Caudal mucogingival lesions secondary to traumatic dental occlusion in 27 cats: macroscopic and microscopic description, treatment and follow-up.

The main aim of this retrospective study was to describe clinical and histopathological findings in cats with mucogingival lesions developed at the contact point of the premolar and molar teeth of the opposite quadrant. Cases were retrieved following manual review of the medical records, dental records and photographic documentation of all feline dental patients visited in the period between February 2001 and August 2011. Cats showing different lesions at different times were calculated as multiple cases. A total of 27 cats (31 cases) with 44 lesions (26 proliferations [59%], 11 clefts [25%] and seven foveae [16%]) were included. Mean age at the time of the first visit was 6.6 years. The lesion object of the study was the main reason for presentation in only five cases (16%). Proliferations showed two different histopathological patterns and had characteristics in common with human oral pyogenic granuloma. Successful treatment was achieved in all cases by removing the occlusal contact by dental extraction or coronal reduction, possibly associated with lesion excision. This study underlines the need for a thorough oral examination and evaluation of dental occlusion in all patients. Causes for the development of traumatic occlusion may include an acquired overbite (possibly secondary to selective dental extraction), congenital or post-traumatic malocclusion, abnormal latero-lateral mobility of the mandible, occlusal drift of the premolar and molar teeth, and/or alveolar bone expansion.

Treatment of caudal mandibular fracture and temporomandibular joint fracture-luxation using a bi-gnathic encircling and retaining device.

Fractures of the caudal portion of the mandible and temporomandibular joint (TMJ) fracture-luxation can be challenging to treat with direct fixation methods. This paper describes a simple technique for the indirect treatment of caudal mandibular fracture and TMJ fracture-luxation using a subcutaneous loop of nylon leader line tunnelled around the maxilla, incisive and nasal bones, and under the mandible, placed just caudal to the canine teeth, and crimped ventral to the mandibular skin: a bignathic encircling and retaining device (BEARD). A BEARD was used to treat two immature dogs with simple, unilateral caudal mandibular fractures, six cats with unilateral injury (two with TMJ luxation, three with TMJ fracture-luxation, one with caudal mandibular fracture), and two cats with bilateral injury (comminuted caudal mandibular fracture with contralateral TMJ luxation; bilateral condylar neck fracture). The BEARD treatment failed short-term due to poor tolerance in one cat, and concurrent injuries and poor initial reduction in another cat. One cat was lost to long-term follow-up. Rostral dental occlusion was normal in six out of seven cases, and reported jaw function was normal in seven out of seven cases. The case with poor occlusion had imperfect initial reduction. Complications included dorsal nasal skin swelling or discharge, oesophagostomy tube dislodgement or blockage, BEARD loosening, and regurgitation. Treatment of uni- or bilateral caudal mandibular trauma using a BEARD can lead to clinical union, and normal rostral occlusion, provided that case selection is appropriate and immediate-post-surgical occlusion has been corrected.