Review Article| Volume 52, ISSUE 1, P271-288, January 2022

Download started.


Patient Triage, First Aid Care, and Management of Oral and Maxillofacial Trauma


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.


      Subscribe to Veterinary Clinics: Small Animal Practice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Mulherin B.L.
        • Snyder C.J.
        • Soukup J.W.
        • et al.
        Retrospective evaluation of canine and feline maxillomandibular trauma cases; a comparison of signalment with non-maxillomandibular traumatic injuries (2003-2012).
        Vet Comp Orthop Traumatol. 2014; 27: 192-197
        • Mulherin B.L.
        • Snyder C.J.
        • Soukup J.W.
        • et al.
        Retrospective evaluation of canine and feline maxillomandibular trauma cases. Comparison of lunar cycle and seasonality with non-maxillomandibular traumatic injuries (2003-2012).
        Vet Comp Orthop Traumatol. 2014; 27: 198-203
        • De Paolo M.H.
        • Arzi B.
        • Pollard R.E.
        • et al.
        Craniomaxillofacial trauma in dogs—Part I: Fracture location, morphology and etiology.
        Front Vet Sci. 2020; 7
        • Lopes F.M.
        • Gioso M.A.
        • Ferro D.G.
        • et al.
        Oral fractures in dogs of Brazil—a retrospective study.
        J Vet Dent. 2005; 22: 86-90
        • Umphlet R.C.
        • Johnson A.L.
        Mandibular fractures in the dog a retrospective study of 157 cases.
        Vet Surg. 1990; 19: 272-275
        • Kitshoff A.M.
        • de Rooster H.
        • Ferreira S.M.
        • et al.
        A retrospective study of 109 dogs with mandibular fractures.
        Vet Comp Orthop Traumatol. 2013; 26: 1-5
        • De Paolo M.H.
        • Arzi B.
        • Pollard R.E.
        • et al.
        Craniomaxillofacial trauma in dogs—Part II: Association between fracture location, morphology and etiology.
        Front Vet Sci. 2020; 7
        • Soukup J.W.
        • Mulherin B.L.
        • Snyder C.J.
        Prevalence and nature of dentoalveolar injuries among patients with maxillofacial fractures.
        J Small Anim Pract. 2013; 54: 9-14
        • Scherer E.
        • Hetzel S.
        • Snyder C.J.
        Assessment of the role of the mandibular first molar tooth in mandibular fracture patterns of 29 dogs.
        J Vet Dent. 2019; 36: 32-39
        • Gioso M.A.
        • Shofer F.
        • Barros P.S.
        • et al.
        Mandible and mandibular first molar tooth measurements in dogs: relationship of radiographic height to body weight.
        J Vet Dent. 2001; 18: 65-68
        • Scherer E.
        • Snyder C.J.
        • Malberg J.
        • et al.
        A volumetric assessment using computed tomography of canine and first molar roots in dogs of varying weight.
        J Vet Dent. 2018; 35: 131-137
        • Kim C.G.
        • Lee S.Y.
        • Kim J.W.
        • et al.
        Assessment of dental abnormalities by full-mouth radiography in small breed dogs.
        J Am Anim Hosp Assoc. 2013; 49: 23-30
        • Somrak A.J.
        • Marretta S.M.
        Management of temporomandibular join luxation in a cat using custom-made tape muzzle.
        J Vet Dent. 2015; 32: 239-246
        • Lantz G.C.
        • Verstraete F.J.M.
        Fractures and luxations involving the temporomandibular joint.
        in: Verstraete F.J.M. Lommer M.J. Bezuidenhout A.J. Oral and maxillofacial surgery in dogs and cats. Saunders/Elsevier, Edinburgh2012: 321-332
        • Gemmill T.
        Conditions of the temporomandibular joint in dogs and cats.
        Practice. 2008; 30: 36-43
        • Schulz K.
        Diseases of the joints.
        in: Fossum T.W. Small animal surgery. 3rd edition. Mosby, St. Louis, MO2007: 1145-1315
        • Thatcher G.
        Temporomandibular joint luxation in the cat: diagnosis and management.
        Can Vet J. 2017; 58: 989-993
        • Grubb T.L.
        • Perez Jimenez T.E.
        • Pettifer G.R.
        Neonatal and pediatric patients.
        in: Grimm K.A. Lamont L.A. Tranquilli W.J. Veterinary anesthesia and analgesia. Wiley Blackwell, Ames, IA2015: 983-987
        • Smith M.M.
        Pharyngostomy endotracheal tube.
        J Vet Dent. 2004; 21: 191-194
        • Hartsfield S.M.
        • Genfreau C.L.
        • Smith C.W.
        • et al.
        Endotracheal intubation by pharyngotomy.
