Imaging Studies

See the list below:

Panorex
- Panorex is the study of choice. The patient must be cooperative and motionless while the radiograph machine rotates. Patient movement may simulate a fracture. Most available equipment requires the patient to be able to sit upright; therefore, this examination may not be possible in critically ill patients or those with suspected cervical spine injuries. (Some facilities have special equipment for the supine patient.)
- A series of plain radiograph views may provide similar information and often are easier to obtain in the acute trauma setting.
Plain radiography: Standard radiograph views that evaluate the mandible include the following:
- Lateral oblique view - Provides the best view of the mandible from the condyle to the mental foramen
- Posteroanterior (PA) view - Can visualize displacement of fractures of the ramus, angle, and body and fractures of the anterior mandible that may be obscured by the vertebral bodies
- Towne occipitofrontal view - Demonstrates condylar fractures and displacement medially or laterally
- Mandibular occlusal views - Demonstrate symphyseal displacement
- Dental radiographs - May prove useful in alveolar fractures or dental root fractures
CT scanning
- Thin-section (≤ 3 mm) CT scans through the mandible can be useful.
- Direct coronal images and/or 3-dimensional or multiplanar reconstructions can help to delineate relation of the temporomandibular joint (TMJ).

Treatment & Management

Zhou H, Lv K, Yang R, Li Z, Li Z. Mechanics in the Production of Mandibular Fractures: A Clinical, Retrospective Case-Control Study. PLoS One. 2016. 11 (2):e0149553. [QxMD MEDLINE Link].
Khatri A, Kalra N. A conservative approach to pediatric mandibular fracture management: Outcome and advantages. Indian J Dent Res. 2011 Nov. 22(6):873-6. [QxMD MEDLINE Link].
Hegab A. Management of mandibular fractures in children with a split acrylic splint: a case series. Br J Oral Maxillofac Surg. 2011 Dec 5. [QxMD MEDLINE Link].
MacLennan WD. Fractures of the mandible in children under the age of six years. Br J Plast Surg. 1956. 9:125.
Rowe NL. Fractures of the jaws in children. J Oral Surg. 1969 Jul. 27(7):497-507. [QxMD MEDLINE Link].
Thoren H, Iizuka T, Hallikainen D. Different patterns of mandibular fractures in children. An analysis of 220 fractures in 157 patients. J Craniomaxillofac Surg. 1992 Oct. 20(7):292-6. [QxMD MEDLINE Link].
Ul Haq ME, Khan AS. A retrospective study of causes, management, and complications of pediatric facial fractures. Eur J Dent. 2018 Apr-Jun. 12 (2):247-52. [QxMD MEDLINE Link]. [Full Text].
Ghosh R, Gopalkrishnan K, Anand J. Pediatric Facial Fractures: A 10-year Study. J Maxillofac Oral Surg. 2018 Jun. 17 (2):158-63. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Morisada MV, Tollefson TT, Said M, Hwang J, Hsieh TY, Funamura JL. Pediatric Mandible Fractures: Mechanism, Pattern of Injury, Fracture Characteristics, and Management by Age. Facial Plast Surg Aesthet Med. 2022 Sep-Oct. 24 (5):375-81. [QxMD MEDLINE Link].
Swanson EW, Susarla SM, Ghasemzadeh A, et al. Application of the Mandible Injury Severity Score to Pediatric Mandibular Fractures. J Oral Maxillofac Surg. 2015 Jul. 73 (7):1341-9. [QxMD MEDLINE Link].
Kaban LB, Mulliken JB, Murray JE. Facial fractures in children: an analysis of 122 fractures in 109 patients. Plast Reconstr Surg. 1977 Jan. 59(1):15-20. [QxMD MEDLINE Link].
Posnick JC, Wells M, Pron GE. Pediatric facial fractures: evolving patterns of treatment. J Oral Maxillofac Surg. 1993 Aug. 51(8):836-44; discussion 844-5. [QxMD MEDLINE Link].
Smith DM, Bykowski MR, Cray JJ, et al. 215 mandible fractures in 120 children: demographics, treatment, outcomes, and early growth data. Plast Reconstr Surg. 2013 Jun. 131(6):1348-58. [QxMD MEDLINE Link].
Myall RW. Management of mandibular fractures in children. Oral Maxillofac Surg Clin North Am. 2009 May. 21(2):197-201, vi. [QxMD MEDLINE Link].
Cole P, Kaufman Y, Izaddoost S, Hatef DA, Hollier L. Principles of pediatric mandibular fracture management. Plast Reconstr Surg. 2009 Mar. 123(3):1022-4. [QxMD MEDLINE Link].
Kushner GM, Tiwana PS. Fractures of the growing mandible. Atlas Oral Maxillofac Surg Clin North Am. 2009 Mar. 17(1):81-91. [QxMD MEDLINE Link].
Goth S, Sawatari Y, Peleg M. Management of pediatric mandible fractures. J Craniofac Surg. 2012 Jan. 23(1):47-56. [QxMD MEDLINE Link].
Pickrell BB, Serebrakian AT, Maricevich RS. Mandible Fractures. Semin Plast Surg. 2017 May. 31 (2):100-7. [QxMD MEDLINE Link]. [Full Text].
Chopra CS, Neubauer DC, Hornacek M, et al. Analysis of Pediatric Facial Fracture Repair Rates and Complications Using California's Office of Statewide Health Planning and Development Database. J Craniofac Surg. 2022 Sep 1. 33 (6):1745-7. [QxMD MEDLINE Link].
Odom EB, Snyder-Warwick AK. Mandible Fracture Complications and Infection: The Influence of Demographics and Modifiable Factors. Plast Reconstr Surg. 2016 Aug. 138 (2):282e-9e. [QxMD MEDLINE Link].
Shi J, Chen Z, Xu B. Causes and treatment of mandibular and condylar fractures in children and adolescents: a review of 104 cases. JAMA Otolaryngol Head Neck Surg. 2014 Mar. 140 (3):203-7. [QxMD MEDLINE Link].
Eppley BL. Use of resorbable plates and screws in pediatric facial fractures. J Oral Maxillofac Surg. 2005 Mar. 63(3):385-91. [QxMD MEDLINE Link].
Poore MC, Penna KJ. The use of resorbable hardware for fixation of pediatric mandible fracture. Case report. N Y State Dent J. 2008 Jun-Jul. 74(4):58-61. [QxMD MEDLINE Link].
MacLennan WD. Consideration of 180 cases of typical fractures of the mandibular condylar process. Brit J Plast Surg. 1952. 5:122.
Cascone P, Marra Marcozzi M, Ramieri V, Bosco G, Vellone V, Spallaccia F. Mandibular Condylar Fractures in Children: Morphofunctional Results After Treatment With External Fixation. J Craniofac Surg. 2017 Oct. 28 (7):1742-5. [QxMD MEDLINE Link].
Landes CA, Day K, Glasl B, Ludwig B, Sader R, Kovács AF. Prospective evaluation of closed treatment of nondisplaced and nondislocated mandibular condyle fractures versus open reposition and rigid fixation of displaced and dislocated fractures in children. J Oral Maxillofac Surg. 2008 Jun. 66(6):1184-93. [QxMD MEDLINE Link].
Tanaka N, Uchide N, Suzuki K. Maxillofacial fractures in children. J Craniomaxillofac Surg. 1993 Oct. 21(7):289-93. [QxMD MEDLINE Link].
Imahara SD, Hopper RA, Wang J, Rivara FP, Klein MB. Patterns and outcomes of pediatric facial fractures in the United States: a survey of the National Trauma Data Bank. J Am Coll Surg. 2008 Nov. 207(5):710-6. [QxMD MEDLINE Link].
Leake D, Doykos J 3d, Habal MB. Long-term follow-up of fractures of the mandibular condyle in children. Plast Reconstr Surg. 1971 Feb. 47(2):127-31. [QxMD MEDLINE Link].
Norholt SE, Krishnan V, Sindet-Pedersen S. Pediatric condylar fractures: a long-term follow-up study of 55 patients. J Oral Maxillofac Surg. 1993 Dec. 51(12):1302-10. [QxMD MEDLINE Link].
McGuirt WF, Salisbury PL 3d. Mandibular fractures. Their effect on growth and dentition. Arch Otolaryngol Head Neck Surg. 1987 Mar. 113(3):257-61. [QxMD MEDLINE Link].

