Rhesus monkey suffering from tooth pain
(23.11.2005) Another of our close relative friend from Gänsendorf primate center appealed to our dental service.
Fig.1
It is the dominant male of the group, that is the "Boss, named Pascal after the famous physician, a 12 year old Rhesus monkey (Macaca Mulatta) who suffered for over one year of tooth pain and a swelling in the right side of the face just around the canine area.
Now just a few words about the Rhesus monkeys and their importance. The name "rhesus" comes from Greek, Rhesos, the King of Thrace who assisted Priam at Troy. Audebert, the person who applied the name to the species, stated that it had no meaning.
The common name, rhesus monkey, is responsible for the naming of the hereditary blood antigen Rh-factor that was discovered on their red blood cells in 1940. Rh-factor is also found in humans.
The mixing of Rh blood with non-Rh blood during blood transfusions or the later stages of pregnancy can result in potentially dangerous defense reactions.
Now coming back to our patient "Pascal the physician, that had to undergo surgery for removal of the bad tooth. After proper assessment of the health status and complete blood analysis, the anesthesia department applied the usual primate anesthesia protocol.
After pre-anesthesia, induction and intubation, Pascal was maintained with isofluran during surgery. We than managed to properly asses the situation.
The right upper canine, or 103 in Triadan nomeclature was fractured and all of the crown part was gone (Fig.1). However the X-ray performed using our Explor-X dental unit, didnt show any dramatical changes in the periapical or periodontal ligament area (Fig.2).
We performed an L shaped flap, having considered this design the most efficient, since it allows better vascularisation of the flap and prevents thus the eventual local hypotrophic necrosis.
After debridement of the alveolar bone and demarcation of the periodontal space we could nicely see the root of the canine together with a fracture line in a rostro-caudal direction marked with an arrow in Fig.3.
The extraction of the canine was more difficult than anticipated since the chronic process and the recurrent fistulisation and abscessation had caused an ankylosis of the root and hypercementosis thus making the extraction particularly difficult.
However after 20 minutes of work using several size root elevators and a root extraction forceps the tooth was out and the post-extractional alveolus clean (Fig.4).
We curetted the alveolar bone and eliminated one small piece of alveolar bone that got broken during extraction, and proceeded in suturing the flap in a simple interrupted pattern using size 3.0 resorbable vycril multifilament suture material (Fig.5).
Fig.7
The extracted root had a curved shape with a tortuous trajectory (Fig.6). The post-extractional Xrays shows a clean alveolus and no left-overs from the root or alveolar bone.
After surgery we instituted a pain control protocol using Temgesic and Rymadil, and the antibiotherapy with Clyndamicin (Antirobe) 11 mg/kg for 7 days.
Pascal did well after surgery and the nest day the "Boss came back to work at the usual time and this time in a really good mood, the right time for the colleagues to ask for a "banana promotion.
DDr. Camil Stoian PhD