Septic suturitis: A suspected cause of periapical infection in a young horse

This case report describes septic suturitis as a likely cause of periapical dental disease in a 3-year-old Thoroughbred colt. The horse was presented for a unilateral sinusitis initially managed by a frontal osteotomy and sinus lavage and subsequently developed a septic suturitis. Subsequently, a computed tomography (CT) examination identified a periapical infection of cheek tooth 109 with associated sinusitis of the rostral sinus compartments and an extensive suturitis, with the most severe changes located at the right nasomaxillary suture line. There was an associated local fistulous tract rostral to the mesial periapical region of cheek tooth 107 but unassociated with typical periapical or endodontic dental disease changes on CT. The sinusitis did not respond to oral extraction of cheek tooth 109 and sinus lavage. A repeat head CT 2 weeks later, now revealed buccal alveolar bone loss surrounding cheek tooth 107 with obvious periodontal and endodontic dental disease changes. Oral extraction of cheek tooth 107 was performed and local curettage of the fistulous tract was conducted. We conclude that septic suturitis can become extensive and slow to resolve and its rostral extension can cause periapical infection of the closely associated rostral cheek teeth in young horses.