Dental extraction and endodontic techniques in horses

Although equine incisor, wolf (first premolar), or canine teeth seldom require extraction on medical grounds, the wolf teeth are frequently removed because of client requests. Three techniques for extracting equine cheek teeth are repulsion, oral extraction, and lateral buccotomy extraction. Oral extraction is most readily performed in aged horses or in cases that involve extensive periodontal disease in the absence of caries. Unlike the other extraction techniques, oral extraction does not require general anesthesia. The repulsion technique is the most widely used extraction method and may be the only technique that is applicable in cases that involve advanced caries of the caudal cheek teeth; this method has a considerable rate of postoperative sequelae. By contrast, the lateral buccotomy extraction technique apparently causes relatively few postoperative sequelae; this method is of most value for the rostral cheek teeth. A rare but very serious sequela to lateral buccotomy extraction is nasal paralysis. All extraction techniques lead to overgrowth of the opposing cheek tooth. Endodontic treatment can be used in cases that involve early, localized apical infections of the rostral cheek teeth; if successful, treatment allows continued eruption of the treated tooth. To perform this technique through external approaches over the apex of the tooth, additional equipment and training as well as prolonged general anesthesia are required.