Executive Editor: Marcelo Figari, Gregorio Sánchez Aniceto General Editor: Daniel Buchbinder

Authors: Ricardo Cienfuegos, Carl-Peter Cornelius, Edward Ellis III, George Kushner

Mandible - Angle and ramus, complex

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Glossary

1 Treatment top

Closed treatment for complex fractures of the angle enlarge

Arch bars are applied to the teeth and MMF is secured. The patient is monitored for positional changes of the mandibular ramus using x-rays. After a period of at least 6 weeks, MMF is released and fracture stability determined by manipulation. The patient is placed on a soft diet and if the occlusion maintains for a two-week period the arch bars may be removed.

2 Case example top

Closed treatment of complex fractures of the angle enlarge

Case example

OPG shows a right comminuted mandibular fracture.


Closed treatment of complex fractures of the angle enlarge

PA x-ray of the same case.


Closed treatment of complex fractures of the angle enlarge

Principles

Massively swollen face with comminuted angle fracture. Open treatment would be extremely difficult no matter which surgical approach is selected.

Because the occlusion could be readily reestablished, MMF was the selected treatment.


Closed treatment of complex fractures of the angle enlarge

Postoperative x-rays

"Postoperative" x-rays following closed treatment and MMF show good alignment of bone fragments ...


Closed treatment of complex fractures of the angle enlarge

... and reestablishment of occlusion.


Closed treatment of complex fractures of the angle enlarge

Outcome

Six weeks of MMF was indicated. Following rehabilitation of function, patient developed good mouth opening and occlusion and solidification of the fracture.


Closed treatment of complex fractures of the angle enlarge

Closed treatment of complex fractures of the angle enlarge

v1.0 2008-12-01