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
