Jaw fractures in medical practice occur quite often. Doctors note that damage to the jaw bone accounts for a seventh of total number fractures.

To recognize the problem in time and take action necessary measures, you should understand the existing types of injury and their symptoms.

What is a jaw fracture?

Jaw fractures are damage to the jaw bone anywhere, accompanied by a violation of the integrity of the surrounding tissues. This may affect the muscles facial nerves, vessels.

The causes of this type of injury are different, but most often they are caused by mechanical force: a blow, a fall, an accident. In addition, there is also a pathological fracture, which occurs as a result external influence on the jawbone if present chronic diseases, such as bone syphilis, osteomyelitis, tumors. Yes, when severe course Osteomyelitis causes parts of the bone to die, which leads to spontaneous fracture.

How to recognize a jaw fracture

There are several signs that suggest the presence of a jaw fracture:

1. When injured, a person feels severe pain.
2. When trying to open or close your mouth painful sensations intensify and a clicking sound may be heard.
3. The jaw may move to the side.
4. When there is a rupture of the facial tissue above the jaw bone.
5. In cases where the nerve endings are affected, some numbness is felt when touching the face.
6. Headache, dizziness.

Symptoms may vary depending on which part of the bone is damaged.

To determine the type of jaw injury, you should immediately consult a doctor and conduct a diagnostic test. It includes an external examination and x-ray examination.

A jaw fracture is often accompanied by brain damage or cervical spine spine. To exclude such complications, additional analysis is performed.

Types of jaw fractures

Jaw fractures have a broad classification in several areas:

1. Separation according to etiological or causative factor:

• the occurrence of a jaw fracture as a result of injury;
• fracture of the jaw as a result of tissue and bone pathology.

2. Depending on the fracture line:

• longitudinal;
• straight;
• oblique;
• zigzag;
• fragmented;
• transverse.

3. By the number of debris:

• multiple;
• single;
• double;
• triples.

4. Depending on the location of the fracture:

• fracture upper jaw.

5. According to the degree of jaw bone disorder:

• full;
• incomplete (cracks, breaks).

6. Depending on the degree of impact soft tissue:

• closed fractures - soft tissues are not affected;
• open - the integrity of the soft tissues is compromised.

In addition, jaw fractures occur:

• with defects and without defects;
• combined.

Treatment of a mandibular fracture

The main symptoms of fractures lower jaw are:

• pain;
• inability to chew food due to pain;
• possible numbness of the chin, lips;
• malocclusion;
• nausea;
• dizziness.

In the diagnostic process, the doctor, first of all, determines the general physical condition sick. To do this, pulse and blood pressure are measured. After this, in order to exclude traumatic brain injury, a tomography is performed.

During an external examination, painful points, defects, and hematomas are determined. A test is performed to identify the suspected location of the fracture. After which an X-ray examination is carried out.

It has a very thin structure at the corners and even with a minor impact or other lateral damage, a fracture is possible.

Double, triple and multiple fractures of the lower jaw are common. Treatment of such injuries is complex and takes more long period rehabilitation.

Therapy

When a fracture of the lower jaw is observed, treatment should follow immediately - this will avoid many complications.

Before transporting a person to medical institution First aid should be provided to the patient. It is necessary to fix the lower jaw immobile with a bandage or bandage.

Most frequent places fractures of the lower jaw are:

• mental aperture projection;
• middle of jaw;
• articular process;
• angles of the jaw.

Tissue swelling often accompanies a fracture of the lower jaw. Treatment in this case begins with applying a cold compress. After this, under local anesthesia, the doctor performs a procedure to align the bone fragments, and then fixes the jaw for the entire period of treatment.

The lower jaw bone can be secured using a nylon core or wire. At the same time, anti-inflammatory therapy is carried out, vitamins and drugs to strengthen the immune system are prescribed.

Maxillary fracture

The upper jaw is a paired bone, it is located in the center of the face and participates in the formation of the nasal cavity, mouth, and eye sockets. A fracture of the upper jaw is very dangerous. Firstly, the skull may be affected. Secondly, there is a danger of a concussion or the development of a disease such as meningitis.

In addition to standard symptoms, fractures of the upper jaw can be accompanied by hemorrhage, hematomas in the eye area, blurred vision, and loss of consciousness. Respiratory and chewing functions become difficult. If a person cannot breathe, they should be released respiratory tract and the oral cavity from interfering foreign bodies.

With such an injury, bleeding may occur. To stop it, you should apply a tampon or a pressure bandage.

Complicated jaw fracture

A displaced jaw fracture is considered to be complicated, in which the normal arrangement of bone fragments is disrupted. May be complete or incomplete.

Complete fracture - the connections between the components of the bone are broken.

Incomplete - the connection between the components of the bone is not broken or only slightly broken.

A displaced fracture of the lower jaw initially requires alignment of fragments, removal of swelling, after which rigid fixation is necessary.

In case of a fracture, traction is often necessary. To do this, a special orthopedic device is used, which gradually returns the damaged bone to its correct position.

This kind of injury is very dangerous because it can cause asphyxia, which, if assistance is not provided in a timely manner, can lead to fatal outcome. To prevent suffocation, clean oral cavity from foreign bodies, blood, then place the person in a horizontal position, face down, placing a rolled-up blanket or clothing under the chest.

