Mandibular fractures 1 / fixed orthodontic courses

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
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Mandibular fractures 1 / fixed orthodontic courses

  1. 1. www.indiandentalacademy.com
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  3. 3. Surgical Anatomy www.indiandentalacademy.com
  4. 4. Facial muscles attached www.indiandentalacademy.com
  5. 5. MUSCLES ATTACHED www.indiandentalacademy.com
  6. 6. Arterial supply www.indiandentalacademy.com
  7. 7. Venous supply www.indiandentalacademy.com
  8. 8. Nerve Supply www.indiandentalacademy.com
  9. 9. CLASSIFICATION  Kruger’s general classification  Simple or closed  Compound or open  Comminuted  Complicated or complex  Impacted  Green stick  Pathological  Generalized Skeletal diseases  Localized skeletal diseases www.indiandentalacademy.com
  10. 10.  Rowe Anatomical location & Killy’s classification  Fracture not involving the basal bone- Dentoalveolar fracture  Fracture involving the basal bone  Single unilateral Condyle  Coronoid  Ramus  Angle & Body  Canine  Symphysis   Double unilateral  Bilateral fracture Dislocation of the condyles  Horizontal & vertical unfavourable fractures of the angles  Bilateral fracture in the canine region  Vertically and horizontally favourable  Verically favourable but horizontally unfavourable  Vertically unfavourable but horizontally favourable  Vertically and horizontally unfavourable www.indiandentalacademy.com   Multiple fractures
  11. 11. Dingman & Natvigs classification  Symphysis fracture  Canine region fracture  Body of the mandible fracture  Angle Region  Ramus region  Coronoid region  Condyler fracture  Dentoalveolar region Olsons study in 1982 www.indiandentalacademy.com
  12. 12. According to direction of the fracture and favorability for treatment Horizontally favorable Horizontally unfavorable Vertically favorable Vertically unfavorable www.indiandentalacademy.com
  13. 13. Relation of the fracture to the site of injury  Direct fracture  Indirect fracture www.indiandentalacademy.com
  14. 14. According to presence or absent of tooth in relation to fracture line Kazanjian and Converse classification  Class 1- When teeth are present on the both side of the fracture line  Class 2- When teeth are present on the one side of the fracture line  Short edentulous posterior fragment  Long edentulous posterior fragment  Class 3 When both the fragments on each side of the fracture line are edentulous. www.indiandentalacademy.com
  15. 15. Extended AO/ASIF cranio-maxillofacial fracture classification of Haug & Greenberg (1993). www.indiandentalacademy.com
  16. 16. ETIOLOGY OF FRACTURE MANDIBLE  Typical Causes    Crush injuries     Direct violence Indirect violence Road traffic incident Aero plane crashes Mining accident Predisposing causes   Presence of cysts, tumors, osteomyelitis, 3rd molars Systemic diseases affecting the formation of structure of bone www.indiandentalacademy.com
  17. 17. Clinical features        PAIN ABNORMAL MOBILITY BLEEDING CREPITUS DEFORMITY ECHYMOSIS & EDEMA FUNCTIONAL LOSS OR INTERFERANCE IN FUNCTION www.indiandentalacademy.com
  18. 18. RADIOGRAPHS REQUIRED OPG PA VIEW LATERAL OBLIQUE VIEW OCCLUSAL IOPA www.indiandentalacademy.com CT SCANS
  19. 19. Basic principles for Rx of Fracture Reduction  Closed  Direct interdental wiring Indirect interdental wiring (eyelet or Ivy loop)  Continuous or multiple loop wiring  Arch bars  Cap splints  'Gunning-type' splints  Pin fixation  Open         Transosseous wiring (osteosynthesis) Plating Intramedullary pinning Titanium mesh Circumferential straps Bone clamps Bone staples www.indiandentalacademy.com Bone screws Fixation  Direct  Indirect
  20. 20. Immobilization  Methods of immobilization  (a) Osteosynthesis without intermaxillary fixation  (i) Non-compression small plates  (ii) Compression plates  (iii) Mini-plates  (iv) Lag screws  (b) Intermaxillary fixation  (i) Bonded brackets  (ii) Dental wiring Direct  Eyelet   (iii) Arch bars  (iv) Cap splints  (c) Intermaxillary fixation with osteosynthesis  (i) Transosseous wiring  (ii) Circumferential wiring  (iii) External pin fixation  (iv) Bone clamps www.indiandentalacademy.com  (v) Transfixation with Kirschner wires
