OralFracturesin Dogsof Brazil- A RetrcspectiveStudy

FernandaM .Lopes,DVM;MarcoAntonioGioso,DVM,DDS,PhD;DanielG.Ferro,DVM;MarcoA .
Leon-Roman,DVM;MichdleA.F.A.Venturini,DVM;HerbertL.Correa,DVM,MS

Figure1
Summaryi , Photographof a mandiblespecimenshowingthe anatomic
focationof mandibularfractures(n = 121)in dogs of Brazil.
A retrospectivestttdy wasperfotmed in I00 dogswith I 2 t fNumberof casesand percentages].
(43.0
mandibular and 2l maxillaryfracnres. Dogfight %o)
and automobite (12.0 %o)trauma were the most common
etiologiesfor fracture. The cause of fracare
ok
was;unknown in 23.0 of the cases,while
pathologicfrach'res occurred
>
in l3.A %oofcases.Youngdogs (< I-year-old) and dogs
9-vears af age were most fficted. Mandibular fractures
occurred in 90 dogs (90.A %o),with two dogs (2.2 %o)
hming concunent maxillary fractures. Maxillary fractures
onk v'erediagnosedin 10 dogs (10.0 %o)The.molar region
o/d
(47.1 was the most commonly fficted location for
mandibular fracture, followed byfrac tures of the synphysis
and parasymphysis (30.6 %o),premolar region (17.4 %o),
oQ.
angulcr process (4 I %o)and vertical ramus (0.8 In
fractures of the mandibular region, the mandibular Jirst Figure2
molar tooth was often (85.9%o)irwolved while the canine
teeth were involved in 67.5 ?5 of symphyseal and Photographof a maxlllaspecimenshowingthe anatomic
location of maxillaryfractures (n = 21) in dogs of Brazil.
parasymphysealfractures. The most common fracture of the
maxilla was the maxillary bone (52.4 %o}followed by the
lNumber of cases and percenlagesl.
o/o)
incisive (33.3 %o),palatine (9.5 n, and nasal (4 8
bones.J VetDent 22(2); 86 - 90, 2005

lntroduction
Oral fractwes are classified according to type. anatomic
locatioq and are often related to the etiology ofthe fracture.
The tlpe of fractwe includes simple, multiple, comminute4 and
pathologic.As in humans,the anatomic location of the fracture
is most helpful to the clinician since clinical signs and
treatrnent options will be directly relatedto which areais
fractured.Direction and force of the trauma combined with
muscle confraction rnpacts the pattern of the oral fracture,
especially those of the mandible.'rFurther, the tlpe and
location of the fracture influencesprognosis.o
Fracturefragment location following an mjury to the middle
third ofthe facial skeletondependsupon severalfactors including and the pattems of distribution of tensile strain as well as the
the: degreeof force - direct$ relatedto the momentum of the head determination of debilif and resistancelines in the maxilla in
at the time of trauma,the agentresponsiblefor the hauma or both; humans.ur
resistanceto the force offered by the facial bones; direction of Severalstudieshavefocusedon the occurrenceofmandibular
force; point of impact; tlpe of injuty - blunt or sharp; an4 the and maxillary {iactures in dogs.&'oMandibular fracturesrepresent
influence of attached muscles - having greater impact on the oh
1.5 - 6.0 of all fracturesdiagnosedin dogs while maxillary
mandible comparedwift the maxilla.''''u
fracfurescomprise less than 1.0 70.8''5Most oral ftactures are
In humans, maxillofacial fractures have been studied in car
causedby automobileor bite wound trauma.e'"The-" prevalenceof
accidentvictims accordingto direction of force (.tpper,inferior, or oral ftacturesin dogshasnot beenwell defined in Brazil and South
lateral), intensity of impact (low, middle, or high level), and cross- America.r6The purpose of this study is to report the fracture
sectionalareaof the bone(s)involved.uThere havebeennumerous etiology, patient age and breed and location oforal fractures in a
investigationsinto the resistanceof the mandible to applied forces populationofdogs from Sio Paulo,Brazil.

