Radiographic Findings - Dental Structures

1. Incisors

2. Cheek Teeth (Premolars and Molars)

• Occlusal plane: The normal flat, horizontal occlusal surface is completely lost. A markedly irregular, stepped, wave-like pattern ("step mouth" or "wave mouth") is visible.
• Clinical crown elongation: Uneven, elongated clinical crowns are present, indicating painful intraoral spikes/spurs that lacerate the tongue and cheek mucosa.
• Loss of normal crown height symmetry across the cheek tooth arcade.

3. Reserve Crowns (Tooth Roots) and Alveolar Bone

Maxillary cheek teeth:

• Severe dorsal elongation of reserve crowns, with roots intruding upward into the floor of the orbit and the nasal cavity.
• This is associated with nasolacrimal duct compression (causing epiphora) and potential exophthalmos.

Mandibular cheek teeth:

• Severe ventral elongation of reserve crowns with roots penetrating deep into the mandible.
• Visible thinning and ventral cortical bulging/distortion of the mandibular body - a hallmark of advanced ADD in rabbits.

4. Periapical Changes and Bone Pathology

• Periapical radiolucency (osteolysis): Dark halos around apices of multiple cheek teeth, indicating periapical infection, tooth root abscessation, or periodontal disease.
• Cortical thinning: The ventral mandibular cortex is structurally compromised - extremely thin and deformed, suggesting osteomyelitis secondary to root penetration and infection.
• Alveolar bone remodeling is evident throughout.

Summary Diagnosis

End-stage Acquired Dental Disease (ADD) - also termed Dental Dysplasia or Progressive Dental Disease of Rabbits

• Incisor malocclusion with massive overgrowth
• Cheek tooth wave mouth / step mouth
• Apical elongation into orbit (maxilla) and through mandibular cortex
• Periapical lucencies indicating abscessation
• Mandibular cortical thinning

RADIOGRAPHIC INTERPRETATION REPORT

TECHNICAL QUALITY

RADIOGRAPHIC FINDINGS

Incisors

Cheek Teeth - Clinical Crowns

Cheek Teeth - Reserve Crowns and Roots

Periapical and Alveolar Bone

INTERPRETATION

CLINICAL CORRELATION

• Anorexia and progressive weight loss
• Epiphora and/or nasolacrimal duct obstruction (secondary to maxillary root impingement)
• Mandibular swelling or subcutaneous abscess formation
• Ptyalism (excessive salivation)
• Facial asymmetry

CONCLUSION

1. Severe incisor malocclusion and overgrowth
2. Cheek tooth wave mouth with marked occlusal plane disruption
3. Maxillary cheek tooth apical elongation encroaching on the nasal cavity and orbital floor
4. Mandibular cheek tooth apical elongation with ventral cortical thinning and distortion
5. Multifocal periapical osteolysis - suspected tooth root abscessation and secondary osteomyelitis

Ear Pinna Cartilage - Radiographic Findings

What is Seen

• The ear pinna cartilage, which is normally composed of elastic cartilage and should appear as a faint soft-tissue shadow (or barely visible at all) on a radiograph, is instead highly radiopaque - approaching bone-like density.
• The mineralization follows an irregular, mottled and reticulated (branching, net-like) pattern, outlining the internal folds and ridges of the auricular cartilage.

• The cartilage walls are visibly thickened and the normal pliable contour of the pinna is replaced by a rigid, distorted, calcified structure.
• The abnormality extends from the base of the external acoustic meatus (near the tympanic bulla) dorsally and caudodorsally through the proximal and middle portions of the pinna.

• The calcification originates at the level of the external ear canal and extends upward - suggesting the disease process began at or near the tympanic bulla and progressed outward into the pinna.

Interpretation

• Chronic otitis externa and/or otitis media - repeated or long-standing ear infection causes tissue necrosis and inflammation, triggering calcium deposition in the damaged cartilage.
• Ear mite infestation (Psoroptes cuniculi) - a very common cause of chronic auricular inflammation in rabbits that can progress to calcification if untreated for prolonged periods.

Clinical Significance and Link to Dental Disease

• The roots of the maxillary cheek teeth lie in close anatomical proximity to the Eustachian tube openings and the tympanic bullae.
• Severe apical elongation and periapical abscessation of the upper cheek teeth can directly spread infection to the middle ear (otitis media) and subsequently to the outer ear canal and pinna.
• This makes the ear pinna calcification a likely secondary consequence of the end-stage dental disease seen in this patient.

Addendum to the Radiographic Report

Additional Finding - Auricular Cartilage: There is extensive dystrophic mineralization and calcification of the right auricular (pinna) cartilage, with a mottled, reticulated, bone-like radiopacity extending from the base of the external acoustic meatus into the proximal and middle pinna. This is consistent with chronic dystrophic calcification secondary to long-standing otitis externa/media. Given the severe periapical dental disease identified in this patient, ascending infection from the maxillary cheek tooth roots via the Eustachian tube to the middle and external ear is a probable contributing pathway. Clinical otoscopic examination and tympanic bulla evaluation are recommended.