Splinting for a jaw fracture

The main method of treating jaw fractures is splinting - this is the fixation of fragments using a special structure made of wire or plastic.

Splinting is of the following types:

1. Unilateral - used for a fracture of one half of the jaw bone. A wire is used that is attached to the injured area.
2. Double-sided - a stiffer wire is used, hooks and rings are additionally installed.
3. Double-jawed - used for displaced fractures of the upper and lower jaws. A copper wire is used, which is attached to the teeth and secures both jaws with rubber rings.

A splint for a jaw fracture can also be made of plastic. It is placed under the chin, passes along the cheeks and is secured with a bandage around the head. But this method, as a rule, is used if urgent splinting is required (for example, when transporting a patient to a medical facility).

If a person has a complicated jaw fracture, splinting is carried out strictly after combining the fragments. Additional external fixation devices may also be required.

Possible complications

Possible complications from fractures of the upper and lower jaws include:

• sinusitis;
• osteomyelitis;
• improper fusion of fragments;
• false joint.

Sinusitis most often occurs with a fracture of the upper jaw and is caused by the presence of small bone fragments in the maxillary sinuses.

Osteomyelitis - common complication with a fracture of the lower jaw. It is a purulent formation that affects the bone. In order to prevent the development of this pathology, it is prescribed antimicrobials, physiotherapy, taking vitamins.

Jaw pain may occur in the following cases:

• the patient came to a medical facility late;
• the treatment regimen was violated;
• when a jaw fracture occurred, splinting was carried out using an incorrectly selected method.

The situation can be corrected surgically(most often they do this) or using an exhaust system.

It can occur with osteomyelitis and is a disorder of the jaw bone with mobility in some parts. Treatment is only surgical.

Rehabilitation

The recovery period after a jaw fracture includes the following stages:

1. Fixation of fragments. A splint is used for a jaw fracture and some other types of fastening devices.
2. Anti-inflammatory therapy. Includes taking antibiotics, antifungal and restorative drugs.
3. Proper oral hygiene. It is carried out both by the doctor and the patient himself. It consists of cleaning the splint, teeth from food debris, treating the oral cavity with special antimicrobial agents. You should rinse daily with a soda solution, and use antiseptics after meals.
4. Physiotherapy is special gymnastics aimed at restoring jaw function. Exercises should be started from the first day of injury in order to prevent the formation of scars and avoid complications such as an improperly healed jaw fracture.

To restore all functions of the jaw, you should perform gymnastics daily. Its principle is to develop muscles and joints. To do this, you need to make massaging movements, and then move on to pronouncing letters and sounds, opening your mouth wide. You can imitate chewing movements. At first it will cause pain, but gradually the discomfort will pass.

If a child is hurt...

According to statistics, this kind of damage is observed in boys aged 6 to 14 years, i.e. during a period of increased motor activity, then the number of accidents declines. In girls, a similar dependence of the incidence of fractures on age is not observed. In any case, this injury is very unpleasant, but the worst thing is that it is mainly accompanied by craniocerebral injuries and damage to the integrity of other bones and soft tissues. Do-it-yourself activities are strictly not recommended. At the slightest suspicion of a fracture, you should immediately seek qualified help.

When visiting a doctor, a medical history is taken. It is not always possible to visually diagnose a jaw fracture, so a specialist in mandatory appoints X-ray examination. Based on its results, a treatment regimen is drawn up. The rehabilitation process is not much different from that described above.

Nutrition rules

Due to the fact that during therapy and rehabilitation the jaws are in a fixed position, it is imperative to adjust the diet. The bone heals within a month (at least), and during this time you should eat only liquid foods.

Jaw fractures involve eating food that is no thicker in consistency than sour cream. Approximate menu may consist of soups with pureed vegetables, fruit purees, dairy products, broths, and various cereals. After removing the splint, you should start eating solid food gradually so as not to provoke gastrointestinal disorders.

Breakfast may consist of a glass of kefir, liquid oatmeal, applesauce.

For lunch, you can cook any cereal, chicken or rabbit broth, wash it down with a glass of orange juice.

Can be used as a snack fermented milk products. For dinner you should prefer thin potato soup and fruit puree.

The main task of a dental surgeon during treatment of a fracture of the upper or lower jaw is to restore anatomical structure broken bone and the correct relationship of the dentition. Many techniques help to achieve this, but the effectiveness of treatment also depends on how correctly and quickly first aid was provided.

Before hospitalization

First aid to the victim includes:

• stopping bleeding (pressing or packing the wound, applying cold);
• if necessary, cardiopulmonary resuscitation;
• pain relief (analgin, revalgin intramuscularly);
• immobilization of the jaw with the help of fixing bandages (contraindicated if the victim is unconscious, since this increases the risk of suffocation from the retraction of the tongue or vomit entering the respiratory tract).

Treatment methods

1. Surgical, or osteosynthesis, involves fastening jaw fragments with special, often metal, structures.
2. Conservative or orthopedic - involve the use of special splints that fix the fracture site.

Osteosynthesis

Indispensable for complex, comminuted and multiple fractures with displacement, loose teeth and complete absence of teeth, periodontal disease and others inflammatory diseases gums in the area of ​​injury. Osteosynthesis is also effective in cases of fracture of the condylar process complicated by dislocation of the articular head of the lower jaw.

Fastening materials can be steel knitting needles and rods, pins, nitride-tinan wire with shape memory, quick-hardening plastics, polyamide thread, special glue.

