Treatment of jaw fracture
A jaw fracture is a complex injury affecting the bone, muscles, and soft tissues of the face. If improperly treated, the consequences can be serious: malocclusion, chronic pain, and lower facial deformity. Therefore, it is important to seek treatment from an experienced maxillofacial surgeon skilled in modern diagnostic and bone fracture fixation techniques.
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Anatomy of the maxillofacial region
The maxillofacial region consists of two main bony structures: the maxilla and mandible. The mandible is mobile and connected to the skull at the temporomandibular joint, allowing for mouth opening, speech, and chewing. The mandible is static but bears significant load during breathing and articulation.
The bone in this region is dense, but during a blow or fall, the load is distributed unevenly, often resulting in a fracture or crack. Depending on the direction of the injury, damage may occur to the submental area, the body or angle of the jaw, the alveolar process, and, in more severe cases, even the zygomatic and nasal structures.
The jaw has a complex blood supply and numerous nerve endings. Therefore, any injury is accompanied by pain, swelling, and impaired facial sensation. Inadequate fixation of the fragments poses a risk of complications, ranging from tissue necrosis to the formation of a pseudoarthrosis.
Causes of jaw fractures
There are many causes, but the most common are a blow to the face, a fall, a car accident, an industrial injury, or a sports collision. In older people, a fracture or crack often occurs with minimal impact due to osteoporosis and decreased bone density.
Pathological fractures also occur when the bone is destroyed from the inside due to tumors, cysts, chronic inflammation, or osteomyelitis.
It's important to remember: even a minor crack or pain in the tooth area after a blow should be seen by a doctor. A fracture can often be hidden—the displacement is minimal, but without treatment, the fragments separate, and within a few days, facial asymmetry and malocclusion develop.
Classification of jaw fractures
Each jaw fracture has its own characteristics – the direction of the fracture line, the degree of displacement of the fragments, and the involvement of teeth and soft tissues. To select the optimal treatment method and ensure proper fixation of bone structures, the doctor determines the type and level of injury, classifying the fracture by location and nature of the injury.
Classification of mandibular fractures
The mandible most often fractures in typical areas – the angle, body, chin, and condylar processes. Based on the nature of the injury, there are:
- Transverse and oblique fractures – caused by a direct blow
- Comminuted – caused by strong mechanical impacts, accompanied by soft tissue damage
- Bilateral – caused by trauma to the chin area
- Multiple – several fracture lines, often with displacement
Based on the degree of displacement of the fragments:
- Without displacement – the bone structure is preserved, but fixation with a splint is required
- With displacement – occlusion is impaired, surgical osteosynthesis is required
When choosing a treatment method, the surgeon considers not only the fracture line, but also the condition of the teeth, gum tissue, and the general health of the patient.
Classification of maxillary fractures
The maxilla is less frequently fractured, but such injuries are often more dangerous, as they involve the maxillary sinuses, nasal passages, and orbit. The Le Fort classification is used:
- Le Fort I – horizontal fracture, extends above the teeth
- Le Fort II – pyramidal, involving the nasal region and orbits
- Le Fort III – complete separation of the facial skeleton from the base of the skull
Such injuries require hospitalization and immediate surgical intervention.
Symptoms of a jaw fracture
The severity of symptoms depends on the force of the impact, the location of the fracture, and the condition of the facial soft tissues. The doctor evaluates not only the visual manifestations but also the sensations described by the patient, as subjective symptoms help pinpoint the injury site.
Subjective symptoms
The patient complains of:
- Sharp pain when opening the mouth or chewing
- A feeling of "split" bite
- Numbness of the lips or chin (damage to the nerve branches)
- Difficulty speaking, drooling
- A feeling of teeth shifting
Even with a small crack, the patient may feel a crunching or clicking sound when moving the lower jaw – this is a sign of instability of the bone fragments.
