Lower jaw fracture treated non surgically
The temporomandibular joints are the two joints that connect the lower jaw (mandible) to the temporal bone of the cranium. Part of the mandible that forms the temporomandibular joint is known as mandibular condyle. Injury to the para symphysis or symphysis region of the mandible may cause fracture of the condylar region due to indirect impact. Fractures involving the condylar region of mandible have a significant impact on the patient’s mouth opening and the dental occlusion ( the way the upper and lower teeth meet each other). These fractures if not treated correctly can cause malunion of the mandible thereby leading to a permanent deformity and difficulty in mouth opening, difficulty in chewing and in some cases can also cause TMJ ankylosis.
Whether the fracture needs to be treated by surgical methods or by conservative treatment depends upon the type of fracture and the area of the mandibular condylar region involved. Fractures involving the intracapsular part of the TMJ are seldom treated by surgical methods. These fractures are treated by conservative methods like arch bar application, maxillomandibular fixation(MMF) and/or intermaxillary elastics. Patients upon removal of the elastics or MMF are encouraged for active mouth opening exercises to attain complete mouth opening and a complete range of jaw motion. These patients should completely remain on fluid diet during the period of intermaxillary fixation which is the main concern for most of the patients. But this is beneficial to the patients when the risk of involving vital structures like facial nerve during open surgery of this area is compared.