Assessing the Accuracy of Oral Examination and Radiology in the Diagnosis of Pathological Dental Changes in Alpacas ( <i>Vicugna pacos</i> )

As alpacas (Vicugna pacos) gain popularity globally, the need for improved knowledge about the species grows, including a better understanding of dental pathologies increasingly recognized in domesticated populations. Oral examination and radiology are commonly used tools for the detection of periapical infections and other dental diseases. In this diagnostic accuracy study, we aim to calculate the sensitivity and specificity of these two modalities to determine their agreement with histology in the detection of periodontal (periapical and periradicular) and pulpal pathologies. Seven alpacas were included in the study and underwent oral examination and radiography. After euthanasia, 18 teeth were harvested for histological evaluation. Sensitivity and specificity of radiography in detecting periapical infections were 100% and 85%, respectively, compared to a sensitivity of 54% and a specificity of 75% for clinical evaluation. The level of agreement between these two modalities for the detection of periapical disease was weak (22%). Sensitivity and specificity of radiography in diagnosing periapical periodontal changes were 100% and 83%, compared to clinical evaluation, which had a sensitivity of 100% and a specificity of 36%. The sensitivity of radiology in detecting pulpar changes was low (8%), while it was high (77%) for clinical examination. These findings demonstrate that radiography is a meaningful supplement for confirming suspected clinical diagnoses of periodontal and periapical changes in alpacas.