Feline mandibular canine extraction

RE: Feline mandibular canine extraction

Evelyn Barbour-Hill — Tue, 15 Feb 2022 17:09:11 GMT

[quote userid="4108" url="~/001/veterinary-clinical/small-animal/dentistry/f/discussions/30186/feline-mandibular-canine-extraction/235825#235825"]All I can say is that the patient didn't seem to be very appreciative on recovery[/quote]

C'est la vie...

RE: Feline mandibular canine extraction

a.bardell — Tue, 15 Feb 2022 14:16:06 GMT

Just an update on how things went if anyone is interested.

Day one was a no go as said patient broke out of cat box and savaged owner.

Finally got to surgery but turned into spawn of Satan in newly reinforced basket, funnily enough all my nurses were suddenly extremely busy at this point!

Eventually managed to triple through door of cat box.

Dental exam was then the easy part. Only issue was with tooth 304 which was broken at tip and had a visible crack down the length of it. I decided it might be safer to remove surgically in case it shattered so raised a flap and got it out all root intact quite easily.

I think not twisting the luxators was probably what helped.

Anyway thank you for all your support. I'll try to stop worrying so much in future.

All I can say is that the patient didn't seem to be very appreciative on recovery

RE: Feline mandibular canine extraction

Evelyn Barbour-Hill — Fri, 11 Feb 2022 17:46:17 GMT

Your precaution against breaking the jaw, after sensitivity and visualisation of anatomy, is firmly holding the mandible with your other hand.

RE: Feline mandibular canine extraction

a.bardell — Fri, 11 Feb 2022 14:01:39 GMT

Thanks for all your replies. I think I'm probably just overthinking things, all I can remember is when I was a new grad another vet in the practice fractured a cats jaw removing such a tooth and it put the fear of God into me!

Stupid really as I'm perfectly happy raising a flap etc in dogs. Also if the worst happens and the symphysis does go I'm perfectly capable of repairing it.

I will take your advice Evelyn and just be patient and not twist my luxators and will make sure they've been sharpened before I start.

I'll let you know how I get on.

RE: Feline mandibular canine extraction

Evelyn Barbour-Hill — Thu, 10 Feb 2022 20:37:25 GMT

Alexa, which bit of the extraction gives you trouble? I wonder if those you have found difficult have been part ankylosed.

If there's ankylosis there's no point attempting to extract, you have to remove the tooth by other surgical means. So you do want to radiograph.

I've no special tips I'm afraid. You need good quality luxators and they must be sharp. The other thing you need is patience. The luxators in width must approximately fit the tooth width, so you'll be using at least two. Maybe 2mm for the mesial and distal aspects, 3mm for for labial and lingual. (Sorry, I think 1mm would be much too small.) Work them down, going a bit from side to side to cut the ligament but not twisting. Angled ones may help with mesial and distal but these aspects can be done with straight instruments. Work at each aspect in rotation. When you think it may be giving a bit you can take suitable small forceps and try a very gentle twist. Hold the mandible very firmly with your free hand during all this. The second or third time you try the forceps, you may find just a little "give". Now you can try twist-and-hold just a little bit harder. You don't want to separate the symphysis! If you get a bit of give, you can carry on doing this, though you will probably do best to do a bit of luxator work alternately with the forceps. I cannot teach forceps work in words, it is a skill that has to be learned by experience.

If the tooth remains rock solid, you need to raise a flap and remove bone. Personally I'd suggest removing bone dorsally (i.e. distally) rather than buccally – consider the anatomy and where the root lies in the bone.

RE: Feline mandibular canine extraction

Beats — Thu, 10 Feb 2022 13:36:50 GMT

I tend to use a few 20G 1inch (yellow) needles to go round the tooth and cut attachement - bevel pointing away from tooth. Not sure if this is advisable or not, but works for me. Then 1mm dental luxator perhaps.

RE: Feline mandibular canine extraction

Norman Johnston — Thu, 10 Feb 2022 13:16:56 GMT

I agree with Bob. Sometimes quite easy with careful luxation. Must take rads though. If there is root resorption you need to know first. If you’re getting nowhere with lyxation consider a wide flap and buccal bone removal to facilitate

RE: Feline mandibular canine extraction

Bob Russell — Thu, 10 Feb 2022 11:57:47 GMT

These are not always that difficult to remove especially if there is long term infection. I am sure it will not meet with approval but gentle use of very sharp instruments is often what is required.

X-rays first!