Equine Odontoclastic Tooth Resorption and Hypercementosis: A Comprehensive Clinical Perspective

Abstract

Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a progressive, age related, destructive disease of equine dentition that involves odontoclastic resorption of dental tissues with hypercementosis. This narrative review aims to synthesize current available clinical evidence, as well as to establish a consistent staging model that can be used in making therapeutic decisions in horses suffering from EOTRH. A review of relevant peer reviewed literature was conducted through the key scientific databases to determine the studies that cover the clinical, radiographic, pathophysiological, and therapeutic nature of EOTRH. EOTRH mostly influences the incisors and canines of horses over the age of 20, and the incidence rate in this age group is up to 34%. High level imaging procedures such as intraoral radiography and cone beam computed tomography (CBCT) are essential in the detection of certain radiographic signals of tooth resorption and hypercementosis. Therefore it is required for its proper diagnosis. Treatment of this disease includes the use of pharmacological therapy involving anti inflammatory drugs and bisphosphonates, and also surgical intervention in the advanced stages. It is extremely important to detect EOTRH as early as possible because the delay in managing the condition may lead to serious complications. Combining modern literature and introducing the diagnostic staging as a treatment decision pathway has allowed this review to develop a practical, clinically applicable algorithm of EOTRH intervention. It is vital to identify and treat equines with EOTRH early in their life to improve welfare outcomes and to have better prognoses in the long term. Future research is justified to assess the accuracy of the suggested algorithms, as well as to outline long term treatment efficacy.