        J Am Anim Hosp Assoc. 1977; 13: 71-74
        • Soukup J.W.
        • Snyder C.J.
        Transmylohyoid orotracheal intubation in surgical management of canine maxillofacial fractures: an alternative to pharyngotomy endotracheal intubation.
        Vet Surg. 2015; 44: 432-436
        • Morgan J.P.
        Radiography of the head.
        in: Techniques of veterinary radiography. 5th edition. Iowa State Press, Ames, IA1993: 121-133
        • Buelow M.E.
        • Marretta S.M.
        Diagnostic imaging in veterinary dental practice. Mandibular fractures diagnosed by radiography.
        J Am Vet Med Assoc. 2011; 239: 931-933
        • Schloss A.J.
        • Marretta S.M.
        Prognostic factors affecting teeth in the line of mandibular fractures.
        J Vet Dent. 1990; 7: 7-9
        • Bar-Am Y.
        • Pollard R.E.
        • Kass P.H.
        • et al.
        The diagnostic yield of conventional radiographs and computed tomography in dogs and cats with maxillofacial trauma.
        Vet Surg. 2008; 37: 294-299
        • Lechuga L.
        • Weidlich G.A.
        Cone beam CT vs fan beam CT: A comparison of image quality and dose delivered between two differing CT imaging modalities.
        Cureus. 2016; 8
        • Döring S.
        • Arzi B.
        • Hatcher D.C.
        • et al.
        Evaluation of the diagnostic yield of dental radiography and cone-beam computed tomography for the identification of dental disorders in small to medium-sized brachycephalic dogs.
        Am J Vet Res. 2018; 79: 62-72
        • Heney C.M.
        • Arzi B.
        • Kass P.H.
        • et al.
        The diagnostic yield of dental radiography and cone-beam computed tomography for the identification of dentoalveolar lesions in cats.
        Front Vet Sci. 2019; 6
        • Heney C.M.
        • Arzi B.
        • Kass P.H.
        • et al.
        Diagnostic yield of dental radiography and cone-beam computed tomography for the identification of anatomic structures in cats.
        Front Vet Sci. 2019; 6
        • Roza M.R.
        • Silva L.A.F.
        • Barriviera M.
        • et al.
        Cone beam computed tomography and intraoral radiography for diagnosis of dental abnormalities in dogs and cats.
        J Vet Sci. 2001; 12: 387-392
        • Soukup J.W.
        • Drees R.
        • Koenig L.J.
        • et al.
        Comparison of the diagnostic image quality of the canine maxillary dentoalveolar structures obtained by cone beam computed tomography and 64-multidetector row computed tomography.
        J Vet Dent. 2015; 32: 80-86
        • Winer J.
        • Verstraete F.
        • Cissell D.
        • et al.
        The application of 3-dimensional printing for preoperative planning in oral and maxillofacial surgery in dogs and cats.
        Vet Surg. 2017; 46: 942-951
        • Macready D.M.
        • Hecht S.
        • Craig L.E.
        • et al.
        Magnetic resonance imaging features of the temporomandibular joint in normal dogs.
        Vet Radiol Ultrasound. 2010; 51: 436-440
        • Legendre L.
        Intraoral acrylic splints for maxillofacial fracture repair.
        J Vet Dent. 2003; 20: 70-78
        • Boudrieau R.
        • Arzi B.
        • Verstraete F.
        Principles of maxillofacial trauma repair.
        in: Verstraete F. Lommer M. Arzi B. Oral and Maxillofacial Surgery in Dogs and Cats. 2nd edition. St. Louis, MO, Saunders (Elsevier)2020: 252-261
        • Howard P.E.
        Tape muzzle for mandibular fractures.
        Vet Med Small Anim Clin. 1981; 76: 517-519
        • Castejon-Gonzalez A.C.
        • Buelow M.E.
        • Reiter A.M.
        Management and outcome of maxillofacial trauma in a 9-week-old dog.
        J Vet Dent. 2018; 35: 167-177
        • Goodman A.E.
        • Carmichael D.T.
        Modified labial button technique for maintaining occlusion after caudal mandibular fracture/temporomandibular joint luxation in the cat.
        J Vet Dent. 2016; 33: 47-52
        • Oikarinen K.S.
        Clinical management of injuries to the maxilla, mandible, and alveolus.
        Dent Clin North Am. 1995; 39: 113-131
        • Bennett J.W.
        • Kapatkin A.S.
        • Marretta S.M.
        Dental composite for the fixation of mandibular fractures and luxations in 11 cats and 6 dogs.
        Vet Surg. 1994; 23: 190-194
        • Hoffer M.
        • Manfra Marretta S.
        • Kurath P.
        • et al.
