Jaw Fractures

As described in a recent post, dental conditions are often hidden and painful. The following posts are going to help describe conditions that pets can get as well as treatment. Many people I talk with are surprised how we can help pets with dental conditions and save teeth whenever possible.

As stated above, oral trauma should be corrected through non-invasive methods to save teeth whenever possible. Most training programs for boarded veterinary surgeons do not teach wiring and acrylic methods of correcting jaw fractures as seen below:

It is necessary to watch were the teeth contact and prevent the acrylic from contacting the gum tissues.

Wires may be used adjunctively to help in other areas of the mouth:

I urge extreme caution with fracture repairs in many general practices. Far too frequently, fracture repairs fail due to gum and/or bone infection that was present prior to fracture or occurred secondarily to improper technique.

Repairs of the jaw by a veterinary dentist allow for follow up root canal therapy when indicated. Sometimes parts of teeth can be removed while others saved (hemisection). In all cases, keeping the structural teeth (canines and carnassials) when possible is best for the patient.

Cats are more likely to fracture the front and back parts of the jaw:

Studies have shown 1.6 to 2 times as likely to find additional injuries with 1mm or less CT slice images for cases of trauma. 3D imaging is needed for all fracture patients. TMJ imaging is performed as part of this scan. Just because a facility has CT imaging, it does not mean the detail is adequate for accurate diagnosis and treatment. Please ensure micro CT imaging is available. The imaging available in our facility is 3D cone beam computed tomography containing soft tissue as well as bone algorithms with true data instead of interpreted data. The detail is as thin as 0.09mm and uses less radiation. Most traditional CT units use about twice as much radiation and have typical slice thicknesses of 4-6mm = 20+ times less detailed.

Be cautious of symphyseal separation and normal laxity in a cat. This is one possible ‘fracture’ that may truly not be. Here is a video of normal wide symphyseal movement in a cat. Intraoral radiographs or 3D imaging need to be used to help check for the need for repair. How the mouth closes, patient history, and concurrent disease are also use to help guide treatment decisions.

Contact us to learn more about fracture repair for your pet.