An estimated 40-year-old female wild-born African elephant (Loxodonta africana) housed at an AZA-accredited institution was evaluated for a 48-hour history of fracturing her right tusk within the enclosure. The fracture occurred at the labial margin and a portion of the fracture site extended obliquely below the labial margin; moderate bleeding (later determined to be of gingival origin) and discomfort were present. A literature review of different techniques for estimating coronal pulp length within the tusk revealed both the traditional method of measuring the distance of the labio-dental fold to the eye and assuming a 1:1 ratio of the pulp cavity,1 as well as the more recent formula that has been published describing findings that suggest the coronal pulp length varies based on age and sex of the animal, but will not extend 300 mm past the lip.2 According to both measurement techniques, a fracture site at the labial margin should have exposed the pulp canal of the tusk requiring further therapeutics such as vital pulpotomy, endodontics, or extraction; however, on clinical examination, there did not appear to be any pulp exposure. The fractured portion of the tusk was removed without sedation. Due to the individual’s age and other health concerns, conservative medical treatment with flunixin meglumine (Banamine: Intervet Inc./Merck Animal Health, Summit, NJ 07901) 1500 mg PO q 24 h for three days, then q 48 h for six days, omeprazole (Gastrogard: Merial; Duluth, GA 30096) 3.42 g PO q 24 h for two days, and doxycycline 9000 mg PO q 24 h for seven days was elected over sedation or anesthesia for more definitive therapy. Eighteen months after initial presentation, no abscessation had been noted and the tusk had begun to regrow. Despite the severity of the fracture, no pulp had been exposed and the tusk was not devitalized.
The authors thank Dr. Michael Q. Lowder of the University of Georgia for his consultation on this case.
1. Robinson PT, Schmidt M. Dentistry in zoo animals: dental diseases of elephants and hippos. In: Fowler ME, ed. Zoo and Wild Animal Medicine. 2nd ed. Philadelphia, PA: WB Saunders; 1986:534–547.
2. Steenkamp G, Ferguson WH, Boy SC, et al. Estimating exposed pulp lengths of tusks in the African elephant (Loxodonta africana africana). J S Afr Vet Assoc. 2008;79:25-30.