Mandible Fractures

2021 ◽  
Author(s):  
John J. Chi ◽  
Emily Konkus
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Penetrating Trauma ◽  
Mandibular Fracture ◽  
Facial Fractures ◽  
Surgical Interventions ◽  
Maxillomandibular Fixation ◽  
Mandible Fracture ◽  
Fracture Management ◽  
Mandible Fractures

Mandible fractures are often caused by blunt or penetrating trauma and are one of the most common facial fractures. It is critical to understand facial and mandibular anatomy to best evaluate, classify, and treat mandible fractures. The primary goal of treatment is to restore the jaw to the preinjury occlusion. This can be achieved through open reduction with internal fixation or closed reduction with maxillomandibular fixation (MMF) in conjunction with dietary changes and/or physiotherapy. The main risks and concerns in mandible fracture management are infection, malunion, airway compromise, pain, and temporomandibular joint (TMJ) dysfunction. This chapter will provide a brief overview of facial and mandibular anatomy as well as common treatment methods and surgical interventions.  This review contains 17 figures, 2 tables, and 43 references Key words: Mandibular fracture, maxillomandibular fixation, occlusion, malunion, closed reduction, open reduction, TMJ dysfunction

scholarly journals A Comparative Study between ORIF and ORIF with Mandibulomaxillary Fixation in Unfavourable Mandible Fractures

2018 ◽  
Vol 26 (1) ◽  
pp. 48-50
Author(s):  
Kripamoy Nath ◽  
Rudra Prakash ◽  
Bapan Devnath ◽  
Avinava Ghosh
Keyword(s):  
Open Reduction ◽  
Mouth Opening ◽  
Initial Assessment ◽  
P Value ◽  
Mandibular Ramus ◽  
Mandible Fracture ◽  
Diagnosis And Classification ◽  
Mandible Fractures ◽  
A Prospective Study

Introduction  This study aims to evaluate the efficacy of open reduction and the combination of open reduction with mandibulomaxillary fixation (MMF) in cases of unfavourable mandible fractures.   Materials and Methods   This is a prospective study carried out from 2010 to 2015 on 60 patients with mandible fracture attending the Dept. of ENT.  The diagnosis and classification of mandible fracture into favourable and unfavourable types were done on the basis of clinical and CT faciomaxillary findings. The outcomes were assessed by comparing the preoperative and postoperative occlusion, mouth opening and symmetry of mandibular ramus. Patients with favourable mandible fractures were excluded from the study.   Results   We found that out of 60 patients, 40 cases were of the unfavourable type. ORIF with MMF gave better outcome compared to ORIF alone. The data were statistically analysed using Z score and P value.   Conclusion  Initial assessment of mandible fractures into favourable and unfavourable category plays a significant role in planning the management.  Management of unfavourable mandible fractures with ORIF and MMF gives functionally and aesthetically better results as compared to ORIF alone.

scholarly journals Effects of Exogenous Nerve Growth Factor on The Expression of BMP-9 and VEGF in The Healing of Rabbit Mandible Fracture With Local Nerve Injury

2020 ◽  
Author(s):  
Sen Yang ◽  
Jiao Cheng ◽  
Cheng Man ◽  
Lian Jiang ◽  
Guogeng Long ◽  
...  
Keyword(s):  
Nerve Growth Factor ◽  
Growth Factor ◽  
Fracture Healing ◽  
Mandibular Fracture ◽  
Vascular Endothelial ◽  
Lower Lip ◽  
Nerve Growth ◽  
Qrt Pcr ◽  
Mandible Fracture ◽  
Mandible Fractures

Abstract Background: Mandibular fracture healing is a complex process involving nerves and growth factors. Nerve growth factor (NGF) not only facilitates the maintenance of sympathetic neurite growth but also stimulates other growth factors that can promote the essential osteogenesis and angiogenesis for fracture healing. Therefore, it is necessary to analyze the combined effects of NGF, bone morphogenic protein-9 (BMP-9), and vascular endothelial growth factor (VEGF) to accelerate the healing of mandible fractures.Methods: The models of mandible fracture with local nerve injury established in forty-eight rabbits were randomly divided into nerve growth factor group (NGF group), gelatin sponge group (GS group), blank group, and intact group. The recovery of nerve reflex was assessed by observing the number of rabbits with lower lip responses to acupuncture. The fracture healing was observed with visual and CBCT, and then callus tissues from the mandibular fracture area were collected for hematoxylin and eosin (HE) staining observation, and the expression of BMP-9 and VEGF in callus at different stages was detected by quantitative real-time PCR (qRT-PCR).Results: Needling reaction in the lower lip showed the number of animals with nerve reflex recovery was significantly higher in the NGF group than that in the GS and blank groups at the 2nd and 4th weeks after the operation. The combined results of macroscopic observation, CBCT examination, and histological analysis showed that a large number of osteoblasts and some vascular endothelial cells were found around the trabecular bone in the NGF group and the amount of callus formation and reconstruction was better than that in the GS group at the 2nd week after the operation. The qRT-PCR results indicated that the expression levels of BMP-9 and VEGF in the four groups reached the highest values at the 2nd week, while the expression levels of both in the NGF group were significantly higher than that in the GS group.Conclusion: The exogenous NGF could accelerate the healing of mandible fractures. This work will provide a new foundation and theoretical basis for clarifying the mechanism of fracture healing, thereby promoting fracture healing and reducing the disability rate of patients.

