Abstract
The objectives of this retrospective study were to describe the prevalence and characteristics of post-operative complications that occur following equine mandibular cheek tooth extractions and to assess for possible associated risk factors. Clinically significant post-extraction complications necessitating repeat referral developed following 20/302 (6.6%) mandibular cheek tooth extractions. Horses developing complications were younger than the overall population having mandibular cheek teeth extractions and the most commonly affected teeth were the Triadan 07 s and 09 s. Alveolar sequestration was the most prevalent complication, occurring in 18/20 horses (90%), with the complete alveolus sequestering in some cases. Post-extraction mandibular fistula formation occurred in 5/20 cases (25%) and mandibular abscessation in 4/20 cases (20%). All cases were successfully treated, including sequestrectomy, and wound debridement with some cases taking up to 5 months for resolution. Anatomical features of the equine mandibular alveoli and bone appears to make them more prone to develop extensive sequestration compared to published complications on maxillary alveolar bone. This requires good pre-operative examination including diagnostic imaging to identify cases of higher risk and thorough risk disclosure toward horse owners as well as owners' compliance.
Highlights
Dental extractions are standard procedures in horses with diseased cheek teeth, especially apical infections, but they are associated with a higher prevalence of complications compared to other commonly performed surgical procedures (1–3)
The development of newer instrumentation for less invasive techniques, improvements in training and advancements in sedation and analgesia have negated the need for standard dental repulsions under general anesthesia and have made dental surgeries less debilitating for horses (4)
The prevalence of postextraction complications was highest for mandibular Triadan 07 s (7/55 horses; 12.7%) and 09 s (7/101 horses; 6.9%)
Summary
Dental extractions are standard procedures in horses with diseased cheek teeth, especially apical infections, but they are associated with a higher prevalence of complications compared to other commonly performed surgical procedures (1–3). The highest complication rates are reported for repulsion of cheek teeth under general anesthesia with up to 80% post-operative complications (2, 5) whereas standing oral extractions have considerably lower complication rates of 4–20% (2, 6, 7) making this the preferred method whenever possible. The aims of this study were to describe clinical and demographic findings of horses that developed clinically significant complications following mandibular cheek tooth extraction, and to describe possible risk factors for their development. This knowledge will hopefully allow objective information on the risks of mandibular cheek teeth extraction to be disseminated
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