Jaw fracture

Jaw fractures can be quite diverse, and there are many different variations.

First of all, all jaw fractures can be divided into upper and lower jaw fractures:

• upper jaw (maxilla) fracture.

Occurs less frequently and is usually the result of car accidents, falls from great heights, and other serious facial injuries;

• lower jaw (mandible) fracture.

Occurs more often due to anatomical features and is characterized by a large number of different types.

All fractures can be divided into six types:

• closed jaw fracture (the bone breaks but there is no soft tissue damage);
• open jaw fracture (the bone breaks with simultaneous soft tissue destruction);
• non-displaced fractures (bone fragments remain in the correct position);
• displaced fractures (bone fragments shift from their normal position);
• fracture with cracks (cracks form in the bone while cortical plate integrity is maintained);
• comminuted fracture (the bone breaks into several pieces).

Practice shows that closed mandibular fractures occur in approximately 10% of cases; open mandibular fractures are much more common.

Note that doctors do not always deal with one type of fracture; combined injuries are common: open fractures with displacement, comminuted fractures with cracks, etc.

All jaw fractures can also be divided into three groups by severity:

• minor fractures (without displacement, without skin and mucosal integrity violation);
• moderately severe (with slight displacement, with mild skin and mucosal damage);
• severe (with pronounced displacement, with open wounds, bleeding, and other complications).

The following jaw fracture symptoms are distinguished:

• pain (usually occurs in the fracture area and can be both sharp and dull);
• swelling (forms around the fracture site, becomes large over time);
• hematoma (develops as a result of hemorrhage into tissues around the fracture, may occur immediately or appear several hours after injury);
• deformity (visual distortion of jaw shape or structure, especially noticeable if the fracture is accompanied by bone displacement);
• functional impairment (inability to close and open the mouth, difficulties with chewing, swallowing, speaking, and bite changes);
• pressure sensitivity (pain or sensitivity in the fracture area may occur when touching or pressing);
• open wound (open jaw fracture is accompanied by bleeding, bone fragments may be visible);
• clicking or grinding (displaced jaw fracture can cause clicking during movement);
• tooth loss (fractures in the dental alveoli area may result in loss of one or several teeth).

Jaw fracture symptoms partially overlap with dislocation or contusion symptoms, so we recommend consulting specialists in case of injuries and suspected jaw fractures. Only an X-ray can confirm or deny the diagnosis, while early diagnosis and proper treatment affect not only the result but also the ease of achieving it. In case of jaw fractures, a doctor should be consulted within the first 24 hours.

At the slightest suspicion of a jaw fracture, you should immediately call emergency services. If you are in Kyiv, “Osadchyi Dental Clinic” provides emergency care: we work 24/7, so feel free to call us.

Before visiting the clinic, the following measures should be taken:

• if there is bleeding, use sterile bandages, but without applying force, without direct pressure on the fracture area;
• find a comfortable head position and try to ensure jaw immobility;
• for some injuries and fractures, it is also not recommended to move the neck;
• most importantly: do not try to set the fracture yourself!

A jaw fracture, strictly speaking, can only be treated by two methods: conservative or surgical. This does not mean that the patient or doctor can choose the treatment method at will — everything is determined by indications. For jaw fractures without displacement, conservative methods may be applied. If there is a complex jaw fracture, surgery is inevitable.

Surgical treatment may be necessary in cases of:

• displaced fractures;
• fractures with soft tissue, vascular, or nerve damage;
• fractures that may lead to bite disorders;
• practically all cases of upper jaw fractures.

A number of medical institutions in Ukraine and Kyiv have recently been abandoning tooth splinting for jaw fractures if osteosynthesis surgery was performed. However, the leading surgeon of our clinic, Igor Oleksandrovych, is adamant: “I consider splinting necessary in 100% of jaw fracture cases. Immobilization is the key to salvation and recovery.”

A splint for a jaw fracture is applied for 21 days, during which time the patient eats soft food.

The cost of jaw fracture treatment always depends on the complexity of the case and includes material costs plus the doctor’s fee. In case of surgical intervention, the cost of medical support for the operation is also added. In Kyiv, the price of jaw fracture treatment starts from 6 thousand hryvnias but can reach 50 thousand hryvnias.