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Chapter 5: Mandibular Trauma
observing grimacing with painful stimulation. The nerve can be injured
anywhere throughout its course.
Three major areas of concern for facial nerve injury is to the main trunk
in the region of the condylar neck, marginal mandibular nerve injury in
the submandibular approach, and frontal branch injury in the preauricu-
lar approach to the condyle.
Facial nerve monitoring should be considered on open approaches to
avoid further injury.
H. Fixation Failure
Fixation failure results in fracture mobility that can lead to nonunion,
malunion, or infection. Causes include insufficient fixation, fracture of
the plate, loosening of the screws, and devitalization of the bone around
the screws (Figure 5.15).
VII. Pediatric Mandibular Fractures
A. Pediatric Dental and Skeletal Anatomy
The dentition (Figure 5.16) and mandible (Figure 5.17) in children are
very different from those in adults. Pediatric teeth have poor retentive
Figure 5.17
Differences between the adult and pediatric mandible
include size, shape, and high cancellous-to-cortical
ratio, making the pediatric mandible more flexible.
Figure 5.16
Differences in crown
and root structure
between permanent
and deciduous teeth.