Standing oral extraction of cheek teeth in 100 horses (1998–2003).

The research article discusses the feasibility and potential advantages of performing oral extractions of cheek teeth in standing horses, as compared to the conventional repulsion technique under general anesthesia, as the new method might reduce the need for general anesthesia and post-operative complications.

Overview of the Research

• The study aims to explore an alternative method of extracting cheek teeth (CT) in horses, specifically performing this operation while the horses are standing, as opposed to putting them under general anesthesia for the conventional repulsion technique.
• The research was carried out on 100 horses, with a median age of 8 and ranging from ages 2 to 18. These horses had firmly attached CT that needed to be extracted due to issues like apical infections, displacements, diastemata, idiopathic fractures, and the presence of supernumerary CT.
• Each affected tooth was extracted orally under standing sedation. A follow-up was performed for all the test subjects after a median period of 16 months.

Results of the Research

• Of the 100 horses, oral extraction was successful in 89 of them. It was not successful in 11 cases due to issues like damage to the CT clinical crown during extraction, behavioral issues of the horse, and the apex of a partly extracted CT falling back into the alveolus following sectioning.
• In 5 of the 9 aforementioned failed cases, there were predispositions to extraction-related CT fractures present, such as advanced dental caries and pre-existing idiopathic fractures. These fractured CT were later repulsed under standing sedation or general anesthesia.
• For 81 out of the 89 successful cases, there were minimal or no intra- or post-operative complications. The remaining eight horses experienced complications such as post-extraction alveolar sequestration, localized osteomyelitis, incorporation of alveolar packing material into alveolar granulation tissue, and nasal discharge due to continued intranasal presence of purulent food material and ongoing sinusitis. These complications were all successfully treated, with general anesthesia required only in one case.
• In a direct comparison between horses with apically infected CT, significantly fewer post-operative problems were noted in horses that underwent oral extraction as compared to those that underwent the conventional repulsion technique.

Conclusions Derived from the Research

• The research concluded that the method of performing oral extraction of cheek teeth in standing horses is generally successful in younger horses with firmly attached cheek teeth.
• This technique has been found to greatly reduce the post-operative complications when compared to the conventional repulsion technique, thereby avoiding the costs and potential risks associated with general anesthesia.
• The authors suggest that with more experience and refinement in the implementation of this protocol, the success rate could potentially be increased further, and the incidence of post-operative complications could be further reduced.