Everything about a fracture of the lower jaw in questions and answers

Why does the lower jaw break?

Experts note that in the vast majority of clinical cases, pathology occurs due to injuries received in everyday life. These are falls, blows. You can get injured by slipping, doing physical activity and traumatic sports, or in active games (for children). The number of fights, domestic conflicts under the influence of alcohol and drugs, and road traffic accidents, due to which people suffer a broken jaw, as in the photo, are growing. Some people encounter problems with poor industrial safety on the shop floor, when working with heavy equipment and at heights.

This is what a mandibular fracture looks like

For many, it comes as a surprise that a fracture of the lower jaw can be caused by a number of dental and chronic diseases. As a rule, such trauma is caused by advanced pathologies, for example, a follicular cyst that has grown on the root of a tooth, or osteomyelitis. Oncological tumors, metabolic disorders and osteoporosis can also gradually destroy bone tissue, as a result of which the patient develops symptoms of a fracture.

According to statistics, young men (under 40 years of age) receive such injuries more often than women. The male sex tends to engage in dangerous sports, works in heavy industries, more often takes part in fights, and has a tendency to take risks and aggression.

Some researchers also argue that in rare cases, damage can occur during dental procedures, for example, during tooth extraction in case of extremely low qualifications of the doctor.

Doctors' opinion

Experts note that in cases of jaw damage, treatment should begin immediately after diagnosis. The duration of recovery, on average, according to various estimates (depending on the complexity of the injury) varies from thirty to ninety days. The doctor must determine the treatment method that the patient will adhere to until the end of the recovery period. The main goal in the treatment of such an injury is to prevent inflammatory processes and the occurrence of complicating factors, as well as rehabilitation and further preservation of chewing function.

For complex injuries, experts recommend contacting a plastic surgeon, who may resort to prosthetic procedures. Doctors can also prescribe a number of other procedures that will help you recover from such a serious injury and fully resume all functions.

Can the upper jaw break?

Maybe, but doctors admit that this is a very rare situation. Due to anatomical features and lack of mobility, even in the most complex accidents, the upper jaw often remains intact. However, experts also emphasize that when the upper jaw is damaged, the symptoms and consequences are much stronger, they more often lead to death.

A fracture of the upper jaw is much more serious and dangerous than the lower jaw

The mandibular bone is massive and mobile, protrudes forward, therefore, with any external influence on it, it “suffers” first of all. According to statistics, it is damaged in 80% of cases of the total number of injuries to the bones of the facial skeleton.

Are fractures the same for everyone or are they always different?

Jaw fractures can be completely different, and it is impossible to independently determine which one you have. It all depends on the nature of the injury, the direction of the force, and the position of the person at the time of exposure to the traumatic factor. The diagnosis can only be made based on x-rays. Here are the main types and classifications of fractures:

• direct and indirect: in the first case, the area that was affected is directly injured. With an indirect injury, it is not the area of ​​impact that is damaged, but the tissues located next to it,
• oblique, transverse, longitudinal: it all depends on the direction in which the fracture of the jaw bone will go,
• single and multiple: there can be only one fault, but most often there are many of them,
• large and small: if the bone is split into several fragments, then we are talking about a major fracture. If there are a lot of fragments and they are small, then doctors diagnose a minor fracture,
• one-sided and two-sided,
• open and closed: the first type involves damage not only to bone tissue, but to the mucous membrane, periodontal tissue, and teeth. The second type is much less common and only damages bone tissue.

Fractures can be different

How can you tell if a person has a broken jaw?

A person who has suffered such a serious injury experiences severe pain that radiates throughout the head. Due to the painful shock, you can lose consciousness or experience severe dizziness. Nausea and vomiting are possible. It becomes impossible to open or, conversely, close your mouth; accordingly, in this state you cannot chew, swallow, speak, and sometimes even breathe. Saliva and blood may involuntarily flow from the mouth.

