Page 252 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Musculoskeletal system: 1.6 The hea d 227

VetBooks.ir 1.426 1.427

Figs. 1.426, 1.427 (1.426) A 301 tooth, following removal of a fractured apical fragment, undergoing
debridement of the necrotic and non-vital pulp tissues. (1.427) The same tooth following a restorative pulp
capping procedure.

1.428 1.429

Figs. 1.428, 1.429 (1.428) Cerclage wire fixation of a maxillary fracture using intraoral wires placed in the
incisor interdental spaces and in the groove cut in the caudal aspect of the canine. (1.429) Radiographic view of
the repaired maxillary bone fracture shown in 1.428 prior to intraoral wire removal.

teeth on one side are involved, the canine teeth, if for this reason the technique is not commonplace.
present, can be used to aid fixation either by passing Alternative methods of fixing the cerclage wire
the cerclage wires tightly around them or by creat- caudally include passing through a hole drilled in
ing a notch on the caudal aspect of the clinical crown the mandible in the interdental space or wrapping
with a saw or burr (Fig. 1.430). In patients without around a cortex screw positioned in a similar location.
canine teeth, the wire may be inserted through the Alignment of the incisor occlusal surfaces is used to
interdental spaces between the ’06 and ’07 cheek assess fracture reduction. The viability of any teeth
teeth. The latter procedure is more complicated and involved in the fracture is often unknown at the time
usually requires the wire to be inserted through the of repair; however, they should remain in situ until
soft tissue of the cheek. The adjacent essential neu- the fracture has healed and only be removed at a later
rovascular structures complicate this procedure, and time if necessary. Postoperatively the horses can be