Fracture of the lower jaw. The most popular 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.

Restoration of bone tissue in periodontitis and periodontal disease

Almost every adult faces the problem of losing molars. The most common reason leading to tooth extraction is periodontitis (progressive destruction of the structure of the alveolar process of the jaw). This disease is very common; its initial signs (bleeding gums, exposure of the neck of the tooth) can be found in everyone after 40–50 years. Less common is periodontal disease, which develops in the absence of normal blood supply to the periodontal tissues. For example, with diabetes and atherosclerosis. Restoration of bone tissue during periodontitis or periodontal disease is required when atrophy of the bone tissue of the alveolar processes of the jaws occurs.

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.

Restoration of bone tissue after implant removal and surgery

Unsuccessful implant installation (the doctor’s choice of a very thin or short implant, its incorrect installation without taking into account the bite) leads to tissue inflammation - peri-implantitis, loosening, breakage or rejection of the implanted tooth. In such cases, the implant fragments are removed from the bone, and then a major reconstruction of the alveolar process is required.

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

Causes of damage

Many people think how hard it takes to break a jaw. In fact, even if you bite food incorrectly or close your jaws, you can injure them and, if the bone tissue is weakened, its integrity can be disrupted.

Main reasons:

blows;
injuries in athletes;
falls;
car crashes.

In some sports, only the teeth are protected from impacts. But the jaw, the bone tissue itself, is almost always defenseless. Even an unsuccessful fall can injure this bone.

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.

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.

Indications for osteosynthesis of the jaw with plates

The main indication for installing metal plates for osteosynthesis is the prevention of complications that cannot be effectively prevented by applying a traditional splint. In the case of osteosynthesis, an important task for the surgeon is to compare the fragments and fix them in the correct position. If successful, fusion will take up to 3–4 weeks.

Indications:

fracture behind a row of teeth;
inflammation that provoked injury;
significant displacement of bone elements;
high mobility of teeth at the fracture site;
incorrect position of the jaws relative to each other.

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

Possible complications

The rate of jaw fusion depends on the age of the patients. In adolescents, metabolic processes proceed faster, so bone tissue regeneration proceeds without complications. On average, the ability to chew and speak is fully restored after 45-60 days. Adults experience complications associated with chronic diseases, infections, smoking and alcohol abuse.

The jaw heals faster after a fracture if there are no complications.

Possible consequences of severe injury:

Traumatic osteomyelitis. In 10−25% of patients with the splintered form, inflammation of the bone tissue develops. The cause is a carious cavity, a growing wisdom tooth, chronic periodontal disease, gingivitis, and reluctance to follow the rules of oral hygiene.
Maxillary sinusitis. In case of injury with damage to the chewing teeth, the risk of rupture of the mucous membranes of the maxillary sinus increases. When pathogenic bacteria enter, traumatic sinusitis occurs with fever, respiratory failure, and severe swelling. Requires surgical treatment, removal of damaged molars.

In rare cases, pseudarthrosis or false joint occurs. It is a proliferation of fibrous tissue that connects the fragments, preventing them from growing together correctly. They must be broken during surgery and connected with hooks or titanium plates.

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

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 to make regeneration faster

To make the recovery period shorter, you should treat the hole as carefully as possible. Several central means help speed up regeneration:

Brush your teeth correctly. It is important that the oral cavity is cleaned properly and that pathogenic bacteria that can cause inflammation and other problems do not multiply in it.
Use antiseptics. They need to be rinsed after eating. But from the side of the extracted tooth, you should not rinse your mouth too much, creating a vacuum inside the mouth.
Try not to put pressure on the gum so that the socket is constantly at rest. Strong mechanical pressure and other similar effects on tissue are especially dangerous.

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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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. – 2021.

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: 9 years

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

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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How much does tooth extraction hurt the gums?

Assessing how severe the harm from tooth extraction will be is not always easy. Sometimes removal can take much longer and have a very negative impact on the condition of a person’s gums. And here it doesn’t really matter which doctor performs the procedure - there are many potential complications.

Among the most notable factors of injury are the following:

Rupture of the ligaments and muscles that hold the tooth. They help the tooth stay inside the socket and not become loose over time.
Tissue damage. We are talking about both periodontal and periodontal tissues. They can heal for quite a long time.
Impact on the vascular system and nerves. Serious damage to blood vessels and nerves can usually occur. It is precisely because of the likely contact of blood with pathogenic bacteria during the recovery period that it is important to observe hygiene standards.

When going through the recovery process, you should be prepared for the fact that signs characteristic of inflammation will be observed for some time. In this case, swelling may appear, the temperature of the tissue at the site of removal may increase, and bleeding may occur. Pain also becomes a frequent companion during the recovery period.

In our clinic, removal is performed as carefully and carefully as possible. The extensive experience of doctors allows us to minimize tissue damage and reduce trauma. We will also answer the question of how long it takes for gums to heal and how to properly care for the socket so that it heals as quickly as possible.