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Chapter 5: Mandibular Trauma
4. Treating Pediatric Body and Angle Fractures
y
y
Greenstick fractures are managed with soft diet and pain control.
y
y
Minimal to moderate displacement is treated with MMF with or
without elastics.
y
y
Angle fractures cannot be treated with dental splints.
y
y
An extraoral open reduction approach may be indicated for severe
displacement.
5. Treating Pediatric Dentoalveolar Fractures
Dentoalveolar injuries range from 8 percent to 50 percent of pediatric
mandibular fractures.
a. Primary Teeth
Replacement of primary teeth is unnecessary. Primary teeth act as
space holders for the permanent dentition. Space-holding appliances
may be needed after the premature loss of primary teeth in trauma.
b. Permanent Teeth
y
y
Permanent teeth should be reinserted within 2 hours. The teeth may
be transported in saline or milk.
y
y
Single or multiple teeth may be fixated with wire-acid etch composite
splinting using stainless steel wire. Care should be take to avoid the
gingiva and the opposing teeth (Figure 5.12).
y
y
The fractured segment may be reduced, and the patient is placed in
MMF.
y
y
Large fractured segments may require plate-screw fixation, if this is
possible without injuring the teeth.
VIII. References
1. Peltier J, Ryan MW. Mandible fractures. Grand Rounds
Presentation. Galveston, Texas: University of Texas Medical Branch,
Department of Otolaryngology; May 26, 2004. Accessed at: http://
www.utmb.edu/otoref/grnds/Mandible-fx-040526/Mandible-fx-040526.htm.
2. Barton JR. A systemic bandage for fractures of the lower jaw.
Am
Med Recorder Phila.
1819;2:153.
3. Gunning TB. Treatment of fracture of the lower jaw by interdental
splints, I.
Amer J Dent Sci.
1868;2:53-55.
4. Gilmer TL. A case of fracture of the lower jaw with remarks on
treatment.
Arch Dent.
1887;43(4):388.