A 2-year, 4-month-old female Loxodonta africana weighing 740 kg (1,631 lb.) was found to have a fractured right tusk. The fracture had exposed approximately 1 cm of pulpal tissue and the fractured tusk margins were 2–3 mm sub-sulcular.

Etorphine HCI 10 mg/ml was used for immobilization (1 mg IM via hand syringe, supplemented with an additional 1 mg eleven minutes later). Intubation was with a 26 mm endotracheal tube and maintained on Isoflurane at 1–2% for 105 minutes.

Two radiographs were taken. Electrosurgery was utilized to expose the entire periphery of the fractured tusk. A sterilized 0.25 inch drill bit in a cordless drill was utilized to remove necrotic pulp tissue and expose vital bleeding pulp tissue (approximately 2 cm apically into the tusk). Gentamicin antibiotic ointment was placed over the vital pulp tissue followed by a layer of Consil® ( Bioglass® synthetic bone graft particulate). A bonding agent ( OptiBond Solo Plus®) and a chemical-cure composite core paste (Compcore®) were used to seal the access opening. Anesthesia was reversed with 100 mg IV naltrexone HCI 50 mg/ml. During the procedure 7.75 grams amoxicillin trihydrate was given IM. Oral antibiotics (sulfamethoxazole/trimethoprim 300 mg/ml) 15,000 oz were given once a day for two weeks. The sulcus area was flushed with 0.075% chlorohexidine and 0.9% saline three times a day for one week. Four weeks post-treatment, the elephant showed no signs of infection and the tusk had grown approximately 0.5 cm.