Angina

Splints on teeth, jaw fracture. Splinting for a fracture of the lower jaw

Injuries associated with damage to the jaw bones can lead to dangerous consequences for a person, so you should know about the symptoms and treatment of a jaw fracture, as well as how much does it clamp?

The pathology occurs due to a pronounced mechanical effect on the jaw, or due to other pathologies. There are partial bone lesions, complete, with displacement and others. Self-medication in cases of such injuries.

Causes of a jaw fracture

The main causes are divided into two types: pathological and traumatic.

Pathological, including anomalies of the anatomy of the jaw bones and the consequences of diseases of various etiologies:

hereditary pathologies;
neoplasms, malignant and benign;
cysts;
tuberculosis;
treatment with certain drugs;
metabolic disorder;
lack of nutrition, vitamins and minerals;
infections and others.

Traumatic, including the consequences of falls, injuries, impacts, injuries, intense stress, road accidents and other conditions. Most often injuries are caused by:

driving various types of transport;
active lifestyle and other incidents;
abnormal removal of one or more teeth;
under severe physical impact, for example, when using a firearm, jaw injuries can be complicated by the appearance of fragments.

Symptoms

Pain, intense and pronounced, increasing with jaw movement, chewing, and talking. The pain is caused by damage to the thin shell of the bone - the periosteum, in which many nerve endings are located. In addition, inflammation may develop at the site of injury, which additionally creates pain signals. In some particularly difficult cases, the nerves themselves are damaged, and the pain increases.
Referred pain (locally). This phenomenon is verified by the fact that when pressing on the chin at the fracture site, pain occurs. This phenomenon is possible due to shrapnel irritation of the nerves.
The damaged jaw is mobile, the usual closing of the jaws is difficult, the relief of the bones and skin is changed. This can be determined both by external examination and by palpation, but any touching should be done with extreme caution.
Teeth can move out of their places, and gaps and gaps can form between them.
With both open and closed fractures, the blood vessels of the bone itself, surrounding soft tissue and periosteum can be damaged. Depending on the location of the injury and its cause, blood either flows into the oral cavity or through the skin if the fracture is open. With closed injuries, blood accumulates where the impact occurred, forming clots and causing pastiness. Bleeding is a reason for immediate medical examination.
Swelling of the entire facial contour and the formation of asymmetry are signs of a jaw fracture. The cause of edema is anti-inflammatory agents that act on blood vessels. They, in turn, expand, acquiring the property of greater permeability to blood. Manifestations of edema: pastiness, enlargement of soft tissues, redness of the skin. In this case, either part of the face in the area of injury, or half of the face, or the entire face may become enlarged. Swelling is caused not only by the fracture, but also by bleeding.
Formation of increased salivation.
Moving teeth, occurrence.
Recession of the tongue.
Damage to mucous tissues, skin in the form of wounds and abrasions of varying depths. Sometimes other fractures are detected in other parts of the face and in the neck area.
It is difficult or impossible for the patient to chew, swallow, or speak.
At the site of injury there are hematomas and bruises.
Subjectively, the patient feels headaches, dizziness, nausea, and weakness.

Species

The bones of the lower jaw are arranged in the shape of a horseshoe; it is easily crushed. The most common location of fractures is the area of the coronoid process, incisors, canines, and angles.

On the upper jaw, the weakest places in the structure are the closure with other bones. With minor injuries, as a rule, displacement occurs without the formation of fragments. In case of injuries received in the upper jaw area from the front, there is a risk of the fragment moving downwards and backwards. In case of falls or indirect impacts, there is also a risk of formation of fragments and their displacement to the base of the skull.

Classification of fractures according to the severity of the lesion:

Open, in which bone fragments are displaced towards soft tissues, tearing or damaging them (mucous, muscle, skin). Open fractures of the lower jaw are more common, and less often - of the upper jaw. With this type, there is a high risk of bacterial infection of damaged tissues; medical care is provided immediately.
Closed, in which the bone is damaged, but soft and nearby tissues are not affected. Closed types of fracture are more often localized in the area of the branches of the lower jaw and its angle. They are easier to treat than open ones.

Classification depending on the displacement of debris

A displaced fracture occurs when exposed to a strong traumatic force. The jaw bones move in relation to each other and other bones. In this case, the displacement can be both sagittal and vegetal, transversal.
A non-displaced fracture, in which the bone is damaged or divided into fragments, but they are not displaced, are related to each other anatomically. More often these are incomplete fractures.
Sometimes this classification includes the “concussion” type.
Splintered, occurring with the formation of several bone fragments of different sizes, randomly located. Characteristic of a powerful traumatic effect on the jaw. They require only hospital treatment; self-medication is not acceptable.
Complete, in which the fragments or fragments (fragments) of the damaged bone are displaced and have a transverse, oblique slope.

Degrees of complete fracture:

Single;
Double;
Multiple;
Splintered.

Treatment for a complete fracture is long and complex. An incomplete fracture is characterized by the presence of injured areas of the jaw with fragments; they, in turn, are not displaced.

Types of jaw bone injuries according to Lefort:

Lefort – I. The boundaries of the injury run along the base of the nose, then along the upper wall of the orbit and the zygomatic arches. Otherwise it is called subbasal. The patient's medical history includes complaints of visual splitting of objects and pain when swallowing. This fracture is characterized by swelling and characteristic eye symptoms.
Lefort – II. The boundaries of the fracture are located along the base of the nose, the lower wall of the orbit, then along the zygomatic-maxillary joint. Suborbital type. With it, some parts of the face become numb, tears are produced, and bleeding from the nasopharynx is characteristic.
Lefort – III. The boundaries of the fracture run along the base of the pyriform foramen and the bottom of the maxillary sinus. Bottom type. The patient will complain of pain, difficulty chewing, bleeding, and difficulty biting.

Based on location, fractures are divided into:

Middle - in the area of the central incisors.
Incisive - between the lateral and first incisors.
Canine - on the canine line.
Mental - in the area of the mental foramen.
Angular – in the area of the angle of the lower jaw.

In relation to the place of impact, fractures are divided into direct (directly in the area of injury), indirect (in the opposite place).

First aid

Medical assistance on site, while awaiting qualified assistance, should be provided as quickly as possible. The basic rules are:

provide complete rest to the patient in a motionless state;
restore breathing (cardiopulmonary resuscitation if necessary);
offer analgesics;
remove all excess from the oral cavity;
disinfect the wound;
stop bleeding;
If you have minimal knowledge, try to align the bones.

