissures further decreased fracture resistance.

SUBMITTER: Pollaris E

PROVIDER: S-EPMC8453076 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Background: It has been suggested that fissures of the occlusal surface of equine cheek teeth may develop into crown fractures. Objectives: To examine the evolution of fissures present on the occlusal surface of cheek teeth. Furthermore, to investigate the presence of a fissure as a risk factor for the development of a subsequent crown fracture. Study Design: Observational longitudinal study. Methods: Bi-annual dental examinations were performed on 36 horses for 3 years. Video-recordings were made to evaluate the evolution of detected fissures. The effect of possible predictors on the development of tooth fractures was investigated by regression analysis. Results: The evolution of 785 fissures (467 type 1a, 271 type 1b, 47 type 2) was recorded. Fissure characteristics were observed to remain unchanged, disappear, become longer, shorter, change in configuration or change in color. Partial crown fractures (22 maxillary, 50 mandibular) were recorded in 52 cheek teeth in 22/36 horses. Fifty-nine of these fractures evolved from previously observed fissures (24 type 1a, 29 type 1b, 6 type 2). All fissure types proved to be a significant risk factor for the development of a crown fracture (p < 0.001), with the highest odds for type 2 fissures (OR = 14.27; 95% CI = 4.88-41.71). Other significant risk factors were the time of follow-up (p < 0.001), mandibular teeth (p < 0.001) and the lingual side of a tooth (p < 0.001). All fractures were non-complicated. Main Limitations: Some horses were prematurely lost for follow-up, which perhaps influenced the results. A longer follow-up period would have also allowed an evaluation of the risk for pulp disease on the long term subsequent to partial crown fractures. Conclusions: The presence of a fissure of any type, mandibular cheek teeth, the lingual side of cheek teeth, and time of follow-up proved to be significant risk factors for development of a cheek tooth crown fracture. Type 2 fissures showed the highest odds followed by type 1b fissures. The observed partial crown fractures demonstrated a low clinical impact whereby no tooth showed signs of development of endodontal disease.

Project description:BACKGROUND:The use of cadavers for radiology research methodologies involving subjective image quality evaluation of anatomical criteria is well-documented. The purpose of this method comparison study was to evaluate the image quality of dental and adjacent structures in computed tomography (CT) and high-field (3 T) magnetic resonance (MR) images in cadaveric heads, based on an objective four-point rating scale. Whilst CT is a well-established technique, MR imaging (MRI) is rarely used for equine dental diagnostics. The use of a grading system in this study allowed an objective assessment of CT and MRI advantages in portraying equine cheek teeth. As imaging is commonly performed with cadaveric or frozen and thawed heads for dental research investigations, the second objective was to quantify the impact of the specimens' conditions (in vivo, post-mortem, frozen-thawed) on the image quality in CT and MRI. RESULTS:The CT and MR images of nine horses, focused on the maxillary premolar 08s and molar 09s, were acquired post-mortem (Group A). Three observers scored the dental and adjacent tissues. Results showed that MR sequences gave an excellent depiction of endo- and periodontal structures, whereas CT produced high-quality images of the hard tooth and bony tissues. Additional CT and MRI was performed in vivo (Group B) and frozen-thawed (Group C) in three of these nine horses to specify the condition of the best specimens for further research. Assessing the impact of the specimens' conditions on image quality, specific soft tissues of the maxillary 08s and 09s including adjacent structures (pulps, mucosa of the maxillary sinuses, periodontal ligament, soft tissue inside the infraorbital canal) were graded in group B and C and analysed for significant differences within CT and MR modalities in comparison to group A. Results showed that MRI scores in vivo were superior to the post-mortem and frozen-thawed condition. CONCLUSIONS:On comparing the imaging performance of CT and MRI, both techniques show a huge potential for application in equine dentistry. Further studies are needed to assess the clinical suitability of MRI. For further research investigations it must be considered, that the best MR image quality is provided in live horses.

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Fracture Resistance of Equine Cheek Teeth With and Without Occlusal Fissures: A Standardized ex vivo Model.

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