A 10-year-old mixed/breed mare was presented to the Veterinary Hospital of Uniderp/Anhanguera, in Campo Grande (MS), with signs of respiratory distress. The owner reported that the problem had been present for > 1-year. The horse was cachectic, anemic, and dyspneic with breathing limited to the right nostril. The horse also had halitosis and a bilateral mucopurulent nasal discharge (Fig. 1) Oral examination revealed a complicated crown fracture of the left maxillary fourth premolar tooth (208). Fragments of the tooth crown were displaced into the alveolus of 208. An oronasal fistula was present adjacent to the fractured 208 (Fig. 2). The sagittally oriented crown fragments of the 208 were removed. A large amount of food and debris was observed in the left maxillary sinus. Given the severity of the case, the recommendation of euthanasia was accepted by the owner.
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