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Cheek Tooth Extraction - Horse (view source)
Revision as of 11:40, 1 September 2011
, 11:40, 1 September 2011Created page with "==Introduction== Tooth extraction is the '''most common''' surgical procedure performed in the horse. However it should always be considered a la..."
==Introduction==
[[Teeth - Anatomy & Physiology|Tooth extraction]] is the '''most common''' surgical procedure performed in the horse. However it should always be considered a last resort as there are considered to be both '''welfare''' issues and '''potential risks/complications''' associated with the procedure. The extraction of a cheek teeth is considerably more '''invasive''' that the removal of wolf teeth and caps and is considered to be a major operation which should be performed either under '''sedation or general anaesthetic'''. Ideally '''radiography''' should be performed to identify the affected tooth before any extraction.
==Indications==
There are numerous reasons for cheek tooth extraction, these include: '''fractured teeth, loose teeth, displaced teeth, peridontal disease, impaction, apical and periapical abcessation, infundibular necrosis, [[Mandibular Fractures|mandibular fractures]], neoplasia and the removal of supernumarary teeth'''.
==Techniques==
With all extractions the entire tooth should '''always''' be removed. It is necessary to disrupt the '''[[Enamel Organ|periodontal ligament]]''' and '''alveolar margin''' in order to remove the tooth. Care should be taken not to damage the adjacent teeth. There are three commonly used techniques for cheek tooth extraction:
===Oral Extraction===
This technique is the '''least invasive''' (as the alveolus remains intact) and it can be performed under '''sedation'''. If the technique is unsuccessful subsequent surgical extraction may be required. It is ideal for use in elderly horses as the [[Enamel Organ|periodontal ligament]] is often already loose.
First, the gingival margin should be lifted using '''elevators'''. Secondly, '''molar spreaders''' should be placed between the extraction tooth and the surrounding teeth. Finally, '''forceps''' should be placed on the extraction tooth and gently rotated to loosen the surrounding attachments. This final step can take a '''very long time''' - particularly where the periodontal ligament is intact, but it should not be rushed as this could result in fracture of the extracted tooth.
Complications include tooth fracture and incomplete extraction.
===Repulsion===
This technique approaches the tooth from the '''apical margin''' and '''repulses''' the tooth back into the oral cavity.
Having accessed the apical surface the tooth either via a '''trephine hole''' or an '''osteoblastic flap''', a '''punch''' and '''mallet''' are used to knock the tooth into the oral cavity.
This has more associated complications due to its '''invasive''' nature. These include incomplete extraction, sequestra formation, haemorrhage, [[Fistula|fistula]] formation, slow healing and damage to adjacent teeth.
===Buccotomy===
This technique is most suited to the extraction of '''abnormally shaped teeth''' that cannot be removed by the above mentioned methods.
The tooth is accessed from the '''lateral surface of the skull''' and removed '''piece meal'''.
Complications include damage to surrounding structures such as salivary glands and nerves, incomplete extraction and sequestra formation.
==Post-op Care==
* '''Analgesics''' such as [[NSAIDs]]
* '''[[Antibiotics]]''' to prevent infection
* Placement of a plug in the gap left by the tooth - this needs removal or replacement post-op.
Most horses will need '''preventative dental care''' for the rest of their lives. This is because the tooth apposing the extracted tooth will not be exposed to as much wear as the other teeth, and is susceptible to [[Abnormal Wear of Teeth|overgrowth]].
