Periapical curettage: an alternative surgical approach to infected mandibular cheek teeth in horses.

Authors: Carmalt James L, Barber Spencer M

Journal: Veterinary surgery : VS

DOI: 10.1111/j.1532-950X.2004.04039.x PubMed: 15104634Log in to save

Summary

Periapical infection of mandibular cheek teeth presents a significant clinical challenge, and whilst tooth repulsion remains the conventional approach, this retrospective analysis examines periapical curettage as a viable alternative that may be more accessible to first-opinion practitioners. Over a ten-year period, eleven horses (aged 3–13 years) with fourteen infected mandibular molariform teeth underwent periapical curettage to establish alveolar drainage, with clinical, radiographic and surgical records reviewed and long-term outcomes obtained through follow-up contact or examination. Of the nine horses with adequate follow-up data (mean 41 months), seven horses (78%) achieved complete healing, whilst two subsequently required tooth repulsion; two of the healed cases retained mild local mandibular swelling. The technique's principal advantage lies in its simplicity and economy—requiring neither advanced imaging modalities nor specialised surgical equipment—making it a practical option for both referral centres and general equine practice, particularly in cases where full repulsion may be unavailable or where owner finances preclude more invasive intervention. These findings suggest periapical curettage merits consideration as a first-line surgical approach, though the modest case number and variable follow-up methodology mean further prospective data would strengthen confidence in its routine application.

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Practical Takeaways

•Periapical curettage is a simple, cost-effective alternative to more complex surgical approaches for infected mandibular cheek teeth and can be performed in first opinion practice
•Success rate of approximately 78% makes this technique a viable option when tooth extraction is not feasible or desired
•No specialized equipment or advanced imaging is required, making this approach practical for field and referral practice situations

Key Findings

•78% (7/9) of horses with follow-up healed completely after periapical curettage for mandibular cheek tooth infection
•Mean follow-up period was 41 months with 2 horses requiring subsequent tooth repulsion
•Procedure allows effective alveolar drainage without requiring expensive imaging or specialized surgical equipment

Conditions Studied

periapical infection of mandibular cheek teethmandibular molariform tooth root infection

Related References

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