Equine cheek tooth repulsion using small diameter repulsion pins: 20 cases.
Authors: Kamps Melissa, Barakzai Safia
Journal: Equine veterinary journal
Summary
# Equine cheek tooth repulsion using small diameter repulsion pins When oral extraction proves unsuccessful for diseased or fractured cheek teeth, repulsion offers a viable alternative to extraction, though historical data suggest complication rates as high as 80%. Kamps and Barakzai's retrospective review of 20 horses (mean age 10.3 years) undergoing cheek tooth repulsion with small diameter pins (3–5 mm) between 2014–2023 demonstrates that modern technique has substantially improved outcomes; all 20 teeth were successfully repulsed, with 80% of procedures performed standing under sedation and regional anaesthesia, using intraoperative radiographs to guide instrument placement and PMMA packing of the alveolus post-extraction. The cohort experienced a combined intra- and post-operative complication rate of 25% (5 cases), comprising one case of mandibular bone damage, two superficial surgical site infections, one sinus flap dehiscence, one recurrent sinusitis and one horse with persistent bitting problems from retained alveolar fragments—a rate comparable to contemporary trans-buccal screw extraction methods. Given that 75% of cases involved pre-existing dental fractures and three-quarters were managed standing, these results suggest that small diameter repulsion pins offer a practical, effective option when conventional oral extraction has failed, though the small case number and retrospective design warrant cautious interpretation of complication incidence.
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Practical Takeaways
- •Small diameter repulsion pins (3-5 mm) are an effective alternative for extracting cheek teeth when conventional oral extraction fails, with complication rates no worse than historical methods
- •Most repulsions can be performed with the horse standing under sedation with regional anesthesia rather than general anesthesia, reducing anesthetic risk
- •Intra-operative radiographs and post-extraction alveolar packing with polymethyl methacrylate are important technical considerations; plan for follow-up examination at 4-6 weeks to monitor for delayed complications
Key Findings
- •All 20 cheek teeth (15 maxillary, 5 mandibular) were successfully repulsed using small diameter pins (3-5 mm) when oral extraction failed
- •Total intra- and post-operative complication rate was 25% (5/20 cases), including 1 intra-operative mandibular bone damage, 2 short-term complications (infection, sinus flap dehiscence), and 2 long-term complications (sinusitis recurrence, intra-alveolar fragments)
- •Complication rate of 25% with small diameter pins is comparable to historical rates reported for Steinmann pin repulsion and trans-buccal screw extraction methods
- •75% of cases involved pre-existing dental fractures; 80% of procedures performed with horse standing under sedation and regional nerve block