Sugar: Steinman Pin Repulsion


Sugar is a four year old Quarter horse with a six month history of a swelling on her left lower cheek bone (mandible) that oozed pus. Antibiotics were given during this time but they only seemed to be able to temporarily stop the drainage.

Drain Tract

Upon examination a drain tract was observed on the lower left mandible. Films were taken which also show the drain tract under the second cheek tooth or third premolar (tooth 307). The dark area under the tooth is where an apical root abscess destroyed the roots and lower tooth . The abscess formed a drain tract that went through the mandible and drained to the outside of the skin.

Steinman Pin

A nerve block was administered to the mandibular nerve and dental forceps were used to try to extract the tooth through the mouth. However the tooth was structurally weak due to the decay from the abscess and the crown crumbled away to where the forceps could not grasp the tooth. So the tooth was removed by using a Steinman pin through the drain tract and repulsing the tooth into the mouth. A film was taken to check for any fragments of the tooth left behind and none were found. Pictures of the tooth show the damage the abscess created.

This tooth was causing a lot of pain for Sugar. Now she is pain free and the drain tract and cheek have healed very quickly. With regular dental floats and exams she will have a long and productive life.