Cases (2)

Text Box: Westrow Equine Dental Service Ltd

::Cases:: Altiora peto

For the Good of the Horse and Rider

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Case 2

Text Box: Intra-oral extraction of 207, first stage The pony was sedated by the veterinary surgeon using a combination of detomidine (Domosedan, Pfizer) and Butorphanol (Torbugesic, Fort Dodge). Local analgesia was provided by the injection of 10 ml of 2% solution of mepivacaine hydrochloride (intra-epicaine, Arnolds) into the left infraorbital foramen. When sedation appeared adequate and all necessary equipment was to hand, we began the preparation of the periodontal structures for the extraction of 207. The first step was to separate the tooth from its immediate neighbours. Using molar spreaders, the jaws were placed at the junction of 207 & 206 to create slight rostral displacement of 206. The jaws were placed at the junction of 207 & 208 to pull the 207 rostrally. This process was repeated for 30 minutes thus stretching and weakening the periodontal ligaments and structures sufficiently to start elevating the gingival mucosa and the buccal and lingual alveolar walls. It was to our advantage that the tooth concerned was fairly rostral in the arcade. The good access enabled the use of a long handled wolf tooth elevator and a surgical mallet. Repeated gentle upward taps to the periodontal structures allowed better control of the instrument greatly reducing the risk of slipping.

Radiograph

Radiograph

Text Box: Second Stage Once peripheral structures had been prepared molar extractors were applied to the tooth and to achieve maximum grip the head of the forceps was pushed well up to the rim of the alveolus. With gentle lateral movement, palatally and buccally, of the closed forceps, loosening of the tooth began. This procedure took roughly 4 hours, including intermittent breaks to allow the pony’s jaw to rest. Once the tooth was sufficiently loose, a fulcrum was placed between 206 and the forceps, so that upward pressure to the handles exerted coronal force to the tooth, which was extracted completely from the alveolus with relative ease.

Text Box: Examination of the tooth The tooth was cleaned and decaying food debris was cleared from the abnormal infundibulum. A hypodermic needle was pushed gently into the infundibulum and it passed through easily into the pulp chamber. This confirmed that the periapical infection initiated at the occlusal surface. Food material had packed into the infundibulum (which was presumably defective, probably through hypocemetosis). And subsequent fermentation resulted in decay of the hard dental tissues (infundibular caries). The defect had penetrated through cementum, enamel and dentine to the pulp.

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