Jaw fracture - treatment

Any type of injury, both upper and lower jaw, is treated in a surgical hospital. In complicated cases, surgery is indicated.

Upon admission, the patient is anesthetized, a bandage is applied, diagnostics are performed (X-ray, CT, MRI), and bone structures are restored with sutures, staples, and plates. Implants are installed if it is not possible to put the patient’s bones together. Treatment includes antibiotic therapy and physiotherapy. The main methods of treatment are splinting and bypass surgery.

Splinting

The bone fragments are adjusted using a special plastic device. In case of a fracture on one side of the face, the device will be applied on one side, in case of a complicated fracture - on both sides with the addition of special rings and hooks.

In case of injury to both jaws, complicated by the displacement of fragments, splints are applied to both jaws (two-jaw technique). The main goal of the method is to ensure the immobility of healing tissues. Treatment may take up to 2 months. Before the splints are removed, the patient is x-rayed to ensure tissue fusion.

Bypass surgery

The method is used in complicated cases. In this case, the injured bone fragments are fixed with special splints consisting of hooking loops and rubber intermaxillary rods (Tigerstedt splint).

The method allows, in addition to fixation, to reduce the load on the patient’s bones.

Nutrition

Even with a simple fracture, the patient experiences difficulty eating. Depending on the severity of the injury, the patient is selected a method of nutrition with auxiliary measures.

Sippy cups with tubes are used when some teeth are missing. It is injected directly into the stomach. Food should be moderately warm, served in small portions, fractionally. The method is suitable for home use.
Probes are used strictly in hospitals in the first weeks. The tube is inserted into the stomach.
A dropper for parenteral food intake if the victim is unconscious.
Nutritional enemas are used in cases of unconsciousness and difficulties in feeding the patient through the veins.

What can you eat if your jaw is damaged:

high-calorie meat dishes diluted with milk or pureed broth;
baby food;
milk and fermented milk liquid drinks;
broths;
pureed soups;
fruit, vegetable purees and soufflés;
porridge diluted with milk.

Important: the diet must compensate for the patient’s daily calorie needs.

Video: how to eat properly if you have a broken jaw? Personal experience of a video blogger. You can also find other tips on his channel.

Consequences

Jaw fractures, as a rule, do not go away without unpleasant consequences. As a result of injuries, the following may occur:

Complications can be avoided by contacting professionals in a timely manner.

Rehabilitation

Recovery after surgery or treatment includes physiotherapy, physical therapy, and oral hygiene.

Physical therapy is prescribed no earlier than a month after the splints are removed. It is important to restore chewing function, swallowing, and facial expressions.

Physiotherapy methods such as exposure to electromagnetic fields of different frequencies, pulsed magnetic therapy, ultraviolet irradiation, electrophoresis, ice application, microwave therapy, paraffin therapy, infrared irradiation, and massage of the collar area are effective.

Additional questions

How long does it take for a fracture of the lower and upper jaw to heal?

In the absence of complications, such as traumatic osteomyelitis, inflammatory processes, milder fractures heal from 30 to 45 days. Injuries to the lower jaw are often more complex than to the upper jaw. Bone restoration can take up to 60 days.

Does it hurt to remove splints after a broken jaw?

The process of getting rid of splints is less painful than developing muscles and tissues after injury and immobilization. During rehabilitation, the muscles have become partially rigid; the patient will experience pain while eating, swallowing, and speaking.

How to determine a jaw fracture or bruise?

Common signs of injury are bruising, pain, swelling, and hematomas. Moreover, it is during a fracture that speech is difficult, the pain is more pronounced, the patient feels obvious weakness, even to the point of loss of consciousness. An accurate diagnosis can only be made by a surgeon after radiography.

How long are they in the hospital?

The duration of hospital treatment varies for different fractures. Complicated fractures, with displacement, surgical intervention, will require a course of inpatient treatment of up to 4 weeks.

Treatment of jaw injuries is not complete without the use of splints to fix displaced or fragmented fragments. The medical task is to connect bone tissue with maximum tightness.

A splint for a jaw fracture performs the function of individual fastening, or immobilization, of bone fragments. However, such damage requires lengthy and labor-intensive treatment.

Splinting for a jaw fracture is the main method of fastening the structure until its final fusion.

Design Features

The splinting technique was created by military doctors in the last century. Methods of application have been improved, new materials are used, but the principles of treatment have been preserved to this day.

Splinting of the lower jaw in case of destruction of the bone structure is used to fix the elements for proper fusion in the shortest possible time. Professional treatment is carried out either using a wire structure or plastic elements.

Before fixing the broken bones, surgery is necessary to restore the normal shape of the face and remove the fragments. The doctor also treats ruptured tissues and blood vessels.

Design solutions are different:

Vasiliev tape tires. A fastening with hooking loops made of bronze-aluminum wire is installed on the teeth. Fixation is carried out using a rubber rod. A simple and inexpensive device made of stainless steel.
Tigerstedt tires are made of aluminum wire. The most common three designs.

The first is a smooth splint.

The second one consists of rubber rods and loops for traction.

The third is a tire with a spacer bend.

Attachment to the teeth is carried out with wire ligatures individually for each patient. A single jaw splint is effective. Bronze-aluminum ligatures hold structural elements. Important advantages are the uniform distribution of the load and minimal trauma to the teeth.

Therapeutic splints have special qualities.

The most common materials are copper and aluminum. The wire thickness is no more than 2 mm. One patient usually requires 8 g of aluminum and 9 g of wire made of a bronze and aluminum alloy.

The splint is made strictly individually to exactly fit the dental arch.

Application manipulations are carried out under local anesthesia.

The more severe the jaw fracture, the more complex the design with hooks and rings for fixing bone tissue.

It is impossible to do without splinting, i.e. immobilizing the jaws.

Otherwise, the patient faces:

repeated trauma due to displacement of debris;
wound infection;
inflammation of soft tissues.

And anti-tetanus injections are required to eliminate the risk of infection during the treatment of injury.

Types of splinting

A panoramic photograph of the fracture site allows you to select and accurately install the required splint design.

The techniques depend on the characteristics of the bone tissue injury:

unilateral splinting is performed on the damaged area with copper wire;

bilateral splinting is the fixation of parts with rigid wire on both sides. If necessary, install hooks and rings to strengthen the strength of the structure;
double-jaw splinting is used in the most severe cases - bilateral fractures with displacement of parts. The anchors are held on strong teeth or installed in drilled holes in the bone. The jaws are connected with rubber rings attached to hooks.