However, the most convenient and safe method Today osteosynthesis with metal miniplates is considered. They allow you to cut the skin and muscles on only one side, which simplifies the operation itself and shortens the recovery period. Another undeniable advantage is the ability to reliably fix fragments in areas with significant dynamic loads.

Splinting the jaw

This is the immobilization (fixation) of bone fragments using a special plastic or wire structure.

The technique, created by military doctors at the beginning of the 20th century, is successfully used by dentists today. The materials used to make the splint have changed, and the methods of applying it have been improved.

Today, a specialist has many types of tires in his arsenal:

• from standard Vasiliev tape splints, the simplest and cheapest method of treatment;
• to Tigerschdedt aluminum splints, which are made individually for each patient, due to which they are more effective. In addition, they evenly distribute the load and minimally injure the teeth.

The type of splinting depends on the type of injury and can be unilateral (when one jaw is fractured) or bilateral (when both are damaged).

If the teeth are preserved, it is not difficult to apply a bent dental wire splint. It is bent to the shape of the dental arch and fixed with bronze-aluminum wire ligatures, which, like a hairpin, cover the tooth on both sides. Manipulations are performed under local anesthesia.

When both jaws are fractured, a structure with a more rigid base is installed; in addition to wire, hooks and rings are also used that immobilize the lower jaw.

Is it possible to do without splinting?

Even if the case is not severe - the fracture is one-sided, closed and without displacement - it is imperative to take measures to prevent the development of such unpleasant complications as:

• accidental displacement of fragments,
• re-injury
• development of inflammation of soft tissues,
• infection of the fracture site.

To do this, it is necessary to immobilize the jaw with any accessible method. This can be a sling bandage, but it is much more convenient and effective to use a splint. In case of a complicated fracture, splinting is absolutely indispensable, regardless of the location of the injury.

What will happen to the tooth at the site of injury?

If it is mobile, crushed, dislocated or prevents the reduction of jaw fragments, it will have to be removed. The same fate awaits a tooth in the presence of periodontal disease, cysts, granulomas and other inflammations. In other cases, teeth can be saved, but require careful monitoring.

Treatment tactics for displaced fractures

In such cases, before applying a splint, it is necessary to compare the jaw fragments, for which reduction orthopedic devices are used. A broken upper jaw requires traction using special dental splints.

Such injuries are very dangerous because they can cause asphyxia. But correctly provided first aid will prevent suffocation. Clear the oral cavity of foreign bodies or blood, lay the victim face down, placing a cushion rolled up from clothes, blankets, etc. up to the chest.

Rehabilitation after a jaw fracture

For successful treatment For a jaw fracture, anti-inflammatory and restorative therapy, physiotherapy, mechanotherapy and special oral hygiene are also important.

1. Within 3-4 days after the injury, antibiotics must be prescribed to prevent inflammation, which are injected directly into the area of ​​injury.
2. General strengthening therapy is taking vitamins C, P, D and group B, drugs that stimulate tissue regeneration and restore the level of leukocytes in the blood.
3. Among the effective physical procedures, we note UHF therapy, general ultraviolet irradiation, and magnetic therapy. After the third procedure, swelling and pain are noticeably reduced, swelling subsides. For better healing of fragments, 2 weeks after a jaw fracture, electrophoresis is performed using a two to five percent solution of calcium chloride.
4. Mechanotherapy, or physical therapy, accelerates the restoration of jaw function and helps if, after an injury, the mouth opens poorly or does not open at all. It can also be practiced at home, starting 4-5 weeks after the fracture, when the splints are removed and a callus has formed.
5. Special hygiene involves irrigation at least 8-10 times a day. For unconscious victims, their teeth and mucous membranes are treated with a special solution at least twice a day.

How to eat?

Because during intensive care and during the recovery period, the jaws are rigidly fixed and habitual chewing of food is out of the question; during this period, a correction of the diet is necessary.

Food should have the consistency of low-fat sour cream. These are broths, pureed soups, carefully chopped vegetables and fruits, milk drinks, liquid cereals. Spices are excluded, salt consumption is limited. The temperature of the dish should not be higher than 45-50 °C. The most convenient way to eat food is through a straw.

Go to usual diet After removing the tire you need to gradually. This is important not only for restoring chewing functions, but also for preventing disorders in the gastrointestinal tract.

When are the splints removed, and how long does it take for the jaw to heal?

The older the patient and the more complex the fracture, the longer the period required for rehabilitation. Approximately it ranges from 45 to 60 days. Removal of the splints is carried out on days 30-45, if the treatment did not include osteosynthesis, and on days 5-14 after it.

How much does it cost to treat a broken jaw?

The price depends on the nature of the injury, whether osteosynthesis was performed, what splints were used, and whether the patient attended physical therapy procedures. But let's say for sure that the service is not cheap. Osteosynthesis alone will cost from 14,000 to 55,000 rubles.

It is also necessary to take into account the cost of subsequent dental treatment for the restoration of lost teeth or damaged teeth after splinting. Our service will help you choose a competent specialist and not waste your money. Compare prices and services of different clinics, read reviews from real patients.

Dear friends! It's Thursday, which means that today we'll talk about dentistry. More precisely, about the point of contact between dentistry and maxillofacial surgery, namely, about fractures of the lower jaw and how this can and should be treated.

