Successful Application and Outcome of a Direct Pulp Cap in a Malaysian Elephant
Thomas J. Clark, DMD
Clinical Professor, Department of Surgical and Hospital Dentistry, School of Dentistry, University of Louisville, Louisville, KY, USA
Significant tusk fractures in elephants usually result in a pulp exposure. Untreated pulp exposures inevitably result in an infection of the pulp, pulpal necrosis, infection of the periapical tissues, loss of the tusk, and in some instances loss of the host animal to septic processes.
We present a successful application of a procedure for a fractured elephant tusk with pulp exposure that was simple, performed with readily available instrumentation, and did not require any form of anesthesia. The procedure involved a partial pulpectomy, followed by application of topical antibacterial medication, direct pulp cap utilizing calcium hydroxide (Dycal), followed by obliteration of the access canal utilizing glass ionomer, amalgam, and photo-cure resin. Subsequently, a machined aluminum crown was placed on this tusk for final restoration. Follow-up approximately 1.5 years later showed a continual and uninterrupted growth of the tusk of approximately 10 inches. This indicates that there was no significant permanent physiological damage to the pulp, and normal odontogenesis has ensued.
This procedure was performed on a 14-year-old Malaysian elephant (Elephas maximus hirsutus). The successful outcome of this procedure warrants consideration in situations like this one.