CT Scans and 3D Printed Model Help Kodiak the Two-Toed Sloth Fix His Smile

3D printing is often put to the test by helping out our animal friends, from furry and feathered to scaled and shelled…and now, the two-toed sloth.

One-year-old Kodiak resides at Busch Gardens in Tampa Bay, Florida, but took a trip to the University of South Florida (USF) Health not long ago for some dental assistance. One of his veterinarians made an appointment with the USF Radiology team for Kodiak to undergo a CT scan, due to an off-set jaw that makes him appear to be smiling. While this may look adorable, his elongated teeth actually prevent his mouth from closing properly, which makes it hard for the young sloth to eat.

At the end of April, a story on the show Wildlife Docs aired about how the USF Health medical team and the Busch Gardens Tampa Bay veterinary group worked together to fix Kodiak’s dental problem.

Kodiak’s interprofessional health care team was made up of two imaging research scientists, his veterinarian, dentist Dr. William Geyer, and a radiologist. The radiology department can scale the anatomy of a patient from human to animal, and USF Health’s Summer Decker, PhD, assistant professor and director of imaging research in the department, holds several patented imaging techniques that use 3D printing and virtual technologies to visualize anatomy.

USF Health’s radiology team worked with a veterinarian and a dental consultant from Busch Gardens Tampa Bay to form the unlikely team. Members drew upon their different fields to create a solution.

Dr. Dominique Keller, DVM, senior veterinarian at Busch Gardens Tampa Bay, said, “When it comes to the specialty of radiology, Dr. Summer Decker and her team have been unbelievable.

“We need that collaboration. To me that’s the beauty of working near an academic medical institution, and USF is perfect for us.”

The innovative USF Radiology team often helps surgeons and physicians develop treatment plans and roadmaps for patients, which can definitely be enhanced through 3D technologies. But for most of them, including Dr. Decker, who was excited to “draw on all the different fields and combine that knowledge to create a solution” for Kodiak, this situation was definitely out of the ordinary.

Dr. Decker said, “This was very different from what we normally do.”

Kodiak’s CT scan was necessary, as it would shed light on whether his problem was caused by a jaw deformity, or his habit of sucking his foot. USF Health has previously assisted the zoological park’s veterinary team with advanced diagnostic scans of penguins and wallabies, so they were more than up to the challenge.

“We take pictures in slices and take all of those slices and push them back together to get the exact same patient in 3D. You can essentially fly through the body,” Dr. Decker explained.

USF CT technologist Joe Henry first had to modify the radiation dose and scan protocol in order to meet pediatric guidelines.

Dr. Decker said, “Because of Kodiak’s size, he is basically a little kid, like a baby and has to be scanned differently than an adult.”

The team also had to be careful of the sloth’s razor-sharp teeth during the craniofacial scan.

While the images were being generated, they compared them to normal sloth skulls from Busch Gardens’ skeletal reference collection.

“None of us had ever scanned a sloth before so we were unfamiliar with the anatomy,” Dr. Decker explained. “Using a reference like the normal skull allows us to determine where Kodiak’s differences are.”

Comparisons from normal sloth skulls shown with a 3D print from Kodiak’s scan.

Neuroradiologist Ryan Murtagh, MD, MBA, associate professor in the Department of Radiology, reviewed the images, while Jonathan Ford, PhD, biomedical engineer and assistant professor in the department’s Division of Imaging Research, was in charge of the 3D modeling analysis.

Dr. Geyer and USF Health’s Decker review digital models of Kodiak’s craniofacial scans with Joe Henry, USF CT technologist.

While they found no evidence of a structural deformity in the jaw, Ford was able to open and close the virtual mouth of the sloth to find where the teeth and jaw were not aligning properly to cause his bite problem. Then, they could determine how to fix it.

“That’s why the CT is so nice. You can take an image, rotate it in three-dimensions and look exactly at what’s happening with him,” said Dr. Keller.

A few months after Kodiak’s CT scan, the Busch Gardens veterinary team and dental consultant Dr. Geyer came back to USF for a follow-up appointment, and to look over the treatment plan worked up by Dr. Decker’s team. Included was a 3D print, made from the 3D model and CT scan, that showed how many teeth, and where they were located, would need to be individually shaved to fix the sloth’s bite. This helped the team really visualize the treatment plan.

(L-R) Summer Decker, PhD, assistant professor and director of imaging research in the USF Health Department of Radiology; Tampa dentist William Geyer, DDS; and Dominique Keller, DVM, senior veterinarian at Busch Gardens Tampa Bay.

Soon after returning to Busch Gardens, Dr. Geyer carefully shaved down Kodiak’s teeth at the Animal Care Center. The whole interprofessional care team, along with a small of group of children, watched the simple procedure.

While the kids were understandably concerned about Kodiak, the young sloth came through with flying colors – however, since his teeth will continue growing, he will require similar dental treatments from time to time.

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