OMFS Fractures Of The Mandible

Question 1

What might cause numbness of the lip/ chin?

Answer 1

Damage to the IAN by:
Direct trauma
Infection of bone (myelitis)
Cysts
Tumours
Tooth extraction

Question 2

What are the signs and symptoms of a mandibular fracture?

Answer 2

Pain, swelling, limitation of function
Occlusal derangement
Numbness of lower lip
Loose/ mobile teeth
Bleeding (may be in floor of mouth in edentulous patients- sublingual hematoma)
Anterior open bite
Facial asymmetry

Question 3

What are the 7 classifications of a mandibular fracture?

Answer 3

1. Involvement of surrounding tissues
2. Number of fractures
3. Side of fracture
4. Site of fracture
5. Direction of the fracture line
6. Specific features
7. Displacement of the fracture (can tell clinically)

Question 4

Which radiographs would be used to assess the mandibular fracture?

Answer 4

Two radiographs at right angles to each other eg
OPT and PA mandible + occlusal/ lateral oblique/ Townes view.
Can also take CBCT

Question 5

What are the 2 basic principles of treatment of mandibular fracture?

Answer 5

Reduction and fixation

Question 6

What is the treatment for an un displaced fracture?

Answer 6

No surgical treatment - antibiotics, soft diet, spontaneous healing.

Question 7

What is the treatment for a displaced fracture?

Answer 7

Fixation - can be internal or external.
Closed reduction and fixation (IMF) - reduction is guided by patients occlusion, external fixation for 4-6 weeks. Contraindicated in patients with epilepsy.
Open reduction and internal fixation (ORIF) - most common, expose bony edges surgically and reduce with direct vision, fix with titanium plates and screws