This week, we present a challenging case involving a patient who presented with a facial injury and fractured upper canine that had occurred 1 week prior to presentation. This patient was seen by an urgent care and was referred to us due to a possible jaw fracture.
- Urgent Care Findings:
- Fractured 104 and possible misalignment of the mandible.
- Physical Exam:
- Dr. Ulbricht noted a possible left TMJ luxation. Maxillary and mandibular 4th premolar and 1st molar were traumatically occluding, resulting in an open bite.
- Other findings included:
- Missing 104 with retained root and fractured 204.
- Feline resorptive lesions.
- Moderate dental calculus with grade 2 gingivitis.
| You can see a deviation of the lower canines to the left side of the picture pre-procedure. |
| Treatment Plan |
Based on the comprehensive exam, a treatment plan was developed to address both the possible TMJ luxation and resorptive lesions. The chosen treatment modality involved:
- Consult with Anesthesiologist: Each patient has an individualized anesthetic plan created by a Board-Certified Veterinary Anesthesiologist.
- Professional Cleaning: To remove tartar buildup and staining.
- Cone Beam CT and Full Mouth Radiographs: For this case, the Cone Beam CT was used to visualize TMJ joints on both sides to get a clearer picture on the amount of displacement.
- Tooth Extraction: Crown amputation with intentional root retention on teeth with resorptive lesions. The retained root on 104 was also extracted.
- Reduce Left TMJ Luxation
| Diagnostic Imaging Findings |
Pre-Treatment CT Post-Treatment CT
| Diagnosis |
- Left temporal mandibular joint (TMJ) luxation.
- Complicated crown fractures of #104 and 204.
- Uncomplicated crown fracture of #108
- Feline resorptive lesions on #107, 207, 304, and 404.
- Periodontal disease stage 2 (<25% attachment loss).
| Results |
The patient recovered smoothly and comfortably from anesthesia. The owner reported the patient was comfortable after discharge. The outcome of the treatment was successful based on the most recent recheck. We will continue to monitor the jaw alignment to make sure that it stays in the proper location. The sutures that were placed during extractions should dissolve within 4-6 weeks. We will address the remaining possible extractions once the jaw is healed.
| Key Takeaways |
- Comprehensive Diagnosis: Thorough assessment with advanced imaging is crucial for identifying all client concerns and underlying issues.
- Tailored Treatment: A personalized treatment plan ensures optimal results.
- Interdisciplinary Approach: Collaboration with anesthesiologists is vital for achieving superior anesthetic outcomes.
If your pet has experienced facial or dental trauma, contact our team for a comprehensive evaluation and specialized treatment.
Photo by Keanu K on Unsplash used with permission under the Creative Commons license for commercial use 09/16/2026