J . VET . DENIVol . 22No . 2 June2005

 Figure3
;;;; the age distributionof dogs (n = 100)at the timeot oratfracturediagnosis.
"r"wing

Materialsand Methods molar teeth in 85.9 %oof thesecases(Fig. 1). Thc caninetooth
The case records of 3,666 dogs with oral injuries seen region (67.5 %o)andsymphysealseparation(21. 6 %) contributed
betweenAugustl994andApril 2003 aTODONTOVET Centro to the overall fracture incidence of the parasymphysis region
Odontol6gicoVeterinririo,in S5o Paulo, Brazil were reviewed. (30.6%). Other regions affected included thc area of the premolar
Data obtained included patient signalment,fracture etiology, teeth (17.4 %o),angularprocess(4.1 %) and vertical ramus(0.8 %).
and location. Bilateralmandibularfractureoccurredn22 dogs usually adjacentto
The etiology was classified primarily as traumatic (including the first molar or canineteeth.
car accidents, fbll from height, bite wound trauma, gun shots),
pathologic,iatrogenic,andidiopathic.The locationof fracturewas
classified to 7 rcgions ofthe mandible and 5 regionsofthe marilla Table 1
(Figs. I and 2). The location of fracture was established by
Etiologyof oral fracturesin dogs betweenAugust 1994
to adjacentteeth in dentulousportions of the and April2003(n = 100).
mandible and maxilla.
Etiology Number of doqs
Results Fighting 43 (43Y")
Fracturesof the mandible and,/ormaxilla occurred h 100
Car,accidents 12fiz%\
dogs,or 2.7 %oof the casesevaluatedMandibular. fiactureswere
Gunshot 3(3%)
presentin 90 dogs with 2 of these dogs also having maxillary
Traumas Fallfromheioht 2(2%)
fiacture.Ten dogshad only maxillary fractures.Dogs < 2-years-old
Rear quard 2(2%)
and > 8-years-oldwere most commonly affected (Fig. 3).
Male dogs (66) were more likely to have fracture.Trauma rr'as Violence- kick 1 (1 "/")
the most common (64.0 %) etiologyfor fracturewith bite nound Elevator 1fiok\
trauma occurring in 43.0 % of dogs. Pathologicfiacturesu'ere 64 (64Vo)
o/o Periodontaldisease s(e%)
diagnosedin 13.0 of casesand the etiology u'asunknoun in
23.0% flable l). Pathological Chewing 3(3%)
Sixry-eightpercentoffractures occurredin dogscon:idered latrogenic 1fi %\
oh) Neoplasia 0
small while the remaining fracturesoccurred in medium ( 1'.0
t3 (1370)
andlarge ( I 5.0 %) breeds.Poodle(3 1. 0 9o) and mhed-breed
(24.0 %) dogswere the most prevalentbreed: all-ectedtFig. -l t. Unknown 23(.23"/"1
There were 121 fracture locations in the mandible and I I Totalnumber 100
in the maxilla. The most commonlv affbcted FrmL-lnrrf rhe
oot.
mandiblewas the molar region (47.1 inrtrlrl_g ihe t-r:t

J . VET . DENTVol. . 22No . 2 June2005

 Figure4
= fracture,
Graphshowingthe breeddrstributionof dogs (n 100)withoral

$ Beagle Ll tsoxer I Brazilianterrier I Cocker I Collie

S Germanshepard I Goldenretriever I Labrodorretriever $ Lhasaapso I Maltese
E Mixed-breed I Pekingese I Pinscher @ Pit Buil I Pomeranian
I Poodle E Ronweiler $ Sharpei I Shihtzu I SiberianHusky
Teckel 0 Yorkshireterrier

dogs are consideredto be more

Maxillary fractures included the maxilla (52.4 %), incisive of male dogs reported.Male
with females. The Poodle
bone (33.3 oh),hardpalate(9.5 %\ and nasalbone (4. 8%) [Fig' territorial and aggressive compared
prevalent breed and is well-known for its
2]. Most maxillary fractures were located in the premolar region' dog was the most The
temperament.The Poodle dog is also a
association of mandibular fracture and etiology brave and excitable
may be overrepresentedin the local
indicated that the majority of bite wound hauma and periodontal popular breed inBrazll and disease
cduntry,particularly in SdoPaulo.
pathologic frachres occurred in the molar region, urban dog populationsofthis
at dog
whereasfractures secondaryto vehicular trauma were usually The predominantdog breed and genderin the local urban
region (Fig. 5). population as well as the breed incidence in our hospital
the symphysealandparasymphyseal that
population were not evaluated. Howeveq it is our opinion
in
Discussion the Poodle breed and Poodle-mixedbreeds,and male dogs
in
Mandibular fractures are relatively common in dogs and generalare common in urban dog populationsof Brazil.
some casescan be concurrentwith maxillary fractures'which are Allowing dogs outdoor access without supervision
less frequent than mandibular fractures.The decreasedincidence combined with roaming activity common in males
the incidence of traumatic injury'
of maxillary fracture may be related to anatomical and structural undoubtedly impacts
and
differences compared with the mandible.sThe anatomical including oral fracture.'o'"Lack of owner responsibility
have
sffuctural differencesbetweenthe mandible and the maxilla contributed to the high prevalence of oral fractures with
unknown etiology.
been studied in humans showing the maxilla to be more resistant
maxilla
to fracture with lines of debility and resistance in the As observedin previous surveysof oral fracture in dogs,
The relatively high
establishedusingthe Leforr classificationsystem.' young animalswere commonly affected.14'r8
is usually was
As reported here, the etiology for oral fracture incidence of oral fracture in the older dogs of this study
traurna.e'r2Maxillofacial-r4 frachre in humans is also related to likely related to advancedperiodontal diseasein small breed
fiauma, especially secondary to motor vehicle accidents and dogs. Mandible and mandibular first molar tooth height
for
interpersonal violence,r'Bite wound trauma as an etiology measurementsindicate that small and toy breed dogs have
number
oral fracture in this study may have been related to the small facial bones and teeth that are excessivelylarge relative

