Rice M K, Henry T J
Midwest Veterinary Dental Services, Elkhorn, Wisconsin, USA.
William B. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California - Davis, Davis, California, USA.
Equine Vet J. 2018 Jan;50(1):48-53. doi: 10.1111/evj.12727. Epub 2017 Aug 28.
Diseased cheek teeth in horses often require invasive extraction techniques that carry a high rate of complications. Techniques and instrumentation were developed to perform partial crown removal to aid standing intraoral extraction of diseased cheek teeth in horses.
To analyse success rates and post-surgical complications in horses undergoing cheek teeth extraction assisted by partial crown removal.
Retrospective cohort study.
This study included 165 horses with 194 diseased cheek teeth that were extracted orally assisted by partial crown removal between 2010 and 2016. Medical records were analysed, including case details, obtained radiographs, surgical reports and follow-up information. Follow-up information (≥2 months) was obtained for 151 horses (91.5%). There were 95 horses examined post-operatively by the authors and, 16 horses by the referring veterinarian; in 40 horses, post-operative follow up was obtained by informal telephone interviews with the owner.
Successful standing intraoral extraction of cheek teeth was obtained in 164/165 horses (99.4%). Twenty-five of these horses (15.2%) required additional intraoral extraction methods to complete the extraction, including minimally invasive transbuccal approach (n = 21) and tooth sectioning (n = 4). There was one (0.6%) horse with intraoral extraction failure that required standing repulsion to complete the extraction. The intraoperative complication of fractured root tips occurred in 11/165 horses (6.7%). Post-operative complications occurred in 6/165 horses (3.6%), including alveolar sequestra (n = 4), mild delay of alveolar healing at 2 months (n = 1), and development of a persistent draining tract secondary to a retained root tip (n = 1).
Specialised instrumentation and additional training in the technique are recommended to perform partial crown removal in horses.
Horses with cheek teeth extraction by partial crown removal have an excellent prognosis for a positive outcome. The term partial coronectomy is proposed for this technique.
马的患病颊齿通常需要采用侵入性拔牙技术，而这些技术并发症发生率很高。现已开发出相关技术和器械，用于进行部分牙冠切除术，以辅助马站立时在口腔内拔除患病颊齿。
分析在部分牙冠切除术辅助下进行颊齿拔除的马的成功率和术后并发症。
回顾性队列研究。
本研究纳入了2010年至2016年间165匹患有194颗患病颊齿的马，这些马在部分牙冠切除术辅助下经口腔拔除。分析了病历，包括病例细节、获取的X光片、手术报告和随访信息。对151匹马（91.5%）获得了随访信息（≥2个月）。术后有95匹马由作者进行检查，16匹马由转诊兽医进行检查；40匹马通过与主人进行非正式电话访谈获得术后随访信息。
164/165匹马（99.4%）成功站立在口腔内拔除颊齿。其中25匹马（15.2%）需要额外的口腔内拔牙方法来完成拔牙，包括微创经颊途径（n = 21）和牙齿分割（n = 4）。有一匹马（0.6%）口腔内拔牙失败，需要站立时推挤来完成拔牙。11/165匹马（6.7%）发生了根尖骨折的术中并发症。6/165匹马（3.6%）发生了术后并发症，包括牙槽骨坏死（n = 4）、2个月时牙槽愈合轻度延迟（n = 1）以及因根尖残留继发持续性引流道形成（n = 1）。
建议在马身上进行部分牙冠切除术时使用专门器械并接受该技术的额外培训。
通过部分牙冠切除术拔除颊齿的马预后良好，有望取得积极结果。建议将该技术称为部分牙冠切除术。