  21. 21. Guide for time of immobilization Young adult with Fracture of the angle receiving Early treatment in which Tooth removed from fracture line 3 weeks IF (a) Tooth retained in fracture line: add 1 week (b) Fracture at the symphysis: add 1 week (c) Age 40 years and over: add 1 or 2 weeks (d) Children and adolescents: subtract 1 week www.indiandentalacademy.com
  22. 22. CLOSED REDUCTION  HISTORY William Saliceto(1210-1277) Tied the teeth (MMF)  Thomas Gilmer(1849-1931) Reveiwed the tech, introduced Arch Bars in 1907.  Barton bandage by JOHN BARTON Lingual-Labial occlusal splint. Vaccum formed acrylic splint Royal Berkshire Haio Frame  www.indiandentalacademy.com
  23. 23. DIRECT INTERDENTAL WIRING www.indiandentalacademy.com
  24. 24. INTERDENTAL EYELET WIRING IVY LOOP METHOD www.indiandentalacademy.com
  25. 25. WILLIAMS MODIFICATION(1968) www.indiandentalacademy.com
  26. 26. LEONARD BUTTON WIRING www.indiandentalacademy.com
  27. 27. CLOVE HITCH TECH IN CASE OF SINGLE TOOTH www.indiandentalacademy.com
  28. 28. STOUT METHOD(1943)  Continous or Multiple loop wiring www.indiandentalacademy.com
  29. 29. Fulton Risdon (1968)  Twisted Labial Wire www.indiandentalacademy.com
  30. 30. OBWEGESER METHOD  Continous Multiple Loop Wiring  www.indiandentalacademy.com
  31. 31. ARCH BARS RISDON ARCH BAR JELENKO ARCH BAR ERICH ARCH BAR KRUPPA ARCH BAR ERICH ARCH BAR HAMILTON (1967) www.indiandentalacademy.com
  32. 32. BARKER(1986) www.indiandentalacademy.com
  33. 33. ACRYLATED ARCH BARS schuchardt(1956) schuchardt&metz(1966) stanhope(1969) clarke(1977) www.indiandentalacademy.com
  34. 34. DIRECTLY BONDED ARCH BARS Baurmash et al(1988) Wall(1986) www.indiandentalacademy.com
  35. 35. CAP SPLINTS 1. Cast silvercap splints 2.Acrylic splints ROBTERTSON(1965) www.indiandentalacademy.com
  36. 36. FRACTURES OF EDENTULOUS MANDIBLE  GUNNING TYPE SPLINTS THOMAS BRYAN GUNNING-(1885) www.indiandentalacademy.com
  37. 37. TREATMENT MODALITIES FOR EDENTULOUS MANDIBLE PERALVEOLAR WIRING www.indiandentalacademy.com
  38. 38. The Obwegeser technique for circumferential wiring CIRCUMMANDIBULAR WIRING (Bradley-1975) www.indiandentalacademy.com
  39. 39.  INTER OSSEOS WIRING  EXTRA ORAL PIN FIXATION ROGER ANDERSON APPLIANCE  PRIMARY RIB GRAFTING - OBWEGER& SAILER (1973) www.indiandentalacademy.com
  40. 40. OPEN REDUCTION HISTORY 1. Gorden Buck(1807-1877) 2. Hansmann(1886) 3. Christiansen(1954) 4. Luhr(1968) 5. Spiessel(1970 & 1974) 6. Schmoker & Niederdellmann & Schilli(1973) 7. Michelet & Champy(1978) 8. Marciani & Gonty(1993) 9. Ellis(1993 & 1996) www.indiandentalacademy.com
  41. 41. Surgical approaches to the mandible Intraoral symphysis and paarasymphysis Intraoral body, angle and ramus www.indiandentalacademy.com
  42. 42. Extraoral approaches Submental Submandibular www.indiandentalacademy.com
  43. 43. Submandibular approach www.indiandentalacademy.com
  44. 44. Retromandibular approach www.indiandentalacademy.com
  45. 45. Transosseous wiring www.indiandentalacademy.com
  46. 46. Hayton Williams method www.indiandentalacademy.com
  47. 47. Transosseous wiring www.indiandentalacademy.com
  48. 48. Compressive and tension forces www.indiandentalacademy.com
  49. 49. Mini plates www.indiandentalacademy.com
  50. 50. Lag screws www.indiandentalacademy.com
  51. 51. Compression plating www.indiandentalacademy.com
  52. 52. DCP AND EDCP www.indiandentalacademy.com
  53. 53. www.indiandentalacademy.com
  54. 54. Reconstruction plate www.indiandentalacademy.com
  55. 55. Comminuted fracture treated www.indiandentalacademy.com
  56. 56. Kirschner wiring www.indiandentalacademy.com
  57. 57. Reconstruction plate www.indiandentalacademy.com
  58. 58. COMPLICATIONS  Non-Union  Malunion  Fibrous Union  Paresthesia  Anesthesia  Infection www.indiandentalacademy.com
  59. 59. Conclusion www.indiandentalacademy.com
  60. 60. Thank you www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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