Equine idiopathic cheek teeth fractures: part 3: a hospital-based survey of 68 referred horses (1999-2005).
Authors: Dixon P M, Barakzai S Z, Collins N M, Yates J
Journal: Equine veterinary journal
Summary
# Editorial Summary: Idiopathic Cheek Teeth Fractures in Referred Horses Between 1999 and 2005, Dixon and colleagues examined 68 horses presenting to an equine hospital with idiopathic cheek teeth fractures to characterise the clinical presentation, diagnostic findings, and treatment outcomes of this serious condition. The study identified 60 maxillary and 17 mandibular fractures, with lateral slab fractures predominating in the maxilla (45%) and more centrally positioned teeth (Triadan 08s and 09s) being preferentially affected; clinical signs were varied and non-specific, ranging from quidding (47% of cases) and behavioural problems (28%) to signs of apical infection such as bony swellings and nasal discharge (21%). Treatment was predominantly conservative, involving corrective rasping (46%), extraction of loose fragments only (32%), or complete tooth removal via oral extraction (28%) or repulsion (13%), with the critical distinction being whether gross apical infection was present. The findings indicate that horses without evidence of apical disease can often be managed successfully by removing only loose fragments and rasping the remaining tooth structure, whilst those with apical involvement typically require complete extraction; notably, prophylactic treatment of adjacent teeth with carious infundibula may reduce the risk of midline sagittal fractures in healthy contralateral teeth. These results provide evidence-based guidance for practitioners to adopt a graduated treatment approach based on clinical and diagnostic assessment of infection severity, potentially avoiding unnecessary complete extractions and preserving functional tooth structure in selected cases.
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Practical Takeaways
- •Suspect idiopathic cheek teeth fractures when horses present with quidding, bitting problems, or nasal discharge; centrally-positioned cheek teeth (08s and 09s) are at highest risk
- •Conservative treatment preserving the tooth is often successful if apical infection is absent; extraction of only loose fragments may resolve clinical signs without removing the entire tooth
- •Horses with signs of apical infection (bone swellings, nasal discharge) require full tooth extraction, preferably by oral extraction when possible to avoid surgical repulsion
Key Findings
- •77 idiopathic cheek teeth fractures identified in 68 horses, with maxillary lateral slab fractures being most common (45%)
- •Maxillary and mandibular Triadan 08s and 09 teeth were preferentially fractured
- •Clinical signs included quidding (47%), bitting/behavioural problems (28%), and signs of apical infection (21%)
- •Conservative treatment with fragment extraction or tooth rasping was successful in most cases without gross apical infection, while extraction was necessary when apical infection was present