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A study of the forces generated during equine cheek tooth extraction
Tom N A McGinley1, Richard J M Reardon2
1The Liphook Equine Hospital, Hampshire, UK.
Background:
Significant force is often applied when elevating equine teeth from the alveolus during extraction. No previous studies have investigated these forces.
Objectives:
To develop a method to allow measurement of elevation forces (EF) applied during extraction, and to record forces during extraction of cheek teeth in both cadaver specimens and clinical cases, evaluating factors that might affect this and comparing differences between tooth positions and horse signalments.
Study Design:
In vitro experimental study of cadavers and observational study of a convenience sample of clinical cases.
Methods:
Strain gauges were installed on extraction forceps and calibrated to give a value of force in Newtons. Cheek teeth were extracted from cadaver specimens. Two groups allowed comparison between tooth oscillation time (5 min vs. 10 min) and partial coronectomy versus no coronectomy. Measurements were also made during clinical cases presenting for cheek tooth extraction.
Results:
Oscillation group: Elevation forces (EF) ranged from 406.7 to 4640.4 N. The median EF was not significantly (p = 0.8, V = 187) higher in the 5-min oscillation time group (1369.75) than the 10-min oscillation time group (1158.95). Coronectomy group: EF ranged from 332.5 to 4015 N. The median extraction forces were significantly (p = 0.03) lower in the teeth that developed root fractures (947.6 N) than in the teeth that did not (1584.4 N). Clinical cases group: Elevation forces ranged between 564.3 and 2851.8 N and were significantly higher (p = 0.02, W = 114) in Maxillary (median = 1341 N) than Mandibular (median = 870 N) teeth extractions.
Main Limitations:
Low numbers reduced statistical power. Postmortem changes presented difficulties for ex vivo extractions, reducing validity. Conversion of input force to elevatory force and variations in fulcrum position potentially affected the accuracy of values recorded.
Conclusions:
High elevation forces (up to 4640.4 N in cadavers and 2851.8 N in live horses) were recorded. Elevation forces were observed to vary with tooth position, horse age, and with preparation technique.
