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OCT 07 TUE 2008 « 2011 »

22:03
Mandibular fractures
1 2 3 4 5
: 讚 6 7 8 9 10 11 12
13 14 15 16 17 18 19
Oral and Max illof ac ial S urgery Mandibular Frac t ures
20 21 22 23 24 25 26
27 28 29 30 31

E t iology of mandibular f rac t ures

V ehic ular ac c ident s ( 43% )
(18)
A s s ault s ( 34% )
(17)
Work relat ed ( 7% ) (38)
Fall ( 7% ) (40)
S port ing ac c ident s ( 4% ) (5)
Guns hot injuries . . . (rare) (11)

E t iology play s a role in f rac t ure loc at ion

A ut omobile ac c ident s c ondy lar region; Mot orc y c le ac c ident s s y mphy s is ;

(3963) (Salivary gland
A s s ault angle disease)
(3324) (Dentigerous cyst) /
* Fridric h K L et al. 1992
(radicular cyst)
Number of f rac t ures per mandible (2635)
A pprox imat ely 50% of t he pat ient s wit h mandibular f rac t ures had more t han one
f rac t ure. (2195) (Cellulitis) /
, : (Osteomyelitis)

Double f rac t ure: (1876)

angle+ body c ondy le

Triple f rac t ure:
c ondy le+ s y mphy s is
E g.
...
...(part 2)
Clas s if ic at ion
...(part 1)
> S imple, or c los ed
(2009725 )
A f rac t ure t hat does not produc e a wound open t o t he ex t ernal env ironment ,
whet her it be t hrough t he s k in, muc os a, or periodont al membrane.
Bisphosphonate-related
> Compound, or open
osteonecrosis of the jaws (BRONJ)
A f rac t ure in whic h an ex t ernal wound, inv olv ing s k in, muc os a, or periodont al
membrane, c ommunic at es wit h t he break in t he
bone. > I nc omplet e
> Greens t ic k
A f rac t ure in whic h one c ort ex of t he bone is brok en, t he ot her c ort ex being bent .
> Complet e
> Comminut ed
A f rac t ure in whic h t he bone is s plint ered or c rus hed.
> P at hologic
A f rac t ure oc c urring f rom mild injury bec aus e of pre-ex is t ing bone dis eas e.
Wikipedia
> Mult iple
A v ariet y in whic h t here are t wo or more lines of f rac t ure on t he s ame bone not
c ommunic at ing wit h one anot her.
> I mpac t ed princess
A f rac t ure in whic h one f ragment is f irmly driv en int o t he ot her.
> A t rophic
A s pont aneous f rac t ure res ult ing f rom at rophy of t he bone, as in edent ulous
mandibles .
> I ndirec t
A f rac t ure at a point dis t ant f rom t he s ide of injury .
> Complic at ed, or c omplex
A f rac t ure in whic h t here is c ons iderable injury t o t he adjac ent s of t t is s ues or
adjac ent part s ; may be s imple or c ompound.
03/04
, ...
Dent it ion of t he jaw wit h ref erenc e t o t he us e of s plint s
10/02 mccoybe08
S uf f ic ient ly dent ulous jaw
~~ !
E dent ulous or ins uf f ic ient ly dent ulous jaw
09/11
P rimary and mix ed dent it ion

09/08 cin
Loc aliz at ion
, ^...
Frac t ures of t he s y mphy s is region bet ween t he c anines
08/17
Frac t ures of t he c anine region
~~ ~~ ...
Frac t ures of t he body of t he mandible bet ween t he c anine and t he angle of t he
08/17
mandible
~~ ~~ ...
Frac t ures of t he angle of t he mandible in t he t hird molar region
08/11 Debbie
Frac t ures of t he mandibular ramus bet ween t he angle of t he mandible and t he
Dr : ...
s igmoid not c h
08/07
Frac t ures of t he c oronoid proc es s
8 8/13 8/27 ...
Frac t ures of t he c ondy lar proc es s
* A ngle f rac t ures c las s if ied
V ert ic ally f av orable or unf av orable
Horiz ont ally f av orable or unf av orable
Relat es t o:
t he direc t ion of t he f rac t ure line
t he ef f ec t of mus c le ac t ion on t he f rac t ure f ragment s

Diagnos is
* His t ory
. . . pre-ex is t ing s y s t emic bone dis eas e t hat may c aus e or be direc t ly relat ed t o t he
f rac t ured jaw
. . . s ignif ic ant medic al and ps y c hiat ric problems t hat will inf luenc e t he management
of t he pat ient
A his t ory of TMJ dy s f unc t ion c an hav e s ignif ic ant legal and pos t -t x ramif ic at ions .
The t y pe and direc t ion of t raumat ic f orc e c an be ex t remely helpf ul in diagnos is .
aut omobile and mot orc y c le ac c ident s
mult iple, c ompound, c omminut ed
hit by a f is t
s ingle, s imple, non-dis plac ed
The objec t t hat c aus e t he f rac t ure c an inf luenc e t he t y pe and t he number of
f rac t ures .
broad, blunt objec t (2! 4 piec e of wood)
s y mphy s is , c ondy le. . . s ev eral f rac t ures
s maller, well-def ined objec t (hammer)
s ingle c omminut ed f rac t ure

Forc e direc t ion: Conc omit ant f rac t ures

ant . blow direc t ly t o t he c hin:
bilat eral c ondy lar f rac t ures
angled blow t o t he paras y mphy s is :
c ont ra-lat eral c ondy lar or angle f rac t ure
t eet h c lenc hed t oget her at t he moment of impac t : Powered By Hiiir.com

dent al and alv eolar proc es s f rac t ures

* Clinic al ex aminat ion
The s igns and s y mpt oms of mandibular f rac t ures :
Change in oc c lus ion
A nes t hes ia, pares t hes ia, or dy s es t hes ia of t he lower lip
A bnormal mandibular mov ement s
Change in f ac ial c ont our and mandibular arc h f orm
Lac erat ions , hemat oma, and ec c hy mos is juaios
Loos e t eet h and c repit at ion on palpat ion
Dolor, t umor, rubor, and c olor
73 ( )
* Radiologic ex aminat ion
1975/01/20
P anoramic radiography : f or ov erall diagnos is
Lat eral oblique radiography
P os t eroant erior (P A ) radiography : good f or general apprais al
Oc c lus al v iew: f or judging t he s y mphy s eal region
P eriapic al v iew
Rev ers e Towne’s v iew: part ic ularly good f or c ondy lar f rac t ures Juaios

Temporomandibular joint , inc luding t omograms from Juaios

Comput ed t omography (CT) s c an

Murmur ( )
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2010-09-11
S kul l vi ew P A vi ew
17:31
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Typ e s o f Pa n o re x X-ra y a cci d e n t We b MD FD A

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