Jaw Fractures

By February 3, 2019Family Pet Veterinary Blog

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.

to learn more about fracture repair for your pet.