It is visually noticeable that the lower jaw has shifted relative to the upper jaw, and facial asymmetry has appeared. The lower row of teeth has also shifted relative to the upper one. With open fractures of the jaw, some teeth are often twisted, knocked out, broken, they can stagger, tilt and fall out.

With such an injury, the dentition shifts

A little later, a person with a similar injury may feel numbness in the chin area, which indicates that the trigeminal nerve has been damaged in the process. Another striking symptom indicating a problem is bleeding not only from the mouth, but also from the nose and ears. Naturally, in a person with a similar problem it is difficult not to notice bruises, hematomas, bruises, and wounds of different nature.

A jaw fracture is often accompanied by other injuries, damage to the head and body, and concussion.

Types of jaw osteosynthesis

Osteosynthesis with a metal plate for a jaw fracture is carried out in different ways. It is divided into types according to 2 characteristics - the method of fixing the plates and the technology of the operation itself.

• According to the method of fixing the plate for a jaw fracture, osteosynthesis can be: focal, when the elements of the plate are installed so as to cross the fracture gap and adjoin it;
• extrafocal, in which the plate is fixed outside the jaw fracture gap or passes through it above the mucous membrane and skin (without touching damaged tissues).

The closed method provides accelerated healing, since it does not involve complications that are possible due to impaired microcirculation in soft tissues. But the lack of visual control during closed osteosynthesis of the jaw makes it difficult to properly connect the bone elements and carry out the manipulation in general. This requires a very highly qualified specialist.

The open method of installing plates for jaw fractures (with visualization of the bone) makes it possible to most accurately compare the fragments, as well as remove damaged (interposed) soft tissues or small fragments of hard tissue. The main difficulty of the operation is the risk of tissue hypoxia, which is a common cause of enchondral osteogenesis.

The latter involves the transition of callus to the stage of cartilage, which is not typical for the lower jaw. With enchondral osteogenesis, the formation of a typical (ossified) callus of the lower jaw slows down.

Modern methods also include ultrasonic osteosynthesis with plates . It is carried out using special modern technology and is less traumatic. Installing plates for fractures using ultrasound equipment reduces the likelihood of complications.

Is it possible to help a person with such an injury on your own?

If your friend or loved one has suffered a broken jaw, then the only right decision in this case is to call an ambulance. If the person is conscious and able to swallow and breathe on their own, give syrup or a pre-crushed painkiller tablet to relieve pain. You can quickly take him to the hospital by personal vehicle, but before that you must try to immobilize the damaged area with the help of a bandage that secures the lower jaw to the upper.

Often people who receive such injuries lose consciousness. Many people stop breathing because their tongue becomes stuck and their airways become clogged with blood clots and vomit. In this case, delay and prolonged absence of professional medical care is dangerous, because without pulmonary resuscitation and other measures, respiratory failure and death can develop.

How will the treatment be carried out?

How is pathology treated and what do doctors do for it? First, specialists restore vital body functions: breathing, heartbeat. Immediately after the patient is admitted to maxillofacial surgery, it is necessary to stop the bleeding and relieve acute pain. Then a thorough diagnosis of the condition is carried out using x-rays and the type and nature of the injury is determined, because this will determine how to treat a fracture of the lower jaw.

There are different methods of repositioning (comparing) and immobilizing (fixing) fragments. There are conservative (splinting) and operative (direct and indirect osteosynthesis). All of them allow you to assemble a broken jaw into a single whole.

Conservative treatment uses splinting

If, according to indications, the patient requires surgical intervention, then doctors act in the following sequence: antiseptic treatment is carried out, fragments are removed and the fractures are combined with each other. Various devices help to fasten fragments of bone tissue - intraosseous pins and screws, compression devices, and metal plates on the bone. Then the mucous membranes are sutured and sutured. Another mandatory step is the removal of teeth located in the damaged area. After the operation, doctors install a fixation splint.

The conservative method involves installing a therapeutic splint. As a rule, this is an intraoral intermaxillary structure that is attached to the teeth using a ligature wire.

