Multiple tooth and jaw fracture

34 Multiple tooth and jaw fracture




INITIAL PRESENTATION


Hesitation and anxiety about bite work, and multiple fractured teeth.



PATIENT DETAILS


A 6-year-old, intact male, German shepherd, working police dog.



CASE HISTORY


The dog was a working police dog that had started to hesitate during bite work a few months earlier. During bite work he firstly seemed worried about having to bite and then he would not hold on to the sleeve. He had been taken off training several times due to anxiety and hesitation.


His own veterinarian identified several fractured teeth on conscious examination and referred the case to us. There was no history of any previous oral or dental problems.


The handler reported that the dog was an obsessive cage biter and was certain that the teeth had been fractured for at least a year, i.e. this was not a new injury, but his bite work had been fine until a few months ago.



ORAL EXAMINATION – CONSCIOUS


An extremely well-behaved dog that allowed careful examination, which revealed the following:


1. Occlusion normal

2. Generalized gingivitis

3. Generalized tooth wear

4. Complicated crown fracture of 103, 104 and 203

5. Discoloured 102

6. Missing 405 and 308.


ORAL EXAMINATION – UNDER GENERAL ANAESTHETIC


A thorough oral and dental examination was performed, including investigating periodontal parameters. All findings were noted on the dental record sheet.


In summary, examination under general anaesthesia identified the following:


1. Generalized mild gingivitis

2. Generalized tooth wear (attrition and abrasion)

3. Complicated crown fracture (CCF) of 103 (Fig. 34.1), 104 (Fig. 34.1) and 203 (Fig. 34.2a)

4. Discoloured 102 (Fig. 34.1)

5. Uncomplicated crown fracture (UCF) of 105 and 107

6. Missing 405, 411, 308 and 311.

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Figure 34.1 Oblique lateral photograph of the rostral right upper jaw. Note the complicated crown fracture of 103 and 104, and the discoloured 102.


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Figure 34.2 Photographs and radiographs centring on 203.


(a) Oblique lateral photograph of the rostral left upper jaw. The complicated crown fracture of 203 is obvious. Note also the wear facet on the distal aspect of 204 due to cage biting.

(b) Rostrocaudal radiograph centring on 203. Note the fracture of the premaxilla level with the apex of 203.

(c) Rostrocaudal radiograph of the extraction socket of 203. The fracture line is even more obvious after extraction of 203.

(d) Oblique lateral photograph of the extraction site. The flap used to suture the socket closed will provide stabilization during healing of the jaw fracture.


FURTHER INVESTIGATIONS


Radiographs were taken of 102 (discoloured), 103 (CCF), 104 (CCF), 203 (CCF), 204 (contralateral healthy), 105 (UCF) and 107 (UCF), as well as of the 405 and 308 regions (where the teeth were missing).

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Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on Multiple tooth and jaw fracture
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