Wire Reinforced Acrylic Splint for Jaw Fracture Repair in a Dog with Edentulous Caudal Mandible.
by Brett on Feb.07, 2010, under Veterinary Dental Cases
This is the dog with left mandibular fracture previously repaired with titanium mesh. Three days after the repair the other jaw suffered a pathologic fracture. It was also severely compromised from chronic periodontal disease. Repair was accomplished with a combination of wire, orthodontic chain, composite buttons and acrylic. Wire was passed under the body of the mandible and through the mucosa then tied and wires bent. Two wires on either side of the fractures on both the right and left mandible. Composite buttons were made using a silicone mold on the mandibular canines. Orthodontic massel chain was then attached to all wires and around the canine buttons to form a horseshoe orientation. Acrylic was added in increments while fracture ends were approximated. This relatively non-invasive approach avoids complications with plates commonly associated with pathologic mandibular fractures where bone density is severely compromised. Four days postop the patient is eating well and pain is well controlled.
Brett Beckman, DVM, FAVD, DAVDC, DAAPM
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Mandibulectomy in a Cat
by Brett on Feb.06, 2010, under Veterinary Dental Cases
This cat presented with profound disfigurement from a rostral mandibular mass. Salvage excision and euthanasia were the options provided. The mass was excised and postoperative and next day images shown. This cat has full tongue function despite taking the mandible back to the level of the first molars at the base of the tongue. He is learning how to eat and doing quite well 3 days postop.
Brett Beckman, DVM, FAVD, DAVDC, DAAPM
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Cat Mandibulectomy PreopMandibulectomy in a Cat
Gingival Hyperplasia, Ossifying Epulis and a Jaw Cyst in a Boxer Dog
by Brett on Jan.31, 2010, under Veterinary Dental Cases
This 4 ½ year old boxer was referred for excision of gingival hyperplasia. Both mandibular canines had gingival enlargement as did the maxillary premolars. Treatment pending biopsy was excision with a scalpel and contouring with a #12 fluted finishing bur. Biospy revealed an ossifying epulides on the right canine definitive therapy would be removing the mass and extracting the canine. Closure will be a problem due to the involvement of the entire attached gingiva adjacent to the canine.
Unfortunately the left mandible has a large cyst forming. See caption below for details.
Intially this ossifying epulis was treated with bulk excision with a blade and contour with a #12 fluted bur pending histopath.
Immediate postop. The bur decreases hemorrhage to a minimum.
The left mandible had similare changes
Postoperative view
A large cyst is present in the left mandible. This will eventually destroy the jaw if not treated. Note the supernumery first premolars with resorption on them and the mesial root of the second premolar.
Jaw Fracture Repair in a Dog Utilizing Titanium Mesh
by Brett on Jan.30, 2010, under Veterinary Dental Cases
This dog had a right mandibular fracture secondary to chronic periodontal disease. The jaw fractured spontaneously. It was repaired utilizing a titanium mesh material and an osteoconductive bone putty. http://www.securos.com/downloads/SI%20VelosityPuttyBrochure5.pdf
The fracture line can be seen overshadowed by the first molar mesial root. The site of the mesial root of the 4th premolar was near fracture. The veterinarian did a great job avoiding fracture when extracting these teeth.
Post extraction the fracture line becomes visible. This was a chronic fracture that had the body had attempted to heal. Fibrous tissue was present around the site and provided minor stability.
View of the right mandible after fitting the titanium mesh. The ventral mandible had considerable fibrous tissue present. Disrupting this would have created more instability. The plate was placed over the fibrous tissue. This gives the appearance on the final radiography that the plate doesn't conform well to the mandible. On the contrary this material is very compliant and fits tightly to the bone with minimal anchorage.
The vestibular aspect of the right mandible, screw placement
You can appreciate the delicate structure in relation to my fingers. The plate placed was about 5 times the size of this peice that was clipped off of the portion utilized in this case.
The final repair preclosure
Postop radiograph showing screw placement. Accomodation of the mesh was excellent. Consequently a lingual screw was not needed
Sliding Pedicle Flap for Repair of V-shaped Gingival Recession in a Dog
by Brett on Jan.27, 2010, under Veterinary Dental Cases
This is a (very sweet) middle aged miniature schnauzer with v-shaped gingival defects. Surgery is required to regenerate attachment and slow or prevent further compromise of the periodontal tissue associated with this canine (both were affected) and the 4th premolar. Rostral and caudal sliding pedicle flaps were utilized to repair the canine defect. Donor tissue was taken rostral for the 4th premolar.
For a link to the article describing this procedure Step By Step from the Journal of Veterinary Dentistry please follow this link:
http://veterinarydentistry.net/blog/wp-content/uploads/2010/01/Sliding-Pedicle1.pdf
