A long-term study of equine cheek teeth post-extraction complications: 428 cheek teeth (2004-2018)

Background Complications, especially delayed alveolar healing, are common following equine cheek teeth extraction, however, limited objective information is available on the prevalence and nature of these problems. Objectives To document the type and prevalence of complications that occur following equine cheek tooth extraction and to identify possible risk factors for these complications that could be used to predict their occurrence and hopefully reduce their prevalence. Study design Retrospective cohort study. Methods Clinical records of all cheek teeth extractions performed between February 2004 and September 2018 were examined and written questionnaires sent to owners. Details of post-extraction complications were analysed and logistic regression was used to evaluate potential associations between the likelihood of post-extraction nonhealing alveolus managed by the authors and the variables: age, breed, reason for extraction, Triadan position and extraction technique. Results Post-extraction complications were recorded following 58/428 extractions giving an overall complication rate of 13.6%, that caused a longer term clinical problem in 34/428 (7.9%) cases, with complications being asymptomatic or quickly self-resolving in the other 24 cases (5.6%). The most frequent complication was alveolar bone sequestration, including alveolar infection. Risk of developing a post-extraction alveolar disorder managed by the authors (n = 53) increased following extraction of the mandibular 06s, 07s or 08s compared with all other cheek teeth combined (P = .001); for cheek teeth with apical infections (P = .002) compared with those without; and following repulsion or minimally invasive transbuccal extraction (MTE) than following oral extraction (P = .01 and P = .02 respectively). Main limitations Length of time between exodontia and survey data collection for some cases, use of clinical records and survey data and biases associated with decision to treat. Conclusions In agreement with previous studies, oral extraction had the lowest risk of complications. This study provides new information regarding the prevalence, types and risk of development of post extraction complications. Knowledge of these risk factors may help reduce these complications.