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

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

Mandible - Body, complex

back to CMF overview

Glossary

1 Treatment top

Closed treatment of complex fractures of the body enlarge

Treatment

Apply arch bars in the mandible and maxilla.

Reduce the bony deformity as far as possible in a closed manner prior to putting the patient into occlusion. Apply intermaxillary ligatures to maintain the occlusal position.

The patient has to be maintained in MMF for at least 6-8 weeks.


Closed treatment of complex fractures of the body enlarge

Pearl: individual laboratory designed arch bars

After taking impressions individual arch bars can be fabricated on plaster of paris casts. Prior to the arch bar fabrication these casts are sawed and the fracture is reduced (see blue zone on the cast).


Closed treatment of complex fractures of the body enlarge

Thus, the arch bar helps in the reduction. Furthermore, individual arch bars prevent damage of the periodontal soft tissues and are less invasive.

2 Case example top

Closed treatment for complex fractures of the body enlarge

Diagnosis

Patient presents left mandibular body comminuted fracture.


Closed treatment for complex fractures of the body enlarge

Acceptable preoperative occlusion despite complex fracture.


Closed treatment for complex fractures of the body enlarge

OPG depicts the extent of bone comminution.


Closed treatment for complex fractures of the body enlarge

Axial CT views


Closed treatment for complex fractures of the body enlarge

Coronal CT sections.


Closed treatment for complex fractures of the body enlarge

3-D CT view of the same fractures.


Closed treatment for complex fractures of the body enlarge

Closed treatment for complex fractures of the body enlarge

Treatment

The patient underwent MMF with arch bars and wires. Photograph shows the postoperative occlusion.


Closed treatment for complex fractures of the body enlarge

OPG shows fracture after treatment.


Closed treatment for complex fractures of the body enlarge

Stable occlusal result 7 weeks after treatment.


Closed treatment for complex fractures of the body enlarge

Mouth opening 7 weeks after treatment.


Closed treatment for complex fractures of the body enlarge

OPG shows consolidation in process 8 weeks after treatment.

v1.0 2008-12-01