I foresee the skepticism of some of my colleagues and exclamations: “Fractures are oral surgery, not dentistry!”, “Patients with fractures should be treated in hospitals!”, “Fractures cannot be treated in a clinic!” etc. This is your opinion, live with it as you wish. I prefer to act in a slightly different way and below I will prove to you that such tactics are justified in places.


Most dental surgeons, when a patient comes to them with a fracture of the lower jaw, prefer one approach - quickly write a referral to the department of maxillofacial surgery and send the patient away from them. There are a small number of conscientious doctors who carry out at least some diagnostics (do x-rays), even fewer of my colleagues are able to provide first aid - fix jaw fragments with splints and then, if necessary, send them to a hospital for treatment.
At the same time, the majority of not only dentists, but also maxillofacial surgeons consider splinting to be the optimal way to treat jaw fractures. I even remember from my university books that Tigerstedt splints can cure 98% of jaw fractures. However, I consider this thesis to be clearly outdated and not taking into account modern realities.
In this regard, it would be appropriate to give several arguments that mainly determine the tactics of treating jaw fractures:
1. In modern maxillofacial surgery splinting can be considered solely as a temporary method of fixing jaw fragments.
2. When modern development techniques of external osteosynthesis treating jaw fractures by applying splints for 1.5-2 months is a mockery of the patient, there is no other way to call it. Try walking around for four weeks with your jaws tied - maybe you’ll become wiser?
3. By negative influence on the dental system with splints(of absolutely any design) there is little that compares. Leaving splints in the mouth for more than two weeks condemns the patient to subsequent periodontal, surgical or orthodontic treatment. Truly, we cure one thing and cripple another.
4. Tigerstedt tires, which we all “love” so much, were invented by the military doctor R. Tigerstedt at the beginning of the 20th century. They were invented only because other methods of treating fractures simply did not exist. Think for yourself, with the modern development of medicine, is it appropriate to use methods that were centuries old?
5. Chin sling, which some people really like to treat fractures “without displacement” - also a temporary remedy. Very often, we subsequently get a displacement - simply because the patient accidentally yawned or was careless about his own health and did not wear a splint.
6. Overlay plaster cast on the head- mockery of the patient, I won’t even discuss this method.
7. Some people's favorite Ivy intermaxillary bondage, as well as interdental binding for jaw fractures does more harm than good. Firstly, a thin wire cannot ensure complete immobility of the fragments and, therefore, ensure their consolidation. Secondly, often after removing the ligatures we find dislocations of teeth, periodontitis, periodontitis, etc. And this again comes to the question: “Do no harm!”

Next, let's look at the reasons for sending patients with jaw fractures to the hospital.
The first reason and main : “I don’t want to get involved.”
Second: "I can't."
Third: “There are no conditions and no possibility to carry out treatment in the clinic (no materials, tools, etc.).”
And only the last, fourth reason: "This is a complex case that requires the intervention of a qualified maxillofacial surgeon" . Such patients are a rarity at a dental appointment, since most often they go to the hospital directly.

Very brief requirements for the treatment of mandibular fractures can be summarized as follows:
1. Minimum discomfort for patients. In other words, a week after the fracture, our patient should be able to open his mouth and chew food normally. Very respected man, Professor P. G. Sysolyatin, whom I can proudly call my Teacher, compresses these terms even more: " Full life- the day after the fracture!” I completely agree with him.
2. Minimum of predictable and unpredictable complications during treatment. In addition to the frequent traumatic osteomyelitis, which “scares” patients in maxillofacial departments, complications include tooth dislocations, tooth fractures, periodontitis, periodontitis and pulpitis of teeth, improper consolidation of fragments, etc. That is, everything that we “treat” after our patient wore Tigerstedt splints for two months.
3. The fastest possible rehabilitation. Time is money and most people can't devote time to treatment for a long time. By putting splints on for at least a month, we actually deprive the patient of communication, work, normal food intake, etc. Naturally, few people are ready to live as hermits for a month and do nothing. And only homeless people in the cold season agree to stay in the hospital for four weeks.
4. Work without rework. In other words, if we apply splints to a displaced fracture (or at least when there is a threat of this displacement), in almost 90 percent of cases we get incorrect consolidation of fragments - in Russian, they grow together crookedly. The result is problems with the joint, problems with bite, loss of teeth, etc. It is better to avoid this.

The optimal way to treat jaw fractures that meets all requirements and has no disadvantages is extramedullary osteosynthesis. Unfortunately, there are no other options.
Again, some of my colleagues narrowed their eyes skeptically at this phrase: “Osteosynthesis is only possible in a hospital.”
I answer: “Not always!”
Indeed, jaw fractures in the area of ​​the condylar processes, multiple fractures, cases of combined trauma, etc. are best treated in a hospital setting. If the fracture line runs within the dentition, osteosynthesis can be performed under conditions dental clinic. Believe me, it's not difficult.
Hence the indications for referral to hospital:
- Fractures of the lower jaw outside the dentition, as well as multiple fractures of the jaws and associated trauma.

