Clinical history An Inlander, 4 years of age sustained an injury following use of a mouth gag that was being used to open the mouth during dentistry - a draining tract developed ventrally during the next days. Lateral and slightly oblique radiographs were made of the mandible just caudal to the incisors 10 days following the incident in the standing animal - a metallic probe was placed in position near the draining tract. Radiographic changes
- An area of destruction in the ventral cortex of the mandible
- Minimal periosteal new bone production
- A question of sequestrum formation
- Placement of the metallic probe indicates the depth of the lesion
Radiographic diagnosis
- The diagnosis is an osteomyelitis without a fracture but with possible sequestrum formation
Comments Bone injury in this portion of the mandible is difficult to evaluate - the mandibular symphysis creates a large ovoid area of decreased opacity with a thin, more opaque border just caudal to the incisors - this area blends with the alveolar region of the incisors creating mixed bone opacity. The endosteal border of the ventral cortex of the mandible is not identified and thus, any change in its contour cannot be used as a radiographic feature. Periosteal new bone is probably present around a traumatic or infectious lesion, but usually not identified because it is “burned out” by the radiographic technique used. Use of a metallic probe can assist in determining the depth of a tract and its relationship with a tooth root.
