Modified Labial Button Technique for Maintaining Occlusion After Caudal Mandibular Fracture/Temporomandibular Joint Luxation in the Cat

Abstract

Maxillofacial trauma in cats often results in mandibular symphyseal separation in addition to injuries of the caudal mandible and/or temporomandibular joint (TMJ). Caudal mandibular and TMJ injuries are difficult to access and stabilize using direct fixation techniques, thus indirect fixation is commonly employed. The immediate goals of fixation include stabilization for return to normal occlusion and function with the long-term objective of bony union. Indirect fixation techniques commonly used for stabilization of caudal mandibular and temporomandibular joint fracture/luxation include maxillomandibular fixation (MMF) with acrylic composite, interarcade wiring, tape muzzles, and the bignathic encircling and retaining device (BEARD) technique. This article introduces a modification of the previously described "labial reverse suture through buttons" technique used by Koestlin et al and the "labial locking with buttons" technique by Rocha et al. In cases with minimally displaced subcondylar and pericondylar fractures without joint involvement, the labial button technique can provide sufficient stabilization for healing. Advantages of the modified labial button technique include ease of application, noninvasive nature, and use of readily available materials. The construct can remain in place for a variable of amount of time, depending on its intended purpose. It serves as an alternative to the tape muzzle, which is rarely tolerated by cats. This technique can be easily used in conjunction with other maxillomandibular repairs, such as cerclage wire fixation of mandibular symphyseal separation. The purpose of this article is to demonstrate a modified labial button technique for maintaining occlusion of feline caudal mandibular fractures/TMJ luxations in a step-by-step fashion.

Etiology, Clinical Presentation, and Outcome of Mandibular Fractures in Immature Dogs Treated with non-Invasive or Minimally Invasive Techniques

“…[6][7][8] Stabilization of mandibular fractures can be achieved with non-invasive and minimally invasive techniques (muzzling, sutures through labial buttons, interarch splinting, or interdental wiring and intraoral splinting) or invasive techniques (intraosseous wiring, external skeletal fixation, and bone plating). 5,[7][8][9][10][11][12] Stabilization techniques in immature dogs are limited because of the presence of dental germs in the jaw bone, the absence of sufficiently erupted permanent teeth, the softness of the bone, and the potential for interference with dental and jaw development. 9,[13][14][15] Complications derived from mandibular fractures include mal-union or non-union, malocclusion, infection, and periodontal and/or endodontic disease of teeth in or near the jaw fracture line.…”

Kraniomaxillofaziales Trauma bei der Katze

“…Bei dem Lippenverschluss mit Knöpfen ( Abb. 11 ) handelt es sich um 2 Knöpfe seitlich auf dem Nasenrücken, die mit nicht-resorbierbarem Nahtmaterial subkutan mit einem Knopf unter der Mandibula verbunden werden 14 .…”

Feline skull injuries: Treatment goals and recommended approaches

“…In this situation a maxillary–mandibular ESF, cerclage wire, dental bonding, labial reverse suture through buttons or a bi-gnathic encircling and retaining device (BEARD technique) is recommended. 2,3,5,6,11,13,24 Techniques more commonly used for uni- or bilateral caudal mandibular or TMJ injuries are described in the box above.…”