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Equine veterinary journal2026; doi: 10.1002/evj.70178

Piezosurgical partial ostectomy of the incisive bone for an ossifying fibroma removal in a 4-year-old Warmblood gelding.

Abstract: Ossifying fibromas are uncommon in horses and complete surgical excision with premaxillectomy, maxillectomy or mandibulectomy is recommended. Piezosurgery has been previously used in equines only in one study. Objective: To report a case of ossifying fibroma treated with piezosurgery and to describe its follow-up. Methods: Clinical case report. Methods: A 4-year-old Zangersheide gelding was presented for a mass occupying the space of tooth 202. Histology confirmed the diagnosis of ossifying fibroma, which was removed by resection of soft tissues and a slice of the premaxilla with a piezotome. First intention closure was achieved with a U-plasty between the soft palate and the gingiva. Afterwards, histology confirmed complete removal of the mass. Results: At 5 months, the horse did not show signs of recurrence. Surgery was easy to perform with the piezotome and the cosmetic result was excellent. Conclusions: Piezosurgery is a feasible technique for oral surgeries in horses, although more prospective studies are required.
© 2026 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2026-04-26 PubMed ID: 42035987DOI: 10.1002/evj.70178Google Scholar: Lookup
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Summary

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Overview

  • This research article reports on the successful use of piezosurgery to remove an ossifying fibroma from the incisive bone of a 4-year-old Warmblood gelding.
  • The case demonstrated effective removal and good postoperative outcomes, suggesting piezosurgery as a viable technique for equine oral surgery.

Introduction to the Condition and Surgical Challenge

  • Ossifying fibromas are rare benign tumors involving fibrous tissue and bone formation, uncommon in horses.
  • Typical treatment involves complete surgical removal, often through extensive procedures such as premaxillectomy (removal of part of the premaxilla), maxillectomy, or mandibulectomy.
  • These traditional surgeries can be invasive, require significant bone removal, and may lead to challenging recovery and cosmetic concerns.
  • Piezosurgery is a relatively new technique using ultrasonic vibrations to cut bone precisely while sparing soft tissues; however, its use in horses had only been documented in one prior study before this report.

Case Description and Methods

  • A 4-year-old Zangersheide gelding presented with a mass occupying the location of tooth 202 in the oral cavity.
  • Histological analysis of a biopsy confirmed the lesion was an ossifying fibroma.
  • The surgical approach involved:
    • Resection of the mass including affected soft tissues.
    • Removal of a thin slice of the premaxilla bone using a piezotome device (a specialized ultrasonic surgical instrument) to ensure precise cutting and minimal trauma.
    • Closure of the surgical site was performed using a U-plasty—a surgical technique to close a defect—between the soft palate and gingiva to promote healing.
  • Postoperative histology analyzed the excised tissue to confirm the entire mass had been removed.

Results and Outcomes

  • Five months after surgery, there was no evidence of tumor recurrence based on clinical examination.
  • The procedure was reported as easy to perform using the piezotome, especially due to its precision and minimized damage to surrounding tissues.
  • Cosmetic results were excellent, implying that the surgical site healed well with minimal visible deformity, an important consideration for the patient’s function and appearance.

Conclusions and Implications

  • The study suggests piezosurgery is a feasible and effective alternative for oral bone surgeries in horses, specifically for lesions like ossifying fibromas.
  • Benefits highlighted include precise bone cutting, preservation of soft tissues, easier surgery, and better postoperative cosmetic outcomes.
  • Despite promising results, authors stress the need for further prospective studies to:
    • Confirm the reproducibility of the technique in larger populations of horses.
    • Evaluate long-term outcomes and the rate of tumor recurrence.
    • Compare piezosurgery with conventional surgical methods in terms of efficacy, recovery, and complication rates.

Significance of the Study

  • This report adds valuable clinical evidence supporting the use of advanced ultrasonic surgical tools in veterinary medicine, particularly equine surgery.
  • It reinforces the potential of piezosurgery to improve surgical precision and patient outcomes in complex oral procedures.
  • By documenting first-hand successful management with follow-up data, it encourages clinicians to consider piezosurgery in suitable cases and stimulates further research in this field.

Cite This Article

APA
Forni G, Falomo ME, Casalini I, Isola M. (2026). Piezosurgical partial ostectomy of the incisive bone for an ossifying fibroma removal in a 4-year-old Warmblood gelding. Equine Vet J. https://doi.org/10.1002/evj.70178

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Forni, G
  • Department of Animal Medicine, Productions and Health, University of Padova, Legnaro, Italy.
Falomo, M E
  • Department of Animal Medicine, Productions and Health, University of Padova, Legnaro, Italy.
Casalini, I
  • Private Practitioner, Florence, Italy.
Isola, M
  • Department of Animal Medicine, Productions and Health, University of Padova, Legnaro, Italy.

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