I would like to tell you about just such a case:
One day, after some noisy holiday, a 30-year-old woman approached me. The complaints are as follows: I fell, hit my jaw, now everything hurts, my teeth move and don’t close. We send the patient to the picture, we see the following (Fig. 1):

Open bilateral fracture of the lower jaw in the area of ​​the condylar process on the left and 42-43 teeth on the right with displacement of fragments. Fracture lines are indicated by red arrows. What is characteristic is that the fracture line is in the area of ​​the condylar process without displacement - one can hope that it will heal without any third-party intervention (also because the fracture here is closed). In the case of a fracture line in the area of ​​42-43 teeth, the displacement of fragments is obvious, and there is a bleeding wound on the oral mucosa. Without ensuring high-quality reposition of fragments here and without reliable fixation, we can easily get osteomyelitis or worse.
Pay attention to the condition of the dental system in this patient. Practically complete absence chewing segments suggests that it is not possible to properly apply fixing splints here, and wearing them for a long time will inevitably lead not only to damage to the remaining teeth, but also, quite possibly, to their loss.
Let us also not forget that in front of us is a young, able-bodied girl who works as a secretary in large organization - social aspect very important to consider when planning treatment.

So, taking this data into account, we plan treatment:
1. Temporary splinting using Vasiliev splints and intermaxillary rubber traction. Maximum - for two weeks.
2. A week after applying the splints - osteosynthesis surgery in the frontal region.
3. After another week, the tires will be removed. If necessary, periodontal treatment, professional hygiene oral cavity.
4. For six months - observation, complete sanitation of the oral cavity, orthodontic treatment, rational prosthetics (on implants).

Are there any objections to the treatment plan? I think not.

Let's get started.

First of all, we reposition and fix the jaw fragments using Vasiliev splints with an intermaxillary rubber traction. You can use Tigerstedt tires - it doesn't matter here. We use orthodontic wire, and we also borrowed rubber bands from orthodontists.
The most important thing at this stage, as well as at all subsequent ones, is QUALITY PAIN RELIEF. If your patient endures, this is torture, and you are not a dentist, but a sadist.
After splinting, we check the teeth according to the bite and do a control orthopantomography (Fig. 2):

As you can see, the fracture gap has decreased, and on the left side has disappeared completely, all the teeth are in contact.
Now we give the patient recommendations, make appointments and send her home for a week. Among the prescriptions - antibacterial, anti-inflammatory therapy, vitamins C, P and D3 would not be superfluous.

A week later we meet, examine the patient and perform osteosynthesis surgery.
How this is done - see the photos below:

To begin with - QUALITATIVE PAIN RELIEF ( local anesthesia). I specifically emphasize this point because there are some dentists who believe that a well-attached patient does not need anesthesia.
Remove the rubber rods and mark the location of the cut (Fig. 3):

Notice how much gum recession has occurred in the canine area. Imagine if we were required to wear splints not for two weeks, but for eight? The patient would simply lose half her teeth...

We make an incision (Fig. 4), reach the bone layer by layer and open the fracture line (Fig. 5):

In the fifth picture it is very clearly visible.

Now we try on the plate, bend it according to the shape (Fig. 6):

and fix it with microscrews. To do this, use a drill to make holes in the bone, and tighten the screws themselves with a screwdriver (Figure 7 and 8):

We make sure that everything is fixed correctly (Figures 9 and 10):

We check whether we have enough mucous membrane to apply sutures without tension. This is very important - otherwise the plate will cut through and the seams will come apart (Fig. 11):

We cover the plate with an FRP membrane, which we prepare in advance. This is necessary to isolate it, prevent it from erupting and isolate the operation site (Fig. 12 and 13):

and finally we apply stitches. We use non-absorbable suture material - monofilament (Fig. 14):

All. The operation is completed. In total, we spent 30 minutes on it. For some doctors, Tigerstedt splinting takes longer.
We send the patient for a control X-ray. What we see on it now (Figure 15):

Unfortunately, the picture is not entirely clear - the patient moved in the orthopantomograph. However, we will see the main nuances. You can see everything on the microplate; the black arrows indicate the fixing screws. For such a fracture there must be at least four of them. The red arrow indicates the mental foramen - the exit point of the mental nerve. We knew and saw this, so we positioned the plate with screws in this way - if we lowered it a little lower, we would have damaged the nerve. The blue arrow indicates the fracture line in the area of ​​the condylar process on the left. As you can see, there are no problems there.

In the postoperative period, the patient continues antibacterial and anti-inflammatory therapy (for another three or four days, taking into account the fact that she has been taking antibiotics for a week since the splinting). She will also take increased doses of vitamins for a month to speed up the healing of the fracture. The stitches are removed on the tenth to twelfth day. After the stitches are removed, we meet with the patient in a month for an examination.
In the future, the plate can be removed after about a year, or you can leave it - great harm it won’t (this applies mainly to imported plates).

Let's sum it up short summary:
1. We treated the fracture for two weeks, causing minimal discomfort to the patient and without spoiling her oral health. Using the traditional method, treatment would take at least a month and a half.
2. The patient did not require hospitalization. All treatment took place in outpatient setting- and without any problems.
3. We avoided abuse of teeth, periodontal disease and bite. Accordingly, the patient will not spend money on “follow-up treatment” for what we have ruined.
4. The most important thing is that the girl was satisfied! And this is worth a lot.

This is what work is like. As you can see, osteosynthesis operations for jaw fractures are quite feasible in a dental clinic. If only the doctor had his head and hands on in the right places...

