# Intranasal Dental Repulsion of a Displaced Cheek Tooth in an Arabian Filly

## TL;DR

A 3-year-old Arabian filly had a displaced cheek tooth successfully removed using an innovative intranasal technique, avoiding traditional invasive methods.

## Contribution

An intranasal dental repulsion technique is introduced for extracting unusually displaced cheek teeth in horses.

## Key findings

- The displaced cheek tooth had an oblique vertical angulation of 135°, making traditional extraction methods impractical.
- The intranasal repulsion technique allowed successful extraction without skin incisions or maxillary osteotomy.
- The procedure resulted in no intra-operative or post-operative complications.

## Abstract

Dental diseases in horses, particularly those associated with disorders of the cheek teeth, are frequently encountered and can significantly affect an animal’s overall health. Consequently, equine dentistry has advanced rapidly in recent decades, introducing innovative techniques that enable veterinarians to conduct most exodontia procedures using only standing sedation. General anesthesia is now primarily reserved for more complex cases. This case report presents an unusual dental disease along with an alternative surgical approach for its extraction, due to the tooth’s unusual inclination. The methods of tooth extraction continue to evolve, aiming to create increasingly minimally invasive and less traumatic surgical procedures. Further studies and additional cases treated with the described technique warrant consideration.

This case report documents an unusual cheek tooth (CT) displacement in a 3-year-old Arabian filly. The horse was referred to the clinic for loss of appetite and right-sided facial deformity. At admission, an oral inspection was performed, followed by a dental radiographic examination. The radiographs showed a very oblique vertical angulation (135°) of the CT 106 compared to the other premolars (107 and 108 CTs) (40°). In consideration of the clinical and radiographic findings, surgical extraction of the 106 CT was indicated. Due to the unique positioning of the displaced tooth, traditional extraction methods such as standing oral extraction or minimally invasive buccotomy were deemed impractical. An innovative intranasal dental repulsion technique was selected to minimize invasiveness while ensuring the possibility of performing a complete oral extraction. The procedure was performed under general anesthesia without requiring skin incisions or a lateral osteotomy of the maxilla. The surgery was successful, with no intra-operative or post-operative complications. This original approach offers a viable alternative for similar cases, reducing the morbidity associated with conventional repulsion techniques.