Standing intraoral extractions of cheek teeth aided by partial crown removal in 165 horses (2010–2016)

Rice, Molly; Henry, Travis

doi:10.1111/evj.12727

Cited by 22 publications

(29 citation statements)

References 19 publications

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“…Nevertheless, our findings support the consensus that oral extraction is the method of choice whenever possible. It is notable that the most recent advances in equine cheek tooth extraction, such as the minimally invasive transbuccal approach with intradental screw extraction (MITSE) and the partial coronectomy , are fundamentally oral extraction techniques in the standing horse. Standing oral extraction of fractured cheek tooth under endoscopic guidance is another example of applying current technology to facilitate oral extraction of cheek teeth in the standing horse.…”

Section: Discussionmentioning

confidence: 99%

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Equine cheek tooth extraction: Comparison of outcomes for five extraction methods

Caramello

Zarucco

Foster

et al. 2019

Equine Veterinary Journal

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Summary Background Post‐operative complications are reported for all methods of equine cheek tooth extraction but not all methods carry the same risks. An outcome comparison for commonly used methods is needed so that clinicians can make informed treatment decisions. Objectives We conducted a side‐by‐side comparison of five cheek tooth extraction methods, comparing types and incidence of complications among oral extraction, tooth repulsion (three surgical approaches) and lateral buccotomy techniques. Study design Retrospective clinical study using hospital medical records. Methods Medical records of all horses undergoing cheek tooth extraction between 1997 and 2013 were reviewed. Logistic regression was used to determine the likelihood of various post‐operative complications, comparing oral extraction, tooth repulsion by maxillary and mandibular trephination or maxillary sinus bone flap, and lateral buccotomy. Results The study included 137 horses and 162 cheek teeth extractions. Oral extraction was successful in 71% of patients in which it was attempted. Oral extraction (n = 55) had the lowest incidence of complications (20%) and repulsion by sinus bone flap (n = 20) the highest (80%). Complication rates for repulsion by maxillary (n = 19) and mandibular trephination (n = 28), and extraction by lateral buccotomy (n = 15) were 42, 54 and 53%, respectively. Cheek tooth repulsion by sinus bone flap significantly increased the odds of damage to adjacent teeth, post‐operative sinusitis, damage to alveolar bone, delayed alveolar granulation and orosinus fistulation. Repulsion by maxillary trephination significantly increased the odds of superficial incisional surgical site infection; and extraction by lateral buccotomy significantly increased the odds of facial nerve neuropraxia. Post‐operative pyrexia was more common in all repulsion methods. Main limitations Some clinically relevant differences may have been missed due to small group numbers in several categories. Conclusions Oral extraction was associated with fewer post‐operative complications than any other methods. Standing oral extraction remains the preferred choice, and recent surgical advances promise to further improve its success rate.

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Section: Discussionmentioning

confidence: 99%

“…Standing oral extraction of fractured cheek tooth under endoscopic guidance is another example of applying current technology to facilitate oral extraction of cheek teeth in the standing horse. Reported success rates for these procedures range from 81 to >99% with 3.6–14% complication rates .…”

Section: Discussionmentioning

confidence: 99%

Equine cheek tooth extraction: Comparison of outcomes for five extraction methods

Caramello

Zarucco

Foster

et al. 2019

Equine Veterinary Journal

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“…As in the human field, equine surgeons are progressively increasing the number of procedures that are performed standing under sedation or in a minimally invasive fashion to reduce the cost and risks associated with general anesthesia. [5][6][7][8][9][10][11]15 There are clear benefits associated with the reported technique and this may encourage more equine surgeons to perform standing metacarpophalangeal and metatarsophalangeal joint arthroscopy. First, the reported technique allows safe and thorough arthroscopic examination of the dorsal aspect of the metacarpophalangeal and metatarsophalangeal joint.…”

Section: Discussionmentioning

confidence: 95%

“…metacarpophalangeal and metatarsophalangeal joint has not gained the popularity that other recently developed standing procedures such as sinus surgery, dental surgery and laparoscopy have obtained. [1][2][3][8][9][10] The reasons for this lack of general acceptance for standing arthroscopy of the metacarpophalangeal and metatarsophalangeal joint are unclear. Some factors may be (1) surgeon discomfort from the required kneeling position during the procedure, (2) concerns over damaging the valuable 4-mm arthroscope traditionally used for the standing procedure or (3) lack of training or interest to perform the procedure in a new fashion when the traditional technique under general anaesthesia is performed relatively quickly and is not particularly challenging for the trained surgeon.…”

mentioning

confidence: 99%

Standing Needle Arthroscopy of the Metacarpophalangeal and Metatarsophalangeal Joint for Removal of Dorsal Osteochondral Fragmentation in 21 Horses