{{Learning
|flashcards = [[Veterinary Dentistry Q&A 22]]
}}
==References==
Howarth, S (1995) '''Equine Dental Surgery''' ''In Practice 1995 17: 178-18''
RVC staff (2009) '''Alimentary System - Part I''' RVC Intergrated BVetMed Course, ''Royal Veterinary College''
Tremaine, H (1997) '''Equine Practice: Dental care in horses''' ''In Practice 1997;19:186-199''
Verstraete, F. J. M. (1998) '''Self-Assessment Colour Review - Veterinary Dentistry''' ''Manson''
[[Category: To Do - Siobhan Brade]]
[[Category:To Do - Manson review]]
[[Teeth - Anatomy & Physiology|Tooth extraction]] is the '''most common''' surgical procedure performed in the horse. However it should always be considered a last resort as there are considered to be both '''welfare''' issues and '''potential risks/complications''' associated with the procedure. The extraction of a cheek teeth is considerably more '''invasive''' that the removal of wolf teeth and caps and is considered to be a major operation which should be performed either under '''sedation or general anaesthetic'''. Ideally '''radiography''' should be performed to identify the affected tooth before any extraction.
==Indications==
There are numerous reasons for cheek tooth extraction, these include: '''fractured teeth, loose teeth, displaced teeth, peridontal disease, impaction, apical and periapical abcessation, infundibular necrosis, [[Mandibular Fractures|mandibular fractures]], neoplasia and the removal of supernumarary teeth'''.
==Techniques==
With all extractions the entire tooth should '''always''' be removed. It is necessary to disrupt the '''[[Enamel Organ|periodontal ligament]]''' and '''alveolar margin''' in order to remove the tooth. Care should be taken not to damage the adjacent teeth. There are three commonly used techniques for cheek tooth extraction:
===Oral Extraction===
This technique is the '''least invasive''' (as the alveolus remains intact) and it can be performed under '''sedation'''. If the technique is unsuccessful subsequent surgical extraction may be required. It is ideal for use in elderly horses as the [[Enamel Organ|periodontal ligament]] is often already loose.
First, the gingival margin should be lifted using '''elevators'''. Secondly, '''molar spreaders''' should be placed between the extraction tooth and the surrounding teeth. Finally, '''forceps''' should be placed on the extraction tooth and gently rotated to loosen the surrounding attachments. This final step can take a '''very long time''' - particularly where the periodontal ligament is intact, but it should not be rushed as this could result in fracture of the extracted tooth.
Complications include tooth fracture and incomplete extraction.
===Repulsion===
This technique approaches the tooth from the '''apical margin''' and '''repulses''' the tooth back into the oral cavity.
Having accessed the apical surface the tooth either via a '''trephine hole''' or an '''osteoblastic flap''', a '''punch''' and '''mallet''' are used to knock the tooth into the oral cavity.
This has more associated complications due to its '''invasive''' nature. These include incomplete extraction, sequestra formation, haemorrhage, [[Fistula|fistula]] formation, slow healing and damage to adjacent teeth.
===Buccotomy===
This technique is most suited to the extraction of '''abnormally shaped teeth''' that cannot be removed by the above mentioned methods.
The tooth is accessed from the '''lateral surface of the skull''' and removed '''piece meal'''.
Complications include damage to surrounding structures such as salivary glands and nerves, incomplete extraction and sequestra formation.
==Post-op Care==
* '''Analgesics''' such as [[NSAIDs]]
* '''[[Antibiotics]]''' to prevent infection
* Placement of a plug in the gap left by the tooth - this needs removal or replacement post-op.
Most horses will need '''preventative dental care''' for the rest of their lives. This is because the tooth apposing the extracted tooth will not be exposed to as much wear as the other teeth, and is susceptible to [[Abnormal Wear of Teeth|overgrowth]].
{{Learning
|flashcards = [[Veterinary Dentistry Q&A 22]]
}}
==References==
Howarth, S (1995) '''Equine Dental Surgery''' ''In Practice 1995 17: 178-18''
RVC staff (2009) '''Alimentary System - Part I''' RVC Intergrated BVetMed Course, ''Royal Veterinary College''
Tremaine, H (1997) '''Equine Practice: Dental care in horses''' ''In Practice 1997;19:186-199''
Verstraete, F. J. M. (1998) '''Self-Assessment Colour Review - Veterinary Dentistry''' ''Manson''
[[Category: To Do - Siobhan Brade]]
[[Category:To Do - Manson review]]