The Cat Mandible (II): Manipulation of the Jaw, with a New Prosthesis Proposal, to Avoid Iatrogenic Complications

Abstract

The cat mandible is relatively small, and its manipulation implies the use of fixing methods and different repair techniques according to its small size to keep its biomechanical functionality intact. Attempts to fix dislocations of the temporomandibular joint should be primarily performed by non-invasive techniques (repositioning the bones and immobilisation), although when this is not possible, a surgical method should be used. Regarding mandibular fractures, these are usually concurrent with other traumatic injuries that, if serious, should be treated first. A non-invasive approach should also first be considered to fix mandibular fractures. When this is impractical, internal rigid fixation methods, such as osteosynthesis plates, should be used. However, it should be taken into account that in the cat mandible, dental roots and the mandibular canal structures occupy most of the volume of the mandibular body, a fact that makes it challenging to apply a plate with fixed screw positions without invading dental roots or neurovascular structures. Therefore, we propose a new prosthesis design that will provide acceptable rigid biomechanical stabilisation, but avoid dental root and neurovascular damage, when fixing simple mandibular body fractures. Future trends will include the use of better diagnostic imaging techniques, a patient-specific prosthesis design and the use of more biocompatible materials to minimise the patient’s recovery period and suffering

Type and impact of clinical incidents identified by a voluntary reporting system covering 130 small animal practices in mainland Europe

“…Knowing the types, severity and location of treatment‐related incidents can help identify areas for improvement and may inform research to explore the causality of these events. There are likely multiple factors contributing to the reasons for treatment‐related incidents, but one factor could be the increase in new healthcare technologies, requiring advanced equipment and new technical skills 32 . Fifty‐six percent of reported incidents were due to incompletely or inadequately performed treatments.…”

“…There are likely multiple factors contributing to the reasons for treatmentrelated incidents, but one factor could be the increase in new healthcare technologies, requiring advanced equipment and new technical skills. 32 Fifty-six percent of reported incidents were due to incompletely or inadequately performed treatments. To reduce risk of recurrence, actions such as making practice teams aware of different types of incidents and frequency, alongside other interventions such as checklists and further training may be helpful.…”

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

“…Recent advances include the manufacture of feline-specific pre-printed titanium implants in a variety of sizes that are contoured to the feline caudal mandible for repair of fractures of the ramus and caudal mandibular body (Figure 14), 38 and a conceptual model of a mandibular prosthesis for use in repairing mandibular body fractures. 39 it is likely that techniques at the forefront of human maxillofacial fracture repair will continue to gradually filter down into veterinary maxillofacial surgery. it may not be long before we are using 3d planning for all complex head trauma cases and producing the high-performance titanium alloy or resorbable composite patientspecific osteosynthesis plates that are becoming the standard of care in human surgery.…”

“…Recent advances include the manufacture of feline-specific pre-printed titanium implants in a variety of sizes that are contoured to the feline caudal mandible for repair of fractures of the ramus and caudal mandibular body ( Figure 14 ), 38 and a conceptual model of a mandibular prosthesis for use in repairing mandibular body frac-tures. 39 …”

Advances in Animal Anatomy

“…Consequently, in order to prevent this complication, the use of spring-loaded mouth gags to keep their mouth wide open should be avoided in cats. Complementary to this information, Part II, also by Lombardero et al [ 7 ], described different mandibular fractures and temporomandibular joint dislocations and how they could be solved when possible non-invasive techniques should be considered first. Otherwise, it was recommended that simple jaw fractures should be used to repair caudal to rostral, preferably, using a ventral approach.…”