Mandible Fracture

Question 1

Pt attends w/ mobile LR3 and thinks bite has changed. He informs you he got in fight last night. Dx?

Answer 1

Mandibular fracture

Question 2

How are mandibular fractures defined?

Answer 2

By location
Symphysis, parasymphsis, body, angle, ramus, condyle and coronoid

Question 3

What q’s ask pt?

Answer 3

PC: pain, altered sensation, altered occlusion, mobility, loss of teeth
Hx: what happened, other injuries, LOC
MH/ dh
SH

Question 4

How examine pt with suspected mandibular fracture?

Answer 4

EO - look swelling/ deformity/ laceration
IO - look mucosal lacteration, fractured teeth, sublingual haematoma, stepped occlusion

Question 5

How to see if change in occlusion?

Answer 5

Check occlusion against existing wear facets

Question 6

What images should take for suspected mandibular fracture?

Answer 6

Need two images at different angulation
Common OPT and PA mandible

Question 7

What should immediate mx of mandibular fracture be in dental practice?

Answer 7

Ensure no airway or acute issues
Contact on call max fax at nearest hospital for advice
Write a referral letter to give to pt
Can infiltrate w/ LA for pain relief
Ensure contemporaneous notes - if assault police may require clinical notes

Question 8

If change in occlusion what type of mandibular fracture?

Answer 8

Displaced

Question 9

How are displaced fractures usually managed?

Answer 9

Surgically under GA - open reduction and internal fixation

Question 10

What instructions would be given to pt following mandibular surgery?

Answer 10

Good OH
Avoid smoking
Soft diet and avoiding contact sports 6 weeks