Oral Extraction and Nasal Retrieval of a Fragmented Maxillary Fourth Premolar Tooth in a Horse Using Endoscopic Guidance: A Case Report.

This research article is about the successful use of minimally invasive techniques to extract a broken tooth in a horse, which had caused a long-term nasal discharge, with the help of endoscopic guidance.

Overview of the Case

• The case under study involved a 9-year-old Warmblood mare with a malodorous nasal discharge that had persisted for 14 months. The discomfort was traced to a complicated crown root fracture of the left maxillary fourth premolar tooth, also referred to as 208, which had resulted in an oronasal fistula; a connection between the oral and nasal cavities.

Detection and Diagnosis

• The root cause of the nasal discharge was found through a thorough check-up and a radiographic examination. These tests revealed the chronically fractured tooth and the oronasal fistula.

Surgical Approach

• As part of the treatment, the broken parts of the tooth were removed. Some parts that were difficult to reach for an oral extraction were removed through a transnasal route, using a specialized tool known as bronchoesophageal forceps. This procedure was performed under endoscopic guidance, making it minimally invasive and thus reducing potential complications.
• The oronasal fistula was also surgically debrided, meaning that diseased or dead tissue was removed to promote healing.
• After the tooth extraction and fistula treatment, the alveolus – the socket in the jaw bone where the tooth had been – was filled with polyvinyl siloxane. This material was used to prevent the contamination of the cavity by food after the surgery.

Conclusion

• The successful application of these minimally invasive techniques helped to avoid the need for a more extensive and potentially risky external approach. The treatment of this case emphasizes the importance of careful surgical planning in dealing with complex equine dental extractions.
• This method can serve as a template for treating similar cases in the future, establishing that the use of endoscopic guidance in surgery is a feasible and effective method.