Removal of 11 Incompletely Erupted, Impacted Cheek Teeth in 10 Horses using a Dental Alveolar Transcortical Osteotomy and Buccotomy Approach

Abstract

Transcortical buccotomy approach is an effective technique for removal of unerupted impacted equine cheek teeth.

Equine cheek tooth extraction: Comparison of outcomes for five extraction methods

“…In horses, cheek tooth extraction (exodontia) is indicated for a variety of conditions, including cheek tooth fracture, displacement, maleruption/impaction or supernumerary tooth; periapical infection, with or without dental sinusitis; neoplasia; and severe periodontal disease. Because the equine premolars and molars have compound roots and, particularly in young adults, long reserve crowns, cheek tooth extraction in horses can be challenging and carries a significant risk for intra‐ and post‐operative complications .…”

“…Complications include cheek tooth fragmentation and incomplete removal of all dental fragments; damage of adjacent cheek teeth; persistent dental sinusitis; delayed alveolar granulation, resulting in trapping and subsequent putrefaction of food in the open alveolus; damage to the alveolar bone, resulting in sequestration and/or osteomyelitis; incisional infection; fistulation (orosinus, oronasal, or orocutaneous); regional nerve damage (facial, infraorbital, or mandibular nerve); haemorrhage (e.g . laceration of the palatine or mandibular artery); and parotid duct injury .…”

“…Reported complication rates vary considerably among studies, from less than 4% to over 70%, but generally they are lowest for oral extraction in the standing horse and highest for repulsion of maxillary cheek teeth under general anaesthesia . Extraction methods continue to evolve, with an emphasis on less traumatic approaches that minimise damage to the alveolar bone and adjacent CT. One such technique is the minimally invasive transbuccal technique which is used to remove fractured cheek teeth that cannot be successfully extracted orally and has few of the disadvantages of the traditional lateral buccotomy technique .…”

Complications Associated with Cheek Tooth Extraction in the Horse

“…11,12 The lateral mandibular cortex and alveolar bone were sectioned using a surgical length crosscut bur y and surgical length round bur z on a high-speed handpiece aa ; and then elevated with a bone chisel bb and elevator cc . The mesial and distal root apices were isolated and sectioned.…”

“…[9][10][11][12] Most extraction procedures can be performed with the horse standing using perineural anesthesia and appropriate sedative combinations. [13][14] Extraoral examination should be done that assesses the head/ maxilla for swelling, fistulas, nasal discharge, malodorous breath, and abnormal sinus percussion.…”