At the end - a small lyrical digression.
Sometimes people reproach me for why I write about dentistry and show such “bloody” photographs. Like, people are already afraid.
My policy regarding medicine (not just dentistry) is that the patient should know everything about his treatment! The more he knows, the better. If the patient is informed about the methods of treating diseases, he sees that there is different options treatment - he worries and worries less, and most importantly - he has the opportunity to choose! He understands doctors better and immediately sees if an unscrupulous doctor is fooling him. He strictly follows the doctor’s recommendations and prescriptions. And this has a direct impact on the outcome of treatment.
However, do what you like. If you don't like it, don't watch it))).

I wish you good luck!
Best regards, Stanislav Vasiliev.

A jaw fracture is a partial or complete damage to the bone due to mechanical impact or under the influence of general pathological conditions. There are also double and triple types of fractures. The phenomenon itself is a serious injury, in which it is necessary to visit a doctor. What can be the consequences if the jaw is broken, what to do? It is unacceptable to treat such cases on your own, since this can cause many problems that will lead to tooth loss, as well as bone damage.

Take into account the following types based on the reason:

• traumatic nature as a result of physical impact on bone tissue. Often occurs in road accidents, violence against a person;
• pathological ones are caused by bone diseases: tumors, osteochondrosis, etc.

Based on the degree of damage:

• open fracture of the jaw, when fragments extend beyond the boundaries of the gums and, as a result, the mucous membrane ruptures;
• closed, in which the facial tissues remain intact.

If you are injured, you should consult a doctor

The lower jaw is more prone to injury, because it is mobile. After receiving an injury, you must immediately consult a doctor for a proper examination of the lesion.

Signs of a fracture

1. Intense jaw mobility.
2. Severe pain as a result of any movement.
3. Moving teeth, creating gaps between them.
4. Difficulties arise when closing the mouth.
5. Increased salivation.
6. The tongue sinks or the bone is damaged.
7. The mucous part is severely torn.
8. The wounds are bleeding.
9. The face becomes asymmetrical and swelling occurs.
10. Difficulties in speaking, chewing, and swallowing appear.
11. The sensitivity of the face decreases due to nerve damage.
12. The patient experiences shock and dizziness.

Mobility of the jaw as a sign of a fracture

Causes of injury

A fracture can be caused by the following reasons:

• intense stress in everyday life, falling, performing sports exercises, road accidents;
• pathologies of bones, formations and cysts;
• improper tooth extraction.

Sports as a cause of jaw fracture

When the jaw is damaged, displacement can occur in three types:

• sagittal;
• vegital;
• transversal.

It plays very important role in identifying correct scheme therapy, choosing the equipment that will be used for correction. As a rule, in case of a displaced jaw fracture, treatment, symptoms, photo consequences, what to eat are special splints that are fixed on the teeth. The doctor collects bones with his hands. The person at this moment is under local or under general anesthesia. Fragments can be fixed using nylon devices. The jaw can be attached with special metal spokes that are installed externally. After adjustment, the patient needs peace of mind with mandatory antimicrobial actions.

We consider in detail all aspects of such a complex facial injury as a displaced jaw fracture: treatment, symptoms, consequences, photos. What to eat - separate question, because in postoperative period fixation of the jaws is necessary, the patient is given splints. And the consistency of the food is, for obvious reasons, extremely liquid.

Patients must be prescribed a special diet. This must be done due to the fact that the patient will not be able to fully move his jaws.

The bones heal in at least a month, so during this period the patient will have to eat only liquid meals.

The consistency of all food should be puree, so a person should consume soups, broths, fruits and vegetables, ground through a meat grinder.

How is the treatment carried out?

Medication qualified assistance can only provide medical workers. Before they arrive at the scene of the incident, the victim should be completely calm to ensure the immobility of the limbs. Analgesics can improve your health. It is worth remembering that it is impossible to treat a fracture of the lower and upper jaw at home. Symptoms, photos and signs can be found below.

The faster the treatment is carried out, the better it will be for the patient.

Therapeutic measures involve the following actions:

The upper jaw breaks much less frequently than the lower jaw.

The following signs are distinguished:

• patients' cheeks swell, profuse bleeding between teeth;
• numbness in the area under the eyes is possible, hematomas also appear, blood is released from the nose, strong discharge saliva, no sense of smell;
• in severe cases, people lose their vision and cannot open their mouth.

Patients often complain of severe nausea and severe pain. Vital functions complicated. It is difficult for a person to talk, breathe, or eat. In parallel with jaw damage, patients are diagnosed with a concussion.

When providing first aid, the patient needs to restore breathing. All unnecessary objects are removed from the oral cavity. You can clearly see what a broken jaw looks like in the photo.

Splinting method

One of the main treatment methods is splinting. The event involves adjusting the fragments with displacement of the plastic device.

The type of action will depend on the type of damage:

• in case of a unilateral fracture, the device is applied on one side;
• equipment of a more rigid form is applied on both sides. In addition to it, special rings and hooks are installed;
• in case of a displaced fracture of the upper and lower jaw, it is necessary to use a two-jaw technique.

Fixation for unilateral fracture

If plastic equipment is used, it is installed under the patient’s chin and a bandage is wrapped. However, this procedure is performed when assistance must be provided immediately in order for the victim to be taken to the emergency room.

Consequences of a fracture

To exclude unpleasant consequences, it is necessary to seek professional help in time. The following complications are possible:

• tooth movement;
• the appearance of distances between teeth;
• facial deformation;
• the appearance of malocclusion.

