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Mandibular fracture

life science Maturity 7-9 Next article →

A mandibular fracture is a medical term for a break in the jaw bone. This injury is significant because the mandible is essential for eating, speaking, and facial structure. Most fractures occur due to trauma, such as a hard hit to the side of the face or a fall onto the chin. These injuries are most common in males during their 30s. In about 60% of cases, a single impact causes the bone to break in two different places.

Mandbular fractures
Mandbular fractures

When the bone breaks, it changes how the mouth functions. One major symptom is traumatic malocclusion, which means the teeth no longer meet correctly. Because teeth are highly sensitive to pressure through a sense called proprioception, even tiny shifts feel wrong. Patients often experience trismus, which is a difficulty in opening the mouth fully. Some may have a mouth opening of less than 3 cm. Other signs include swelling, bruising, and numbness in the chin or lower lip. This numbness happens because the inferior alveolar nerve runs along the jaw and can be compressed.

NoDisManFracMark
NoDisManFracMark

Fractures can occur at several specific anatomical locations. The most frequent site is the condyle, located near the ear, which accounts for 36% of cases. The mandibular body is the next most common at 21%. The angle of the jaw follows at 20%, and the symphysis, or the midline of the chin, accounts for 14%. It is much rarer to see fractures in the ramus at 3% or the coronoid process at 2%. Doctors divide the mandible into these specific zones to decide on the best treatment.

Mandbular fractures
Mandbular fractures

There are different ways to classify the physical state of the bone. A simple fracture is a complete break with very little fragmentation. In contrast, a comminuted fracture occurs when the bone is shattered into many small pieces. This often results from high-velocity injuries like those caused by bullets. A compound fracture is one that connects to the external environment. In the mouth, any fracture in the tooth-bearing area is considered compound because it connects to the oral cavity via the periodontal ligament.

NoDisManFracMark
NoDisManFracMark

Condylar fractures require special attention because of their location. These can be unilateral, affecting one side, or bilateral, affecting both. A unilateral fracture might cause bleeding in the ear canal if the external auditory meatus is injured. If the bones overlap, the height of the ramus may shorten. This can cause the teeth to meet too soon on one side, creating an open bite. In rare cases, a bilateral body or parasymphysis fracture is called a "flail mandible." This can cause the tongue to move backward and block the airway.

Multiple mandible fractures
Multiple mandible fractures

To find these breaks, doctors use various imaging technologies. Traditional plain film radiography uses different views like the Towne's view for the condyle. However, these can be difficult to read due to overlapping structures. Panoramic radiography provides a flat, 2-dimensional image of the entire mandible. This is often as accurate as a CT scan for most areas. Computed tomography, or CT, is the most sensitive method available. It allows doctors to see the bone in axial, coronal, or sagittal slices.

NoDisManFracMark
NoDisManFracMark

Modern medicine can reconstruct CT images into a 3-dimensional view. This helps surgeons understand how bone fragments have moved or displaced. Treatment varies depending on the fracture type and location. Some patients may require immediate surgery using open reduction internal fixation, known as ORIF. This involves using hardware to hold the bone together. Another method is maxillomandibular fixation, which wires the teeth to stabilize the jaw. While antibiotics like penicillin are sometimes used, the evidence for this practice is considered poor.

Multiple mandible fractures
Multiple mandible fractures
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