Depending on the fracture, the patient may require bone plating for appropriate healing. Bone plating is tricky because the screws that hold the plate to the bone have to be placed in such a way as to not traumatize the teeth or the important neurovascular structures.
The complexity of repairing a dog or cat jaw fracture requires a veterinary dental specialist with a high level of experience and a high degree of understanding of the anatomy of the pet’s mouth in order to have the best possible outcome for pet with a broken jaw.
Orofacial trauma can result from a variety of mishaps, such as motor vehicle accident, fall from a height, kicking injury or bite wounds. Initial assessment of orofacial injuries should be done gently and preferably under sedation, proceeding from least invasive to most invasive. Evaluation should focus on asymmetry, swelling, discharge and injuries to adjacent structures.
Intraoral radiography is essential for accurate and complete evaluation of oral fractures, especially in relation to the teeth, important nerves, important blood supply, and the intricate bone of the mandibles and the maxilla. Occlusion, tooth mobility, tooth fracture, TMJ function and soft tissue defects/injuries must all be assessed. CT scanning is becoming almost an essential requirement for the complete assessment or all oral fractures and head trauma in general.
The main objectives in the repair of oral fractures are the maintenance of proper occlusion, the return to full function of the jaws, and avoidance of damage to important underlying anatomical structures. For this reason and because there are so many sensitive and vital structures in and around the mouth, minimally invasive repair techniques are preferred whenever possible. With the above objectives in mind and in order to have the best possible outcome for pet with a broken jaw, the complexity of repairing a dog or cat jaw fracture requires a veterinary dental specialist with a high level of experience and a high degree of understanding of the anatomy of the pet’s oral and head structures. In many cases, over aggressive repair techniques such as plating, screws and pins are detrimental and not necessary. In most oral fracture situations, interdental wiring techniques in combination with acrylic or composite splinting actually represent less invasive and more effective means of repairing oral fractures. These techniques are not only more conservative, they are less expensive and involve less patient morbidity. Occasionally circumstances involving the fracture type or the patient’s general health will indicate that more esoteric or more invasive fracture repair techniques are needed. The veterinary dentist/oral surgeon are among the most knowledgeable specialists for fracture evaluation and determining the most effective, least invasive and cost effective treatment options are available.
Post-operatively, the patient is fed a softened diet and is not permitted to have chew toys while the appliance is in the mouth. Antibiotics are frequently indicated to prevent infectious complications in the healing process. Often the use of an Elizabethan collar is appropriate to prevent self trauma and loosening of the splint. The fracture repair materials are left in place for about four to six weeks, until a bony union has occurred. Under general anesthesia, healing is verified with intraoral radiographs. If stability exists and there is radiographic evidence of bony healing, the splint is carefully removed. The teeth are thoroughly scaled and polished to eliminate plaque build-up from the healing phase.