Equine cheek tooth repulsion using small diameter repulsion pins: 20 cases.

The research studies the outcomes of dental repulsion using small-diameter repulsion pins in horse teeth, specifically the 20 cases of horse exodontia where oral extraction failed but repulsion was successful. The study concluded that this technique effectively extracts the teeth, with a complication rate of 25%, which aligns with previous research.

Study Design and Methods

• The study is a retrospective case series, assessing records of horses that underwent cheek tooth repulsion between 2014 and 2023.
• Only cases that met certain criteria were included in the study. The criteria incorporated horses that needed mandibular or maxillary cheek tooth extraction where oral extraction methods failed, and repulsion was used to complete the process. Cases with accessible clinical follow-up data were also included.
• The dental repulsions were performed under sedation with a regional nerve block or under short general anaesthesia, using a small diameter repulsion pin that ranged between 3mm and 5mm in size.
• During the surgery, intraoperative radiographs were used to guide instrument placement, and the alveolus (socket in the jaw bone where a tooth is fixed) was packed with polymethyl methacrylate after tooth extraction. Post-operatively, the horses were re-examined for a follow-up assessment in 4 to 6 weeks.

Results

• The 20 horses included in the study had an average age of 10.3 years (5-16-year age range), and three-quarters of them had existing dental fractures.
• Both maxillary (upper) and mandibular (lower) cheek teeth were successfully removed using the repulsion method—15 upper and 5 lower teeth in total. A majority of the procedures —16 out of 20— were performed with the horses in a standing position, whereas the other 4 underwent general anesthesia.
• In terms of complications, there was one intraoperative complication where the mandibular bone was damaged. Short-term complications (in 2 cases) included superficial site infection post-surgery and one sinus flap dehiscence (opening or splitting). In the long term, complications were rare, with only one recurrence of sinusitis and some small intra-alveolar fragments causing persistent bitting problems in another case.

Conclusions

• Despite being a retrospective study with a small number of cases, the research concluded that using small diameter repulsion pins for cheek tooth extraction after failed oral extraction is an effective method.
• The overall intra- and post-operative complication rate was 25%. This is comparable to previously published complication rates for repulsion using Steinmann pins and those cases that encountered complications after trans-buccal screw extractions.