A long-term study of equine cheek teeth post-extraction complications: 428 cheek teeth (2004-2018).
Authors: Kennedy Rebekah, Reardon Richard J M, James Oliver, Wilson Cherith, Dixon Padraic M
Journal: Equine veterinary journal
Summary
# Editorial Summary: Post-extraction complications in equine cheek teeth Kennedy and colleagues' 14-year retrospective analysis of 428 cheek tooth extractions identified post-extraction complications in 13.6% of cases, with 7.9% developing longer-term clinical problems requiring ongoing management; alveolar bone sequestration and infection dominated the complication profile. Using logistic regression to evaluate risk factors, the authors determined that mandibular molar teeth (particularly 06s, 07s and 08s), pre-existing apical infections, and extraction technique significantly influenced complication likelihood, with oral extraction conferring substantially lower risk than repulsion or minimally invasive transbuccal extraction (MTE). These findings align with established understanding that oral extraction remains the safest approach, whilst providing quantifiable evidence that mandibular molars and teeth with periapical disease warrant heightened post-operative vigilance and potentially more conservative treatment planning. For practitioners managing extraction cases, this work suggests that patient age and breed were not significant predictors—allowing focus on the modifiable factors of tooth location, infection status and technique selection when counselling clients on complication risk and optimising outcomes.
Read the full abstract on PubMed
Practical Takeaways
- •Oral extraction technique carries the lowest risk of post-extraction complications and should be preferred when anatomically feasible
- •Be especially vigilant for complications when extracting mandibular back teeth (06, 07, 08) or teeth with existing apical infections, as these carry significantly elevated risk
- •Expect some form of post-extraction complication in roughly 1 in 7-8 cases, with about half requiring ongoing clinical management; appropriate owner communication and follow-up protocols are essential
Key Findings
- •Post-extraction complications occurred in 58/428 extractions (13.6%), with 7.9% causing long-term clinical problems and 5.6% asymptomatic or self-resolving
- •Alveolar bone sequestration including alveolar infection was the most frequent complication
- •Mandibular 06s, 07s, or 08s teeth had significantly higher complication risk compared to other cheek teeth (P=0.001)
- •Teeth with apical infections (P=0.002), repulsion technique (P=0.01), and minimally invasive transbuccal extraction (P=0.02) all showed increased risk compared to oral extraction