1 Treatment topenlarge
Arch bars are applied to the teeth and MMF is secured. The patient is monitored using x-rays for positional changes of the mandibular ramus. At 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 2 weeks the arch bars may be removed.
Note: in complex fractures, the period of MMF may need to be increased up to 8 weeks or more.
2 Case example topenlarge
Panoramic and PA view of a minimally displaced comminuted symphyseal/body fracture in an adolescent patient.
Note: treatment of a simple or a basal triangle fracture would be no different.
Pretreatment occlusal relationship
A malocclusion is the result of this minimally displaced comminuted symphysis/body fracture.
Closed reduction was selected for this patient mandibulomaxillary fixation (MMF) because the extended area of comminution would have required a large reconstruction plate being placed.
The patient did not object to a course of MMF and did not want a larger operation.
"Postoperative" x-rays following closed treatment and MMF show good alignment of bone fragments and reestablishment of occlusion.
Patient underwent 5 weeks of MMF. Final occlusal photographs show restoration or normal occlusion.
Photograph shows rehabilitation of mouth opening.