Equine veterinary journal2019; 52(2); 181-186; doi: 10.1111/evj.13150

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

Caramello, V
·
Zarucco, L
·
Foster, D
·
Boston, R
·
Stefanovski, D
·
Orsini, JA

Abstract: Post-operative complications are reported for all methods of equine cheek tooth extraction but not all methods carry the same risks. An outcome comparison for commonly used methods is needed so that clinicians can make informed treatment decisions. Objective: We conducted a side-by-side comparison of five cheek tooth extraction methods, comparing types and incidence of complications among oral extraction, tooth repulsion (three surgical approaches) and lateral buccotomy techniques. Methods: Retrospective clinical study using hospital medical records. Methods: Medical records of all horses undergoing cheek tooth extraction between 1997 and 2013 were reviewed. Logistic regression was used to determine the likelihood of various post-operative complications, comparing oral extraction, tooth repulsion by maxillary and mandibular trephination or maxillary sinus bone flap, and lateral buccotomy. Results: The study included 137 horses and 162 cheek teeth extractions. Oral extraction was successful in 71% of patients in which it was attempted. Oral extraction (n = 55) had the lowest incidence of complications (20%) and repulsion by sinus bone flap (n = 20) the highest (80%). Complication rates for repulsion by maxillary (n = 19) and mandibular trephination (n = 28), and extraction by lateral buccotomy (n = 15) were 42, 54 and 53%, respectively. Cheek tooth repulsion by sinus bone flap significantly increased the odds of damage to adjacent teeth, post-operative sinusitis, damage to alveolar bone, delayed alveolar granulation and orosinus fistulation. Repulsion by maxillary trephination significantly increased the odds of superficial incisional surgical site infection; and extraction by lateral buccotomy significantly increased the odds of facial nerve neuropraxia. Post-operative pyrexia was more common in all repulsion methods. Conclusions: Some clinically relevant differences may have been missed due to small group numbers in several categories. Conclusions: Oral extraction was associated with fewer post-operative complications than any other methods. Standing oral extraction remains the preferred choice, and recent surgical advances promise to further improve its success rate.

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Publication Date: 2019-07-30 PubMed ID: 31260572DOI: 10.1111/evj.13150Google Scholar: Lookup

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Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research investigates the outcomes and complications arising from five different techniques of cheek tooth extraction in horses. The study concluded that the oral extraction method resulted in fewer post-surgical complications, making it the recommended method.

Research Methodology

The team conducted a retrospective clinical study that analyzed the medical records of horses which underwent cheek tooth extraction from 1997 to 2013.
The five methods compared in this study were oral extraction, tooth repulsion via maxillary trephination, tooth repulsion via mandibular trephination, tooth repulsion using a sinus bone flap, and lateral buccotomy.
Logistic regression was utilized to determine the probability of different post-operative complications depending on the extraction method used.

Study Findings

The study entailed 137 horses and 162 cheek teeth extractions altogether.
Through the oral extraction method, 71% of the attempts were successful.
The technique of oral extraction yielded the lowest incidence of complications at 20%, while the highest complication rate was seen with the sinus bone flap method at 80%.
The respective complication rates for tooth repulsion by maxillary trephination, tooth repulsion by mandibular trephination, and lateral buccotomy extraction were 42%, 54%, and 53%.
Certain complications were found to be more common with specific extraction methods. For example, repulsion by sinus bone flap significantly increased the odds of damage to adjacent teeth, post-operative sinusitis, damage to alveolar bone, delayed alveolar granulation and oro-sinus fistulation.
Repulsion by maxillary trephination was more likely to result in superficial incisional surgical site infections, and lateral buccotomy extraction significantly increased the odds of facial nerve neuropraxia.
Post-operative pyrexia was more common across all repulsion methods.

Conclusions

The research concluded that oral extraction was associated with fewer post-operative complications than any other methods, solidifying it as the preferred choice among clinicians.
However, the researchers emphasised that the study might have missed some clinically relevant differences due to the small group sizes for several categories.
Looking towards the future, the researchers anticipate that recent advancements in surgical techniques will further improve the success rate of oral extraction.

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APA

Caramello V, Zarucco L, Foster D, Boston R, Stefanovski D, Orsini JA. (2019). Equine cheek tooth extraction: Comparison of outcomes for five extraction methods. Equine Vet J, 52(2), 181-186. https://doi.org/10.1111/evj.13150

Publication

Equine veterinary journal

ISSN: 2042-3306

NlmUniqueID: 0173320

Country: United States

Language: English

Volume: 52

Issue: 2

Pages: 181-186

Researcher Affiliations

Caramello, V

Department of Veterinary Science, Università degli Studi di Torino, Grugliasco, Torino, Italy.

Zarucco, L

Department of Veterinary Science, Università degli Studi di Torino, Grugliasco, Torino, Italy.

Foster, D

Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.

Boston, R

Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.

Stefanovski, D

Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.

Orsini, J A

Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.

MeSH Terms

Animals
Cheek
Equidae
Horse Diseases
Horses
Retrospective Studies
Tooth
Tooth Extraction / veterinary

Grant Funding

Spot Castle Memorial Fund
Università degli Studi di Torino

References

This article includes 24 references

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