Fractured Jaw Repair in Small Dog

This is Sugar who suffered a broken jaw due to advanced periodontal disease. She had been seen at her family vet after being involved in a dog fight.  He had sedated Sugar to fully evaluate the fracture and had extracted the very loose molar in the area. Once he realized the jaw was fractured, he referred her to Veterinary Dental Specialties and Oral Surgery for care.

On oral exam it was found that she had a fractured right mandible.  She was placed under general anesthesia and a complete oral exam was performed. This confirmed the fracture (Image 1), where the extraction site had been sutured (Image 1).

Pre-operative dental picture of the partially closed extraction site of the mandibular right first molar (409).

In addition, there was significant periodontal loss throughout the mouth (Images 2 and 3).

Intraoral dental pictures of the maxillary left premolars and right incisors demonstrating widespread periodontal loss.

Intraoral dental pictures of the maxillary left premolars and right incisors demonstrating widespread periodontal loss.

A dental radiograph was exposed of the area which confirmed the fracture at the caudal edge of the distal root of the first molar. (Image 4)  Interestingly, it was quite a longitudinal fracture, which is rare in the mandible.  Because of this large area of overlap of the pieces allowed for fixation with a single cerclage wire as opposed to anything requiring making holes in the bone.

Pre-operative dental radiograph of the mandibular right first molar area showing the empty alveolus (blue lines, periodontal loss (yellow arrows), and longitudinal fracture line (red arrows).

The cerclage wire was placed and the post-op radiograph revealed excellent reduction and fixation. (Image 5)

Post-operative dental radiograph of the cerclage wire showing excellent reduction and apposition.

Recovery was uneventful, and the patient went home and healed with no complications.

7 weeks later, Sugar was represented for wire removal.  She had healed very well and outwardly was normal. She was placed under general anesthesia and a complete oral exam and cleaning performed along with recheck dental radiographs. The dental radiographs confirmed excellent healing, with some apparent bony reaction to the wire.  The wire was removed and the patient discharged to normal activity.

Recheck dental radiograph revealing excellent healing with some ventral bony reaction (red arrow).

Recheck dental radiograph revealing excellent healing.

This case is one example of the excellent results that can be achieved with minimally invasive surgical techniques and a good example of why oral surgery cases are best managed by a veterinary dentist, like the ones on vetdentists.com.