How quickly does a broken jaw heal?

Those who have received a maxillofacial injury are primarily concerned with the question: how long does it take for a jaw fracture to heal?
Since such a fracture is quite rare (of the total number of injuries, maxillofacial injuries account for only about five percent), few know what to do with it. Experts in the field of dentistry and maxillofacial surgery note that such an injury directly affects the teeth, lower face and even the brain, for this reason recovery is difficult and can be associated with a number of complications. It is noteworthy that a jaw fracture can rarely occur in everyday life. As a rule, people are injured during martial arts, in a fight, or when interacting with firearms. Therefore, a jaw fracture is almost always diagnosed together with a concussion or other brain damage.

Also, with such an injury, in addition to the impact on the brain, there is a risk of losing teeth, problems with hearing and vision. Because of this, a jaw fracture can bring much more negative consequences than it seems at first glance.

How long will it take for the injury to heal?

When asked how long it takes for a jaw fracture to heal, doctors answer that on average rehabilitation lasts up to 3 months. The trauma is significant, and only after the first month of treatment do patients begin to feel relief. Much of the relief is due to the fact that 21 days after the operation the fragments heal and doctors remove the splint, but sometimes this happens later, only on days 30–40.

On average, rehabilitation lasts up to 3 months

If you do not follow the doctor’s recommendations, in case of chronic diseases that disrupt tissue trophism (for example, diabetes), the healing process may take 2–4 weeks longer.

“I suffered a broken jaw in an accident. How many tears I shed while being treated!!! This whole thing heals quite slowly, you have to wear a splint, and it’s generally difficult to eat normally. If you want to lose weight and get rid of extra pounds, break your jaw. Black humor! This splint also constantly rubbed the mucous membrane on the cheeks and lips. All this time there was pain. After the splint was removed, there were sores and inflammation in my mouth. Then she replaced the teeth, since some were knocked out during the accident. In total, it took six months to recover. Now, thank God, the pain is gone, but it pulls and aches for any reason, for example, if the weather changes...”

Mi, fragment of review from otzovik.com

Cure period

The question of how long it takes for a jaw fracture to heal does not have an exact answer. The minimum period for restoration of basic functions is 1.5 months.

There is no need to rush to remove the splint or constructive devices for restraining the bone, so as not to harm the weakened organ and not be left with displaced teeth or wide dental gaps.

Statistics reflect therapeutic treatment on average up to 60 days. Accurate forecasts are always individual. Removal of splints and fixing elements is carried out after 30-45 days.

The success and duration of treatment largely depends on the patient’s desire to overcome the illness and difficult situation.

You can enjoy your recovery both when the fixation is removed, discharged from the hospital, and when the functionality of the jaw is fully restored without pain.

What needs to be done during the rehabilitation period?

• After the operation, it is allowed to eat exclusively liquid food and broths: it is recommended to eat food through a straw. Later, when the splint is removed (after about 21 days), you are allowed to eat food that has been blended and has a pureed consistency, as well as ground meat. A gentle diet must be followed for at least another month from the moment the tires are removed,
• you cannot open your mouth and strain your jaw: you will have to say “no” to meeting friends, communicating with colleagues, talking and laughing,
• it is necessary to follow the recommendations of doctors and take prescribed medications and drugs,
• It is important to undergo a course of physiotherapy procedures that promote accelerated tissue restoration: they can be carried out no earlier than 3–5 days after surgery. This could be magnetic therapy, electrophoresis,
• physical therapy: it is done after removing the fixing splints,
• undergoing routine examinations: they are carried out at least once a week until complete recovery.

Do not open your mouth or load your jaw

Possible consequences of a jaw fracture

If you do not pay due attention to the resulting injury and do not contact specialists in time, a number of consequences are possible that may appear after removing the fixing bandage or directly during the healing period.

