Apicectomy and retrograde endodontic treatment for an unerupted mandibular cheek tooth

Summary Apicectomy combined with retrograde endodontic therapy is well documented in human and small animal dentistry, but its application in horses remains limited. This report describes the technique in a 2‐year‐old Warmblood mare with an unerupted, infected mandibular cheek tooth (307) that could not be accessed orally. Clinical examination revealed a painful mandibular swelling and radiography demonstrated mild osteitis and a suspected fistula at the mesial root. Under standing sedation, transcortical trephination was performed to access the apex of tooth 307, followed by apicectomy, pulp removal, canal debridement and a layered retrograde restoration comprising a calcium hydroxide‐containing elastic cement, a dual‐curing zirconium oxide‐reinforced core build‐up composite and a moisture‐tolerant resin cement as apical seal. The postoperative course was uneventful. Outcome was assessed by clinical examination and conventional radiography only, without advanced imaging or histological confirmation of periapical healing. At 8 and 24 months, radiographs showed healing at the apicectomy site and age‐appropriate dental development. The mare remained free of clinical signs. Apicectomy with retrograde endodontic therapy is feasible as a tooth‐preserving option in young horses with unerupted, infected cheek teeth when conventional extraction or orthograde treatment is not possible.