The bite is the template: jaw fractures in dogs at the World Veterinary Orthopaedic Congress

At the 7th World Veterinary Orthopaedic Congress in Rome I gave two lectures to an audience of orthopaedic surgeons, including ACVS and ECVS Diplomates and Residents. The question: what makes jaw fracture repair different from classical fracture surgery – and why does it need three-dimensional imaging?

Lecture 1: Injury patterns and traumatic jaw fracture repair in dogs

In orthopaedics the rule is: restore axis, length and rotation, and the bone will heal. In the jaw that is not enough. The mandible and maxilla are the only bones whose reduction is dictated by an external partner – the occlusion with the opposing jaw. A malreduction of less than a millimetre, irrelevant in a femur, can drive the mandibular canine into the hard palate. A jaw that has healed in malocclusion is therefore not a partial success but a failure.

This leads to three principles I presented in Rome:

1. Reduce to the bite, not to the fracture gap. The occlusion must remain checkable throughout surgery, for example with transmylohyoid intubation.
2. As minimally invasive as possible. Most mandibular fractures involve the tooth-bearing segment. Every screw placed there can injure a root or the mandibular canal. Wire-reinforced composite splints use the teeth themselves as anchors and are the treatment of choice for many mandibular body fractures. Plate osteosynthesis is reserved for fractures that cannot be splinted.
3. Young dogs need less stability, not more. In the growing jaw, tooth germs are packed tightly together. In puppies a tape muzzle or splint is often sufficient; in a series of 29 immature dogs, all mandibular fractures managed non-invasively or minimally invasively healed clinically, after a mean of 21 days³.

The causes have shifted, too: in a CT study of 165 dogs, bite wounds were the leading cause of craniomaxillofacial trauma at 50 %, while vehicular accidents accounted for only 13 %. On average, 8.2 bones or regions were fractured per dog².

Lecture 2: Modern imaging using CBCT in oromaxillofacial trauma

Radiographs and palpation show only the tip of the iceberg. In one study, computed tomography detected 1.6 times more injuries in dogs and 2.0 times more in cats than conventional skull radiographs; in dogs the mean number of documented lesions rose from 4.8 to 7.6¹.

Cone-beam computed tomography (CBCT) is the right tool for this: very fine voxels that are equally sharp in every plane, no superimposition, and high detail of teeth and bone at a considerably lower radiation dose than conventional CT. It shows how little safe bone remains between the tooth roots and the mandibular canal⁴ – exactly where screws have to pass.

From the same dataset we can now move to virtual surgical planning and a patient-specific, 3D-printed titanium implant with root-sparing screw corridors planned in advance. I was equally clear about the limits: for the polytrauma survey and for soft-tissue and vascular questions, CT and MRI remain the first choice. CBCT is the precise instrument for the tooth-and-bone question.

What this means for referring veterinarians

• When a jaw fracture is suspected: no definitive repair without three-dimensional imaging.
• The goal of treatment is the occlusion, not just bone healing.
• Especially in young dogs and after bite wounds, early referral to a dental and oral surgery specialist pays off.

Dr. Matthias C. Eberspächer-Schweda, Dipl. AVDC, Dipl. EVDC

← All posts