A two-year-old female spayed Chihuahua was presented to Cornell University Hospital for Animals (CUHA) Emergency Service on referral after being attacked by a larger dog. Skull radiographs taken by the primary care veterinarian revealed a complete fracture of the right mandible. On initial physical exam the patient showed signs consistent with a mandibular fracture including mandibular instability, malocclusion and pain upon manipulation of the jaw. The patient was hospitalized over the weekend before being transferred to CUHA’s Dentistry and Oral Surgery Service for further evaluation and advanced imaging.

A Computerized Tomography (CT) scan of the head showed a complete transverse fracture of the right mandible at the level of the 1st molar, a complicated crown and root fracture of the right mandibular molar 1 and mandibular symphyseal separation with a fracture line tracking through the alveolus of the right first mandibular incisor. Intraoral radiographs showed similar findings. Imaging allowed for surgical planning including extraction of the fractured right mandibular molar, cerclage wire placement around the rostral mandible and open reduction and internal fixation of the mandibular fracture with miniplates and screws. 

A pharyngeal endotracheal tube was placed for the procedure allowing for increased access to the oral cavity. The fractured mandibular molar was extracted and cerclage wire applied around the rostral mandible for stabilization of the symphysis.  The maxilla and mandible were placed in precise occlusion and held in maxillo-mandibular fixation using sutures. An incision was made over the ventral aspect of the mandible and the fracture was exposed and reduced. A 2mm titanium locking miniplate and screws was placed to stabilize the fracture.

This seminar will discuss the clinical appearance, radiographic evaluation and principles of management of mandibular trauma and fractures.