MANDIBULAR

FRACTURE
SUPPLEMENTS
 PARTS OF THE MANDIBLE
SYMPHYSIS PARASYMPHYSIS BODY ANGLE RAMUS

Prein the region between the region between Lateral body; the includes the third molar Ascending
the roots of the the lateral roots of portion distal to the region and the junction ramus;
central incisors the canines and the canine of body and ramus
central incisors (parasymphysis) but
proximal to the
third molar

Mathog Mandibular fusion Anterior aspect of the Horizontal ramus or Triangular shaped area; Vertical ramus; CORONOID CONDYLE
point mandible between body proper; area Anterior border: flat
the canine teeth between the angle anterior border of the quadrilaterally
and the canine masseter muscle shaped,
tooth Posterior border: line superiorly and
from the third molar laterally flared
area to the posterior- extension of the
superior attachment of mandible
the masseter on the toward the base
ramus of the skull
MUSCLE GROUPS THAT EXERT FORCES ON THE
MANDIBLE
OCCLUSION
• Class I- the mesiobuccal cusp of the
maxillary first molar approximates the
buccal groove of the mandibular first
molar

• Class II- the mesiobuccal cusp of the

maxillary first molar is mesial to the buccal
groove of the mandibular first molar

• Class III- the mandibular first molar groove

lies mesial to the mesiobuccal cusp of the
maxillary first molar
 CLASSIFICATION OF
FRACTURE
Based on its local characteristics:
• Simple- overlying mucosa and skin are intact
• Compund or open- fracture is exposed to
the oral cavity or open through a skin
laceration
• Greenstick- fracture is incomplete, usually
with one cortical plate broken and the other
broken
• Comminuted- (+) multiple small fragments
• Complex- extend to multiple directions
• Complicated- occur in both the mandible
and maxilla
 CLASSIFICATION OF
FRACTURE
Based on the potential effects of the muscles on it
• Horizontally unfavorable- fractures that
course downward and posterior (A)
• the posterior fragment will be pulled upward by
the elevator group
• the anterior fragment will be pulled downward
by the depressors

• Horizontally favorable- fractures that

course downward and forward; the
fragments are pulled together (B)
 CLASSIFICATION OF
FRACTURE
Based on the potential effects of the muscles on it

• Vertically unfavorable- fractures are beveled

forward and medially
• the posterior fragment is medially displaced by
the elevator muscle group

• Vertically favorable- fractures are beveled

posteriorly and medially
 CLASSIFICATION OF FRACTURE:
ANATOMIC LOCATION
Symphyseal and parasymphyseal fracture
• Linear and oblique fractures
• Comminution or bone loss is relatively rare
• High energy trauma: (+)inferior butterfly fragment
 CLASSIFICATION OF FRACTURE:
ANATOMIC LOCATION
Body of the mandible

• Fracture patterns in the mandibular body depend

on the energy of the impact and vector.
• Comminution is seen in high-energy trauma.

• Mostly linear
 CLASSIFICATION OF FRACTURE:
ANATOMIC LOCATION
Angle of the mandible

• Most common location: third molar and extend to the

antegonial notch anterior to the true angle.

• They are often oblique.

• A triangular comminution at the inferior aspect of the

mandible is common.
 CLASSIFICATION OF FRACTURE:
ANATOMIC LOCATION
Condylar fracture
• 9–45% of all mandibular fractures in adults
• 50% of all mandibular fractures in children
• Frequently condylar head fractures have an extracapsular component
• In some instances, may run inside the capsule of the temporomandibular joint
 CLASSIFICATION OF FRACTURE:
ANATOMIC LOCATION
Subcondylar fracture
• Subcondylar fractures location: at the base of the condylar process at or below the level of the sigmoid notch
• Classified into:
a) High (condylar neck)
b) Low subcondylar fractures. Subcondylar fractures are
 CLASSIFICATION OF FRACTURE:
ANATOMIC LOCATION
Coronoid process fractures
• Coronoid process fractures are rare.
• Isolated fractures occur in combination with zygoma or zygomatic arch fractures.