10/30/2025
Trying to figure out what is going on here can be hard to wrap your head around! This horse has an extra cheek tooth. There is both a “normal” 208 and a supernumerary (extra) 208. The supernumerary 208 is also dysplastic, or abnormal in shape. Additionally, the supernumerary 208 was sitting sideways across the palate, which was revealed on CT scan! Since the normal 208 and supernumerary 208 were sharing the same alveolus (socket), there was no envelope of bone around each tooth, and thus periodontal disease could develop. For all of these reasons, extraction of both the 208 and supernumerary 208 was necessary.
There was no straightforward way to approach these extractions, but because of all of the advancements in equine dentistry, we were still able to successfully extract these teeth orally WITHOUT the need for general anesthesia or an invasive sinus procedure.
First, we used a burr to remove some crown of each tooth in order to fit forceps around the 208. Then the 208 was extracted. Since the supernumerary tooth was so displaced, it would be difficult to extract this tooth in a traditional manner. Instead, a minimally invasive buccotomy was performed. A small incision was made externally in the cheek, a drill bit was introduced through the incision and a hole was drilled into the center of the tooth, the drill was removed and a screw was tapped into the hole in the tooth. Then, the screw was gently tapped from the outside of the mouth to guide the tooth down into the oral cavity for removal. The crown of the supernumerary tooth did fracture during this process due to its abnormal shape and poor structural integrity, but we were able to repeat the process with the remainder of the tooth and remove it in its entirety. After removal, you can see that the roots of the the supernumerary 208 were shaped like a corkscrew!
After the removal of these two teeth, a temporary packing material was placed in the alveolus to protect it while it healed. In less than 4 weeks, this large hole was more than 50% healed!
