JBCA – Jornal Brasileiro de Ciência Animal 2014 7 (13): 500 – 507. 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. 500 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 501 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. 502 JBCA – Jornal Brasileiro de Ciência Animal 2014 7 (13): 500 – 507. 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. 503 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 504 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. 505 JBCA – Jornal Brasileiro de Ciência Animal 2014 7 (13): 500 – 507. Figure 3 – Postoperative image showing the plug adapted to cleft palate. References 1. Headrick JF, McAnulty JF (2004). Reconstruction of a bilateral hypoplastic soft 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. 506 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 507