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Mandibular Body Fractures Workup

  • Author: Jose E Barrera, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
 
Updated: Sep 28, 2015
 

Imaging Studies

See the list below:

  • CT scanning and plain radiography, including panoramic, lateral-oblique, posteroanterior, occlusal, and periapical views, may be helpful. However, the single most informative radiologic study used in mandibular fracture diagnosis is panoramic radiography.
  • Panorex provides the ability to view the entire mandible in one radiograph. However, it requires an upright patient, and it lacks fine detail in the TMJ, symphysis, and dental/alveolar process regions.
  • Plain radiography may be helpful.
    • The lateral-oblique view helps diagnose ramus, angle, or posterior body fractures. The condyle, bicuspid, and symphysis regions are often unclear.
    • Mandibular occlusal views demonstrate discrepancies in the medial and lateral position of body fractures.
    • Caldwell posteroanterior views demonstrate any medial or lateral displacement of ramus, angle, body, or symphysis fractures.
  • CT scanning also may be helpful in assessment of facial fractures.
    • CT scanning allows physicians to survey for facial fractures in other areas, including the frontal bone, naso-ethmoid-orbital complex, orbits, and the entire craniofacial horizontal and vertical buttress systems.
    • Reconstructions of the facial skeleton are often helpful in conceptualizing the injury.
    • CT scanning is also ideal for condylar fractures, which are difficult to visualize.
 
 
Contributor Information and Disclosures
Author

Jose E Barrera, MD Medical Director, Texas Facial Plastic Surgery and ENT; Associate Professor, Uniformed Services University of the Health Sciences; Clinical Associate Professor, University of Texas Health Science Center at San Antonio School of Medicine

Jose E Barrera, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Sleep Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Stephen G Batuello, MD Consulting Staff, Colorado ENT Specialists

Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Association for Physician Leadership, American Medical Association, Colorado Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Stephen G Batuello, MD Consulting Staff, Colorado ENT Specialists

Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Association for Physician Leadership, American Medical Association, Colorado Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;SymbiaAllergySolutions<br/>Received income in an amount equal to or greater than $250 from: Symbia<br/>Received from Allergy Solutions, Inc for board membership; Received honoraria from RxRevu for chief medical editor; Received salary from Medvoy for founder and president; Received consulting fee from Corvectra for senior medical advisor; Received ownership interest from Cerescan for consulting; Received consulting fee from Essiahealth for advisor; Received consulting fee from Carespan for advisor; Received consulting fee from Covidien for consulting.

Additional Contributors

Hassan H Ramadan, MD, MSc Professor and Vice-Chair, Department of Otolaryngology-Head and Neck Surgery, Professor, Department of Pediatrics, West Virginia University School of Medicine

Hassan H Ramadan, MD, MSc is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Rhinologic Society

Disclosure: Nothing to disclose.

References
  1. Pektas ZO, Bayram B, Balcik C, Develi T, Uckan S. Effects of different mandibular fracture patterns on the stability of miniplate screw fixation in angle mandibular fractures. Int J Oral Maxillofac Surg. 2012 Mar. 41(3):339-43. [Medline].

  2. Boffano P, Roccia F, Zavattero E, et al. European Maxillofacial Trauma (EURMAT) in children: a multicenter and prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 May. 119 (5):499-504. [Medline].

  3. Siwani R, Tombers NM, Rieck KL, Cofer SA. Comparative analysis of fracture characteristics of the developing mandible: the Mayo Clinic experience. Int J Pediatr Otorhinolaryngol. 2014 Jul. 78 (7):1066-70. [Medline].

  4. Dodson TB. Third molars may double the risk of an angle fracture of the mandible. Evid Based Dent. 2004. 5(3):78. [Medline].

  5. Sadhwani BS, Anchlia S. Conventional 2.0 mm miniplates versus 3-D plates in mandibular fractures. Ann Maxillofac Surg. 2013 Jul. 3(2):154-9. [Medline]. [Full Text].

  6. Kuriakose MA, Fardy M, Sirikumara M, et al. A comparative review of 266 mandibular fractures with internal fixation using rigid (AO/ASIF) plates or mini-plates. Br J Oral Maxillofac Surg. 1996 Aug. 34(4):315-21. [Medline].

  7. Ellis E 3rd, Price C. Treatment protocol for fractures of the atrophic mandible. J Oral Maxillofac Surg. 2008 Mar. 66(3):421-35. [Medline].

  8. Katakura A, Shibahara T, Noma H, et al. Material analysis of AO plate fracture cases. J Oral Maxillofac Surg. 2004 Mar. 62(3):348-52. [Medline].

  9. Luhr HG, Hausmann DF. [Results of compression osteosynthesis with intraoral approach in 922 mandibular fractures]. Fortschr Kiefer Gesichtschir. 1996. 41:77-80. [Medline].

  10. Orabona GD, Abbate V, D'Amato S, Romano A, Iaconetta G. Surgical sequence of reduction in double mandibular fractures treatment. Ann Ital Chir. 2014 May-Jun. 85 (3):207-13. [Medline].

  11. Burm JS, Hansen JE. The use of microplates for internal fixation of mandibular fractures. Plast Reconstr Surg. 2010 May. 125(5):1485-92. [Medline].

  12. Alpert B, Engelstad M, Kushner GM. Invited review: small versus large plate fixation of mandibular fractures. J Craniomaxillofac Trauma. 1999 Fall. 5(3):33-9; discussion 40. [Medline].

  13. Barber HD, Woodbury SC, Silverstein KE. Mandibular fractures. Oral and Maxillofacial Trauma. Philadelphia, Pa: WB Saunders Co; 1991. 473-526.

  14. Collins CP, Pirinjian-Leonard G, Tolas A, et al. A prospective randomized clinical trial comparing 2.0-mm locking plates to 2.0-mm standard plates in treatment of mandible fractures. J Oral Maxillofac Surg. 2004 Nov. 62(11):1392-5. [Medline].

  15. Gardner KE, Aragon SB. The mandibular fracture. ENT Secrets. Philadelphia, Pa: Hanley & Belfus; 1996. 302-309.

  16. King RE, Scianna JM, Petruzzelli GJ. Mandible fracture patterns: a suburban trauma center experience. Am J Otolaryngol. 2004 Sep-Oct. 25(5):301-7. [Medline].

  17. Lazow SK. The mandible fracture: a treatment protocol. J Craniomaxillofac Trauma. 1996 Summer. 2(2):24-30. [Medline].

  18. Schilli W, Stoll P, Bahr W. Mandibular fractures. Manual of Internal Fixation. New York, NY: Springer-Verlag; 1990. 65-80.

  19. Spiessel B. The stability principle. Internal Fixation of the Mandible: A Manual of AO/ASIF Principle. New York, NY: Springer-Verlag; 1989. 30-45.

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A mandible body fracture with displacement. (A) Transverse fracture of the right mandible. (B) Fixation achieved using miniplates at the superior and inferior borders. (C) Postoperative radiograph demonstrating fixation.
Forces acting on the mandible and demonstration of the relationship between muscle pulls and fracture angulation. (A) Horizontally unfavorable. (B) Horizontally favorable. (C) Vertically unfavorable. (D) Vertically favorable.
(A) An oblique fracture of the body fixed with 1 lag screw, in combination with a compression plate at the inferior border and a dental splint for tension. (B) A fracture of the mandible body with a basal triangle. (C) Open reduction and adequate fixation using a miniplate at the superior border and a reconstruction plate at the inferior border. (D) Postoperative radiograph demonstrating fixation. An open hole in the reconstruction plate lies between the triangle and the corpus.
 
 
 
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