The rigid fastening does not allow the patient to open his mouth. The chin sling strengthens the connection. The auxiliary device prevents sagging and presses the chin from below.

Splinting teeth for a fracture of the lower jaw is possible as a first aid measure while waiting for an ambulance. The victim should fix his jaw by tightly wrapping his head with a bandage, as shown in the photo:

Treatment of jaw fractures without splinting requires prolongation of the recovery time of the body, therefore this method of installing fixing frames is used in almost most cases.

The application of a splint changes nutritional habits and leads to the need to consume liquid and pureed food.

Proper nutrition while wearing a splint

Diet significantly influences the healing process of a jaw fracture. The body's resources must ensure the supply of bone tissue with microelements.

you will have to eat porridge-like dishes through a tube;
food should be high in calories and varied;
Particular attention should be paid to products with a high calcium content and fermented milk products.

Alcoholic drinks are strictly forbidden. Vomiting can cause death due to the inability to open the mouth independently. The person will simply choke on the vomit.

Removing tires

The period of wearing splints is an important stage in the treatment of jaw injuries. The period is at least one and a half months, but in each case it is individually determined depending on the severity of the injury. When healing bone tissues of complex fractures, the duration of immobilization reaches 60 days.

In severe cases, the fixation splint can be in place for up to a year, and the patient then faces many years of rehabilitation therapy.

The wear life of a tire is affected by:

patient's age;
presence of chronic diseases;
nature of the fracture;
timeliness of medical care

While wearing a splint, the patient should undergo regular examinations and x-rays of the jaw. After completing the course of treatment, the splint is removed by the doctor.

Treatment does not end after the structure is removed. Next comes gradual and painstaking rehabilitation: development of the jaw and restoration of traditional nutrition.

The time spent wearing a splint requires the patient to have endurance and the desire to overcome a difficult life situation. Only the joint efforts of the patient and the doctor will lead to an effective result without complications.

Treatment of a jaw fracture using splinting is the main technique, many years of experience in the use of which has shown its effectiveness in the example of thousands of recovered patients. However, such treatment is quite long and requires maintenance drug therapy.

Jaw fracture is a severe pathological situation in which the linear integrity of the bones that form the lower jaw is disrupted. This occurs under the influence of some traumatic factor, the intensity of which exceeds the strength of the bone. A fracture of the lower jaw is a fairly common pathology that occurs among all age categories, but most often it affects young men aged 21 to 40 years. This is due to several factors, which are determined by both socio-economic status and lifestyle, as well as anatomical and physiological characteristics. Tooth fracture is a tooth injury caused by mechanical force. When a fracture occurs, the anatomical integrity of the tooth root or its crown is disrupted. The causes of tooth fracture are mechanical injuries resulting from an impact, a fall, or during chewing when there are solid foreign bodies in food. The frontal teeth of the upper jaw are more susceptible to fractures than the teeth of the lower jaw; often tooth fractures are combined with their incomplete dislocations.

Reasons

Fractures of the lower jaw occur as a result of exposure to some traumatic factor, the force of which exceeds the strength of the bone. In most cases, this occurs as a result of falls, impacts, road traffic accidents, sports and professional accidents. However, the consequences of traumatic exposure are not the same in all cases and depend not only on the intensity, but also on a number of other factors, among which the physiological and structural state of the bone before the injury is of particular importance.

In medical practice, it is customary to distinguish two main types of fractures, in which the integrity of bone structures is disrupted, but which are the result of slightly different cause-and-effect relationships. Depending on the type of fracture, corresponding to the classification based on the initial cause of the fracture, the most adequate therapeutic and preventive tactics are selected. The following types of fractures are distinguished:

Basically, in clinical practice there are traumatic fractures, which, due to the characteristics of the shape and anatomy of the jaw, differ from fractures of other skeletal bones. First, due to the arched shape of the bone, when pressure is applied in front, in the chin area, the resulting force is applied to the areas of the arch that are located laterally. This is due to the rigid attachment of the jaw in the temporomandibular joint, which does not allow it to move and thereby absorb the impact energy. Thus, under the influence of one traumatic factor, multiple jaw fractures quite often develop ( usually in the area of the mandibular symphysis and angle of the jaw). Secondly, the jaw is a fairly strong bone that requires a lot of force to break. From a physical point of view, to fracture a jaw in the area of the corner, it is necessary to apply energy corresponding to 70 accelerations of free fall ( 70g), and for a fracture in the symphysis area, this figure must be increased to 100. However, it should be understood that in pathological conditions and with disorders of bone development, the force of the required blow is significantly reduced. According to statistical data, the cause of trauma to the lower jaw largely determines the location of the fracture. This is most likely due to the fact that in certain types of injuries the impact mechanism and the location of maximum energy absorption are similar. In car accidents, fractures usually occur in the area of the symphysis of the mandible and the condylar process ( on both sides), in motorcycle accidents - in the area of the symphysis and dental alveoli ( that is, at the level of the jaw body), and for injuries received as a result of an act of physical violence - in the area of the condylar process, body and angle of the jaw. Typical places for the formation of a jaw fracture line are:

Fractures of the lower jaw, like fractures of other bones of the body, are divided into open and closed depending on the contact of bone fragments with the external environment. However, unlike other bones, jaw fractures have their own characteristics, which are associated with the close location of the oral cavity. Fractures of the lower jaw are of the following types:

Depending on the displacement of bone fragments, the following types of jaw fractures are distinguished:

Displaced fracture. A fracture with displacement of fragments occurs when bone fragments lose their normal relationship and are displaced under the influence of some internal ( bone heaviness, muscle pull) or external ( direction and force of impact, displacement during movement) factors.
Fracture without displacement of fragments. In a fracture without displacement, there is a pathological defect between the bone fragments ( fissure or fracture line), however the fragments are correlated correctly. A similar situation is typical for incomplete fractures, in which part of the bone tissue retains its integrity, as well as for fractures that developed under the influence of a low-intensity traumatic factor.
Comminuted fracture. A comminuted fracture of the lower jaw is quite rare, but it is characterized by the presence of many bone fragments that are displaced to one degree or another. The peculiarity of this fracture is that, firstly, for its occurrence it is necessary to apply a large force to a small area of the bone ( for example, when hit with a hammer), and secondly, comminuted fractures require surgical treatment, as they significantly destabilize the bone.