        Evaluation of composite resin materials for maxillomandibular fixation in cats for treatment of jaw fractures and temporomandibular joint luxations.
        Vet Surg. 2011; 40: 357-368
        • Nicholson I.
        • Wyatt J.
        • Radke H.
        • et al.
        Treatment of caudal mandibular fracture and temporomandibular joint fracture-luxation using a bi-gnathic encircling and retaining device.
        Vet Comp Orthop Traumatol. 2010; 23: 102-108
        • Lothamer C.
        • Snyder C.J.
        • Duenwald-Kuehl S.
        • et al.
        Crown preservation of the mandibular first molar tooth impacts the strength and stiffness of three non-invasive jaw fracture repair constructs in dogs.
        Front Vet Sci. 2015; 2: 18
        • Taney K.
        • Smithson C.
        Oral surgery – Fracture and trauma repair.
        in: Lobrise H. Dodd J. Wigg’s veterinary Dentistry principles and practice. 2nd edition. Wiley Blackwell, Hoboken, NJ2018: 265-288
        • Legendre L.
        Maxillofacial fracture repairs.
        Vet Clin North Am Small Anim Pract. 2005; 35: 985-1008
        • Owen M.R.
        • Hobbs S.L.
        • Moores A.P.
        • et al.
        Mandibular fracture repair in dogs and cats using epoxy resin and acrylic external skeletal fixation.
        Vet Comp Orthop Traumatol. 2004; 17: 189-197
        • Woodbridge N.
        • Owen M.
        Feline mandibular fractures: A significant surgical challenge.
        J Feline Med Surg. 2013; 15: 211-218
        • Boudrieau R.J.
        Fractures of the mandible.
        in: Johnson A.L. Houlton J.E.F. Vannini R. AO principles of fracture management in the dog and cat. AO Publishing, Davos (Switzerland)2005: 99-116
        • Snyder C.J.
        • Soukup J.W.
        • Gengler W.R.
        Imaging and management of a caudal mandibular fracture in an immature dog.
        J Vet Dent. 2009; 26: 97-105
        • Boudrieau R.J.
        Miniplate reconstruction of severely comminuted maxillary fractures in two dogs.
        Vet Surg. 2004; 33: 154-163
        • Arzi B.
        • Verstraete F.J.
        Internal fixation of severe maxillofacial fractures in dogs.
        Vet Surg. 2015; 44: 437-442
        • Sverzut C.E.
        • Lucas M.A.
        • Sverzut A.T.
        • et al.
        Bone repair in mandibular body ostetolomy after using 2.0 miniplate system-histological and histometric analysis in dogs.
        Int J Exper Path. 2008; 89: 91-97
        • Freitag V.
        • Landau H.
        Healing of dentate or edentulous mandibular fractures treated with rigid or semirigid plate fixation- an experimental study in dogs.
        J Cranio-Maxillofacial Surg. 1996; 24: 83-87
        • Southerden P.
        • Barnes D.M.
        Caudal mandibular fracture repair using three-dimensional printing, presurgical plate contouring and a preformed template to aid anatomical fracture reduction.
        J Feline Med Surg Open Rep. 2018; 4 (2055116918798875)
        • Liptak J.M.
        • Thatcher G.P.
        • Bray J.P.
        Reconstruction of a mandibular segmental defect with a customized 3-dimensional–printed titanium prosthesis in a cat with a mandibular osteosarcoma.
        J Am Vet Med Assoc. 2017; 250: 900-908
        • Greiner C.L.
        • Verstraete F.J.
        • Stover S.M.
        • et al.
        Biomechanical evaluation of two plating configurations for fixation of a simple transverse caudal mandibular fracture model in cats.
        Am J Vet Res. 2017; 78: 702-711
        • Cornelis M.A.
        • Tepedino M.
        • Cattaneo P.M.
        • et al.
        Root repair after damage due to screw insertion for orthodontic miniplate placement.
        J Clin Exp Dent. 2019; 11
        • Boudrieau R.J.
        • Mitchell S.L.
        • Seeherman H.
        Mandibular reconstruction of a partial hemimandibulectomy in a dog with severe malocclusion.
        Vet Surg. 2004; 33: 119-130
        • Boudrieau R.J.
        Initial experience with rhBMP-2 delivered in a compressive resistant matrix for mandibular reconstruction in 5 dogs.
        Vet Surg. 2015; 44: 443-458
        • Lewis J.R.
        • Boudrieau R.J.
        • Reiter A.M.
        • et al.
        Mandibular reconstruction after gunshot trauma in a dog by use of recombinant human bone morphogenetic protein-2.
        J Am Vet Med Assoc. 2008; 233: 1598-1604
        • Arzi B.
        • Verstraete F.J.
        • Huey D.J.
        • et al.
