General Principles of Mandible Fracture and Occlusion Workup

Updated: Sep 15, 2021
  • Author: Edward W Chang, MD, DDS, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Workup

Laboratory Studies

See the list below:

  • Routine preoperative laboratory studies are ordered in preparation for surgery.

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Imaging Studies

See the list below:

  • A CT scan is extremely useful in maxillofacial trauma. Obtain images in both the axial and coronal planes.

  • A panoramic radiograph (Panorex) affords an excellent 2-dimensional representation of the mandible. The entire mandible and the dentoalveolar structures can be viewed with the Panorex. Historically, the symphyseal region was limited due to overlap wash out, but current orthopantograms give an excellent view of the mandible.

  • Several types of plain films add to the evaluation of mandibular fractures.

    • The dental periapical view gives fine detail to the teeth and their roots.

    • The dental occlusal view helps determine whether the fracture is vertically favorable or unfavorable. It delineates the medializing effects of the internal pterygoid posterior to the first molar and the mylohyoid anterior to the first molar.

  • The mandibular series includes several views to help identify the fracture.

    • The Caldwell is a coronal view that shows displacement in the horizontal plane.

    • The oblique views highlight the ramus angle and posterior body.

    • The reverse Towne view depicts the condylar/subcondylar region well.

  • Obtain a chest radiograph when evidence of a broken denture or missing tooth is present.

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