Mandible fracture in East Paris
Maxillofacial Surgery Pr Meningaud
What X-rays should be ordered for a suspected mandibular fracture?
Most mandibular fractures can be diagnosed with the help of two X-rays: the panoramic dental X-ray and the open-mouth lower view. In case of doubt, or for very complex fractures, the specialist may request a CT scan.
an open-mouth view of the lower jaw allows better assessment of condyles fracture displacements
triple fracture of the mandible on a panoramic dental X-ray
Mandible fracture in East Paris
Maxillofacial surgeon Paris Est Créteil
How are mandibular fractures treated?
Mandibular fractures
These are fractures of the mandible, which can be divided into two very different groups:
Mandibular body fractures
These correspond to fractures of the symphysis, horizontal ramus, angle and ascending ramus.
Clinical features:
* swelling, peri-fragmentary mobility, interdental diastemas, gingival wounds.
* dental articulation disorders (premature contact and hollowness).
* hypo or anaesthesia of the labiomentum (inferior dental nerve).
* asphyxia disorders, rare but classically described in bilateral parasymphyseal fractures.
* frequently associated dental luxations and fractures.
Treatment:
* objective: restoration of dental articulation.
* reduction – support with intermaxillary blocking (5-6 weeks), or osteosynthesis with mini-plates or steel wires.
Fractures of the mandibular condyle
A distinction is made between extra-articular (lower subcondylar) and intra-articular (upper subcondylar and capitellar) fractures. They share a common symptomatology but differ in their treatment.
Clinical features:
* Pain, sometimes swelling, in the temporomandibular region.
* dental articulation disorders (premature contact and hollowness).
* disturbance of mandibular kinetics (limited mouth opening with latero-deviation).
* chin ecchymosis (indirect sign reflecting fracture mechanism).
Treatment:
* extra-articular fractures: restraint-reduction by intermaxillary blocking (4 weeks), sometimes on a molar wedge. In the event of significant displacement, osteosynthesis (miniplate or centromedullary screw fixation) may be proposed.
* intra-articular fractures: early rehabilitation with mechanotherapy to limit the risk of temporomandibular ankylosis.