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      Dental disease in alpacas. Part 2: Risk factors associated with diastemata, periodontitis, occlusal pulp exposure, wear abnormalities, and malpositioned teeth

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          Abstract

          Background

          Dental disorders, of which tooth root abscesses are best documented, are highly prevalent in alpacas. Identification of risk factors can be valuable for prevention of dental disorders in this species.

          Hypothesis/Objectives

          To identify risk factors associated with wear abnormalities, malpositioning, diastemata, periodontal disease (PD), and occlusal pulp exposure at the level of the cheek teeth.

          Animals

          Two hundred twenty‐eight alpacas ( Vicugna pacos ) from 25 farms.

          Methods

          Cross‐sectional study. Dental examinations were performed on sedated animals. Risk factors were determined by clinical examination and interview. Multivariable logistic regression was used to identify risk factors for wear abnormalities, malpositioned teeth, diastemata, PD, and occlusal pulp exposure.

          Results

          Mandibular swelling was significantly associated with PD (odds ratio [OR], 11.37; 95% confidence interval [CI], 3.27‐48.81; P < .001). Nearly 73% of included animals with mandibular swelling concurrently had PD. For every increase in herd size of 1 animal, the risk for PD increased by 2% (95% CI, 1‐4%; P = .01). The association between severe stages of PD and body condition score (BCS) indicates a painful situation, impairing animal welfare ( P < .001). For each 1‐day increase in interval between pasture cleanings, the odds of finding pulp exposure for a single animal was estimated to increase by 1% (95% CI, 0‐2%; P = .05).

          Conclusion and Clinical Importance

          Simple management tools such as measuring BCS, palpating the mandible for bony swellings, removing feces from pasture on a regular basis and decreasing herd size might help identify animals at risk for dental disorders or prevent their development.

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          Most cited references22

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          A systematic review of stress and psychological factors as possible risk factors for periodontal disease.

          Clinical observations and epidemiologic studies suggest that some negative life events and psychological factors may contribute to an increased susceptibility to periodontal disease. The aim of the present study was to systematically review the evidence from case-control studies, cross-sectional studies, and prospective clinical trials reporting on the influence of stress and psychological factors on periodontal disease. The focused question addressed in this systematic review was whether the scientific evidence is enough to consider stress and psychological factors as risk factors for periodontal disease. A literature search was conducted using two databases (MEDLINE and the Cochrane Oral Health Group specialist trials register) in addition to searching reference lists of original and review articles. The search strategy used was the combination of the terms: "stress," "periodontal disease," and "psychosocial disorders." Studies were selected if they were published in dental journals between January 1, 1990 and April 1, 2006; only human studies and studies with adults and middle-aged subjects were included. Suitable variables included control for the potential effect of confounding factors, adequate criteria to define periodontal disease, adequate criteria for establishing stress, and methodologic quality. Only English-language articles were considered, and unpublished data were not sought. Two reviewers independently extracted information regarding quality and study characteristics in duplicate. The studies were assessed regarding their methodologic characteristics, statistical analysis, characteristics of the periodontal outcome measures, and psychological measurements. Of the 58 articles identified in the search, 10 were excluded because they were reviews and 34 did not comply with the selection criteria. Fourteen articles (seven case-control studies, six cross-sectional studies, and one prospective clinical trial) were included in the analysis; their quality and main study characteristics were assessed according to the criteria preestablished in the protocol of the study. With regard to the results of the studies, 57.1% found a positive outcome between psychosocial factors/stress and periodontal disease, 28.5% observed a positive outcome for some characteristics and a negative outcome for others, and 14.2% found a negative outcome. Within the limitations of this systematic review, the majority of studies showed a positive relationship between stress/psychological factors and periodontal disease. However, in the future, well-designed and more representative studies should be considered to confirm these factors as a risk for periodontal disease.
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            A review of equine dental disorders.

