Good afternoon

K . R . Vardan
2nd yr Postgraduate student
Sibar institute of dental sciences
Guntur, Andhra Pradesh
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 MANAGEMENT
OF
PEDIATRIC MANDIBULAR
FRACTURES

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Etiology

Road traffic accidents

Sports and physical abuse.

Fall from height

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Frequency

 5% of mandibular fractures were in children aged 6-11

years- Rowe's 1969 .

 Thoren reported that 7.7% of mandibular fractures

occur in children younger than 16 years and 2.9% occur
in children younger than 10 years.

 Only 12% of pediatric mandibular fractures occur in

patients younger than 6 years.

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Fracture localization

22%

(2%)

9% (12%)

8%
49%

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Signs and symptoms

Malocclusion
Difficulty to open the mouth

Deviation on opening the mouth

Pain and local edema

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Types of fracture
 Simple
 Greenstick fracture (rare, exclusively in children)
 Fracture with no displacement (Linear)
 Fracture with minimal displacement

 Displaced fracture

 Comminuted fracture
Extensive breakage with possible bone and soft tissue loss
 Compound fracture
Severe and tooth bearing area fractures
 Pathological fracture
(osteomyelities, neoplasm and generalized skeletal disease)
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Presentation

 Complete trauma evaluation

 Assessment of occlusion

 Associated injuries

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Factors to be considered

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How different is child
mandible

 High Tooth to Bone ratio.

 More cancellous.

 Growth at different places of mandible.

 More soft tissue cushioning

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 Case :1
 4 yr f

 C/C: Mandibular pain and

Malocclusion.

 PMHx: previously healthy

 Associated symptoms:
denies neck pain

 PDH: IMF for 2 weeks.

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 Mechanism of injury – fall from building.

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Mock surgery

Open reduction

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Placement of acrylic splint

Circum mandibular wiring

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Post op OPG

2nd follow up OPG

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Case 2

 Chief complaint:
Fracture of lower jaw.
 History.of present
illness: History of
trauma 4 days ago.
 CT scan was
advised by physician,
CT revealed fracture
of mandible

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 Stabilisation
Interdental wiring

Treatment plan: Adv reduction of fracture and

stabilization using cap splint

Interdental wiring
Cap splint

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Post op OPG

2nd follow up OPG

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Treatment options

• Before age 2 years

• Acrylic splint with circum mandibular wiring.
• 2-5 years

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Miniplate with dental tension band

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Factors to be considered

 Growth of mandible.

 Esthetics.

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Complications

 TMJ Ankylosis .

 Delayed healing ,nonunion and Malunion.

 Malocclusion

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