The principles of closed reduction of an alveolar fractures are similar to
those of the treatment of a lateral luxation, only the osseous injury is more
extensive. Once the teeth are in alignment, the alveolar bone will
automatically be repositioned. The subsequent interdental fixation enables
If exposed, the root surface of the displaced teeth is cleansed with saline
solution. The tooth-bearing alveolus is then repositioned with combined labial
and lingual digital pressure until its normal position has been reestablished,
indicated by alignment of the dental arch in proper occlusion. Strong force for
reduction is usually required. In rare cases, forceps may be needed for
Fixation is preferably accomplished with a resin splint attached to at least
one neighboring intact tooth on each side of the vertical fracture lines.
Soft-tissue repair should precede the splinting of the teeth.
Involved teeth and neighboring healthy teeth are gently dried with
compressed air or absolute alcohol and kept dry during the fixation
Care should be taken that compressed air and absolute alcohol are not
allowed to enter the soft-tissue wound.
Points of splint fixation on the repositioned teeth of the fractured
alveolus and preferably two neighboring teeth on each side of the fragment are
etched with phosphoric acid for 20 seconds.
Remember to place a suction tube to maintain dryness during etching
The etch gel is removed by saline irrigation. Make sure to direct the saline
jet in a direction away from soft-tissue wounds and to place a suction tube to
remove the spray of the saline and etch gel.
The fixation spots are then dried.
It is imperative that the enamel be kept dry until the resin has completely
A finger on the lingual aspect of the teeth can maintain fragment position
during the fixation procedure.
Resin material (eg, that used for temporary crowns and bridges) is applied
to provide splinting. The resin material allows a certain flexibility of the
splinting and is easy to remove.
Occlusion should be checked, no premature occlusal contacts are allowed.
Alveolar fractures should be fixed for 4 weeks.
Removal of fixation device
After the fixation period (4 weeks), the resin can be peeled off with a
dental scaler or removed with a burr. The teeth of the fractured segment of the
jaw must be supported by digital pressure during this procedure.