Jawbone Exposure
Although it is uncommon, we occasionally see jawbone attached to some teeth when they are extracted - in particular, the canine - in cases of severe root exposure. We have never had any subsequent complications from the few cases we have seen and the jawbone will usually heal itself. Luckily, root exposure does not usually mean jawbone exposure.
This particular dog had a jawbone configuration that was quite unlike that of the dogs we typically see. From our initial exam, we believed the material cut out in the gum line was plaque and tarter. After everything was cleaned, we saw something that looked like the terrain of the moon, was very hard, and would obviously be uncomfortable for the dog, but treatable. The jawbone pressed into the gum and little pieces of jawbone actually poked through the gum tissue. Taking this away and getting underneath the gum lining in this case, since we were dealing with jawbone and not tooth, required a much more delicate approach. If we had cut into the gum tissue and peeled it back to work on the exposed jaw, there would have been excessive bleeding to control and the procedure would become much more costly. Instead, we made that rough terrain as smooth as possible, undercutting the jaw bone under the gum lining. First we applied a very thin coating of composite bonding material over the entire area. It was then built up so that ultimately there was a smooth continuous transition from the enamel surface to as close as we could get to the gum lining. There may have been just a tiny gap between the gum lining and the end of the thin bonding material. When all of this was done, a top coat was applied to all of it, much like putting a coat of urethane on a piece of wood to preserve the finish. That cover coat is light cured to harden it.
The pictures below show the different steps of progression through the process and the end result.
Left: Exposed root/jawbone before cleaning. Center: After cleaning, before being smoothed. Right: After bonding material has been applied and built up to the gumline. The surrounding gum lining will heal in a short period of time.