Knowing the degree of displacement of bone fragments is necessary for planning a therapeutic approach, since significantly displaced fragments require much more labor-intensive treatment, which involves surgical comparison and fixation of the bone. In addition, the displacement of bone fragments, which after a fracture have rather sharp edges, can cause damage to nerves and blood vessels, which is an extremely unfavorable situation and requires immediate medical intervention. Odontogenic osteomyelitis Odontogenic osteomyelitis is an infectious-inflammatory lesion of the bone tissue of the lower jaw, which arose against the background of a dental infection. In other words, this pathology is an infection that has penetrated into the lower jaw from a primary focus localized in a tooth or teeth. It is relatively rare, but is quite dangerous and difficult to treat.

In osteomyelitis of the lower jaw, the developed infectious process stimulates an inflammatory reaction, under the influence of which the environment and local metabolism change. In addition, thrombus formation increases, local blockage of blood vessels occurs, and necrosis occurs ( dying off) bone tissue. Pus forms in the cavity under the tooth, dental ligaments weaken, the causative tooth and adjacent teeth acquire pathological mobility and begin to wobble. Due to malnutrition of the bone, it becomes more fragile and loses its original strength. This is especially pronounced in total osteomyelitis, that is, in cases where the pathological infectious-inflammatory process covers the entire lower jaw. Odontogenic osteomyelitis is one of the most common causes of pathological fractures of the mandible. This disease is accompanied by severe pain in the affected area, aggravated by chewing, putrid odor from the mouth, bleeding from the oral cavity, redness and swelling of the skin over the lesion.

Symptoms

The symptoms of a jaw fracture are quite varied. In most cases, this pathology is combined with a number of external manifestations, as well as a number of subjective sensations. However, since quite often a fracture of the jaw is combined with traumatic brain injuries, in which the victim may be unconscious, those clinical manifestations that the doctor can see during examination are of greatest importance. A fracture of the lower jaw is accompanied by the following symptoms:

Among other symptoms of a jaw fracture, bleeding from the nose or ears deserves special attention, since cerebrospinal fluid may leak along with the blood through the damaged base of the skull. Such bleeding can be distinguished by placing a clean napkin. With normal bleeding, one reddish spot remains on the napkin, while with bleeding combined with loss of cerebrospinal fluid, a yellowish spot appears on the napkin, diverging to the periphery.

Tooth fracture

Tooth fracture- traumatic damage to a tooth, accompanied by a violation of the integrity of its root or crown. There are different types of tooth fracture: fracture of enamel, dentin and tooth root. They manifest themselves as sudden mobility and displacement of the injured tooth, and intense pain. If the crown is fractured, the tooth can be saved with subsequent cosmetic restoration; if the root is fractured, its removal is required. In case of root injury, there is a high risk of developing periostitis, osteomyelitis and other complications.

Tooth fracture

Tooth fracture is a tooth injury caused by mechanical force. When a fracture occurs, the anatomical integrity of the tooth root or its crown is disrupted. The causes of tooth fracture are mechanical injuries resulting from an impact, a fall, or during chewing when there are solid foreign bodies in food. The frontal teeth of the upper jaw are more susceptible to fractures than the teeth of the lower jaw; often tooth fractures are combined with their incomplete dislocations.

Clinical manifestations of tooth fracture

When a tooth is fractured, severe unbearable pain occurs, the victim experiences difficulty opening the mouth and closing the teeth. In addition, a tooth fracture is preceded by some kind of trauma, bleeding gums and pathological loosening of the tooth are noted. Painful sensations from mechanical and thermal irritation depend on the type and location of the fracture, as well as on tooth mobility. During the examination, swelling of the soft tissues of the oral cavity and pinpoint hemorrhages in the skin and mucous membranes are detected. A fracture of the tooth crown is clinically manifested as a defect; often such a fracture is accompanied by an opening of the pulp chamber. When the root of a tooth is fractured, the tooth becomes mobile, its percussion is sharply painful, and the crown sometimes acquires a pink tint. A tooth fracture can be minor in the form of a chipping of the tooth enamel, or significant when there is a dentin fracture with or without exposure of the pulp and a fracture of the tooth root. Fractures with pulp exposure are called complete, and fractures without pulp exposure are incomplete.

Diagnostics

A jaw fracture can be suspected based on a patient interview, examination data and clinical examination. However, in most cases, for a final diagnosis, additional instrumental studies are required to diagnose both the fracture itself and a number of existing and potential complications of this phenomenon. It should be noted that with pathological fractures, the diagnostic process is not limited only to identifying the location and type of fracture, but also involves a number of additional radiographic and laboratory studies aimed at identifying the initial bone pathology. However, since the vast majority of people admitted to hospital trauma departments with a jaw fracture have suffered in various traumatic circumstances, their examination is considered routine and includes an examination and a number of additional procedures. A jaw fracture is detected using the following methods: During a clinical examination, the doctor identifies the main objective ( visible or felt by an outside observer) and subjective ( perceived exclusively by the patient) symptoms, and also finds out the circumstances of the incident. Objective symptoms of a jaw fracture include:

unilateral displacement of the jaw due to shortening of the body on one side;
pathological jaw mobility;
visualization of bone fragments deep in the wound;
violation of the bone relief;
asymmetry when opening the mouth;
spasm of the masticatory muscles;
crepitus ( crunch) bone fragments during movement.

Subjective signs of a jaw fracture usually include pain in the area of the fracture and primary injury, as well as changes in sensitivity in the fragment located behind the fracture line. This is due to the fact that when a fracture occurs, a structural or functional ( due to swelling and inflammation) nerve damage, which reduces the sensitivity of the corresponding area or causes specific sensations of numbness in it. Since this disease is often combined with traumatic brain injuries, it may be accompanied by nausea, vomiting, headaches, lethargy, and loss of orientation. Such sensations should be reported to the doctor, as they may indicate quite serious complications that must be taken into account when planning treatment. In addition to identifying signs of a fracture, the doctor, especially at the stage of providing primary care, checks the patency of the victim’s airways, detects the presence of respiratory movements and heartbeats ( pulse). If there are any abnormalities, the doctor provides the necessary medical care by restoring the airway and performing cardiopulmonary resuscitation. Plain radiography Plain radiography is a quick, effective and non-invasive method that can accurately determine both the presence and location of a jaw fracture. This study is indicated in all cases of suspected jaw fracture, as well as in most cases of traumatic brain injury. The method is based on the ability of X-rays to pass through body tissue and form a negative image on a special film. At its core, this method is similar to photography, with the difference that not the visible spectrum of light, but X-ray radiation is used to form the image. Since solid formations, such as bones, are able to absorb and retain rays, a shadow image is formed on the film placed under the tissue, which will correspond to the bone formation. The degree of absorption of X-rays by bone tissue is very high, due to which it is possible to obtain a fairly clear image of the jaw and adjacent bone formations.

