J Korean Assoc Oral Maxillofac Surg.  2010 Apr;36(2):145-148. 10.5125/jkaoms.2010.36.2.145.

The conservative treatment of mandibular fracture in a child with circummandibular wiring: case report

• Kim HM
• Kim TW
• Song SI
• Lee JK

• KMID: 2190001
• DOI: http://doi.org/10.5125/jkaoms.2010.36.2.145

Abstract

Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.

Keyword

Pediatric mandibular fracture; Circummandibular wiring

MeSH Terms

Adolescent
Adult
Ankylosis
Child
Health Resorts
Humans
Incidence
Mandible
Mandibular Fractures
Maxillofacial Injuries
Regeneration
Splints
Temporomandibular Joint
Tooth
Tooth, Unerupted

Figure

• 

  Fig. 1. Circummandibular wiring on traumatic injury of 5 year old girl under the diagnosis of fracture of the left parasymphysis and luxation of #32 tooth. A. Preoperative panoramic view. B. Intraoral photograph showing circummandibular wiring with surgical splint in situ. C. Intraoral photograph 5 months after operation demonstrating stable occlusion. D. Panoramic view 5 months after operation shows restored continuity of the inferior border of the previous fracture site.

• 

  Fig. 2. Circummandibular wiring on traumatic injury of 6 years old boy under the diagnosis of fracture of skin laceration, fracture of the mandible, and luxation of #41, #42, #83 teeth. A. Preoperative panoramic view. B. Intraoral photograph showing circummandibular wiring with surgical splint in situ. C. Intraoral photograph 8 months after operation demonstrating stable occlusion. D. Panoramic view 8 months after operation shows normal eruption of the #43 which was on the fracture line. The fracture line is invisible after complete bone healing.

Reference

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