Craniomaxillofacial trauma in immature dogs–etiology, treatments, and outcomes

Abstract

Treatment of craniomaxillofacial (CMF) trauma in dogs often requires a multidisciplinary approach and a thorough understanding of the CMF anatomical structures involved. This retrospective study aimed to utilize computed tomography (CT) studies of immature dogs evaluated for CMF trauma and to describe common fracture locations, treatment modalities, and complications, as well as the fracture healing outcomes. The medical records and CT studies of 94 dogs under 1 year of age over a 13-year period were evaluated. The skeletal location of CMF fractures, as well as the severity of displacement and fragmentation of each fracture, was recorded. Case demographic data and trauma etiology were also recorded. Animal bites accounted for the majority of trauma (71.0%). The most likely bone or region to be fractured was the maxillary bones, followed by the molar region of the mandibles. Up to 37 bones or specific regions were fractured in any given patient, with an average of 8.8 ± 3.1 fractured bones or regions per dog. Rostral mandibular trauma was associated with intra-articular fractures of the temporomandibular joint (p = 0.016). Patients sustained concomitant injuries in 32% of the cases. Muzzle therapy was the main treatment performed for most dogs (53.2%), followed by soft tissue closure (47.9%) and selective dental extractions (27.6%). Healing complications were recorded in 71.6% of the dogs, with malocclusion being the most reported complication (55.2%), and associated with dentate mandibular jaw fractures (p = 0.05). The average number of complications per dog was 2.4. No statistically significant association was found between treatment modality and healing outcome. There was a positive correlation between the severity of fracture fragmentation and displacement and a negative healing outcome (all rho >0.7). Further treatment was required in 55.6% of the dogs. Additional dental extractions were performed in 77.7% of patients. Healing complications were common in the immature CMF trauma case. Thus, the need for a comprehensive assessment of the entire CMF region during the initial visit, as well as follow-up, preferably using CT or cone beam CT, is underscored.

Repair and remodeling of the mandibular head of the condylar process in four immature dogs

“…Untreated, it may lead to asymmetrical mandibular growth and the inability to open the mouth (43). A previous study on 94 immature dogs with craniomaxillofacial trauma found that 36.2% had TMJ articular surface fractures, but none developed intraarticular ankylosis, and 10.3% developed extraarticular ankylosis (44). In our case series of four dogs undergoing condylectomy and caudal mandibulectomy, no patient experienced intraarticular or extraarticular ankylosis, reinforcing the rarity of these complications following TMJ trauma demonstrated in this report.…”

Three-Dimensional Volume Rendering in Computed Tomography for Evaluation of the Temporomandibular Joint in Dogs

“…However, 3DVR images of TMJs are only briefly included when studying CT scans of different TMJ pathologies [6,[23][24][25]. Moreover, in specific works about TMJ, only lateral, rostrolateral [6,[25][26][27] and ventral images [27] of TMJ were superficially shown. No detailed studies of the medial, ventral, ventrolateral and caudoventral aspects of the TMJ and its relationship with other bone structures were found to employ 3DVR images.…”