Mandibular fracture repair techniques in cats: a dentist’s perspective

Abstract

Practical relevance: Feline head trauma injuries are common in general practice, often resulting in mandibular fracture. An understanding of the recent advances in the field of mandibular fracture repair will facilitate evidence-based decision-making in clinical practice. Clinical challenges: Feline maxillofacial and oral anatomy brings unique challenges in comparison with dogs. It has been commonplace to adapt techniques and equipment that are better suited to other body regions or are species-inappropriate for use in feline maxillofacial surgery, and this has traditionally resulted in high morbidity. Aims: This review presents an overview of the diagnosis of, and decison-making for, maxillofacial trauma in cats, specifically with reference to the feline mandible. The challenges associated with the management of these injuries are presented. Techniques for repair that can be employed in general practice, as well as more advanced surgical options, are discussed, as well as the indications for invasive vs non-invasive management. Underutilised methods involving composite dental materials and their versatility for the repair of mandibular fractures in cats, and miniplates for caudal mandibular fractures in cats, are specifically covered, as well as other recent advances in the field, including three-dimensional printing and custom-printed implants. Evidence base: Management of feline facial fractures is an often neglected topic, with very few published studies choosing to focus on head trauma outcomes in cats. Where available, however, this review draws on the published literature, as well as the authors’ own clinical experience.

A Comparison of Clinical Outcomes in Patients of Mandibular Condyles Fractures Treated with Open Versus Close Reduction

“…Over the course of time, there has been a growing trend in the application of rigid internal fixation to address injuries in the craniomaxillofacial skeleton 15 . The advancement of enhanced materials for the purpose of stabilisation and improvement of surgical techniques has led to a significant change in perspective, wherein both surgeons and patients now embrace and depend on rigid internal fixation 9 . In the preceding investigation, out of a total of 17 participants, only 2 individuals (11.8%) were unable to attain a mouth opening measurement exceeding 40 mm.…”

“…Closed reduction has been the favored method of treatment for several decades. However, this approach necessitates different durations of maxillomandibular fixation (MMF), ranging from no fixation to a maximum of four weeks, followed by intensive physiotherapy 9 .…”

Normal variation of clinical mobility of the mandibular symphysis in cats

“…Symphyseal mobility in cats has been reported to be affected by conditions such as trauma, inflammation, tooth resorption, infection, or bone proliferation (6). In particular, maxillofacial trauma often leads to symphyseal separation, which has been shown to develop in up to 73% of trauma cases, alone or in association with other bony lesions (15)(16)(17)(30)(31)(32)(33). Considering that the symphysis may also be fused, it should also be noted that occasionally a true symphyseal fracture rather than separation may occur.…”

“…A flexible symphyseal joint may allow for better alignment of carnassial teeth and a more efficient shearing action during mastication, in cats as well as other carnivores with a unilateral masticatory pattern (5,8,(10)(11)(12)(13)(14). Different conditions and diseases such as trauma, open mouth jaw locking, severe periodontitis, neoplasia, and the presence of odontoclastic resorptive lesions affecting the mandibular rostral teeth can potentially affect symphyseal mobility and integrity, and radiographic appearance (6,(15)(16)(17)(18)(19)(20)(21)(22).…”

Osteossíntese de sínfise mandibular e tratamento endodôntico em um gato – relato de caso

“…Traumatismos na cavidade oral e estruturas associadas são comuns em felinos domésticos (NIEMIEC et al, 2020), pela topografia e projeção da mandíbula (PIPPI et al 2010), podendo representar 16% de todas as fraturas em gatos (FREEMAN;SOUTHERDEN, 2023).…”