Orthodontist treats an unusual patient

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When orthodontist Long Hu was asked to fix a patient's crooked jaw four years ago, he knew it would be particularly challenging. The patient was a child, but it was unlike any child he had ever treated before.

It was a male panda, born in 2022, named Bei Xia. His lower jaw was misaligned and one of his front legs had been amputated — injuries that arose shortly after birth when his inexperienced mother picked up the fragile, hairless and undeveloped newborn in her mouth.

With his injuries Bei Xia had no way to suckle properly, and getting life-saving nutrition was difficult.

When Bei Xia was six months old, Long's team decided to conduct an orthodontic correction treatment for him, which would require a procedure never performed on a giant panda before.

Long, an orthodontist at West China Hospital of Stomatology at Sichuan University, collaborated with the Chengdu Research Base of Giant Panda Breeding in Sichuan province to treat the cub's jaw in procedures lasting around six months.

A paper on the case, a world first, was published recently in the international journal The Angle Orthodontist.

After his mother's mistake, Bei Xia's leg became infected, and it had to be amputated just hours after birth. His life was saved, but his lower jaw was adversely affected and gradually drifted to the left as he grew.

By the time he was three months old, the asymmetry had become so pronounced that veterinarians feared it would hinder his growth if not corrected. So they turned to Long's hospital, one of China's top dental institutions.

Long, who led the treatment, acknowledged the challenge. "Doctors knew almost nothing about how a panda's jaw develops, and there was very limited research available for reference," he said.

Veterinarians briefed the orthodontic team on the panda's oral anatomy, and there were several rounds of consultations before they settled on a treatment plan.

"Giant pandas and humans are both mammals, and there are similarities in jaw development," Long said. "So we drew on our experience treating children — using external force to guide jaw growth."

The initial procedure took place at the panda base in early 2023 in an operation lasting several hours.

Safety was a major challenge. Anesthesia is risky for wild animals, but especially for panda cubs. Their low body weight leaves little margin for error, and their weak temperature regulation demands precise control.

Orthodontists needed to bond appliances to the cub's teeth and apply traction with rubber bands, which keepers replaced every 24 hours over the next six months.

Bei Xia's jaw deviation was largely corrected by the treatment, and his sucking, biting and swallowing functions returned to normal, the paper said. He now lives at Panda Valley, a branch of the panda base in Dujiangyan, Sichuan, and is in good health and has a good appetite.

The veterinary team believes the early jaw injury, combined with later adaptive limb compensation, disrupted his facial development.

"Losing a forelimb changed the way the cub nursed — both his posture and how he exerted force," said Huang Wenjun, a veterinarian at the base.

He said the treatment demonstrates the great potential of cross-disciplinary collaboration. The base plans to expand its network of clinical partners to include eye and throat specialists, among others, to support panda care.

Long, the lead orthodontist, said the results exceeded his expectations. After the paper was published, he received congratulations from many international counterparts. The experience, he said, could inform the treatment of other mammals.

He added that the case also vividly confirms a core principle of human orthodontics: facial bone growth is malleable, and early intervention is critical.

"The technique wasn't the hard part," he said. The biggest problem was the lack of information about the animal's development. That's one reason the operation was of such interest to many.

"The operating room was packed with orthodontists, imaging specialists, vets, keepers, and anesthesiologists," Long recalled. "It was like a major human surgery."

Hongxing News contributed to this story.

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