            Equine dentistry is a very important but until recently rather neglected area of equine practice, with many horses suffering from undiagnosed, painful dental disorders. A thorough clinical examination using a full mouth speculum is a pre-requisite to performing any equine dental procedure. Common incisor disorders include: prolonged retention of deciduous incisors, supernumerary incisors and overjet--the latter usually accompanied by cheek teeth (CT) overgrowths. Overjet can be surgically corrected, but perhaps should not be in breeding animals. In younger horses, traumatically fractured incisors with pulpar exposure may survive by laying down tertiary dentine. Loss or maleruption of incisors can cause uneven occlusal wear that can affect mastication. Idiopathic fractures and apical infection of incisors are rare. The main disorder of canine teeth is the development of calculus of the lower canines, and occasionally, developmental displacements and traumatic fractures. The main indications for extraction of "wolf teeth" (Triadan 05s) are the presence of displaced or enlarged wolf teeth, or their presence in the mandible. Developmental abnormalities of the CT include; rostral positioning of the upper CT rows in relation to the lower CT rows--with resultant development of focal overgrowths on the upper 06s and the lower 11s. Displaced CT develop overgrowths on unopposed aspects of the teeth and also develop periodontal disease in the inevitable abnormal spaces (diastemata) that are present between displaced and normal teeth. Diastemata of the CT due to excessive developmental spacing between the CT or to inadequate compression of the CT rows is a common but under diagnosed problem in many horses and causes very painful periodontal disease and quidding. Supernumerary CT mainly occur at the caudal aspect of the CT rows and periodontal disease commonly occurs around these teeth. Eruption disorders of CT include prolonged retention of remnants of deciduous CT ("caps") and vertical impaction of erupting CT that may lead to large eruption cysts and possibly then to apical infections. Disorders of wear, especially enamel overgrowths ("enamel points"), are the main equine dental disorder and are believed to be largely due to the dietary alterations associated with domestication. If untreated, such disorders will eventually lead to more severe CT disorders such as shearmouth and also to widespread periodontal disease. More focal dental overgrowths will develop opposite any CT not in full opposition to their counterpart, e.g., following maleruption of or loss of a CT. Because of the great length of reserve crown in young (hypsodont) CT, apical infections usually cause infection of the supporting bones and depending on the CT involved, cause facial swellings and fistulae and possibly sinusitis. Diagnosis of apical infection requires radiography, and possibly scintigraphy and other advanced imaging techniques in some early cases. When possible, oral extraction of affected CT is advocated, because it reduces the costs and risks of general anaesthesia and has much less post-extraction sequelae than CT repulsion or buccotomy.
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              The role of genetic polymorphisms in periodontitis.

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                Author and article information

                Contributors
                kirsten.proost@ugent.be
                Journal
                J Vet Intern Med
                J. Vet. Intern. Med
                10.1111/(ISSN)1939-1676
                JVIM
                Journal of Veterinary Internal Medicine
                John Wiley & Sons, Inc. (Hoboken, USA )
                0891-6640
                1939-1676
                28 February 2020
                March 2020
                : 34
                : 2 ( doiID: 10.1111/jvim.v34.2 )
                : 1039-1046
                Affiliations
                [ 1 ] Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
                [ 2 ] Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
                [ 3 ] Alpa‐Vet Geluwe Belgium
                Author notes
                [*] [* ] Correspondence

                Kirsten Proost, Salisburylaan 133, 9820 Merelbeke, Belgium.

                Email: kirsten.proost@ 123456ugent.be

                Author information
                https://orcid.org/0000-0003-0846-7150
                https://orcid.org/0000-0003-1026-8433
                https://orcid.org/0000-0002-0248-2715
                https://orcid.org/0000-0001-8136-0232
                Article
                JVIM15740
                10.1111/jvim.15740
                7096605
                32108969
                8ee2cfba-9101-48a0-b73a-8474651765c9
                © 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 08 November 2019
                : 08 February 2020
                : 14 February 2020
                Page count
                Figures: 0, Tables: 7, Pages: 8, Words: 6367
                Categories
                Standard Article
                FOOD AND FIBER ANIMAL
                Standard Articles
                Dental
                Custom metadata
                2.0
                March 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.8 mode:remove_FC converted:26.03.2020

                Veterinary medicine
                apical infection,dental abnormalities,dental disease,dental pathology,new world camelids,tooth root abscesses

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