Mandibular fracture management using
wire and intra-oral acrylic splint

Fractures of the maxilla and mandible may occur in pets from either trauma or periodontal disease. General anesthesia, a complete oral examination, and intra-oral radiographs are needed to evaluate these patients. In fact, fractures of the maxilla may require computer tomography imaging.

Each case is approached with consideration of restoring occlusion while offering adequate stabilization to allow healing. Stabilization of the mandible and maxilla can be accomplished with interdental wiring, dental acrylics, orthopedic wire, external fixation, bone plate, or muzzle.

The relationship of the fracture line relative to the tooth in the fracture must be closely evaluated.

Fractures through the root or apex require extraction for healing to occur. In some instances the tooth maybe hemi–sectioned to preserve part of the crown for stabilization.

To the left is an example of a traumatic fracture of a pet’s left mandible. The fracture was located between the lower fourth premolar and first molar. Interdental wire was placed to align the fracture and the wire served to reinforce the acrylic material.

The teeth were cleaned and polished with a non-fluoride pumice. The teeth were acid etched and dried. The dental acrylic material was placed over the teeth and wire. Care was taken not to build up the acrylic too high as to prevent contact with other teeth. To accomplish this, acrylic was placed on the lingual surface of the first molar. This prevented the upper fourth premolar from contacting the splint.

Our patients tolerate these splints well. Home care consists of oral rinses with water and chlorhexidine after each meal. Healing occurs over 4-8 weeks.

Fractures rostral to the lower first molar or upper fourth premolar are the best candidates for this technique.