If a fracture of the lower jaw is suspected, radiography of both the upper and lower jaw is performed in direct and lateral projection, which also covers the area of the facial skeleton, the vault and base of the skull, and several cervical vertebrae. As a result, diagnosis is not limited to just one bone, but covers the entire anatomical formation. In case of a fracture of the lower jaw, radiography allows one to determine the location of the fracture gap, the number of fractures, the presence or absence of fragments, and the degree of their displacement. In case of a fracture of the upper jaw, the involvement of adjacent bone structures is assessed using a radiograph, and darkening of the maxillary sinuses is also noted ( as a result of hemorrhage in them). It should be noted that, despite its advantages, radiography has a number of significant disadvantages, among which the most significant is the need to irradiate the patient. From an environmental health perspective, one of the objectives of which is the assessment of radiological background and its effects on the body, performing several radiographic procedures increases the dose of radiation to a person, but the overall health impact is relatively small. However, since the effects of ionizing radiation can accumulate, it is highly discouraged to expose yourself to unnecessary radiation. Orthopantomography Orthopantomography is an x-ray research method that allows you to obtain a panoramic image of the dental system. It is performed using a special device - an orthopantomograph, in which the image is obtained by rotating the X-ray source and film around the fixed head of the patient being examined. As a result, the film produces a panoramic image of the dentition, as well as the upper and lower jaw and nearby bone formations. This research method allows you to determine the presence and number of jaw bone fractures, damage to the temporomandibular joint and teeth. The entire procedure takes no more than five minutes and is relatively harmless. Computed tomography (CT ) Today, computed tomography is the preferred method for diagnosing jaw fractures, as it provides more accurate and detailed information. The method is also based on X-ray radiation - the patient is placed in a special computed tomograph, and an X-ray machine rotating around him takes many pictures. After computer processing, a clear layer-by-layer image of the area under study is obtained, and if necessary, you can even create a three-dimensional image of the facial skeleton. CT provides clear information about the presence and number of fractures, the location of the fracture gap, allows you to identify small fractures of the upper and lower jaw, fractures and cracks of nearby bone structures, and visualize small fragments that may not be visible on a simple x-ray. Computed tomography is indicated in the following situations:

in the presence of two or more fractures determined by x-ray;
jaw fractures involving the dentition;
suspicion of fractures of adjacent bone formations;
before surgical treatment of jaw fractures.

It should be noted that the advantage of computed tomography is the clarity of the resulting image and the detail of the image. In addition, this method is extremely informative for traumatic brain injuries, and due to the speed of execution, it allows for a quick diagnosis of cerebral hemorrhages. A significant disadvantage of computed tomography is the slightly higher dose of radiation to which the patient is exposed during the procedure. This is due to the fact that the device produces many sequential images, each of which irradiates the patient. However, given the high degree of image detail and the absence of the need for additional views, this method is comparable in safety to other radiological procedures. Magnetic resonance imaging (MRI ) Magnetic resonance imaging is a modern and highly informative method used in the diagnosis of jaw fractures. It is based on obtaining images of soft tissues by recording the properties of water molecules changed in a magnetic field. This method is more sensitive when examining periarticular tissues, provides information about the condition of the jaw vessels and nerves, allows one to assess the degree of damage to muscles, ligaments, intra-articular discs, determine hemorrhage into the cavity of the joint capsule and rupture of the joint capsule. All these pathologies can be detected only by this method, since other radiological procedures, which are based on X-ray radiation, image soft tissues relatively poorly. If damage to the vessels of the lower jaw, face and base of the skull is suspected, magnetic resonance imaging using contrast can be performed. This method involves the intravenous administration of a special substance, which, under magnetic field conditions, will be clearly visualized in the image. As a result, due to the presence of this substance in the vascular bed, damage to even the smallest vessels can be detected. The great advantage of MRI is the absolute safety of the method, which allows it to be used many times in the diagnosis and treatment of jaw fractures. The only contraindication for MRI is the presence of implants or metal elements in the patient’s body, since they, moving under the influence of a magnetic field, can damage human tissues and organs during the procedure.

Treatment

Surgical treatment of jaw fractures

Surgical treatment of a jaw fracture, which is indicated for most patients, and which in medicine is called osteosynthesis, is the main effective method of restoring bone integrity. The following types of osteosynthesis are used to treat fractures:

In addition to the listed methods used to fix fracture fragments, other methods are used in traumatology practice, the choice of which depends on the severity of the patient’s condition, the type and complexity of the fracture, as well as the skills of the surgeon. Indications for osteosynthesis are:

the presence of large and small bone fragments;
strong displacement of fragments and, as a consequence, the impossibility of comparing them without surgical intervention;
fractures behind the dentition;
pathological inflammatory or neoplastic process in the fracture area;
reconstructive operations;
a small number of healthy, stable teeth on bone fragments.

Bone suture

To apply a bone suture, the fracture area is exposed from soft tissue on the lateral and internal sides. Holes are made in the fragments, through which, after comparison, a wire is passed, which is used to fix the fragments. The wire can be made of stainless steel or titanium. In some cases, synthetic threads are used instead of wire, however, due to their lower strength, this method has limited use. This method of osteosynthesis is indicated in all cases of fresh fractures of the lower and upper jaw, in which there is no significant displacement of bone fragments. Contraindications to this method are:

inflammatory process in the fracture zone;
the presence of many small bone fragments;
osteomyelitis;
gunshot wounds in the area;
presence of bone defects.

The advantage of this method is maintaining the ability to eat independently and perform oral hygiene, as well as eliminating complications in the temporomandibular joint.

Bony metal plates

Bony metal plates are widely used in maxillofacial surgery because, firstly, they reduce soft tissue trauma during surgery ( it is necessary to dissect the skin and muscles on only one side, the lateral side), which has a positive effect on the recovery period and the time of bone fusion, and secondly, they allow better fixation of fragments in areas subject to strong dynamic loads. To fix bone fragments, small narrow plates made of titanium or stainless steel are used, which are screwed into the fracture area so that the fracture line is firmly fixed.

Also, fast-hardening plastics and special glue ( resorcinol epoxy resins), metal staples with memory, Kirschner knitting needles. For closed osteosynthesis, various extraoral wires and staples can be used. These include S-shaped and unified hooks, Kirschner wires, static and dynamic extraoral devices for immobilization, etc. The choice of fixation method is individual and is largely determined by the characteristics of the fracture.