If necessary, surgery may be necessary to restore the affected areas of the face. In case of mild fractures and timely visit to the doctor, following all his recommendations, mobility is restored within a month.

Injuries associated with damage to the jaw bones can lead to dangerous consequences for a person, so you should know about the symptoms and treatment of a jaw fracture, as well as how much does it clamp?

The pathology occurs due to a pronounced mechanical effect on the jaw, or due to other pathologies. There are partial bone lesions, complete, with displacement and others. Self-medication in cases of such injuries.

Causes of a jaw fracture

The main causes are divided into two types: pathological and traumatic.

Pathological, including anomalies of the anatomy of the jaw bones and the consequences of diseases of various etiologies:

• hereditary pathologies;
• neoplasms, malignant and benign;
• cysts;
• tuberculosis;
• treatment with certain drugs;
• metabolic disorder;
• lack of nutrition, vitamins and minerals;
• infections and others.

Traumatic, including the consequences of falls, injuries, impacts, injuries, intense stress, road accidents and other conditions. Most often injuries are caused by:

• driving various types transport;
• active lifestyle and other incidents;
• abnormal removal of one or more teeth;
• under severe physical impact, for example, when using a firearm, jaw injuries can be complicated by the appearance of fragments.

Symptoms

• Pain, intense and pronounced, increasing with jaw movement, chewing, and talking. The pain is caused by damage to the thin shell of the bone - the periosteum, in which many nerve endings are located. In addition, inflammation may develop at the site of injury, which additionally creates pain signals. In some especially difficult cases the nerves themselves are damaged, and the pain increases.
• Referred pain (locally). This phenomenon is verified by the fact that when pressing on the chin at the fracture site, pain occurs. This phenomenon is possible due to shrapnel irritation of the nerves.
• The damaged jaw is mobile, the usual closing of the jaws is difficult, the relief of the bones and skin is changed. This can be determined as follows: external inspection, and during palpation, but any touching should be done with extreme caution.
• Teeth can move out of their places, and gaps and gaps can form between them.
• Both open and closed fractures can cause damage blood vessels the bone itself, surrounding soft tissue and periosteum. Depending on the location of the injury and its cause, blood either flows into the oral cavity or through the skin if the fracture is open. At closed injuries blood accumulates where the impact occurred, forming clots and causing pastiness. Bleeding is a reason for immediate medical examination.
• Swelling of the entire facial contour and the formation of asymmetry are signs of a jaw fracture. The cause of edema is anti-inflammatory agents that act on blood vessels. They, in turn, expand, acquiring the property of greater permeability to blood. Manifestations of edema: pastiness, enlargement of soft tissues, redness of the skin. In this case, either part of the face in the area of ​​injury, or half of the face, or the entire face may become enlarged. Swelling is caused not only by the fracture, but also by bleeding.
• Formation of increased salivation.
• Moving teeth, occurrence.
• Recession of the tongue.
• Damage to mucous tissues, skin in the form of wounds and abrasions of varying depths. Sometimes other fractures are detected in other parts of the face and in the neck area.
• It is difficult or impossible for the patient to chew, swallow, or speak.
• At the site of injury there are hematomas and bruises.
• Subjectively, the patient feels headaches, dizziness, nausea, and weakness.

Species

The bones of the lower jaw are arranged in the shape of a horseshoe; it is easily crushed. The most common location of fractures is the area of ​​the coronoid process, incisors, canines, and angles.

On the upper jaw, the weakest places in the structure are the closure with other bones. With minor injuries, as a rule, displacement occurs without the formation of fragments. In case of injuries received in the upper jaw area from the front, there is a risk of the fragment moving downwards and backwards. In case of falls or indirect impacts, there is also a risk of formation of fragments and their displacement to the base of the skull.

Classification of fractures according to the severity of the lesion:

1. Open, in which bone fragments are displaced towards soft tissues, tearing or damaging them (mucous, muscle, skin). More often observed open fractures lower, less often – upper jaw. With this type there is a high risk of bacterial infection of damaged tissues, medical care appears immediately.
2. Closed, in which the bone is damaged, but soft and nearby tissues are not affected. Closed types of fracture are most often localized in the area of ​​the branches of the lower jaw and its angle. They are easier to treat than open ones.

Classification depending on the displacement of debris

1. A displaced fracture occurs when exposed to a strong traumatic force. The jaw bones move in relation to each other and other bones. In this case, the displacement can be both sagittal and vegetal, transversal.
2. A non-displaced fracture, in which the bone is damaged or divided into fragments, but they are not displaced, are related to each other anatomically. More often these are incomplete fractures.
3. Sometimes this classification includes the “concussion” type.
4. Splintered, occurring with the formation of several bone fragments at once different sizes, chaotically located. Characteristic of a powerful traumatic effect on the jaw. They require only hospital treatment; self-medication is not acceptable.
5. Complete, in which the fragments or fragments (fragments) of the damaged bone are displaced and have a transverse, oblique slope.

Degrees of complete fracture:

1. Single;
2. Double;
3. Multiple;
4. Splintered.

Treatment for a complete fracture is long and complex. An incomplete fracture is characterized by the presence of injured areas of the jaw with fragments; they, in turn, are not displaced.

