Five case studies- Case 1

Here are five of many cases I’ve seen as a dental specialist. All but the first one—a mandibular canine extraction attempt that resulted in a rostral mandibular fracture—failed to refer at the time of the mishap.

Case 1: Rostral mandibular fracture
Performing surgical extractions in dogs and cats require advanced training that includes attending lectures and labs led by board-certified veterinary dentists. Initial instruction should be followed by extensive practice on cadavers until your speed and competency are consistent. During training in dogs, the mandibular first molar and maxillary fourth premolar extractions should routinely take less than 25 minutes each to complete before you perform these procedures on a live patient. It’s crucially important to achieve this level of competency with cadavers first.

Mandibular canine teeth are particularly challenging because of the density of cortical bone and the inability to extend bone removal to the apical extent of the tooth. Figure 1A demonstrates a rostral mandibular fracture secondary to an attempt to extract a partially erupted canine tooth. The referral was correctly sought at the time of fracture.

Figure 1B A splint made of composite buttons, Masel chain and acrylic (Figure 1B) stabilized the fracture in correct occlusion (Figure 1C, see next page), and healing progressed without incident. The splint was removed after radiographic confirmation of adequate callous formation in four to six weeks. The canine teeth did not require extraction and were treated with apically positioned flaps. Figure 1C