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Reasons for performing the study. Equine cheek teeth periodontal disease is a common, often painful dental condition that may lead to premature tooth loss if left untreated. All cases of periodontal disease in this study were associated with diastemata, with the majority of cases being secondary or senile diastemata. At present limited objective information is available comparing different treatment methods for the condition to assist clinicians in making evidence-based treatment decisions. Objectives. To compare the effectiveness of four commonly used treatments for equine periodontal disease (additional to routine dental treatment and equilibration) to assess their merit in reducing periodontal pocket depth. Study design. Retrospective case series. Methods. Four commonly used equine periodontal treatments were compared: Removing feed material and lavaging the periodontal pocket with dilute chlorhexidine and rinsing the mouth with chlorhexidine based mouthwash (‘Hexarinse’), ‘clean and antiseptic lavage’ (CL); CL plus the addition of metronidazole antibiotics into the periodontal pockets (M); M plus the addition of a polyvinyl siloxane temporary filling over the diastema (PVS); and diastema widening to open the diastema and increase the interdental space between adjacent teeth, then PVS (DW). Periodontal pocket depth measurements were compared before and after treatment at treatment intervals between two and six months. Results. Treatment groups CL, M and PVS showed statistically significant reductions in pocket depth following treatment. Mean pocket depth reduction was greatest in the DW group (and this was the only group with no cases involving an increase in pocket depth), but this was based on a small sample size and was not statistically significant. Additional analysis to compare effectiveness revealed a strong confounding effect of initial pocket depth. After taking this into account, there was some evidence that DW was associated with smaller improvements than the other treatments, however this result was also based on a small sample size, and influenced by a small number of cases with particularly large improvements. Among the other treatments, no statistically significant differences in effectiveness were found. Conclusion. This study has shown that treatment methods CL, M and PVS are associated with statistically significant reductions in pocket depth. Due to the confounding effect of initial pocket depth, no clear differences in effectiveness were found between treatment methods.
This version is the final author draft, accepted for publication in the Journal of Veterinary Dentistry. Changes since previous version include additional literature review and several clarifications.
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