Discussion

Aims: To report proportion of cheek teeth (CT) requiring surgical exodontia over a 6 year period and report success rates and complications of surgical procedure. Methods: A total of 214 CT were presented for oral extraction over a 6 year period; 193 were successfully extracted orally by forceps technique, oroscopically guided fragment extractions and oral screw extractions; 21 CT were selected for surgical exodontia following unsuccessful oral extraction or presentations precluding oral extraction. Surgical technique was lateral buccotomy (LB) under general anaesthesia with slight modifications of described techniques to aid identification of facial nerve branches, including lengthening the incision caudally and dissecting further coronally. Results: Twenty- one CT in 20 horses were extracted by LB, age range 4 - 24 years, mean 9 years. Twenty horses had a single tooth removed. One horse had Triadan 109 and 209 removed with a 3 year interval.
62% were maxillary, 38% mandibular. Ninety-two percent of maxillary CT were Triadan _09. Out of 20 horses, 19 had no significant long-term (>2 months) complications (96%). One horse was subjected to euthanasia intraoperatively for complications. One horse developed a surgical wound abscess 2 weeks post operatively with mild lip paresis. One horse required intraoperative transcortical osteotomy to repel an apical fragment. In one horse the parotid duct was inadvertently sectioned requiring surgical repair with no short- or long-term complications. Conclusions and practical significance: Compared to other surgical techniques, LB can be safe and highly successful and is recommended for cases of failed oral extraction. Slight modifications to previously described techniques can significantly reduce reported complications. Maxillary Triadan _09 teeth are markedly over-represented in this and other surgical exodontia studies. Further research is warranted into pathology of these teeth. Clinicians should be particularly cautious when attempting oral extraction of these teeth. Acknowledgements: Bruce Bladon for initial help and guidance with this surgical technique.