scholarly journals A Novel Technique for Attaining Maxillomandibular Fixation in the Edentulous Mandible Fracture

2012 ◽  
Vol 5 (1) ◽  
pp. 7-10 ◽  
Author(s):  
Christopher Knotts ◽  
Meredith Workman ◽  
Kamal Sawan ◽  
Christian El Amm
Keyword(s):  
Oral Cavity ◽  
External Fixation ◽  
Oral Hygiene ◽  
Illustrative Case ◽  
Maxillomandibular Fixation ◽  
Novel Technique ◽  
Mandible Fracture ◽  
Edentulous Mandible ◽  
Gunning Splint ◽  
Mandible Fractures

Edentulous mandible fractures present a unique and challenging surgical problem, particularly because of lack of occlusive dental surfaces to capitalize upon maxillomandibular fixation (MMF). We present a novel technique to achieve MMF using rigid plates spanning the oral cavity to fixate the maxilla to the mandible. The process is rapid and allows stability using the established principles of rigidity, external fixation, and osteosynthesis. This technique allows for a faster MMF than with a Gunning splint and allows for easier oral hygiene. An illustrative case and pre- and postoperative imaging are provided.

scholarly journals Atrophic mandibular fracture treatment: prototyping as a tool in surgical planning

2020 ◽  
Vol 9 (9) ◽  
pp. e796997986
Author(s):  
Reginaldo Fernandes da Silva ◽  
Rebeca Valeska Soares Pereira ◽  
Joana de Ângelis Alves Silva ◽  
Gustavo José de Luna Campos ◽  
Mário César Furtado da Costa ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Clinical Case ◽  
Mandibular Fracture ◽  
Facial Trauma ◽  
Mandibular Fractures ◽  
Surgical Time ◽  
3D Technology ◽  
Mandible Fracture ◽  
Intraoperative Period ◽  
Mandible Fractures

Introduction: Atrophic mandibular fractures are injuries found in old age due to facial trauma. Its treatment is a challenge, even for experienced surgeons, due to the different approaches that can be taken from clinical decisions. Taking into consideration the limitations that the age presented by most of the affected patients brigs, there are devices that stand out by seeking benefits in terms of predictability and time gain in the intraoperative period. The additive manufacturing is a valuable resource in the surgical planning and rehabilitation of these patients. Objective: To expose a clinical case that demonstrates the success in the use of surgical planning through a prototype printed in 3D technology. Clinical case: Elderly woman, 75 years old, victim of a fall from her own height who had a bilateral atrophic mandible fracture due to facial trauma. The surgical procedure was planned using a prototype printed in 3D technology providing predictability and reduced surgical time. The patient evolved in the postoperative period without complaints, with function immediately restores and without signs of infection or plate exposure. Conclusions: Atrophic mandible fractures are still related to a challenging treatment, therefore, adequate surgical planning and the use of auxiliary strategies such as 3D prototyping provide greater predictability of results, as well as time gain during the intraoperative.

scholarly journals Facial injury management undertaken at US and UK medical treatment facilities during the Iraq and Afghanistan conflicts: a retrospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033557 ◽  
Author(s):  
John Breeze ◽  
Douglas M Bowley ◽  
James G Combes ◽  
James Baden ◽  
Rory F Rickard ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Closed Reduction ◽  
Bone Fractures ◽  
Surgical Care ◽  
Secondary Outcome ◽  
Outcome Variable ◽  
Facial Injuries ◽  
Mandible Fracture ◽  
Treatment Facilities ◽  
Mandible Fractures

ObjectivesTo perform the first direct comparison of the facial injuries sustained and treatment performed at USA and UK deployed medical treatment facilities (MTFs) in support of the military campaigns in Iraq and Afghanistan.SettingThe US and UK Joint Theatre Trauma Registries were scrutinised for all patients with facial injuries presenting alive to a UK or US deployed MTF between 1 March 2003 and 31 October 2011.ParticipantsUS and UK military personnel, local police, local military and civilians.Primary and secondary outcome measuresAn adjusted multiple logistic regression model was performed using tracheostomy as the primary dependent outcome variable and treatment in a US MTF, US or UK military, mandible fracture and treatment of mandible fracture as independent secondary variables.ResultsFacial injuries were identified in 16 944 casualties, with the most common being those to skin/muscle (64%), bone fractures (36%), inner/middle ear (28%) and intraoral damage (11%). Facial injuries were equally likely to undergo surgery in US MTF as UK MTF (OR: 1.06, 95% CI 0.4603 to 1.142, p=0.6656); however, variations were seen in injury type treated. In US MTF, 692/1452 (48%) of mandible fractures were treated by either open or closed reduction compared with 0/167 (0%) in UK MTF (χ2: 113.6; p≤0.0001). US military casualties who had treatment of their mandible fracture (open reduction and internal fixation or mandibulo-maxillary fixation) were less likely to have had a tracheostomy than those who did not undergo stabilisation of the fractured mandible (OR: 0.61, 95% CI 0.44 to 0.86; p=0.0066).ConclusionsThe capability to surgically treat mandible fractures by open or closed reduction should be considered as an integral component of deployed coalition surgical care in the future.

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