Referral & Clinical

Oral Trauma to Jaws

Jaw trauma is common in dogs and cats . Fractures to the jaws comprise 6% of all skeletal trauma surgery. New dental techniques, combined with standard surgical techniques, are often available to provide fracture repair without the need for invasive surgery.

With any jaw fracture it is absolutely essential to support the fracture site with a tape muzzle or soft Mikki muzzle as soon as possible. We frequently see cases where support has not been provided. As a result the weight of the fractured jaw pulls on the tissues and blood vessels manking subsquent healing dificult if not impossible.

Normal orthopaedic techniques are tolerated very poorly by the jaws. There are a number of reasons for this. Firstly, most pins or plates are likely to damage the tooth roots and contribute to further pain and instability. Secondly, it is much more important to provide normal dental occlusion in order to allow the mouth to shut and return to normal function than it is to align the fragment accurately. Thirdly, these problems are often see in animals that already have significant dental disease.

Inter-dental wiring combined with composite resin or dental acrylics can be used to splint extensive fractures. Additionally, cats lend themselves well to the bonding together of upper and lower canines to provide a stable environment for healing with the cat still being able to lap soft foods through the gap. Feeding tubes are usually placed for inial nutritional support but can often be removed in 2-3 days.

The radiograph below shows an ellipse round a caudal mandible fracture in Harry The Cat - see photo above. Inter-canine bonding worked very well in this case with full healing in 4 weeks.

Many dogs with periodontal disease of the teeth suffer from pathological fractures of the mandible from minimal trauma. Lack of teeth can be a challenge but occlusion as a primary objective, with rapid return to function as a close secondary objective is still necessary. Flo (French Bulldog)was kicked by a horse and fractured her right mandible. The site was open and infected. This healed well with twin cerclage wires once the compromised teeth and infected tissue was removed. The radiographs below show her before and after surgery and the photograph is of her right mandible 6 weeks following wiring.

TMJ conditions are also common in trauma cases – particularly in high rise syndrome in cats. Luxation of the condyle is easily resolved but fractures of the condyle or zygomatic process of the temporal bone can be challenging to diagnose and resolve. CT scanning provides excellent imaging in these cases