For comparable fractures, patients who received MMF will lose more weight and take longer to regain mouth opening, whereas, those who receive RIF have higher infection rates.The most common long-term complications are loss of sensation in the mandibular nerve, malocclusion and loss of teeth in the line of fracture. The more complicated the fracture (infection, comminution, displacement) the higher the risk of fracture.Condylar fractures have higher rates of malocclusion which in turn are dependent on the degree of displacement and/or dislocation. When the fracture is intracapsular there is a higher rate of late-term osteoarthritis and the potential for ankylosis although the later is a rare complication as long as mobilization is early. Pediatric condylar fractures have higher rates of ankylosis and the potential for growth disturbance.,Rarely, mandibular fracture can lead to Freys syndrome. Epidemiology
Mandible fracture causes vary by the time period and the region studied. In North America, blunt force trauma (a punch) is the leading cause of mandible fracture whereas in India, motor vehicle collisions are now a leading cause. On battle grounds, it is more likely to be high velocity injuries (bullets and shrapnel). Prior to the routine use of seat belts, airbags and modern safety measures, motor vehicle collisions were a leading cause of facial trauma. The relationship to blunt force trauma explains why 80% of all mandible fractures occur in males. Mandibular fracture is a rare complication of third molar removal, and may occur during the procedure or afterwards.
Angle fractures are defined as those that involve a triangular region bounded by the anterior border of masseter muscle and an oblique line extending from the lower third molar (wisdom tooth) region to the posteroinferior attachment of the masseter muscle. Body
Fractures of the mandibular body are defined as those that involve a region bounded anteriorly by the parasymphysis (defined as a vertical line just distal to the canine tooth) and posteriorly by the anterior border of the masseter muscle. Parasymphysis
Parasymphyseal fractures are defined as mandibular fractures that involve a region bounded bilaterally by vertical lines just distal to the canine tooth. Symphysis
Symphyseal fractures are a linear fractures that run in the midline of the mandible (the symphysis). Fracture type
Mandibular fractures are also classified according to categories that describe the condition of the bone fragments at the fracture site and also the presence of communication with the external environment. Greenstick
Greenstick fractures are incomplete fractures of flexible bone, and for this reason typically occur only in children. This type of fracture generally has limited mobility. Simple
A simple fracture describes a complete transection of the bone with minimal fragmentation at the fracture site. Comminuted
The opposite of a simple fracture is a comminuted fracture, where the bone has been shattered into fragments, or there are secondary fractures along the main fracture lines. High velocity injuries (e.g. those caused by bullets, improvised explosive devices, etc...) will frequently cause comminuted fractures. Compound
A compound fracture is one that communicates with the external environment.