Imaging Studies
See the list below:
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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.
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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.
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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.
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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.
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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.
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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.
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(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.
