Sessions

Extraction of diseased teeth is a common procedure in equine dentistry, and appropriate alveolar management is essential for healing. The increasing application of regenerative medicine has also contributed to the development of surgical techniques. The autologous platelet-rich fibrin scaffold used in our study supports tissue regeneration, angiogenesis, and reparative processes due to its biological composition.

The aim of this study was to develop, describe, and evaluate a novel method for alveolar management following extraction that has not previously been applied in equine oral surgery. We hypothesised that the method would promote alveolar healing, reduce the incidence of complications, and decrease the frequency of postoperative veterinary interventions.

Molar extractions were performed in standing, sedated horses under local anaesthesia. Following extraction, the depth of the alveolus was filled with an autologous fibrin-rich biological scaffold prepared from the horse’s own blood. The scaffold was protected and maintained in situ using a two-component silicone packing. The packing was secured by appropriately sized and shaped Steinmann pins fitted over the crowns of the adjacent teeth, forming a temporary bridge covering the alveolus. The timing of bridge removal was determined according to the horse’s age and the type of dental issue. Removal was performed either at the clinic or, in most cases, by the referring veterinarian at the horse’s premises. Healing and postoperative complications were assessed by telephone follow-up with referring veterinarians and owners.

A total of 173 horses and 190 molars from the clinical caseload of the Department and Clinic of Equine Medicine were included in the study. The mean age of the horses was 12.06 ± 6.29 years. The technique was successfully applied to teeth 06–11 according to the Triadan system, in both the maxillary and mandibular arcades. Tooth 109 was extracted most frequently, (21,13%). Complications affecting alveolar healing occurred in 4 cases (2%). Complications associated with the temporary alveolar bridge, including loosening, occurred in 4 cases (2%). Overall, complications were recorded in 17 cases (8%).

Particular attention was paid to the stability and reliability of the Steinmann pins used to secure the silicone packing. Our results indicate that correctly positioned pins became loose or dislodged in only 2% of cases. Based on our clinical observations, dislodged pins were not swallowed by the horses; rather, we assume that the exposed metal component was expelled from the oral cavity.

Based on our clinical experience, the described alveolar management technique offers several advantages. In uncomplicated cases, veterinary postoperative intervention was only required for bridge removal, reducing the workload and costs associated with postoperative care. Furthermore the platelet-rich fibrin scaffold may contribute to healing of the deeper portion of the alveolus.