Elephants use their tusks for a variety of purposes, including digging, carrying objects, and displaying behavioural signals. Despite their remarkable capacity to heal from traumatic injuries, a fractured tusk can lead to serious complications. In managed elephants, tusk fractures present a significant clinical challenge for veterinarians and care staff. When the pulp becomes exposed, these fractures can cause ascending bacterial infections or inflammation of the dental pulp. If left untreated, pulpitis can result in a non-viable tusk, requiring extraction, and has been identified as a cause of sepsis and death. Pain is a frequent consequence, particularly when the pathology spreads to the periodontal ligament or the pulpal apex.

Managing such fractures can be both technically complex and logistically demanding, often necessitating anaesthesia. Administering anaesthesia to elephants requires specialised knowledge, as five out of 159 reported elephant deaths between 1988 and 1999 were associated with anaesthetic or perianaesthetic complications. Furthermore, even when tusk extraction is pursued, multiple procedures may be required to fully resolve infections and remove the tusk, particularly in cases of severe apical disease or when tertiary dentin has become ankylosed into the surrounding alveolar bone. This case report will discuss the results of various possible treatment options and the outcomes of the particular treatment administered.