3 Special Considerations Regarding Equipment and Instruments
Dentistry performed in wild animal sanctuaries and zoos is practiced differently than in the comforts of private companion animal practice. Anesthesia carries more risk for the hundreds of species encountered, and the staff in many sanctuaries often have limited expertise and equipment for monitoring and professionally supporting the long procedure times that may be required to carry out necessary treatments. Because of these limitations, and the condition of animals when rescued, many of the animals that need treatment have long‐standing dental problems, and the facility will be willing to allow only one chance for us to help them. Therefore, like the frontier physician who carried a small bag and made do with what he had, we too must make do with the equipment we bring with us. Excellent radiographs are often difficult to obtain in a sanctuary (field conditions), or zoo venue. Often, a clinician will have to work with what is available and physical diagnostics, combined with experience, may become the most useful tools.
Periodontology and periodontal therapy, both medical and surgical, is important to captive and wild animals. But, when considering periodontal therapy in humans, dogs or cats, periodontal therapy is a life‐long undertaking, ideally with constant, periodic re‐evaluation and therapeutic adjustments for this chronic, manageable but incurable disease. Most sanctuaries and zoos anesthetize their animals as often as they have to, but as seldom as they need to, because the anesthetic experience carries a much higher risk with these animals, and general anesthesia is necessary even merely to transport them, let alone to perform almost any dental procedure. Consequently, most of these animals will not have the luxury of repeated anesthetic experiences, so care must be directed to single‐stage (one‐time only) procedures. These procedures are usually in the form of root canal therapy, occasional surgical extractions, apically re‐positioned gingival flaps or modified surgical osteoplasty to treat periodontal disease.
This book is written for competent clinicians who have dental experience and, at the least, the proper inventory of materials and equipment to carry out endodontic and surgical treatment in companion animal practice. Periodontal therapy is discussed as a surgical one‐time treatment. These equipment setups will not be discussed here, but, some specialized instruments will be described that make treatment of large carnivores and herbivores possible. Very specialized instrumentation of tusks of various mammals is discussed further by Professor Gerhard Steenkamp in his section on Elephant dental therapeutics.
Clinicians should arrive at a facility carrying with them equipment, instruments, and supplies to manage endodontic and surgical needs, including pulp cap therapy, root canal therapy and surgical extractions, as well as being able to perform the occasional incisional or excisional biopsy, tonsillectomy or even a toe amputation when confronted with previously poorly performed procedures.
Following are some suggested types of equipment, instruments, and supplies that are helpful when treating large animals in zoos, sanctuaries and safari camps (see Figures 3.1–3.24).
Figure 3.1 Hand held, battery operated, 2.0 mA X‐ray generator, distributed by iM3.
Source: Edward R. Eisner.
Figure 3.2 Nomad, rechargeable battery‐operated, hand‐held X‐ray generator 2.25 mA.
Source: Edward R. Eisner.
Figure 3.3 Scan‐X: Supplier – All Pro. Has CR processors to accommodate any size phosphor film.
Source: Edward R. Eisner.
Figure 3.4 CR‐7 Durr Medical, supplied by iM3, supplies film sizes up to and including size 5 film. CR processors for digital transfer from phosphor film; field efficient, but requires cleaning.
Source: Edward R. Eisner.
Figure 3.5 Dentalaire electric powered table unit. Delivery systems must have strong torque capabilities. The bone in large carnivores appears to be more dense than in smaller companion animals.
Source: Edward R. Eisner.
Figure 3.6 Crown‐down Technique: Starting with shorter 31mm files and frequent recapitulation will result in less file damage and better access, while increasing sequentially both in larger diameter files and to 60 and 120 mm files that can achieve full working length.
Source: Edward R. Eisner.
Figure 3.7 120 mm endodontic files, necessary for large carnivores, are six times longer than those used on people. But, beginning canal preparation with shorter files used initially, give better control for coronal canal preparation.
Source: Edward R. Eisner.
Figure 3.8 60‐ and 90‐mm gutta percha points are commercially available but, if not, they can be fabricated by fusing two shorter gutta percha points by warming and softening the ends with a cigarette lighter or Bunsen burner, overlapping the ends, and rolling them together between two glass slabs.
Source: Edward R. Eisner.
Figure 3.9 Fabricating these longer gutta percha points ahead of time creates more efficient procedures. Veterinarians are often proudest of their ingenuity.
Source: Edward R. Eisner.
Figure 3.10 120 mm pluggers and spreaders. It is best to hold these long instruments close to their working tips to reduce chances of damage by bending them.
Source: