Traumatic tusk fractures in elephants frequently result in pulp exposure, and ascending bacterial pulpitis is a common sequela.1-3 Uncontrolled pulpitis can result in a non-viable tusk that ultimately requires extraction.1 Since 1996, the Indianapolis Zoo has worked with a human dentist to take an aggressive, early-intervention approach for the management of tusk fractures. In general, fractured tusks with pulp exposure are cleaned and sealed with a dental filling agent within 24 to 48 hours of onset. Systemic and topical antibiotics/antiseptics are started as indicated by the appearance of the pulp tissue and microbial culture. Elephants are then fitted for a metal protective crown placed on the end of the tusk. Most of these tusk repairs have been accomplished with behavioral conditioning and protected contact; however, younger untrained elephants have required general anesthesia. A total of 47 tusk fractures were reviewed involving seven African elephants (Loxodonta africana) from 1996–2017. Of these fractures, 57% had pulp exposure, and 18.5% of those with pulp exposure developed bacterial pulpitis. Two of the seven elephants have undergone multiple partial pulpotomy procedures and crown placements; however, none of these elephants have yet required a tusk extraction. This report reviews clinical data from this 22-year period and describes tusk fracture repair techniques, materials utilized, radiographic findings, progression of tusk healing and outcomes. To the authors‘ knowledge, this is the most comprehensive review of the outcomes of tusk fractures from one institution.
1. Fagan D. Complications associated with elephant tusks. In: Proc Am Assoc Zoo Vet; 2014. p. 122.
2. McCullar M, Mikota SK, Sargent EL, Ranglack GS. Dentistry. In: Mikota SK, Sargent EL, Ranglack GS. Medical Management of the Elephant. West Bloomfield, MI: Indira Publishing; 1994:87–94.
3. Sim RR, Stringer E, Donovan D, Chappell R, Flora P, Hall J, Pillay S, Willis BG, McCain S. Use of composite materials as a component of tusk fracture management in Asian elephant (Elephas maximus) and an African elephant (Loxodonta africana). J Zoo Wildl Med. 2017;48(3):891–896.