These consequences include:

1. Difficulty breathing in and out.
2. Difficulty swallowing saliva and chewing.
3. Deformation of the angle of the lower jaw (cosmetic defect).
4. Constant pain.
5. The appearance of speech defects.
6. Complete lignification of the entire lower facial area.
7. Occurrence of problems with bite.
8. Risk of tooth displacement.

How to take care of your mouth and brush your teeth while wearing a splint?

Often patients are given a splint that tightens the upper and lower rows of teeth. Therefore, difficulties arise with daily care of teeth and gums. However, it is necessary to maintain hygiene, because a number of studies1 show that after wearing splints, many patients experience periodontal inflammation, as well as caries if hygiene was lacking.

Hygiene can be carried out using antiseptics and rinses that are used to rinse the mouth. To clean teeth and dental structures, you need to buy a brush with soft bristles and a brush. It is also recommended to purchase an irrigator that will help thoroughly rinse the mouth from food debris. True, you can use it no earlier than 10 days after the operation, and only on the most gentle regimen. It is necessary to rinse and irrigate up to 8–10 times a day.

How does healing occur after a jaw fracture?

Complete healing occurs in several stages. For a small fracture, an immobilizing splint is applied, so treatment should occur in a hospital.

After the necessary operations and fixation, the stages of fusion begin:

• Proliferation;
• Callus formation;
• Restoration of connective tissue.

After restoration, the new bone matter begins to adapt to its environment. After treatment, the patient's rehabilitation begins.

Proliferation

The stage is characterized by increased synthesis of lymphocytes, which help suppress infection. The rate of cell division at the fracture site increases. New vessels appear that nourish the damaged area of ​​the bone and remove dead cells through filtration through the kidneys.

The appearance of a callus

During this period, the first layer of future bone grows. Connective cells begin to create tissue, the damaged area is finally destroyed, which is excreted through the blood. Gradually, cartilage tissue grows on the osteoblasts, which serves as a framework.

Restoration

During restoration, the bone acquires the necessary functions. The synthesis of hormones and vitamins begins, the connective tissue takes on normal shape, and blood vessels are formed.

Gradually, the new bone acquires everything for normal functioning.

Can fragments heal incorrectly?

In 85% of clinical cases the outcome is favorable, that is, recovery occurs. But sometimes (in 7% of cases) a broken jaw does not heal as it should. Doctors attribute this to the fact that the patient did not follow all the recommendations and violated the regime. This may also be due to incorrectly chosen tactics and treatment methods, or poor fixation of fragments. But improper bone fusion is not the most dangerous consequence or complication of injury. Sometimes the patient’s suffering continues further because he develops traumatic osteomyelitis.

If not treated promptly or correctly, the fracture may heal incorrectly.

Osteomyelitis is a serious purulent-infectious lesion of the jaw bone tissue. It can occur due to a violation of asepsis at the time of the operation or after it, in the presence of unremoved and broken teeth, roots, caries, pulpitis, and periodontitis in the mouth.

A disease such as osteomyelitis, as well as untimely seeking of specialized help, can lead to the formation of a pseudarthrosis after the jaw has healed. This cosmetic defect greatly spoils the aesthetics of the face and disrupts the bite, so it needs to be corrected through surgical manipulation. But pathology can be completely avoided if the patient receives all the necessary medical care quickly and in a timely manner.

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prevention

1. Zoirov T.E., Bobamuratova D.T., Elnazarov A.T. The state of hygiene and periodontal disease during treatment using splinting in patients with a jaw fracture // Questions of science and education. – 2022.

Expert “After removing the splints, it is very important to sanitize the oral cavity and remove plaque, as well as restore the functionality and beauty of teeth damaged as a result of injury. Contact a dentist who will perform professional oral hygiene and, depending on the clinical situation, offer composite building, installation of crowns and veneers, prosthetics with removable and fixed structures, and implantation.” Dentist therapist, periodontist Marina Igorevna Tarabanovskaya

Consulting specialist

Tarabanovskaya Marina Igorevna

Specialization: Dentist therapist, periodontist Experience: 10 years

Negative factors in treatment

Prognosis depends on the condition of the patient's bone tissue, which depends on:

• from hereditary characteristics;
• the presence of chronic and acute inflammatory processes.

