# Corkscrew Technique for Extraction of Premolars and Molars in Standing Sedated Horses: Cadaveric Study and Clinical Cases

## TL;DR

This paper introduces a corkscrew technique for safely extracting cheek teeth in standing sedated horses, reducing the need for mallet strikes and showing promising success rates.

## Contribution

The novel corkscrew extraction technique for equine cheek teeth is introduced, offering a minimally invasive alternative to traditional methods.

## Key findings

- The corkscrew technique achieved a 75% success rate in cadaver heads and 76% in clinical cases.
- Tooth fractures and screw thread stripping were the main complications affecting success.
- Longitudinal drilling is essential for the technique's effectiveness.

## Abstract

Cheek teeth extractions are a laborious procedure. A minimally invasive transbucal screw extraction technique has been described. This technique requires several mallet strikes to disrupt the periodontal ligament to loosen the affected tooth. The objective of this study is to provide evidence that the use of a corkscrew-like mechanism is effective in completing cheek tooth extraction in standing sedated horses without the use of a mallet. The instruments and methodology described here can help equine practitioners to improve dental screw extractions. Further studies are needed to refine the instruments and procedures as well as evaluate both intraoperative and postoperative complications.

Several tooth extraction techniques are described in equine literature, and oral extraction techniques in standing sedated horses are popular among equine practitioners. The objectives of this study were to develop the corkscrew technique for cheek tooth extraction (CSET) in equine cadaver heads and evaluate this technique in clinical cases. We hypothesized that the CSET could be performed safely to extract cheek teeth in standing sedated horses. First, the CSET was attempted and developed in eight equine cadaver heads. Second, the CSET was performed in clinical cases between 2016 and 2020, and the following information was recorded: diagnosis, affected tooth, procedure duration, intraoperative difficulties, tooth size, postoperative complications, medication, hospitalization time, and 1-year follow-up. Sixteen CSET procedures were performed in eight equine skulls with a 75% success rate. In 24 clinical cases, 25 CSET procedures were attempted to extract 22 superior and 3 inferior cheek teeth. CSET was successful in 76% of procedures. Fractures of the tooth and stripping of screw threads were the major complications that led to the failure of CSET. CSET is a viable and safe technique to extract cheek teeth in standing sedated horses. Longitudinal drilling is a must for this technique to be successful.