Objective symptoms
During examination, the doctor notes:
- Swelling and hematoma of the soft tissues of the face
- Deformity of the chin or cheekbones
- Abnormal mobility of bone fragments
- Malocclusion
- Bleeding from the mouth or nose
With fractures of the upper jaw, nosebleeds, swelling under the eyes, and difficulty breathing are often observed.
First aid for a jaw fracture
First aid should be provided before the doctor arrives. Basic steps:
- Immobilize the jaw using available means (bandage, gauze, sling)
- If there is an open wound, cover it with a sterile dressing.
- If bleeding occurs, apply a cold compress to the face.
- If breathing is difficult, turn the patient's head to the side to prevent aspiration of blood.
- Administer pain medication (if available).
Do not attempt to realign the jaw or replace teeth on your own. Only a doctor, after diagnosis, can determine whether surgery is required or a splint is sufficient.
Diagnostic methods
To confirm a fracture, the following are used:
- Radiography in two projections is the basic method
- Orthopantomogram – to assess the dentition and alveolar bone
- Computed tomography – to accurately detect fragment displacement and assess bone structures
- Examination by an oral surgeon and neurologist – to rule out damage to nerve branches
Only after a comprehensive diagnosis does the doctor develop a treatment plan: from medicinal relief of inflammation to surgical fixation with plates.
Treatment methods for jaw fractures
Modern treatment for jaw fractures is aimed at anatomical restoration of bone structures, fixation of fragments, and early return of function. The strategy depends on the nature of the injury and the condition of the teeth and soft tissues.
Drug treatment
Drug therapy always accompanies the main stage of recovery. This includes:
- Broad-spectrum antibiotics to prevent infection and osteomyelitis
- Pain relievers and anti-inflammatory medications (ibuprofen, ketorolac)
- Decongestants and antihistamines
- For open wounds – local antiseptic treatment, a course of antiseptic mouth rinses
- Prescribing vitamins and minerals to accelerate callus formation and tissue regeneration (calcium, zinc, vitamin D)
Drug therapy does not replace the main surgical intervention, but it creates a favorable environment for bone and soft tissue healing.
Conservative treatment
Used for fractures without displacement and in patients with intact teeth. The primary method is jaw splinting.
A splint is a metal or plastic structure secured to the teeth with wire or mini-screws. It holds bone fragments in the correct position, preventing displacement.
Main types:
- Single-jaw splint – for cracks or minor injuries
- Double-jaw splint with intermaxillary fixation – for more complex fractures when complete immobilization of the lower jaw is necessary.
The duration of fixation depends on the patient's age and bone condition, typically 3-4 weeks. The patient eats liquid or soft foods and maintains meticulous oral hygiene. After the splint is removed, the rehabilitation phase begins – restoration of chewing muscle function, articulation, and facial expressions.
Surgical treatment
Surgical treatment is the "gold standard" for complex or displaced fractures. It allows for precise restoration of bone anatomy and avoids complications.
- Open reduction and osteosynthesis. The surgeon accesses the fracture line, aligns the bone fragments, and fixes them with titanium miniplates and screws. This fixation is reliable, does not interfere with function, and does not require rigid immobilization of the jaw.
- Minimally invasive methods. For limited injuries, endoscopic osteosynthesis may be used. Microplates are placed through a small incision, minimizing soft tissue trauma and accelerating rehabilitation.
- Surgical reconstruction. In severe cases, when part of the bone tissue is destroyed or infected, plastic surgery is performed – grafting a bone fragment from the chin or iliac region, or using titanium meshes to restore the shape of the face.
Rehabilitation after such surgeries includes physical therapy, massage, and follow-up with a surgeon and orthodontist.
Complications of a jaw fracture
Even with timely treatment, a fracture remains a complex injury, and it is important to be aware of the possible consequences.
Traumatic sinusitis
When the upper jaw is damaged, the maxillary sinus is often affected. Infection enters the cavity through a crack or wound, causing inflammation. Symptoms include pain under the eye, nasal congestion, and purulent discharge. Treatment includes antibiotics, sinus debridement, and sometimes surgical drainage.