Types of jaw bone injuries according to Lefort:

1. Lefort – I. The boundaries of the injury run along the base of the nose, then along the upper wall of the orbit and the zygomatic arches. Otherwise it is called subbasal. The patient's medical history includes complaints of visual splitting of objects and pain when swallowing. This type of fracture is characterized by swelling, characteristic symptoms from the side of the eyes.
2. Lefort – II. The boundaries of the fracture are located along the base of the nose, the lower wall of the orbit, then along the zygomatic-maxillary joint. Suborbital type. With it, some parts of the face go numb, tears are produced, and bleeding from the nasopharynx is characteristic.
3. Lefort – III. The boundaries of the fracture run along the base of the pyriform opening, the bottom maxillary sinus. Bottom type. The patient will complain of pain, difficulty chewing, bleeding, and difficulty biting.

Based on location, fractures are divided into:

1. Middle - in the area of ​​the central incisors.
2. Incisive – between the lateral and first incisors.
3. Canine - on the canine line.
4. Mental - in the area of ​​the mental foramen.
5. Angular – in the area of ​​the angle of the lower jaw.

In relation to the place of impact, fractures are divided into direct (directly in the area of ​​injury), indirect (in the opposite place).

First aid

Medical assistance on site, while awaiting qualified assistance, should be provided as quickly as possible. The basic rules are:

• provide complete rest to the patient in a motionless state;
• restore breathing ( cardiopulmonary resuscitation if necessary);
• offer analgesics;
• remove all excess from the oral cavity;
• disinfect the wound;
• stop bleeding;
• if available minimal knowledge try matching the bones.

Jaw fracture - treatment

Any type of injury, both upper and lower jaw, is treated in conditions surgical hospital. In complicated cases, surgery is indicated.

Upon admission, the patient is anesthetized, a bandage is applied, diagnostics are performed (X-ray, CT, MRI), and bone structures are restored with sutures, staples, and plates. Implants are installed if it is not possible to put the patient’s bones together. Treatment includes antibiotic therapy and physiotherapy. The main methods of treatment are splinting and bypass surgery.

Splinting

The bone fragments are adjusted using a special plastic device. In case of a fracture on one side of the face, the device will be applied on one side, in case of a complicated fracture - on both sides with the addition of special rings and hooks.

In case of injury to both jaws, complicated by the displacement of fragments, splints are applied to both jaws (two-jaw technique). The main goal of the method is to ensure the immobility of healing tissues. Treatment may take up to 2 months. Before the splints are removed, the patient is x-rayed to ensure tissue fusion.

Bypass surgery

The method is used in complicated cases. In this case, the injured bone fragments are fixed with special splints consisting of hooking loops and rubber intermaxillary rods (Tigerstedt splint).

The method allows, in addition to fixation, to reduce the load on the patient’s bones.

Nutrition

Even with a simple fracture, the patient experiences difficulty eating. Depending on the severity of the injury, the patient is selected a method of nutrition with auxiliary measures.

1. Sippy cups with tubes are used when some teeth are missing. It is injected directly into the stomach. Food should be moderately warm, served in small portions, fractionally. The method is suitable for home use.
2. Probes are used strictly in hospitals in the first weeks. The tube is inserted into the stomach.
3. A dropper for parenteral food intake if the victim is unconscious.
4. Nutritional enemas are used in cases of unconsciousness and difficulties in feeding the patient through the veins.

What can you eat if your jaw is damaged:

• high-calorie meat dishes diluted with milk or pureed broth;
• baby food;
• milk and fermented milk liquid drinks;
• broths;
• pureed soups;
• fruit, vegetable purees and soufflés;
• porridge diluted with milk.

Important: the diet must compensate daily requirement patient in calories.

Video: how to eat properly if you have a broken jaw? Personal experience video blogger. You can also find other tips on his channel.

Consequences

Jaw fractures, as a rule, do not go away without unpleasant consequences. As a result of injuries, the following may occur:

Complications can be avoided by contacting professionals in a timely manner.

Rehabilitation

Recovery after surgery or treatment includes physiotherapy, physical therapy, and oral hygiene.

Physical therapy is prescribed no earlier than a month after the splints are removed. It is important to restore chewing function, swallowing, and facial expressions.

Physiotherapy methods such as exposure to electromagnetic fields of different frequencies, pulsed magnetic therapy, ultraviolet irradiation, electrophoresis, applying ice, microwave therapy, paraffin therapy, infrared irradiation, massage of the collar area.

Additional questions

How long does it take for a fracture of the lower and upper jaw to heal?

In the absence of complications such as traumatic osteomyelitis, inflammatory processes, lighter fractures heal from 30 to 45 days. Injuries to the lower jaw are often more complex than to the upper jaw. Bone restoration can take up to 60 days.

Does it hurt to remove splints after a broken jaw?

The process of getting rid of splints is less painful than developing muscles and tissues after injury and immobilization. During rehabilitation, the muscles have become partially rigid; the patient will experience pain while eating, swallowing, and speaking.

How to determine a jaw fracture or bruise?

Common signs of injury are bruising, pain, swelling, and hematomas. Moreover, it is during a fracture that speech is difficult, the pain is more pronounced, the patient feels obvious weakness, even to the point of loss of consciousness. Accurate diagnosis Only the surgeon can determine it after x-rays.

How long are they in the hospital?

The duration of hospital treatment varies for different fractures. Complicated fractures, with displacement, surgical intervention, will require a course inpatient treatment up to 4 weeks.