mandibular symphyseal fracture repair in cat with fractured lower canine.

RE: mandibular symphyseal fracture repair in cat with fractured lower canine.

intelligenteaser — Wed, 22 Jul 2015 17:42:27 GMT

thanks

RE: mandibular symphyseal fracture repair in cat with fractured lower canine.

Evelyn Barbour-Hill — Wed, 22 Jul 2015 14:35:25 GMT

[quote user="Thomas Johnson"]

[quote user="Will McMullan"]

[quote user="Martin Atkinson"]And like Evelyn I would normally place my cerclage wire around the mandible distal to the canines over the mucosa but bury it under the skin.[/quote]

By distal to the canines do you mean rostral to the canines?

[/quote]

I've always placed the wire caudal to the canines (and I've done 3 in the last month having not done one for a couple of years!), and going back to the OP's question a missing canine shouldn't prevent placement of the wire as it normally sits in a little dip caudal to the canines, so the canines shouldn't be necessary to keep the wire in place.

[/quote]

Exactly. Not sure how you could do it rostral to the canines.

"Distal" in this context is not correct. Distal and mesial are terms used in dental jargon and refer to the position of a tooth or part of a tooth within a single arcade. Invented for human dentistry where the teeth are in Norman arches, useful for veterinary dentistry but not vital when our patients' teeth lie mostly in straightish lines with a flat bit across the top. Excuse the pomposity, I could not resist. Why haven't we got a smug smirk emoticon?

RE: mandibular symphyseal fracture repair in cat with fractured lower canine.

Thomas Johnson — Wed, 22 Jul 2015 14:26:42 GMT

[quote user="Will McMullan"]

[quote user="Martin Atkinson"]And like Evelyn I would normally place my cerclage wire around the mandible distal to the canines over the mucosa but bury it under the skin.[/quote]

By distal to the canines do you mean rostral to the canines?

[/quote]

RE: mandibular symphyseal fracture repair in cat with fractured lower canine.

Will McMullan — Wed, 22 Jul 2015 14:08:11 GMT

[quote user="Martin Atkinson"]And like Evelyn I would normally place my cerclage wire around the mandible distal to the canines over the mucosa but bury it under the skin.[/quote]

By distal to the canines do you mean rostral to the canines?

RE: mandibular symphyseal fracture repair in cat with fractured lower canine.

Martin Atkinson — Tue, 21 Jul 2015 08:58:36 GMT

If I can put my 'pennoworth in here as a dinovet non-dentist. IME there is a very good chance that the fractured tooth socket will just heal over and never cause any future problems provided you prevent infection. And like Evelyn I would normally place my cerclage wire around the mandible distal to the canines over the mucosa but bury it under the skin.

RE: mandibular symphyseal fracture repair in cat with fractured lower canine.

Evelyn Barbour-Hill — Tue, 21 Jul 2015 00:55:19 GMT

I'm tempted to say..... it depends what your 'normal way" is!

My normal way is with an encircling wire that doesn't involve any teeth, so yes, you can still do that.

There might be some micro fractures around the tooth but that won't matter if you get it stabilised nicely.

I know some people wire the lower canines together (which is mechanically unsound) and obviously you can't do that.

The main problem for you is: when are you going to remove the tooth? If you remove it now, theres a really rather good chance of boogering up the bone in the vicinity of the symphysis making accurate repair difficult or even very difficult.. So you want to leave it for now. But in the meantime, the exposed pulp is painful and soon you'll have a pulpitis which is also painful.

Now if it were me, I'd put a temporary pulp capping on the broken tooth so that I can cheerfully leave it till the jaw has healed. Then I might well do endodontics on the stump and keep it in situ. But I'm guessing all that's not available to you. Unless maybe you have a veterinary dentist within reach, who can help out?

Otherwise, in your situation, I'd regretfully just leave the broken tooth, even though it will be uncomfortable, untill the jaw was well healed, and then extract it very carefully. Some antibiotic right now, of course, and keep some analgesic going.

I hope that helps.