Traumatic osteomyelitis
Infectious inflammation of the bone marrow occurs with open fractures and poor hygiene. Symptoms include pain, swelling, and fever.
To prevent osteomyelitis, the surgeon thoroughly cleans the wound and prescribes a course of antibiotics. If infection develops, surgical debridement of the site and lengthy rehabilitation are required.
Incorrect fusion of fragments
The most common complication with late presentation or self-fixation attempts. Fragments fuse, resulting in malocclusion, facial distortion, and chronic pain. Correction is only possible surgically—repeated reduction, osteotomy, and re-fixation.
General information
Rehabilitation after a jaw fracture
Rehabilitation is the most important stage of treatment. Even perfectly performed osteosynthesis requires restoration of muscle tone and joint mobility.
Main areas:
- Remedial gymnastics – 7-10 days after removing the splint, the patient begins light exercises: opening the mouth, moving the lower jaw forward and backward, and laterally.
- Physical therapy – UHF, laser, and magnetic therapy stimulate osteogenesis and reduce inflammation.
- Massage and myogymnastics – restore blood flow and facial symmetry.
- Diet – first liquid food, then soft food. Hard foods are excluded until the bones are fully fused.
- Doctor's checkups – scheduled examinations and X-rays every 2-3 weeks.
After comprehensive rehabilitation, the patient regains full chewing, speech, and facial expression function. The K+31 clinic has developed individualized recovery programs, including exercise program selection and consultations with an orthodontist and physiotherapist.
Prices for jaw fracture treatment in Moscow
The cost of treatment depends on the complexity of the injury, the extent of the surgical intervention, and the materials used.
Approximate guidelines:
- Maxillofacial surgeon consultation – from 3,000 ₽
- X-ray or CT scan – from 5,000 ₽
- Splinting of the lower or upper jaw – from 25,000 ₽
- Surgical osteosynthesis with titanium plates – from 60,000 ₽
- Rehabilitation after a jaw fracture (course of procedures) – from 15,000 ₽
Exact prices are determined after an in-person consultation and the development of an individual treatment plan. The clinic offers cashless payments and tax deduction processing.
FAQ
Which type of osteosynthesis is better: open or closed?
The choice of method depends on the nature of the injury. For a crack or fracture without displacement, closed fixation—a splint or intermaxillary elastic bands—is sufficient. However, if the fragments are displaced, open osteosynthesis is used: the surgeon aligns the bone through a small incision and fixes it with miniplates. This method is more reliable, reduces rehabilitation time, and allows for highly accurate bite restoration.
When can teeth be restored after a jaw fracture?
Implantation or prosthetics are possible only after complete bone fusion—usually after 3-6 months. The doctor assesses the condition of the bone regenerate using CT scan data. If the bone volume is insufficient, bone grafting is performed. At the K+31 clinic, the implantologist and maxillofacial surgeon work as a team, ensuring safe and aesthetic restoration of teeth after trauma.
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General information about jaw fractures
A jaw fracture is one of the most common injuries to the facial bones. In the clinical practice of maxillofacial surgeons, this injury occurs in patients of all ages, most often in men aged 20–40. The main characteristic is that a fracture affects not only the skeletal framework, but also soft tissues, dentition, and sometimes the respiratory tract.
Treatment of such cases requires a comprehensive approach – accurate diagnosis, selection of an appropriate fixation method, and mandatory rehabilitation after a jaw fracture. The full recovery of speech, chewing, and facial expression depends on the correctness of the initial steps.
According to leading Moscow centers, including the K+31 Clinic, most patients seek treatment with fractures of the lower jaw, and less often with damage to the upper jaw. However, in any case, the doctor evaluates all facial bones as a single system, as the displacement of one fragment can alter the biomechanics of the entire area.