Closed comparison of fragments

In addition to the methods of surgical treatment listed above, in some cases it is possible to achieve comparison of bone fragments non-surgically. This approach has a number of advantages, since, firstly, it does not require surgery and therefore is free of a number of risks, and secondly, it is not associated with soft tissue trauma in the fracture area, which disrupts blood microcirculation and slightly increases the time of bone healing. However, the need for external bone fixation and limited jaw function are disadvantages of this method. Closed comparison of fragments of the lower jaw involves the application of a special fixing splint, which is attached to the teeth and stabilizes the bone fragments. Today, closed comparison of bone fragments is used in cases where the bone fracture line allows it, when surgery is associated with high risks, as well as in fractures with a large number of small bone fragments, the surgical comparison of which is impossible.

Rehabilitation period

The effectiveness and recovery time in the postoperative period depend, first of all, on the time of the operation relative to the moment of injury and on the chosen type of osteosynthesis. Also important is the general condition of the patient and the degree of compensation for his chronic and acute diseases. Timely administration of antibiotics and restoratives reduces the risk of complications, thereby reducing the recovery period. The use of physiotherapy, physical therapy and regular oral hygiene in accordance with medical prescriptions are the basis for a rapid recovery with complete restoration of jaw function. Physical therapy can be carried out already 4–5 weeks after the fracture, naturally, after removing the splints. It is aimed at restoring chewing and swallowing functions, as well as speech and facial expressions. The diet should be gentle mechanically and chemically, but at the same time cover the daily need for nutrients. The food is crushed, diluted to a liquid state with broths, and heated to 45 - 50 degrees.

The most common facial injury to be treated by a traumatologist is a jaw fracture; How long such an injury takes to heal depends on a number of factors. These include the characteristics of the fracture, the patient’s age, and the development of complications. Experts state that the recovery period is longer for a fracture of the lower jaw. For the victim, this issue is extremely important, since such an injury complicates his life, preventing him from speaking and eating normally.

Rehabilitation after a jaw fracture

The duration of the rehabilitation period after a jaw fracture depends on what methods were used for treatment - conservative or surgical. Splinting for a fracture of the lower or upper jaw is carried out when there are no fragments or displacement after the injury. This procedure involves connecting jaw fragments with a single structure and then completely fixing them.

There are 3 types of splinting:

One-sided. It is carried out if one half of the lower or upper jaw is damaged as a result of injury. Splinting is carried out with copper wire.
Two-way. The splint is applied to the jaw on both sides. The teeth are fixed with rigid wire.
Double jawed. Used for bilateral fractures with displacement of fragments. Copper wire is attached to the remaining fixed teeth. If there are none, then the splint is installed in pre-drilled holes in the alveolar bone. After this, the lower and upper jaws are connected with rubber rings, and the structure is fixed with hooks.

Since the victim has difficulty eating, liquid or porridge-like food is recommended during the rehabilitation period. This can be vegetable or fruit puree, yogurt and kefir, milk, puree soup, baby formula and cereal, grated meat diluted in broth. After removing the splint, the transition to solid food should be done gradually. This is necessary not only for the gradual development of chewing function, but also to prepare the stomach for the usual diet.

Rehabilitation also includes taking medications that eliminate inflammation and pain, promote rapid healing, and prevent the development of bacterial infections. To fully restore all functions of the damaged part of the face, it is recommended to maintain enhanced oral hygiene, perform physical therapy, and carry out prescribed physical procedures. The active phase of rehabilitation begins a month after the damaged tissues have healed.

Physiotherapy

Physiotherapeutic procedures help accelerate the process of bone fusion, improve blood circulation and tissue regeneration.

In the case of the injury in question, the following procedures are prescribed:

Electrophoresis with calcium. Promotes normal bone healing. There are 15 procedures, each lasting 20 minutes;
Ultraviolet irradiation of the damaged area. UV rays promote the production of vitamin D, which is necessary for the absorption of calcium. Procedures are carried out every 3 days, lasting 30 minutes.
Magnetotherapy. Both low-frequency and high-frequency effects are used. Each procedure is repeated 10 times for 20 minutes. Signs of inflammation and swelling are eliminated, pain is relieved.

When are the splints removed and how long does it take for the jaw to heal?

The length of time you wear a splint after such an injury depends on several factors:

patient's age;
complexity of the fracture;
the presence of concomitant pathologies;
speed of bone recovery.

The older the victim, the longer it will take to recover. If splinting of the jaw for a fracture was carried out without osteosynthesis, then the fixing structure is removed at 30-45 days. If such manipulation was carried out, then 5-14 days after that. The total period of complete rehabilitation is 1.5-2 months.

The splint for a jaw fracture is removed after the bone is restored. Before removing the fixing structure, a control photograph is taken. If a fracture has formed on the fracture line, then there is no need to continue wearing a splint.

It will take at least 1 month for the damaged tissue to heal. With a complicated injury, this period can last up to 3-5 months.

How much does it cost to treat a broken jaw?

The cost of treatment for a jaw fracture is determined by the complexity of the injury and the measures taken to restore its integrity and functionality. Thus, the price of osteosynthesis can range from 15 to 70 thousand rubles. The starting price for splinting is about 14 thousand rubles.

The price is also affected by the quality of the tires used, physiotherapeutic procedures and postoperative observation. It is quite difficult to name the exact total cost of treatment, since this is only possible in a medical institution, when a specialist examines the victim. Services associated with recovery from such an injury are not cheap.

A jaw fracture ranks first in frequency among other injuries to the bone tissue of the skull. It happens as a result of a blow or a fall. In addition to the intense pain that the patient experiences, such an injury causes harm to the entire body, from the nervous system to the digestive organs.

There are incomplete fractures (without displacement) and complete fractures (with displacement). The main factor in the correct healing of any fracture is complete immobilization of the damaged area for a long time. In case of a jaw fracture, this is achieved by splinting. While wearing a splint, the patient must follow a certain diet and oral hygiene rules.

Treatment tactics

Any injury requires immediate medical attention. First of all, the specialist must administer an anesthetic to the patient, perform sanitation of the oral cavity and take an x-ray to determine whether there is a fracture, its exact location and degree.

Based on the X-ray image, the doctor chooses the method of splinting the jaw depending on the type of fracture. Then osteosynthesis is performed, which is a surgical tightening and fastening of scattered fragments using titanium screws and plates, staples, and polyamide threads. A more reliable and safe way to connect bone tissue is to apply metal plates. This procedure is performed under general anesthesia.

