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15 de mayo de 2023

Maxillary and Mandibular Fractures

In dogs and cats, the bony structure of the mouth is made up of two bones: the upper one, or 'maxilla', and the lower one, or 'mandible'. Furthermore, a great force is required for trauma to cause a fracture of the mandibular or maxillary bone.

But what are these fractures and how do they occur? Fractures can vary in severity, ranging from incomplete (fissures) to severe fractures with multiple bone fragments. Similarly, these maxillofacial traumas are very common and originate from fights with other animals, falls from heights, and traffic accidents. Likewise, small breed dogs with advanced periodontitis are more prone to pathological fractures due to bone loss.

Influence of Periodontitis
Small breed dogs have larger teeth compared to their skull size than larger breeds. Therefore, the horizontal and vertical bone loss that occurs in chronic periodontitis poses a high risk of mandibular fracture for these breeds.

This fracture of the bone, weakened by periodontitis, can occur during dental extractions or in such common situations as getting off the sofa or playing. Currently, periodontal disease is the most common disease in dogs, affecting more than 80% of those over 2 years old.

Complications
The complications associated with the repair of these fractures using conventional screws and osteosynthesis plates lie in the special characteristics of these bones. The teeth occupy most of the bone in the mandible, and the mandibular canal houses vessels and nerves that should not be damaged.

What Diagnosis Do We Make at IVeM?

  • Combination of intraoral radiography and computed tomography (CT), as it more easily detects the multiple fractures that often occur in maxillofacial trauma and are often not evident on examination.
  • Conventional skull radiographs are of little use due to the superimposition of structures.

Warning Symptoms
Among the symptoms that indicate a fracture are difficulty eating, opening or closing the mouth, swelling or pain around the jaw, missing teeth, or dental fractures. In older animals that have suffered bone weakening, fractures occur more easily.

If your dog or cat has suffered a serious accident or trauma, it is important that you go to your trusted veterinary clinic for an examination. At IVeM, we are a center specialized in the prevention and treatment of oral cavity pathologies, and we have a qualified and constantly trained human team. Professionals with a responsibility towards each of their patients will evaluate your case and will know how to recommend the best treatment. We will be happy to welcome you if you decide to trust us.

Solutions

  • Intraoral fixation using acrylic splint reinforced with cerclage wire: Intraoral fixation methods are minimally invasive and promote rapid patient recovery. In addition, they eliminate the complications associated with the use of plates and screws, as well as external fixators.
  • Maxillomandibular fixation: Maintains normal occlusion with the mouth semi-open so that the animal can lick a liquid diet. Placement of an esophagostomy tube is recommended to administer medication and ensure adequate food intake.
  • Custom adhesive tape muzzle: It is an economical and effective method for the stabilization of maxillofacial trauma. It is used as initial stabilization until surgery can be performed or the patient can be referred to a specialist. The goal is to provide fracture stabilization and keep the mouth closed to maintain the interdigitation of the teeth. We must allow some slack so that the animal can stick out its tongue and drink water or lick a liquid diet.

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