120
46TH
ANNUAL
CONGRESS
OF
THE
SAEVA
SKUKUZA
16-‐20
FEBRUARY
2014
Skull and Dental Imaging
Sarah M. Puchalski, DVM, DACVR, [email protected]
Skull and Dental Imaging
Radiography is an ancillary technique for the evaluation of pathology of the dentition
and its supporting structures including the paranasal sinuses. The production and
interpretation of dental radiographs require an understanding of the regional
anatomy, radiographic anatomy and dental pathology as well as the anticipated effect
of dental pathology on the surrounding structures. Furthermore the continuous
eruption of equine teeth makes their radiographic appearance variable with
advancing age and hence, the radiographs must be interpreted in light of these
changes.
The oral examination is limited to the erupted portions of teeth and the surrounding
oral tissues. Frequently, primary dental disease results in secondary infectious or
inflammatory lesions of the un-erupted portions of teeth, the periodontal tissues,
skeletal structures and paranasal sinuses. Dental radiography is indicated for any
dental condition suspected to extend beyond the oral cavity, or when the clinical
signs relate to the secondary effects of dental disease. Secondary signs can include
but are not limited to nasal discharge, osseous swelling, maxillofacial deformity,
draining tracts, ozena, pain on mastication or prehension, or even performance
problems related to bitting. Radiography is also indicated for evaluation of the
temporomandibular joint disease.
Radiography
In order to complete a high quality dental radiographic examination, foresight and
planning are required. Equipment recommendations include:
• X-ray generator: The generator should be capable of 80 – 100 kVp and 1.0 – 2.0
mAs. Specific recommendations for kVp and mAs settings depend upon the
radiography equipment being used.
• Cassettes: Large size cassettes (14” x 17”) are preferable. Small size cassettes
and many digital detectors require two projections to complete the evaluation of
the entire arcade.
• Safety equipment: Cassette holders reduce personnel exposure. Lead aprons must
be worn by all persons involved in the study and within range of both primary
beam and scatter radiation. The person holding the cassette even if they are
using a cassette holder must wear lead gloves. Personnel with occupational
radiation exposure must wear radiation dosimeters.
• Markers: lead markers to indicate left and right should be placed on the cassette.
A lead marker such as a BB should be considered to mark the external site of soft
tissue swelling or draining tract.
• Rope Halter
• Wooden block or suitable speculum: 2x4 or other radiolucent block to place
between incisor teeth to produce open-mouth oblique projections
• Sedation: The goal for sedation is to keep the head low and immobile. This must
be done in the face of equipment moving around and above the horse’s head.
Most commonly an alpha-2 agonist +/- an opioid (butorphanol) is used.
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