After all the parts of the broken bone are collected and aligned, a splint is applied. When the lower jaw is fractured, splinting occurs on entire parts of the bone tissue and is tightened with strong elastic bands. If one of them breaks, the tire must be reinstalled. If the upper jaw is broken, in some cases it is used to tighten it with the cheek bone using titanium screws in order to better fix the affected area.

This design completely constrains the oral cavity for 1.5-2 months. To avoid the occurrence of infectious processes, patients are prescribed antibiotics and anti-inflammatory drugs. To maintain body functions in the fight against a fracture, it is recommended to take multivitamins.

Types of splinting

A splint for a jaw fracture can be made of plastic or metal. The plastic structure is temporary and is used to provide emergency care to the patient and transport him to the hospital. Also, as an additional measure, a bandage is applied. Metal fixation in most cases is made of wire and has several types depending on the severity of the fracture:

The unilateral design consists of fixing the damaged area on one side, in most cases it is used for fractures of the lower jaw. It is used by splinting teeth, connecting them into a single tightly tightened structure. Copper wire is usually used for this. If for some reason the teeth are either missing or also damaged due to injury, holes are drilled in the bone tissue through which the wire is threaded.
The double-sided design involves installing the tire on both sides. This requires thicker and stronger wire with rings and hooks. This method is used for multiple fractures. The wire is also fixed on the unaffected dentition or in holes made in the alveolar bone.
A two-jaw design is performed for displaced fractures of the upper and lower jaws. Applying splints in this case forces both jaws to close tightly with the help of rubber rods that fasten the upper and lower hooks. This design is called a Tigerstedt splint.

Splinting procedure

In most cases, splinting a mandibular fracture occurs using an inexpensive Vasiliev tape splint, which is a standard steel structure about 0.3 mm thick with hooking loops. It is attached to the teeth using aluminum wire, which tightly tightens the dentition and thereby fixes the fracture.

In the most difficult cases, a Tigerstedt splint is used, which is created individually for each patient and allows for more reliable and safe fixation of the fracture site.

The entire splinting procedure takes place under general anesthesia or local anesthesia in several stages:

Osteosynthesis, which includes the introduction of anesthesia, treatment of the oral cavity by cleansing it of blood clots and damaged tissue. Next, the bone is freed from the skin, the periosteum is exfoliated, and the destroyed bone tissue is connected using wire or metal plates. The final point is the connection and stitching of soft tissues.
Splinting, which is the application of a wire that is attached to the teeth, tightening them, or to the bone tissue, in which holes are specially drilled.
Fastening the jaws with tight rubber rings attached to wire hooks.
In especially severe cases, to create additional immobility of the patient’s jaws, a special sling is installed, which allows the chin to be securely fastened to avoid displacement of the jaw.

Features in the elderly

With age, many body functions undergo irreversible changes. In most cases, this dynamic can lead to adverse consequences. Such changes certainly affect the bone tissue of patients. In addition to the fact that over the years, the loss and abrasion of the dentition occurs, which certainly affects the bite and chewing muscles, but in addition, the soft tissues of the oral cavity lose their ability to quickly regenerate. The periodontium is depleted, leading to atrophy of the alveolar and coronoid processes. These factors make it difficult to fix dental splints on the jaw.

The synthesis of bone tissue slows down, leading to its gradual decay and increased fragility due to disturbances in protein and mineral metabolism.

Thus, when splinting a jaw fracture in an elderly patient, it is impossible to do without non-surgical osteosynthesis due to the complete or partial absence of teeth or their excessive fragility. The connection of damaged bones is carried out using a bone suture with titanium wire and intraosseous osteosynthesis with titanium wires. The splint is secured to the jaw for a longer period of time than is done for younger people with similar injuries.

Bus power supply

If the jaw is fractured, the patient cannot eat regular food, since any movement of the damaged organ is contraindicated for him. Therefore, he should eat only liquid food, which is supplied to the oral cavity through a tube or a special catheter inserted into the lumen behind the last molar.

At the same time, in order to avoid weight loss and speed up the process of bone tissue regeneration, a mandatory consumption of at least 3000 calories per day is indicated. For this purpose, food is ground in a blender to a pulp. Fruit purees, baby formula, milk porridge, meat broths, kefir or yogurt with a high percentage of fat will help make up for the lack of calories.

Rehabilitation period

The healing time of a jaw fracture is different for each patient, which depends on the severity of the injury, age, speed of assistance provided, properly organized treatment of a jaw fracture and the patient’s compliance with the rules of behavior after applying a splint. Therefore, it is impossible to say exactly how long patients wear the fixation structure. The period of fracture healing can take from 1 month to 1 year.

Throughout the entire period of wearing the splint after a jaw fracture, the doctor regularly takes x-rays. After the next picture shows that the fusion site is covered with callus, the structure can be immediately removed. This is a quick procedure performed with special tools.

The rehabilitation period after removing the splint begins a month after the healing of the jaw fracture and includes regular performance of a specially designed set of exercises to restore the facial joints and muscles, including a light massage. The patient is also prescribed physiotherapeutic procedures, such as magnetotherapy and electrophoresis.

After each meal, it is necessary to rinse your mouth with antiseptics, for example, soda solution or chlorhexidine. Also, after each meal, you should carefully brush your teeth, lightly massaging your gums to improve blood circulation. Compliance with all doctor’s prescriptions will significantly speed up the recovery process.

If treatment is incorrectly prescribed, the patient does not comply with all recommendations, or for other reasons beyond the control of the patient and his attending physician, complications occur after trauma to the jaw:

After wearing a splint for a long time, the masticatory muscles atrophy. Regular exercises to tone the maxillofacial muscles will help correct this.
Osteonecrosis, manifested in the death of bone tissue. In this case, surgery is required.
Change in bite due to displacement of bone fragments. This occurs when the splint is removed prematurely or when the fracture is poorly fixed.
Loss of some teeth that were tied with wire, inflammation of the gums, and the appearance of gaps between the teeth. Therefore, after removing the splint, you should immediately visit the dentist.
Inflammation of the facial nerve.
In rare cases, facial asymmetry may occur.
Due to the disruption of the internal tissues of the face, the upper respiratory tract may be damaged, which can lead to sinusitis.
The appearance of a so-called false joint at the fracture site.

Doctors' opinion

Many doctors agree that although a broken jaw is a complex and painful injury, it can be healed to the extent that there are no reminders of the previous incident. For the patient, the main condition for getting rid of the problem is patient and painstaking implementation of all prescriptions and recommendations of the treating specialist.

