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Peer-reviewed veterinary case report

Oral Extraction and Nasal Retrieval of a Fragmented Maxillary Fourth Premolar Tooth in a Horse Using Endoscopic Guidance: A Case Report.

Journal:
Journal of veterinary dentistry
Year:
2025
Authors:
Clarysse, Michèlle et al.
Affiliation:
Department of Large Animal Surgery
Species:
horse

Plain-English summary

In this case, a 9-year-old Warmblood mare had a broken tooth that was causing a bad smell from her nose for 14 months. After examining her and taking X-rays, the veterinarians found that the tooth had a complicated fracture and a connection between her mouth and nose. They used a special technique to remove the pieces of the tooth that were hard to reach by going through her nose instead of making a larger cut on the outside of her face. They also cleaned up the area and sealed it to prevent food from getting in after the surgery. This careful and less invasive method worked well for her dental issue.

Abstract

This case report presents the removal of the left maxillary fourth premolar tooth (208) which had a chronic complicated crown root fracture in a 9-year-old Warmblood mare. Following a 14-month history of malodorous nasal discharge, clinical and radiographic examination allowed the diagnosis of a comminuted crown root fracture of 208 and oronasal fistula. Some root fragments inaccessible for oral extraction were subsequently removed using a transnasal approach through the existing oronasal fistulous tract using bronchoesophageal forceps under endoscopic guidance. The oronasal fistula was surgically debrided and the alveolus was occluded with polyvinyl siloxane to avoid postoperative food contamination. This minimally invasive approach prevented the need for more extensive external approaches, reducing the risk of complications. This case highlights the value of careful surgical planning and demonstrates the feasibility of minimally invasive techniques for complex equine dental extractions in particular cases.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/40296711/