Bonilla

2019

Vet Comp Orthop Traumatol

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Objective The aim of this study was to report the technique, experience and outcome of standing arthroscopic removal of dorsal osteochondral fragmentation of the metacarpophalangeal and metatarsophalangeal joint using a 1.2-mm needle arthroscope. Study Design This was a prospective clinical study. Materials and Methods All horses referred for standing arthroscopic removal of dorsoproximal first phalanx fragments or fragments embedded in the distal aspect of the synovial plica were included. Relevant information from the cases was recorded. Follow-up was obtained by a telephone questionnaire. Results Twenty-one horses with a mean age of 4.5 years old were included. Osteochondral fragments removed were from the proximal margin of first phalanx in 18 horses (24 joints), in the synovial plica in 2 horses (2 joints) or free-floating fragment in 1 horse (1 joint). Fifteen out of twenty-one horses were unilaterally affected and 6/21 bilaterally. Fifteen out of twenty-seven affected joints were forelimbs and 12/27 hindlimbs. All articular structures within the dorsal recess of the joint were visible. The arthroscope was deemed easy to use and manoeuvre. Only minor complications occurred during the procedure. Surgery time was 15 to 20 minutes for most patients. Conclusions All fragments were successfully removed and needle arthroscopy allowed a thorough evaluation of the dorsal aspect of the joint. The technique offers an alternative for standing fetlock arthroscopy for surgeons concerned about equipment damage or portability.

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“…24 Standing techniques eliminate those risks and are currently replacing some procedures traditionally performed under GA in horses. 10,11,17,[25][26][27] To the best of our knowledge, there is no published information regarding the number of horses requiring arthroscopy of the TCj under GA solely for diagnostic purposes, but it is well known that traditional imaging has some diagnostic limitations. 3,7 Thus, the technique reported here could represent a valuable diagnostic technique for a subset of horses with tarsal pathology, especially those without a definitive diagnosis after diagnostic imaging.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic needle arthroscopy of the tarsocrural joint in standing sedated horses

Bonilla

2020

Veterinary Surgery

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Objective To develop and assess a needle arthroscopic technique to diagnose conditions of the tarsocrural joint (TCj) in standing sedated horses. Study design Experimental study. Sample population Six cadaveric hind limbs (phase 1) and six healthy horses (Phase 2). Methods In phase 1, each TCj was examined with a 1.2‐mm‐needle arthroscope. Suitability of the needle arthroscope and degree of joint visualization with traditional arthroscopic approaches were assessed. In phase 2, the feasibility of the procedure was assessed in six standing healthy horses. A custom‐made splint and base were developed to maintain joint flexion during the procedure. Results Thorough evaluation of the dorsal intra‐articular structures of the TCj via dorsomedial and dorsolateral approaches was possible in both phases. The procedure was feasible, quickly performed, and well tolerated by all horses. Complications consisted of moderate movement (2/6 horses) and hemarthrosis (3/6 horses). Conclusion Diagnostic standing needle arthroscopy of the TCj allowed thorough evaluation of the dorsal aspect of the joint while avoiding the cost and risks associated with general anesthesia. Inadvertent puncture of the dorsomedial vasculature with the cannula and obturator led to significant hemarthrosis. Clinical impact Needle arthroscopy of the TCj offers an alternative diagnostic tool when traditional imaging techniques (radiography and ultrasonography) are unrewarding or nondiagnostic. The technique is conceived mainly for diagnostic purposes, but its use during short interventions warrants investigation.

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Standing intraoral extractions of cheek teeth aided by partial crown removal in 165 horses (2010–2016)

Abstract: Horses with cheek teeth extraction by partial crown removal have an excellent prognosis for a positive outcome. The term partial coronectomy is proposed for this technique.

Cited by 22 publications

References 19 publications

Equine cheek tooth extraction: Comparison of outcomes for five extraction methods

Equine cheek tooth extraction: Comparison of outcomes for five extraction methods

Standing Needle Arthroscopy of the Metacarpophalangeal and Metatarsophalangeal Joint for Removal of Dorsal Osteochondral Fragmentation in 21 Horses

Diagnostic needle arthroscopy of the tarsocrural joint in standing sedated horses

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