        Regenerating mandibular bone using rhBMP-2: Part 1—Immediate reconstruction of segmental mandibulectomies.
        Vet Surg. 2015; 44: 403-409
        • Verstraete F.J.
        • Arzi B.
        • Huey D.J.
        • et al.
        Regenerating mandibular bone using rhBMP-2: part 2—treatment of chronic, defect non-union fractures.
        Vet Surg. 2015; 44: 410-416
        • Bauer T.W.
        • Muschler G.F.
        Bone graft materials: an overview of the basic science.
        Clin Orthop Rel Res. 2000; 371: 10-27
        • Snyder C.J.
        • Bleedorn J.A.
        • Soukup J.W.
        Successful treatment of mandibular nonunion with cortical allograft, cancellous autograft, and locking titanium miniplates in a dog.
        J Vet Dent. 2016; 33: 160-169
        • Messora M.R.
        • Nagata M.J.
        • Fucini S.E.
        • et al.
        Effect of platelet-rich plasma on the healing of mandibular defects treated with fresh frozen bone allograft: a radiographic study in dogs.
        J Oral Implantol. 2014; 40: 533-541
        • Boudrieau R.J.
        • Tidwell A.S.
        • Ullman S.L.
        • et al.
        Correction of mandibular nonunion and malocclusion by plate fixation and autogenous cortical bone grafts in two dogs.
        J Am Vet Med Assoc. 1994; 204: 744-750
        • Klima L.J.
        Temporomandibular joint luxation in the cat.
        J Vet Dent. 2007; 24: 198-201
        • Schwarz T.
        • Weller R.
        • Dickie A.M.
        • et al.
        Imaging of the canine and feline temporomandibular joint: A review.
        Vet Radiol Ultrasound. 2002; 43: 85-97
        • Arzi B.
        • Cissell D.D.
        • Verstraete F.J.M.
        • et al.
        Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006-2011).
        J Am Vet Med Assoc. 2013; 242: 69-75
        • Soukup J.W.
        • Snyder C.J.
        • Gengler W.R.
        Computed tomography and partial coronoidectomy for open-mouth jaw locking in two cats.
        J Vet Dent. 2009; 26: 226-233
        • Reiter A.M.
        Symphysiotomy, symphysiectomy, and intermandibular arthrodesis in a cat with open-mouth jaw locking--case report and literature review.
        J Vet Dent. 2004; 21: 147-158
        • Villamizar-Martinez L.A.
        • Chia H.
        • Robertson J.B.
        • et al.
        Comparison of unilateral rostral, middle and caudal segmental mandibulectomies as an alternative treatment for unilateral temporomandibular joint ankylosis in cats: an ex vivo study.
        J Feline Med Surg. 2020;
        • Strøm P.C.
        • Arzi B.
        • Cissell D.D.
        • et al.
        Ankylosis and pseudoankylosis of the temporomandibular joint in 10 dogs (1993-2015).
        Vet Comp Orthop Traumatol. 2016; 29: 409-415
        • Saverino K.M.
        • Reiter A.M.
        Clinical presentation, causes, treatment, and outcome of lip avulsion injuries in dogs and cats: 24 cases (2001-2017).
        Front Vet Sci. 2018; 5: 144
        • White T.L.
        Lip avulsion and mandibular symphyseal separation repair in an immature cat.
        J Vet Dent. 2010; 27: 228-233
        • Wiggs R.B.
        • Loprise H.B.
        Oral fracture repair.
        in: Veterinary Dentistry Principals and practice. Lippincott-Raven, Philadelphia, PA1997: 261-262
        • Bonner S.E.
        • Reiter A.M.
        • Lewis J.R.
        Orofacial manifestations of high-rise syndrome in cats: a retrospective study of 84 cases.
        J Vet Dent. 2012; 29: 10-18
        • Kim Y.
        • Lee D.
        • Heo S.
        • et al.
        The treatment of gunshot wounds with maxillofacial fracture in a dog.
        J Vet Clin. 2018; 35: 215-217
        • Tian H.M.
        • Deng G.G.
        • Huang M.J.
        • et al.
        Quantitative bacteriological study of the wound track.
        J Trauma. 1988; 28: S215-S216
        • Pavletic M.M.
        A review of 121 gunshot wounds in the dog and cat.
        Vet Surg. 1985; 14: 61-62
        • Pavletic M.M.
        • Trout N.J.
        Bullet, bite, and burn wounds in dogs and cats.
        Vet Clin North Am Small Anim Pract. 2006; 36: 873-893
        • Melugin M.B.
        Maxillofacial firearm injuries.
        in: Fonseca R.J. Walker R.V. Betts N.J. Oral and maxillofacial trauma. 3rd edition. Elsevier-Saunders, St Louis (MO)2005: 931-948