Topic

Mandible

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As with maxilla fractures, these injuries are usually caused by a direct blow. Aside from segmental fractures, which would in most cases be managed in a similar manner to maxillary fractures, the three most common mandibular fractures are body, ramus and condylar fractures. These are illustrated in the image below.

Often, the fracture can be predicted from the nature of the facial blow. For example, a severe blow to the chin point is most likely to result in a fracture at either the point of contact and/or in the condyle area. A blow to the side of the face often results in a fracture at either the point of contact and/or the contralateral condyle or ramus. As these secondary fractures – away from the point of contact – can readily be missed, proper radiographic imaging is imperative.

Management of these fractures can include non-surgical conservative treatment, extra-oral fixation or surgical stabilisation. Undisplaced fractures are generally managed non-surgically with rest and analgesia. Symptoms generally resolve over four weeks.

A common point of fracture is in the area of any impacted wisdom tooth (third molar). Some studies have cited a two-to-four-times greater incidence of mandibular fracture in athletes with impacted wisdom teeth. 4,5 Athletes in contact sports such as football should consider having impacted wisdom teeth removed during the close season.

Click on the following images to see examples of mandible fractures.

  • The mandible

    The mandible (jawbone) is the largest strongest and lowest bone in the face.

  • Mandible anatomy

    The three most common fracture sites are the body ramus and condyle.

  • Angle fracture

    An undisplaced left angle fracture.

  • Body fracture

    An undisplaced fracture on the body of the mandible.

  • Ramus fracture

    A left sided ramus fracture.

Any athlete suffering a severe blow to the maxilla or mandible must be referred for appropriate imaging. Not all of these fractures have reliable clinical symptoms, and can often be missed during a clinical examination.

Dr Paul Piccininni

Sport, Cosmetic and Restorative Dentistry