The jaw fracture: symptoms, diagnostics & therapy
The jaw fracture is one of the most common fractures of the oral and maxillofacial region. Often falls or sports injuries are the cause of jaw fractures. But how do the symptoms express themselves? And how is he treated? Get an overview here.
What is a jaw fracture?
A jaw fracture is defined as an interruption of the bony structure of the jaw. Here, a distinction is made primarily between Oberkieferfraktu and lower jaw fracture. This extremely painful injury results from sudden and strong mechanical forces. Accidents in traffic, violence with a punch or falls from high altitudes are expressed by fractures in the midface – usually in the fracture of the upper jaw.
The lower jaw fracture, however, is increasingly caused by sports injuries, as they are typical in ice hockey. But (triplet) falls are among the causes of lower jaw fractures. Furthermore, massive bone loss in addition to force effects also leads to the risk factors. Since bones feed primarily on compressive and tensile forces, bones quickly recover in long-term unoccupied gaps. This bone loss reduces the bone height and width, upper and lower jaw are frakturanfälliger. Additional changes in metabolism, such as osteoporosis, support the risk.
The symptoms of a jaw fracture are clear
- The feeling that the teeth suddenly do not match anymore
- Loosening of teeth
- Tactile new staging in the area of the jawbone – the safest symptom
- Abnormal sensations in the area of the upper or lower jaw (“… feels funny / / …” it tingles, is dull “
- Jaw pain during movement (chewing, speech) and at rest
Other symptoms include:
- bone rubbing
However, these five signs are among the less safe fracture symptoms.
How is a jaw fracture diagnosed??
Not always expresses a jaw fracture classic with visible and palpable step formation. Extensive examination and evaluation of the injury is considered essential. This is followed by imaging in case of suspected jaw fracture.
The examination is first carried out by a dentist or doctor. He looks for palpable bone levels, checks the degree of loosening or even loss of teeth and examines the patient for bleeding on the face and mouth. Sensory abnormalities in the area of the teeth and face are also checked. A recording of the mobility of the lower jaw or even newly formed mobility of the otherwise rigidly fixed upper jaw is also recorded. After this examination X-ray diagnostics becomes necessary.
X-raying takes place in two planes, so that a second X-ray image is necessary to better reflect the bone trajectories. In more complicated cases, a 3D diagnosis is made with the help of a digital volume tomograph (DVT). This diagnostic allows a three-dimensional and comprehensive representation of the jaw. An assessment of the breakage is thus optimally possible.
Sudden acts of force on the chin increasingly transfer the forces further to the lower jaw joint. Thus, when falling or hitting the chin on both sides, the temporomandibular joint processes and temporomandibular joint heads must be checked for breakage and, at best, excluded.
How is a jaw fracture treated??
The primary initial treatment of the fracture in the bone is done as far as possible with a splint and includes the fixation of the current situation and the acute haemostasis. In addition, a pain medication for temporary and temporary improvement of pain. An operative treatment is essential! A reduction and a subsequent fixation of the reduced jaw fracture situation are performed.
The primary primary care
Primary care is not only to treat pain, but also to maintain the airways to ensure stable breathing. If this is not possible, immediate emergency intubation takes place at the scene of the accident with transportation to the nearest hospital with subsequent surgical treatment.
Simpler jaw fracture cases can be treated with rails for better stabilization by the doctor until the scheduled surgery appointment.
The operative care
The operative restoration serves to restore anatomical bone continuity. The step formations in the bone are directed and then fixed with the aid of (mini) plate osteosynthesis. This plate osteosynthesis serves as a functionally stable supply. These plates are firmly screwed to the jawbone. An originally positionally correct and anatomical growth of the interrupted jawbone is thus made possible again. The active mouth opening and the movement of the lower jaw are not limited by the plate osteosynthesis. Speaking and eating initially soft and passaged food are also well possible with the plate osteosynthesis after swelling of the surgical swellings in the soft tissue. In the long term, a diet is built up, so that normal food becomes well possible in the long term.
Supportive to the operation is a prophylactic antibiotic shielding with an antibiotic via the vascular system, as prolonged intervention on the bone otherwise quickly lead to inflammation in the bone and the bone surrounding bone cuticle. The duration of the antibiotic depends on the severity of the jaw fracture.
Duration of treatment
However, as bone is rebuilt very slowly, splinting with plate osteosynthesis plates takes place for an average of 3 to 6 months. Subsequently, the plate materials are usually removed on successful completion of treatment by a small surgical procedure. Complicated fractures with massive bone loss may result in permanent retention of the osteosynthesis plates.
Complications in the treatment of jaw fractures
Depending on the severity and extent of the injury, complications can occur in the management of jaw fractures.
The most common complications include:
- Redness, bleeding, inflammation, rebleeding
- Postoperative soft tissue swelling, injuries
- Sensations of teeth, gums, skin and cheeks
- (permanent) sensory disturbances
- (permanent) nerve injuries
- Poor healing of the fracture gap
Can one prevent jaw fractures?
Since the jaw fracture is often an accidental injury, accident prevention is difficult. In sports such as ice hockey or Alpine skiing is advisable to wear helmets with appropriate mouth and chin guards. These feathers fall better and thus reduce the risk of excessive force, which can lead to fractures. The risk of a fracture of the jaw can thus be reduced.
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