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Ethylene Vinyl Acetate copolymer (EVA) plug for treatment of
cleft palate in cats
Plug de co-polímero de EVA para tratamento de
fenda palatina em gatos
Enchufe de copolímero EVA para el tratamiento del paladar
hendido en gatos
Marcello Rodrigues da Roza1*, Darney Ferreira de Melo2 e
Vanessa Pimentel de Faria3
Resumo
Os autores apresentam um caso de fenda palatina secundária a trauma em um
gato, tratado com um tampão feito de co-polímero de acetato de etileno vinil
para uso odontológico. Rotineiramente estas placas são utilizadas para a
construção a vácuo de moldeiras para branqueamento dentário e controle de
bruxismo em humanos. O procedimento, simples e rápido, foi realizado há cerca
de 20 meses, e o dispositivo foi substituído por outro igual um ano após o
procedimento. Devido ao seu baixo custo e à facilidade de confecção e
instalação, os autores acreditam que o procedimento possa ser repetido
1 Escola de Medicina Veterinária, Universidade Federal de Goiás, Goiânia-GO, Brazil. * e-mail:
[email protected]
2 Instituto Odontológico Garcia Peres, Brasília – DF, Brazil.
3 Centro Veterinário do Gama, Brasília – DF, Brazil.
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JBCA – Jornal Brasileiro de Ciência Animal 2014 7 (13): 500 – 507.
periodicamente, representando uma boa opção para o tratamento de fendas
palatinas em gatos.
Palavras-chave: fenda palatina, EVA, doenças orais em felinos, obturador
palatino, cirurgia do palato.
Abstract
The authors presented a case of a cleft palate due to trauma in a cat, in which
the patient was treated with a plug made of Ethylene Vinyl Acetate copolymer
(EVA) that, at the procedure time, was made for orthodontic use. These plates
are used to make trays via Vacuum Forming for tooth whitening and for
controlling and treating bruxism in humans. The procedure, performed 20
months ago, was simple and fast, and the device was replaced by an identical
one, one year after the procedure. Due to their low cost and ease of manufacture
and installation, the authors believe that the procedure can be repeated
periodically, and is a good option for cleft palate treatment in cats.
Key words: cleft palate; EVA; feline oral disease; palatal obturator, palate
surgery.
Resumen
Los autores presenta un caso de paladar hendido secundaria a trauma en un
gato, donde el paciente fue tratado con un tapón hecho de co-polímero de
acetato de etileno vinil para uso odontológico. Estas placas son usadas de
rutina para la construcción al vacío de moldes para blanqueamiento dentario y
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JBCA – Jornal Brasileiro de Ciência Animal 2014 7 (13): 500 – 507.
control de bruxismo en humanos. El procedimiento fue simple y rápido, y se
llevó a cabo hace casi 20 meses, con el dispositivo siendo substituido por otro
igual al año del procedimiento inicial. Debido a su bajo costo, facilidad de
confección y colocación, los autores creen que el procedimiento puede ser
repetido periódicamente y ser una buena opción para el tratamiento de paladar
hendido en gatos.
Palabras-clave: hendidura palatina, EVA, enfermedad dentaria de los felinos,
obturador del paladar, cirugía del paladar.
Introduction
Palatal defects may occur in
The palate is comprised of the
cats for various reasons, including
primary palate (lip and incisive bone)
trauma (high-rise injuries, dog or cat
and the secondary palate (hard and
bites,
soft palates). A defect in the primary
wounds, foreign body penetration) or a
palate is usually, but not always, an
surgery complication, radiation, or
aesthetic concern and not a functional
hyperthermic
concern. While the palate primary
lesions3. Palatal congenital defects
electrical
shock,
treatment
gunshot
of
oral
lesions’ have treatment almost with
result from the lack of fusion of the
aesthetic purposes, defects of the
palatal shelves of the maxillary bone
secondary palate have a greater effect
during
on the animal’s well-being due to their
Traumatic palatal disjunction occurs
impact on the functionality of the
most of the time at the level of the
nasooropharynx and must be treated
fusion between the two palatal shelves
to avoid serious consequences to the
(sagittal palatal suture). Fracture of the
animal4,7.
maxillary or palatine bones may also
embryologic
development.
occur.
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Although many defects on the
Considering the short time needed
hard palate can be closed by some
for the procedure, the anesthetic protocol
form of a mucoperiosteal flap6, large
consisted only of intravenous propofol
defects located in the caudal portion of
injection (5 mg/kg). Lactated Ringer’s
the
solution (10 ml/kg/h, IV) was administered
palate
have
often
suture
dehiscence as a complication8.
during the procedure. The cat was kept
under
intubation
throughout
the
procedure time and even during the initial
Case relate
awakening phase.