J . VETDENTVol. . 22No . 2 June2005

 .. " :

fracturein dogs (n=121) in

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Etiology of MandibularFractures

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J . VET . DENTVol. . 22No . 2 June2005 89

 yel
to the amount of supportingbone.'eAlveolar bone resorption 13. UmphletRC,JohnsonAL.Mandibularfracturesinthedog:aretrcpectivestudyofl5Tc6es.

Surg1990;19:272-275,
secondary to periodontitis decreases bone integrity and
14. AlieviMN4,SchosslerJE, GoncalvesV Ostmsint* meilar rostralem cao - relatode ms.
strength. Periodontal disease may have a greater impact on Ainiu Vetei netu 19B..nlgn,.
pathologic mandibular fracture since the canine and the first
15. Giso l/A. Otu1to@ia para o clinb de Wqffi ilinais,4. ediQao,Sao %ulo, iEdibra,
molar teeth generally occupy more than one-third of the M:z]z.
mandible depending on the dog'ssize and breed. Established 16. HlisE,MmKEB-AttarA,Tenyearsofmmdibularfractures.Ananalysisof213TcNs.OtalSurg
periodontal diseasernay have been a predisposing factor for 1985;59:124-129.
'17.
oral fracture associatedwith benign activities such as chewing Wong\/\/tAsurueyoffracturesinthedogtrdtinlvlalaysiaVetRecord1984;115t273.-274.
bones (artificial or natural) or other foo4 and routine playing 18. Gios N4A,ShoferE BarrosPSM,Hfley CE. l\,4andibleand mandibularfirst moltr toot'-r
measurementsin dogs: relationshipof radiographicheightto body weight J VetDent2001;
activities (Table 1). A study of pathological oral fractures '18:
65-68.
reported a high incidence in aged humans with malignant
19. Boudri*u R,J,Kudish M. Miniplatefimlirm ftr repairof mandibularand maxillaryfractum in
disease and atrophic edentulous jaws.'zGreater than 50 % of 15 clogsad 3 caE. Vetfurg 19pf';%: 277-81.
these fractures occurred during mastication and in the body
20. GertErds E Kufner D, U/agrer W Pafnlogical fractlres of he mandible:a reviewof tiE
region of the mandible.'o grrg 19p8,i27: 18-19f..
etiology md trrnent. /naJ Oral Maxilwac
Tooth morphology may influence the location of the 21. WiggsRB,LobpriseHB.OralfracturerepairIn:WiggsRB,Lobprise,eds. VeteinatyDenlsxy:
mandibular fracture. In humans, the canine and the partially- prircipl$ and practice.Philadelphia:Lippinmtt-Raven,1997:259279,
erupted mandibular third molar teeth represent lines of relative
weakness." Although there are no similar studies in veterinary
medicine, our results support prwious studies that suggestthe
mandibular canine and first molar teeth are locations of fracture
predisposition in dogs (Fig. 6). The canine tooth was involved in
parasymphysealfractures that were most commonly associated
with vehicular trauma and probable frontal force or impact.
Whereas, fractures involving the first molar tooth were often
associbted with bite wound injury and prehensile forces
regardlessof the degree of pre-existing periodontal disease.

Author lnformation
From Av. Prof. Orlando Marques de Paiva, 87-Cidade
Universitiria, Sdo Paulo-SP,05508-900,Brazil (Gioso,Ferro,
Leon-Roman);RuaBerlioz,81l-Alto de Pinheiros,S5oPaulo-
SB05467-000,BruAl(Lopes);andAvMagalhdes.deCasfro,12,
S5o Paulo-SP,05502-000,Brazil (Venturini,Correa).Email:
maggioso@usp.lopesfm@uolbr;.com.br

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J.VET.DENTVol..22 No.2 June 2005