This dog came to see us for what was thought to have possibly been a broken tooth. In this case, the dog was aggressive (in conjunction to being in severe pain) and did not allow for a non-sedated oral exam, even with the owner trying to hold the lip up. Under sedation, it was found that there were 2 upper incisors that were hanging on by the gums with no actual attachment to the jaw (teeth were then removed) and that her maxillary bone (upper jaw bone) was fractured and was able to be moved easily with any pressure. The hard palate (the firm part of the roof of your mouth) of the left side was also torn away from the teeth. The only way to stabilize the fracture properly was to produce wire stabilization, like braces. In this case, the only way to do so was to drill behind each canine tooth and run a surgical steel wire through and around the canines and incisors allowing strong stabilization.
The photos below are after 5 weeks of intraosseous wire stabilization and Antibiotics to prevent bone infection from exposure to the environment and wire placement. At the time of removal, there was no movement of the maxilla occurring with gentle force.
Below is the X-ray that was taken prior to wire removal to monitor bone healing, 5 weeks post initial injury and wire placement. You can see the wire (yellow arrows) that was drilled into the bone (behind the canine teeth) that runs around the front of the affected teeth and bone (like braces in humans). Red Arrow: the front part of the maxilla is not completely healed and stabilized, but the Neon green arrow shows new bone growth with the hard palate, allowing for stabilization of bone.
(Before intubation with endotracheal tube: Yellow arrow – absorbable suture to hold gums and lips together where it was torn apart; Blue arrow – steel wire for jaw stabilization (bone was showing originally in this area)
(Below is another view once intubated with an endotracheal tube. The yellow arrows point to the stabilization wire once cut on the hard palate (most left) and untwisted in the front of the arcade (most right) and where it runs around the canine (slightly covered by gingiva). This is just prior to the wire being removed manually.
In this case, she likely got her front teeth caught in a fence or area she tried to pull away and fractured her teeth and maxilla. She’s doing great now and eating without any movement of bone or any pain!! YAY!