soft tissue

Back on the show is Dr. Kate Workman of Denali Equine, co-author of a newly published open access paper on ECBM.

She walks us through what the condition actually is, how it reshapes the soft tissue and vasculature of the lower neck, how it's graded, why some horses cope fine while others hit a breaking point, and how to diagnose it properly.

We'll get into the anatomy, the clinical picture, the breeding implications, and the bigger question underneath it all.

How do we actually manage horses with ECBM? So without any further ado, let's get into the science.

You can really see it on a CT scan.

Like that is a cut and dry, very simple diagnosis to make.

But what is much more complicated is the soft tissue implications that go along with that.

So what happens to, let's say, the longest coli? So the longest coli is your ventral neck stabilizer.

And this is part one of a two-part series.

In this week's episode, we're exploring implants and peri-implant soft tissue.

Did you know that non-disease peri-implant soft tissue deficiencies reach nearly 65% at five years, and that almost every soft tissue defect is actually an underlying bone problem in disguise? In this episode, we're going to unpack the latest consensus literature on why proactive soft tissue grafting is vital to safeguarding crustal bone, how phenotype and muscular tension dictate long-term stability, and why skeletal discrepancies require true orthopedic solutions rather than dental compromises that blow teeth out of the cortical plate.

My guest this week is Dr. Ashley Hoders.

Dr. Hoders earned dual specialty certificate in periodontics and prosthodontics alongside a master's at the University of Texas Health Science Center at San Antonio, where she was the first female to graduate from the dual program.

were the consensus papers.

You know, there was a whole series of consensus papers between the AO and the AAP.

And the highlight of that section was really about peri-implant disease, peri-implant soft tissue deficiencies.

So, um, yeah, it's, it's really, really interesting, and I, I'm sure we could take a lot of those, uh, kind of philosophies from, from farming across to, um, to, to the, the veterinary world and, like you say, the husbandry world.

Um, and then you mentioned as well that, that you've, um, you've worked, y- you know, that you've, you've moved into working an awful lot, um, you know, in, in surgery and, um, particularly soft tissue surgery and orthopedics.

Um, maybe first it's best to ask, you know, what first drew you to that side of veterinary medicine?

Okay.

Maybe in plain English for those of us that don't know a lot about surgery, um, what are those two terms and, and, and what are they all about?

Yeah.

Uh, well, orthopedic surgery relates to, uh, conditions of the bones and the joints, uh, whereas soft tissue surgery is, is kind of like how it sounds.

It's more to do with, um, skin or internal organs.

Epithelial cells from the gums migrate much, much faster than bone-building osteoblasts.

If you just clean a bony defect and suture the gums back, the fast soft tissue cells fill the hole.

So you get a long junctional epithelium.

You reduce the pocket, but you get zero new bone.

Right.

So GTR uses a physical barrier membrane placed over the defect to block the soft tissue.

It gives the slower osteoblasts the exclusive time and space they need to build bone.

But those membranes introduce some nasty surgical complications, right? The text mentions flap sloughing is a major one.