Fracture mandible with edentulous jaw is best treated with -
• Condylar neck is the weakest part of the mandible and MC site of fracture
• Mandible may fracture directly at the point of the blow
• Indirectly where the force from the blow is transmitted and the mandible fractures at a point of weakness distant from the original blow, known as ‘guardsman’ fracture.
• ‘Butterfly’ fracture of the mandible: A segment of mandible is detached from the rest of the mandible in the canine regions.
Diagnosis
• Recommended radiographic evaluation of a mandible fracture: Panoramic radiograph (Panorex) and Towne’s view x-ray.
Treatment
• As in midface fractures, restoration of dental occlusion forms the foundation for fracture management.
• Intermaxillary fixation before fracture exposure and plating is necessary.
• Condylar and subcondylar mandible fractures are most often treated by IMF alone.
• Medical management of mandibular fractures involves a purée-type diet, interdental fixation for several weeks, 1% chlorhexidine mouth rinses, and antibiotics.
External fixator
Minerva-plaster
Interdental wiring
Intermaxillary elastic traction