Results: Of 94 patients, 72 male and 22 female patients belong to the age group of 4–62 years (average 31.57 years).Among the various etiologies, i.e., assault, road traffic accident (RTA), self-fall, workplace injury, and sports-related injury, RTA accounts for 62.76% and self-fall for 18.08% of cases. 1) immediate assessment and treatment of any condition constituting a threat of life. 3) local examination of the mandibular fracture RADIOLOGICAL DIAGNOSIS Panoramic radigraphs . 3 week If tooth retained in fracture line : 4 week Fracture at the symphysis : 4 week. Children and adolescent : 2 week INDICATIONS Absolute indications for removal of a tooth from the fracture line: 1 longitudinal fracture involving the root. 1 functionless tooth which would eventually be removed electively. FRACTURE OF THE CONDYLAR REGION CLASSIFICATION OF CONDYLAR FRACTURE. SURGICAL ANATOMY: Involving joint surface- intracapsular . In a very young with unerupted or very few deciduous teeth---------- use gunning type splint for the lower jaw alone and retained by two circumferential wires.
Injury to teeth Fractured teeth can become infected and cause malunion . Treatment option for dentate patient CONDYLAR FRACURES MOST OFTEN TX WITH MMF ONLY – NONDISPLACED FOR 3 WKS, FOLLOWED BY ELASTICS X 2 WEEKS DISPLACED - 6 WEEKS OF IMF MAY NEED NOTHING OR MAY NEED ORIF TO AVOID ANKYLOSING THE TMJ NEED TO MOBILIZE EVERY 2 WEEKS IF ADULT.
STILL REQUIRES MMT, USEFUL IN ANGLE AND PARASYMPHYSEAL FX.
Of the 100 fractures analyzed, 46% are unilateral fractures and 54% are bilateral.
Sides affected among these are left (58%), right (39%), and symphysis or midline (3%).
A simple guide to the time of immbolization for fractures of the tooth bearing area. 2 institution of appropriate systemic antibiotic therapy. METHODS OF IMMBOILIZATION A) OSTEOSYNTHESIS without INTERMAXILLARY fixation. 1 direct osteosynthesis : A) bone plates B) transosseous wiring. Alveolar nerve) occur in 2% Malocclusion and malunion TMJ problems Complication A study out of UCSF showed no statistically significant difference in complication rate between pts treated with miniplates versus MMF and wire fixation. INTERFERNCE WITH GROWTH POTENTIAL The normal growth of the mandible will be disturbed if unerupted permanent teeth or teeth germs are lost, because the alveolus will not develop normally in the areas affected.
Temporomandibular joint views including tomography. Ct scan FRACTURE OF THE TOOTH BEARING SECTION OF THE MANDIBLE. 5 immediate extraction if fracture become infected. Extraction necessary if root of tooth is fractured A tooth that is intact but in the line of the fracture can be left in place and protected by antibiotics may need extraction later FRACTURE OF THE EDENTULOUS MANDIBLE METHODS OF IMMOBILIZATION. RAMUS FX ARE NATURALLY SPLINTED BY THE PTERYGOMASSETERIC MUSCLE SLING AND USUALLY GET MMF WITH SAME TIMEFRAME AS CONDYLAR. IF CLOSED REDUCTION MAY NEED LINGUAL SPLINTcomplication Delayed healing(3%) and nonunion(1%) most common cause in infection second most common cause is noncompliance inadequate reduction, metabolic or nutritional deficiency can play a role Nerve paresthesia’s (Inf. FRACTURE OF THE MANDIBLE IN CHILDREN The treatment before puberty is generally of a conservative nature because of rapid healing and the adaptive potential of the bone and its contained dentition.Ann Maxillofac Surg 2019;4-8How to cite this URL: Srinivasan B, Balakrishna R, Sudarshan H, Veena G C, Prabhakar S.Ann Maxillofac Surg [serial online] 2019 [cited 2019 Sep 7];4-8. 2019/9/1/124/260352The mandible is immaculate in design with varying strength of bone in different regions, in correlation with stress distribution on function. Minimal jaw movement----------- use simple elastic bandage for chin support. Mixed dentition with inadequate retension ----------use cap splints with cement bond and circumferential wire on each side. Region of coronoid process CLASSIFICATIONClassified by the presence or absence of teeth Class I : Teeth on both side of the fx line dentelous . 2 dislocation or subluxation of the tooth from the socket. INTRACAPSULAR EXTRACAPSULAR Luxation / sublaxation subcondylar neck Condylar head condylar neck hair line high condylar communited low condylar TREATMENT OF CONDYLAR FRACTURES 3 TREATMENT OPTION. Where some occlusion present bur there is wide spread of caries or deciduous teeth------use circumferential wires on each side with cicumzygomatic wires.Management of the mandibular fractures has evolved with time.It has come a long way from the initial use of horse hair as interdental wiring tool, to the present-day use of resorbable hardware and custom-made titanium hardware. permanent Fractures with deciduous dentition can be treated with MMF for 2-3 weeks. Growth center The most feared complication of a Pedi mandible fx is ankylosing of the TMJ with impact on jaw growth that causes severe facial deformity- prevent with weekly mobilization IT IS HARDER TO PERIDONTAL WIRE LIGATURES AROUND DECIDOUS TEETH BECAUSE THE TOOTH IS CLOSER TO THE GINGIVAL MARGIN THAN THE CROWN OF THE PERMANENT TOOTH SO IT MAY BE NECESSARY TO SECURE THE WIRES TO THE PIRIFORM RIM AND MANDIBLE BY CIRCUMANDIBULAR WIRESPOST OPERATIVE CARE THREE PHASES. Sufficient firm erupted deciduous and permanent teeth------eyelets and arch bars UNERUPTED TEETH. Bone plates CONTRAINDICATED Pins Special consideration for children Deciduous teeth vs.Objectives: The objective was to evaluate the age, gender distribution, side and site distribution, etiology, and common patterns of the mandibular fractures.Materials and Methods: This was a systematic retrospective review of records of 94 patients with 162 mandibular fractures treated in a single institution.