Dental sectioning can be used as a less invasive way to extract equine cheek teeth. | Haylie Kerstetter/The HorseWhen a horse fractures or develops disease in a cheek tooth, a veterinarian might need to extract it if conservative treatmentsuch as endodontic therapy to remove infected, injured, or diseased pulp from a tooths root canal systemisnt an option. Equineveterinarydentistscan choose from an array oftoothextractionmethods,depending on the tooths condition.Thosetooth extractionprocedures includethestandard oral extraction technique, whichshouldalways be preferredover other more invasive techniques, said AlexisLeps,DVM, Dipl. EVDC Eq, of the veterinary medicine faculty in the department of large animal surgery, anesthesiology, and orthopedics, at Ghent University, in Merelbeke, Belgium. He said they also include methods such as:Partial coronectomy (partial removal of a crown to make it easier to extract)to promote dental luxation(disruption of theligamentthat holds the tooth in its socket);Minimally invasive transbuccal screw extraction (accessing the oral cavity through a canula inserted into the horses cheek, allowing a screw to be placed in the tooth via that canula);Repulsion (removal by pushing the tooth out from the root into the mouth);andSectioning.What is Dental Sectioning in Horses?When a horse fractures a tooth and there is no clinical crown (the visible part of the tooth) to grasp with forceps for extraction, or it is too decayed for minimally invasive extraction through the cheek, veterinarians can use dental sectioning, said Leps. During this procedure, a veterinary dentist cuts the tooth in three pieces and lifts and removes each piece one at a time, including the dental root.Studying the Benefits of Dental Sectioning in HorsesIn ourretrospective study(using data of past surgeries),we describedcheek teeth extraction by the sectioning technique, thedecision-makingprocess that led dental surgeonsto use this technique,and potentially associated complications,Leps said. However, dental tooth sectioning is still considered an alternative technique, and we wanted to investigate the prevalence of this surgical procedure in ourstudysample.Leps and his fellow researchers analyzed clinical records of all equine cheek teeth extractions performed in his department at Ghent University between October 2020 and July 2023.They recorded29(6.3%)ofthe461 teethinvolved in the study required tooth removal via dental tooth sectioning, which he said isvery low.As with any surgical procedure, dental extractions in horses should be as minimally invasive as possible, said Leps.This meanswe always strive to cause the least collateral damage to the surrounding tissue and anatomical structures as possible.In select casesin modern dentistry, the noninvasive tooth sectioning techniquehasalreadyreplaced the repulsion technique, Leps said.By not damaging surrounding tissues, the postoperative complication rate stays low (around 13%), where repulsion ofteeth with a punch through a bone hole has a reported complication rate ranging from 40 to 60% according to studies on this subject, prolonging recovery time.The complication rate was low in the analyzedcase series, Leps said, but he emphasized the need for meticulous control over the sectioning procedure. It alsorequiresperfectly cooperative patients, which does not always happen.Take-Home MessageTooth sectioning in horses is apractical and less invasivealternative for dental extractions when standard extractionmethods arent possible,Lepssaid. He and his colleagues found that practitioners oftenselectextraction techniquebased on case-specic details from clinical oral exams and medical imaging. Therefore, equine veterinarians should consider this procedure on a case-by-case basis.