Complications Following Mandibular Cheek Tooth Extraction in 20 Horses.
Authors: Gergeleit Hauke, Bienert-Zeit Astrid
Journal: Frontiers in veterinary science
Summary
# Editorial Summary: Mandibular Cheek Tooth Extraction Complications in Horses Mandibular cheek tooth extractions carry a notably higher complication rate than their maxillary counterparts, with Gergeleit and Bienert-Zeit's 2020 retrospective analysis of 302 procedures revealing that 6.6% (20 cases) developed clinically significant post-operative complications requiring referral. Younger horses proved more susceptible to complications, particularly following extraction of the Triadan 07 and 09 teeth, and alveolar sequestration dominated the complication profile, affecting 90% of affected cases with complete alveolar loss occurring in some instances; fistula formation (25%) and mandibular abscessation (20%) were also recorded. The anatomical structure of the mandibular alveolus—notably its bone density and morphology—appears to predispose it to extensive sequestration compared to maxillary sites, with treatment involving sequestrectomy and debridement often requiring up to five months for complete resolution despite successful outcomes in all cases. For practitioners, this underscores the importance of thorough pre-operative imaging and clinical assessment to identify higher-risk candidates, alongside realistic owner communication about the potential for prolonged healing and additional intervention. Given the prevalence and protracted nature of mandibular extraction complications, detailed informed consent and close post-operative monitoring are essential components of best practice in equine dental surgery.
Read the full abstract on PubMed
Practical Takeaways
- •Expect alveolar sequestration in 9 out of 10 horses that develop post-extraction complications; plan for extended treatment timelines (up to 5 months) and include this risk in pre-operative discussions with owners
- •Younger horses undergoing mandibular cheek tooth extraction are at higher risk for complications — use thorough diagnostic imaging (radiography/CT) pre-operatively to identify high-risk cases and optimize extraction technique
- •Teeth Triadan 07 and 09 are most commonly affected; prepare owners for potential secondary procedures including sequestrectomy and wound debridement if complications develop
Key Findings
- •Post-operative complications occurred in 6.6% (20/302) of mandibular cheek tooth extractions, predominantly in younger horses
- •Alveolar sequestration was the most common complication (90% of cases), with complete alveolus sequestering in some horses
- •Mandibular fistula formation occurred in 25% of complicated cases and mandibular abscessation in 20%
- •Mandibular alveolar bone is more prone to extensive sequestration than maxillary bone, with resolution timelines up to 5 months