Repulsion of maxillary and mandibular cheek teeth in standing horses.
Authors: Coomer Richard P C, Fowke Graham S, McKane Shaun
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Standing Cheek Tooth Repulsion in Equines Between 2006 and 2009, Coomer and colleagues evaluated the outcomes of standing sedated repulsion for maxillary and mandibular cheek teeth in 18 horses and ponies (median age 7 years, range 1–30 years) where conventional oral extraction had failed due to diseased or fractured tooth anatomy. Using local nerve blocks, intraoperative radiography to guide instrument placement, and post-operative alveolar packing, the team successfully repulsed 20 cheek teeth (15 maxillary, 5 mandibular) with resolution of clinical discharge in 10 of 17 horses (59%) following the initial procedure. The remaining eight animals (41%) required additional medical or surgical intervention, predominantly for maxillary sinusitis management (six cases), though the authors noted that pre-existing chronic sinus involvement appeared to increase this complication risk. This case series demonstrates that standing repulsion represents a viable salvage technique for diseased cheek teeth when conventional extraction proves unsuccessful, offering practitioners a valuable alternative to recumbent general anaesthesia; however, careful pre-operative assessment for concurrent sinus pathology and realistic owner counselling regarding the potential for follow-up treatment remain essential for appropriate case selection and client expectations.
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Practical Takeaways
- •Standing repulsion is a viable option for removing diseased or fractured cheek teeth when conventional oral extraction is unsuccessful, with a 59% first-treatment success rate
- •Expect that roughly 40% of cases will need follow-up treatment, particularly those with pre-existing sinusitis—plan client communication and aftercare accordingly
- •Aggressive postoperative sinus management (lavage, cavity packing) is essential, especially when chronic sinusitis is present before repulsion
Key Findings
- •Standing repulsion successfully removed 15 maxillary and 5 mandibular cheek teeth in 18 horses and ponies when oral extraction failed
- •59% of horses (10/12 treated) achieved resolution of clinical discharge after first treatment
- •41% of extractions (6 maxillary, 1 mandibular) required follow-up surgical or medical treatment, predominantly for secondary sinusitis
- •Chronic preoperative sinus involvement increased risk of postoperative sinusitis requiring further treatment