Cheek tooth repulsion aided by computer-assisted surgery in 16 equids.
Abstract: This retrospective case series reports on the use of computer-assisted surgery (CAS) to perform cheek tooth repulsion in 16 equids. Thirteen of the 16 subjects in this case series had a mandibular cheek tooth repulsed, and 3 had a maxillary cheek tooth removed. Surgery was performed on all subjects under general anesthesia, and all but one were placed in lateral recumbency. All cheek teeth were successfully removed by navigated repulsion, except in one case where additional intraoral sectioning was performed. In one horse, a surgical approach through the contralateral nasal conchae was made to facilitate exodontia. This led to considerable hemorrhage and a temporary tracheotomy was performed to ensure airway patency postoperatively. Six subjects needed at least one additional revision surgery to remove either osseous or dental fragments or sequestrated alveolar bone. Outcome was successful in all but one subject, which was euthanized after surgery because a squamous cell carcinoma was diagnosed histologically. The real-time intraoperative guidance provided by CAS allows for controlled and accurate surgical access to targeted dental structures and exodontia of cheek teeth.
Copyright © 2025 Klopfenstein Bregger, de Preux, Brünisholz, Van der Vekens, Schweizer and Koch.
Publication Date: 2025-10-08 PubMed ID: 41133193PubMed Central: PMC12541471DOI: 10.3389/fvets.2025.1571539Google Scholar: Lookup
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- Journal Article
Summary
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Overview
- This study evaluates the use of computer-assisted surgery (CAS) to perform cheek tooth repulsion in 16 horses and ponies (equids).
- The technique aims to improve surgical access and removal of problematic cheek teeth with real-time guidance during the procedure.
Study Design and Subjects
- The research is a retrospective case series involving 16 equids that required cheek tooth surgery.
- Among these, 13 had mandibular cheek teeth repulsed (a method to push out teeth through the jaw bone), and 3 had maxillary cheek teeth removed.
- All surgeries were performed under general anesthesia, ensuring the animals were unconscious and pain-free during the procedure.
- Almost all equids (except one) were positioned in lateral recumbency (lying on their side), a common surgical position in veterinary dentistry.
Surgical Procedure and Techniques
- Computer-assisted surgery (CAS) technology was used to provide real-time, intraoperative navigation.
- This technology guided surgeons to access targeted teeth with high precision, minimizing damage to adjacent structures.
- All cheek teeth were successfully removed using navigated repulsion, except one instance that required additional splitting of the tooth intraorally to facilitate removal.
- In one unique case, surgery involved approaching the tooth through the nasal conchae on the opposite side of the mouth, a more complex approach to aid exodontia (tooth removal).
- This particular approach led to significant hemorrhage (bleeding), necessitating a temporary tracheotomy (creating an opening in the windpipe) to maintain the airway after surgery.
Outcomes and Follow-Up
- Six out of the 16 equids needed at least one additional revision surgery.
- The revisions were primarily to remove leftover bone or dental fragments or to address sequestrated (dead) alveolar bone, a possible complication after tooth extraction.
- All equids had successful outcomes except for one, which was euthanized after the surgery when histological examination revealed squamous cell carcinoma, a type of cancer.
- The CAS technology appears to enhance the surgeon’s ability to control and accurately target dental structures, improving surgical precision.
Significance and Conclusions
- This study is among the first to report the use of computer-assisted navigation in equine cheek tooth repulsion.
- CAS provides benefits by allowing real-time guidance, which can reduce the risk of complications, improve surgical accuracy, and potentially reduce operating time.
- However, complex cases like the one requiring a contralateral nasal approach highlight possible challenges, including excessive bleeding and airway management issues.
- While revision surgeries were required in some cases, the overall success rate suggests CAS is a valuable tool for equine dental surgery.
- Future studies could focus on refinement of the technique and evaluation of long-term outcomes to further validate CAS in veterinary dental procedures.
Cite This Article
APA
Klopfenstein Bregger MD, de Preux M, Brünisholz HP, Van der Vekens E, Schweizer D, Koch C.
(2025).
Cheek tooth repulsion aided by computer-assisted surgery in 16 equids.
Front Vet Sci, 12, 1571539.
https://doi.org/10.3389/fvets.2025.1571539 Publication
Researcher Affiliations
- Division of Equine Surgery, Swiss Institute of Equine Medicine, Department of Clinical Veterinary Science, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
- Division of Equine Surgery, Swiss Institute of Equine Medicine, Department of Clinical Veterinary Science, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
- Division of Equine Surgery, Swiss Institute of Equine Medicine, Department of Clinical Veterinary Science, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
- Division of Clinical Radiology, Department of Clinical Veterinary Science, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
- Division of Clinical Radiology, Department of Clinical Veterinary Science, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
- Division of Equine Surgery, Swiss Institute of Equine Medicine, Department of Clinical Veterinary Science, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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