Standing intraoral extractions of cheek teeth aided by partial crown removal in 165 horses (2010–2016)

• Published in: Equine veterinary journal 2018-01, Vol.50 (1), p.48-53
• Main Authors: Rice, M. K., Henry, T. J.
• Format: Article
• Language: English
• Subjects: Animals; Cheek; Complications; dentistry; exodontia; Female; Fractures; horse; Horse Diseases - surgery; Horses; Instrumentation; Instruments; Male; Medical records; oral surgery; Postoperative Complications; Radiography; Retrospective Studies; Sectioning; Surgery, Oral - methods; Surgery, Veterinary - methods; surgical extraction; Teeth; tooth; Tooth Diseases - surgery; Tooth Diseases - veterinary; Tooth Extraction - methods; Tooth Extraction - veterinary; Treatment Outcome; Veterinary medicine
• ISSN: 0425-1644; 2042-3306
• DOI: 10.1111/evj.12727

Summary Background Diseased cheek teeth in horses often require invasive extraction techniques that carry a high rate of complications. Techniques and instrumentation were developed to perform partial crown removal to aid standing intraoral extraction of diseased cheek teeth in horses. Objectives To analyse success rates and post‐surgical complications in horses undergoing cheek teeth extraction assisted by partial crown removal. Study design Retrospective cohort study. Methods This study included 165 horses with 194 diseased cheek teeth that were extracted orally assisted by partial crown removal between 2010 and 2016. Medical records were analysed, including case details, obtained radiographs, surgical reports and follow‐up information. Follow‐up information (≥2 months) was obtained for 151 horses (91.5%). There were 95 horses examined post‐operatively by the authors and, 16 horses by the referring veterinarian; in 40 horses, post‐operative follow up was obtained by informal telephone interviews with the owner. Results Successful standing intraoral extraction of cheek teeth was obtained in 164/165 horses (99.4%). Twenty‐five of these horses (15.2%) required additional intraoral extraction methods to complete the extraction, including minimally invasive transbuccal approach (n = 21) and tooth sectioning (n = 4). There was one (0.6%) horse with intraoral extraction failure that required standing repulsion to complete the extraction. The intraoperative complication of fractured root tips occurred in 11/165 horses (6.7%). Post‐operative complications occurred in 6/165 horses (3.6%), including alveolar sequestra (n = 4), mild delay of alveolar healing at 2 months (n = 1), and development of a persistent draining tract secondary to a retained root tip (n = 1). Main limitations Specialised instrumentation and additional training in the technique are recommended to perform partial crown removal in horses. Conclusion Horses with cheek teeth extraction by partial crown removal have an excellent prognosis for a positive outcome. The term partial coronectomy is proposed for this technique.