Page 764 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Gastrointestinal system: 4.1 The upper gastrointestinal tr act 739

VetBooks.ir is indicated. Local analgesia of the tooth using an more superficial position. Mandibular lower 1 pre-
st
infraorbital nerve block, or local subgingival infil-
molars (Triadan 305, 405) are rare and if present can
tration of mepivicaine or topical application of cin-
to the first cheek tooth (Fig. 4.37). They are com-
chocaine to the gingival mucosa is advised to achieve usually be palpated on the ventral mandible rostral
analgesia of the tooth and gingiva. The gingiva is monly small, but vary in size and position and are
elevated from all around the tooth using a circular more likely to be associated with discomfort with
Burgess-type elevator or a small curve-bladed peri- the bit. They are a noteworthy observation during
odontal elevator. Aberrantly placed teeth or very pre-purchase examinations. The technique for their
large wolf teeth should be radiographed to assess removal is as described previously.
the size and placement of the apical portion before
attempts at extraction. Very large molarised wolf MALERUPTION
teeth may require extensive periodontal separa-
tion before sufficiently loose to extract. Once peri- Definition/overview
odontal elevation is completed the tooth can be Misalignment of the teeth within an arcade as a result
extracted using a small pair of incisor or specialised of asymmetric or delayed eruption of the teeth.
wolf tooth extractors. Subgingival wolf teeth can be
exposed by a small incision in the overlying gingi- Aetiology/pathophysiology
val mucosa. Periodontal attachments can be care- The eruption of the permanent cheek teeth to
fully loosened using an osteotome placed pointing replace the primary dentition is a carefully coor-
caudally between the rostrally angled tooth and the dinated sequence of events. Disturbances resulting
hard palate (Fig. 4.36). The alveolus can be packed in alteration of the position of the permanent tooth
with gel foam or gauze to prevent food impaction, buds or anatomical variations resulting in relative
although this is rarely necessary. Failure to loosen shortening of the maxilla or mandible can result in
the periodontium sufficiently can result in fracture impaction of the erupting tooth and consequently
of the tooth. Remaining sharp fragments should be predispose to disease process. Dental impactions can
elevated and removed to enable healing of the alveo-
lus. Subgingival apical fragments rarely cause clini- 4.37
cal signs and loose fragments may be removed after
several days, during which they usually migrate to a

4.36

Fig. 4.36 After elevation of the gingiva, the Fig. 4.37 A laterolateral radiograph of the cranial part
periodontium is separated with luxators. of the mouth demonstrating wolf teeth within both the
upper and lower jaws. (Photo courtesy Graham Munroe)