Media Gallery

Anatomy of the mandible.

of 1

Author

Abbas A Younes, MD, FACS Assistant Professor, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Assistant Professor, Department of Pediatrics, University of Kentucky College of Medicine

Abbas A Younes, MD, FACS is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Society of Pediatric Otolaryngology

Disclosure: Nothing to disclose.

Coauthor(s)

Wendy Gottlieb, MD Private Practice

Wendy Gottlieb, MD is a member of the following medical societies: American Society of Plastic Surgeons

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.

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; Ryte; Neosoma; MI10<br/>Received income in an amount equal to or greater than $250 from: Neosoma; Cyberionix (CYBX)<br/>Received ownership interest from Cerescan for consulting for: Neosoma, MI10.

Additional Contributors

Todd Schneiderman, MD Private Practice, Bridgewater, NJ

Todd Schneiderman, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Rhinologic Society

Disclosure: Nothing to disclose.

Acknowledgements

Russell A Faust, MD, PhD Consulting Staff, Department of Otolaryngology, Columbus Children's Hospital

Russell A Faust, MD, PhD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Legal Medicine, American Laryngological Rhinological and Otological Society, American Rhinologic Society, American Society for Head and Neck Surgery, and American Society of Law, Medicine & Ethics

Disclosure: Nothing to disclose.