A three-year-old male cat was
presented to the veterinary dentistry
service (Centro Veterinário do Gama,
Brasília - DF, Brazil) with a traumatic
palate cleft. The owner found the cat
on the street and didn´t know how long
the animal had had the lesion, or if the
cat
had
undergone
previous
treatments.
an
recumbency and the oral cavity was
swabbed with 0.12% chlorhexidine. Cleft
palate measurements were made to
manufacture the device with Ethylene
Vinyl Acetate copolymer (EVA) plates for
orthodontic use. These plates are square
or round set for making trays via Vacuum
Forming. Humans use these trays for
Inspection of the oral cavity
revealed
The patient was placed in dorsal
oronasal
with
and for the control and treatment of
dimensions about 2.2 X 0.6cm in the
bruxism (2 and 3mm in thickness). EVA is
caudal portion of the hard palate and
a nontoxic material and has the "elastic
cranial portion of soft palate. The cat also
memory" property (allows deformation
presented a serious bilateral nasal
when under pressure and return to their
discharge. Before treatment, a complete
original shape when pressure ceases).
blood count and a serum chemistry panel
The material for the manufacture of this
were realized and the results were
device is simple and easy to purchase
normal.
(Figure 1).
Intraoral
fistula
tooth whitening (plates with 1mm thick)
radiographs
were
obtained and revealed no other dental or
oral changes.
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JBCA – Jornal Brasileiro de Ciência Animal 2014 7 (13): 500 – 507.
We
cut
two
circles
with
prostheses. Particularly in large caudal
diameters compatible to the dimension
defects the split palatal U-flap is the
of the palate. We then cut a smaller
technique of choice1.
circle that was then glued between the
Cleft palate surgery has been
first two circles to create a spool
reported to be associated with a high
shaped
Fire
rate of surgical failure2. A study
generated from an alcohol lamp was
revealed that, about 58% of dogs with
used to unite the three parts. We
a cleft palate required a second or
introduced one piece of the double-
even a third surgical procedure to
sided device through the palate cleft
attempt a clinical cure5.
device
(Figure
2).
and the other piece covered the palate
Among
in its intraoral portion (Figure 3).
the
prosthetic
techniques, a 3cm conical silastic
The procedure was performed
nasal septal button was applied with
20 months ago. In the meantime, the
excellent results and tolerability in
cat has been examined every six
cats9,10.
months and shows no signs of
dispositive is expensive and difficult to
discomfort or local changes. The
acquire in Brazil.
However
this
kind
of
device was replaced by an identical
one, one year after the procedure.
The cat woke quickly and
Conclusion
quietly after the procedure and there
The EVA plates are easy to
was no need to adopt additional
obtain and to handle, which makes the
measures in the postoperative.
procedure fast and reliable. Because
of the low cost, the authors believe that
the
Discussion
The techniques described for
procedure
can
be
repeated
periodically and is a good option for the
treatment of cleft palate in cats.
the treatment of cleft palate are
surgical approach and placement of
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JBCA – Jornal Brasileiro de Ciência Animal 2014 7 (13): 500 – 507.
Figure 1: Material for the
manufacture of the EVA device.
Figure 2: Manufactured plug.
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JBCA – Jornal Brasileiro de Ciência Animal 2014 7 (13): 500 – 507.
Figure 3 – Postoperative image
showing the plug adapted to cleft
palate.
References
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palate in a cat. Journal of American Animal Hospital Association, 40: 86-90.
2. Roza MR (2004). Cirurgia dentária e da cavidade oral. In: Roza MR. Odontologia em
pequenos animais. Rio de Janeiro: LF Livros de Veterinária, 167-190.
3. Harvey CE (1987). Palate defects in dogs and cats. Compendium of Continuing
Education Practice in Veteterinary, 9: 404-418.
4. Marretta SM, Grove TK, Grillo JF (1991). Split palatal U-flap: a new technique for
repair of caudal hard palate defects. Journal of Veterinary Dentistry, 8: 5-8.
5. Smith MM (2000). Oronasal fistula repair. Clinical Techniques in Small Animal
Practice. 15: 243-250.
6. Gorrell C. Emergencies. In: Gorrel C. 2004. Veterinary dentistry for the general
practitioner. Philadelphia: WB Saunders, 131-155.
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JBCA – Jornal Brasileiro de Ciência Animal 2014 7 (13): 500 – 507.
7. Griffiths LG, Sullivan M (2001). Bilateral overlapping mucosal single-pedicle flaps for
correction of soft palate defects. Journal of American Animal Hospital Association,
37: 183-186.
8. Howard DR, Davis DG, Merkley DF et al. (1974). Mucoperiosteal flap technique for
cleft palate repair in dogs. Journal of American Animal Hospital Association, 16: 352354.
9. Smith, M. M., Rockhill, A. D (1996). Prosthodontic appliance for repair of an oronasal
fistula in a cat. Journal of American Animal Hospital Association, 208:1410-1412.
10. Souza HJM, Amorim FV, Gorgozinho KB et al. (2005). Management of the traumatic
oronasal fistula in the cat with a conical silastic prosthetic device. Journal of Feline
medicine and Surgery, v. 7, p. 129-133.
Recebido em: Fevereiro de 2013
Aceito em: Junho de 2014
Publicado em: Julho de 2014
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