If the body has metabolic disorders, tuberculosis infection, or cancer, the prognosis may be disappointing.

Lack of vitamins and microelements affects the duration of treatment. The body needs correction of its general condition for successful recovery, including a jaw fracture.

The nature of the damage is of great importance in determining the healing period:

1. Simple fractures are fixed with splints and plaster bandages for subsequent conservative treatment.
2. Complex bone fractures require surgery to mechanically fix the parts using special plates and screws. Sometimes auxiliary elements are built in temporarily, sometimes for permanent wear.

Comments

After installing the splint, is the patient allowed to go home or does he have to stay in the hospital?

Mike (06/26/2020 at 02:41 pm) Reply to comment

It all depends on the nature of the injury, accompanying symptoms and the condition of the victim. If a person is unconscious, has fractures and injuries to other parts of the body, then he needs observation and specialized care, which can only be provided in a hospital.

Editorial staff of the portal UltraSmile.ru (06/29/2020 at 09:14) Reply to comment

A very unpleasant phenomenon. I wonder what to do with food for forty days. That is, the patient is unable to chew or take solid food at all. Will this have a negative impact on the digestive system if food comes in liquid form for several months?

Sergey Petrovich (07/23/2020 at 08:50) Reply to comment

How long do the consequences of a fracture of the lower jaw last? What I mean is that at the site of any fracture a certain callus appears. And how long does it usually take to make itself felt after an injury?

Vladimir Logvinov (07/23/2020 at 09:06) Reply to comment

Is it true that after a jaw fracture, this place becomes so vulnerable that if you put a little pressure on it, say, cracking a nut, and a second fracture will immediately occur?

Nikolay (07/23/2020 at 09:22) Reply to comment

Surely, after all, there are consequences from a fracture of the lower jaw, even if surgery and rehabilitation are performed, or only in difficult cases do there remain any consequences?

Lera (07/23/2020 at 09:30) Reply to comment

My husband broke his lower jaw when he hit himself at work. Now he is in the hospital, and through a bunch of bandages on his face, it seems to me that he did not have a very successful operation. What are the consequences if the operation is not performed correctly? Can this be fixed immediately before it is too late?

Zhanna (07/23/2020 at 10:24 am) Reply to comment

During a fight, along with a broken jaw, teeth are often damaged. Are there any contraindications to installing metal-ceramic implants after a jaw fracture has been healed?

Evgeniy (07/23/2020 at 14:37) Reply to comment

It’s very interesting whether this has ever happened in medical practice, when there are no obvious symptoms of a jaw fracture, but there is still a fracture? And is it possible to fully recover after a fracture, without any consequences?

Svetlana (07.23.2020 at 14:46) Reply to comment

Good afternoon My brother has had more than 21 days of rehabilitation, but his jaw is not healing well, the doctor reassures him that everything will heal, but we are worried. Tell me, should I worry or should I expect a full recovery?

Victor (07/23/2020 at 15:26) Reply to comment

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Threats of complications

The fusion of the jaw bone depends on precise anchorage and recovery time.

Late visit to the doctor or incomplete rehabilitation hinder healing and cause complications such as:

• purulent processes at the fracture site;
• malocclusion, tooth damage;
• disorders of smell and vision;
• painful attacks;
• difficulty swallowing and chewing.

In order to prevent complications and achieve a favorable prognosis for recovery, it is important not to skip any stage of complex treatment:

• diagnostics;
• splinting or osteoplasty;
• restorative therapy;
• physiotherapy;
• therapeutic exercises;
• daily wound sanitation.

Treatment is not completed, as a rule, in a hospital - it continues at home. The duration of bone fusion depends on compliance with a special diet and doctor’s prescriptions.