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Contribuição do exame radiográfico no diagnóstico de doença dentária em lagomorfos : estudo retrospetivo
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Resumo(s)
A doença dentária é uma das causas mais frequentes de admissão dos coelhos nos CAMVs
(Centros de Atendimento Médico-Veterinários), apresentando os animais, gradualmente,
alterações na forma, estrutura e posição dos dentes.
O diagnóstico desta doença através do exame da cavidade oral sem anestesia é bastante
limitado, tendo o exame imagiológico grande importância. A radiografia (Rx) fornece
informação crucial para o diagnóstico de doença dentária e, em conjunto com as alterações
encontradas no exame físico e no exame intraoral sob anestesia, permite estadiar a doença
e informar o tutor do animal acerca do prognóstico. Sendo o exame intraoral também um
exame de diagnóstico pode tornar-se tentador dispensar o exame radiográfico.
O presente estudo retrospetivo teve como objetivo avaliar a contribuição do exame
radiográfico para o diagnóstico da doença dentária em lagomorfos, comparando-o com o
exame intraoral. Foram incluídos 24 animais com doença dentária que haviam realizado
exames radiográficos e intraorais. As radiografias foram sujeitas a uma interpretação
subjetiva e objetiva (com recurso a linhas de referência radiográficas), tendo os resultados
obtidos sido descritos, em conjunto com as observações do exame intraoral, para efeitos de
análise.
Compararam-se o sobrecrescimento e má oclusão dentária detetados na avaliação subjetiva
das radiografias com o observado no exame intraoral, existindo na maioria dos casos uma
concordância moderada entre observações. Apenas no 1º incisivo maxilar foram detetadas
diferenças estatisticamente significativas entre os procedimentos, constatando-se que, no
geral, o Rx deteta mais casos positivos que o exame intraoral com anestesia geral.
Na globalidade, o exame intraoral apresentou valores de sensibilidade superiores a 65% e
de especificidade e exatidão superiores a 50%, assumindo o Rx como gold standard.
No que diz respeito às linhas de referência radiográficas, o uso destas só evidenciou
diferenças estatisticamente significativas no caso da linha 7 e 8 com as alterações detetadas
na avaliação subjetiva do Rx e no exame intraoral, havendo na maioria dos casos uma
concordância muito fraca entre observações.
Os resultados deste estudo sugerem que o exame radiográfico é imperativo para o
diagnóstico de doença dentária em lagomorfos. O Rx, em conjunto com o exame intraoral, é
adequado e essencial no diagnóstico desta doença e o uso de linhas de referência
radiográficas pode trazer vantagens.
O exame radiográfico e o exame intraoral devem, portanto, ser utilizados em conjunto pelos
Médicos Veterinários.
ABSTRACT - CONTRIBUTION OF THE RADIOGRAPHIC EXAMINATION IN THE DIAGNOSIS OF DENTAL DISEASE IN LAGOMORPHS – A RETROSPECTIVE STUDY - One of the most frequent causes of rabbits' admission to the veterinary animal care facilities is the dental disease, in which the animals exhibit a gradual change in the shape, structure and position of the teeth. The diagnosis of the disease based on the intraoral exam without anaesthesia is very challenging, thus the radiographic study is paramount. Radiography (x-ray) provides crucial information in the diagnosis of dental disease and together with the physical and intraoral inspection under anaesthesia, allows the veterinarian to stage the disease and advise the animal owner of the prognosis. Being the intraoral exam also a diagnostic tool, it can be tempting to skip the radiographic examination. The main goal of this retrospective study was to assess the contribution of the radiographic examination in the diagnosis of dental disease in lagomorphs, compared to the intraoral exam. For this study 24 animals with dental disease that had done radiographic and intraoral examinations were included. Radiographs were reviewed subjectively and objectively (using radiographic reference lines) and the results were described, together with the results of the intraoral exam, so the data analysis could be performed. The dental overgrowth and malocclusion detected on the x-ray subjective evaluation were compared to the intraoral exam findings, revealing a moderated agreement between them. In general statistically significant differences were only detected on the 1st maxillary incisor and the x-ray detected more positive cases than the intraoral exam. In general, the intraoral exam showed sensitivity values higher than 65% and specificity and accuracy values higher than 50% when using the x-ray as the gold standard. With regard to the radiographic reference lines, there were only statistically significant differences between their use and the subjective x-ray interpretation and intraoral findings in the case of line 7 and 8. In most of the cases, the agreement between the observations was poor. The results of this study suggest that the radiographic exam is imperative for the diagnosis of dental disease in lagomorphs. The Rx together with the intraoral examination is suitable and essential in the diagnosis of this disease and the use of radiographic reference lines can be beneficial. Therefore, the veterinarians should use the radiographic and intraoral examination together.
ABSTRACT - CONTRIBUTION OF THE RADIOGRAPHIC EXAMINATION IN THE DIAGNOSIS OF DENTAL DISEASE IN LAGOMORPHS – A RETROSPECTIVE STUDY - One of the most frequent causes of rabbits' admission to the veterinary animal care facilities is the dental disease, in which the animals exhibit a gradual change in the shape, structure and position of the teeth. The diagnosis of the disease based on the intraoral exam without anaesthesia is very challenging, thus the radiographic study is paramount. Radiography (x-ray) provides crucial information in the diagnosis of dental disease and together with the physical and intraoral inspection under anaesthesia, allows the veterinarian to stage the disease and advise the animal owner of the prognosis. Being the intraoral exam also a diagnostic tool, it can be tempting to skip the radiographic examination. The main goal of this retrospective study was to assess the contribution of the radiographic examination in the diagnosis of dental disease in lagomorphs, compared to the intraoral exam. For this study 24 animals with dental disease that had done radiographic and intraoral examinations were included. Radiographs were reviewed subjectively and objectively (using radiographic reference lines) and the results were described, together with the results of the intraoral exam, so the data analysis could be performed. The dental overgrowth and malocclusion detected on the x-ray subjective evaluation were compared to the intraoral exam findings, revealing a moderated agreement between them. In general statistically significant differences were only detected on the 1st maxillary incisor and the x-ray detected more positive cases than the intraoral exam. In general, the intraoral exam showed sensitivity values higher than 65% and specificity and accuracy values higher than 50% when using the x-ray as the gold standard. With regard to the radiographic reference lines, there were only statistically significant differences between their use and the subjective x-ray interpretation and intraoral findings in the case of line 7 and 8. In most of the cases, the agreement between the observations was poor. The results of this study suggest that the radiographic exam is imperative for the diagnosis of dental disease in lagomorphs. The Rx together with the intraoral examination is suitable and essential in the diagnosis of this disease and the use of radiographic reference lines can be beneficial. Therefore, the veterinarians should use the radiographic and intraoral examination together.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Doença dentária lagomorfos radiografia exame intraoral Dental disease lagomorphs radiography intraoral exam
Contexto Educativo
Citação
Lobo, I.D. (2018). Contribuição do exame radiográfico no diagnóstico de doença dentária em lagomorfos : estudo retrospetivo. Dissertação de mestrado. Universidade de Lisboa, Faculdade de Medicina Veterinária, Lisboa.
Editora
Universidade de Lisboa, Faculdade de Medicina Veterinária