There are cases when, after a serious jaw injury, people prefer not to see a doctor, hoping that the problem will go away on its own. But even if the fracture heals on its own, it is very unlikely that the masticatory apparatus will continue to function correctly and the face will not lose its ethical appearance.

In addition, other equally unpleasant consequences may be added to the fracture, such as an absolute inability to chew food, tongue retraction, which can even lead to suffocation, bleeding, and infections. If you start the disease, the recovery period will take a very long time and there will be a high risk of various complications. Therefore, timely and qualified assistance for such a serious injury is so important.

The effectiveness of the jaw splinting technique for fracture

If you are looking for information about splinting a jaw for a fracture, you have probably encountered the trouble of a broken jaw. In this article you will find necessary and useful information about this technique, as well as learn other details that will be of interest to people who have received this injury.

About a jaw fracture

A jaw fracture is a painful and dangerous injury that often occurs as a result of falls from heights, household injuries and gunshot wounds. No one is immune from getting this type of fracture, however, men aged 21 to 40 years are more often susceptible to this. Approximately 80% of all fractures of the maxillofacial apparatus occur due to damage to the lower jaw.

A fracture involves a violation of the integrity of the bones of the upper or lower jaw and is accompanied by the following symptoms:

Acute pain at the site of injury;
Swelling of both the entire face and exclusively the injured area;
Bleeding;
Possible violation of the integrity of the skin;
Facial asymmetry;
Difficulty swallowing and chewing.

The sooner you see a doctor, the lower the risk of complications and the higher the chance of completely restoring the function and integrity of the damaged jaw. It is strictly not recommended to try to “straighten” the jaw on your own and palpate the damaged area; by doing this, you risk causing even greater harm and complicating the course of further treatment.

Suspicion of a fracture. First steps before seeing a doctor:

Secure the jaw with a bandage;
Taking analgesics for pain relief;
Apply cold to the fracture site;
Stop bleeding using cotton swabs.

After contacting a medical institution, the doctor will conduct diagnostics to make an accurate diagnosis and identify the location and degree of complexity of the fracture. The following methods exist for this:

X-ray is a mandatory procedure for patients with injuries of this kind. This is a quick and effective method that will absolutely help you understand whether there is a jaw fracture, as well as find out its location.
Clinical examination. It includes a visual examination by a doctor, which may reveal symptoms such as excessive mobility of the jaw, the presence of bone fragments in the wound, and disruption of bone relief. After this stage, the doctor begins palpation, which will help determine the severity of the fracture and determine the exact location.
Computed tomography.
Magnetic resonance imaging.
Orthopantomography.

Jaw fractures - treatment methods

Patients with this injury must undergo treatment and observation in a hospital setting. Additionally, antibiotics are prescribed to prevent the occurrence of an infectious process. In most cases, teeth at the fracture site must be removed. For damaged bones to heal, they require complete immobility. This can be achieved by the splinting procedure, which involves installing a structure made of polymers or metal in the oral cavity, which will connect and fix the bone fragments. This procedure will help avoid complications such as displacement of bone fragments, wound infection, inflammation and chronic dislocation. Before splinting, comparison of jaw fragments and local anesthesia are performed.

Types of splinting

The doctor chooses the type of splinting depending on the severity of the fracture. the following techniques are most often used:

This process means constant inspection, checking the installed structure and irrigating the mouth with an antiseptic solution, as well as monitoring the condition of the bite. Additionally, X-rays are taken once a week to monitor the restoration of bone tissue.

Applying a splint is the very beginning of the long process of treating a fracture. In the case of double-jaw splinting, a person is unable to open his mouth, which greatly complicates the process of eating. But despite this, it is necessary to fully satisfy the body’s need for vitamins and microelements every day. The patient is recommended to consume foods such as infant formula, purees and cereals; liquid pureed soups; fermented milk products; liquid porridge with milk, boiled meat, crushed to a pasty state and diluted with broth. The process of eating occurs with the help of a straw.

Recovery period

Most often, patients are concerned about the time after which it will be possible to remove the splints. There is no exact answer, since it depends on the degree of complexity and nature of the injury, and, of course, the individual characteristics of the body. Most often, the tire is installed for a period of 1 to 1.5 - 2 months. After a control x-ray, if a pronounced bone callus is detected at the fracture site, the splint can be removed. It is quite natural that during such a time, without constant load, the jaw muscles partially atrophy, as a result of which the patient experiences discomfort when chewing. A sudden transition from pureed to solid food is strictly not recommended, in order to avoid gastrointestinal upset. To restore motor activity of muscles and joints, a course of physiotherapy is prescribed, which includes:

Electrophoresis;
Massage;
Magnetic therapy;
Therapeutic exercise.

All these methods will speed up the recovery and healing process.

Despite all the difficulties and inconveniences that a patient faced with the need for this procedure has to endure, splinting is the most effective way to restore the functionality of a damaged jaw and is often used all over the world. surgery.

Splinting the jaw for a fracture

Immobilization of the jaw during a fracture is achieved by splinting. Due to the injury, difficulties arise with food consumption, the gastrointestinal tract, central and peripheral nervous systems are affected. If a fracture occurs in old age, healing of damaged tissue is more difficult. In such cases, splinting is used for a period of 2 months.

Various structures are used to fix the jaw. But before carrying out therapeutic immobilization, the victim is given first aid, temporary fixators are placed, and a comprehensive diagnosis is carried out to determine the complexity and location of the injury.

Splinting procedure

Jaw fractures are considered difficult to treat. The problem lies in poor localization of the injury. The doctor makes efforts to correctly carry out the reposition and avoid deformation of the fragments during further immobilization.

Such damage requires specific therapy, and if due to injury the bone is fragmented and cannot be restored, then osteosynthesis is necessary. The splint is placed only after surgery. Attachment is carried out to healthy tissues. According to the decision of the attending physician, physiotherapy, antibiotics and complex vitamins are prescribed for better healing.

End-to-end splinting increases the risk of inflammation. Because of this, strict monitoring of the patient’s condition is carried out at all stages of treatment. Antibacterial therapy is supported by the administration of immunostimulants. If drugs are difficult to give orally, infusion therapy is performed.

For fractures of the lower jaw, dental splinting has proven effective. The wire is pinned onto the teeth of the lower row, tightening them in such a way as to ensure immobility of the lower jaw during a fracture. If teeth are missing, installation is carried out through bone tissue. Additionally, drug therapy is prescribed and complications are prevented.

To treat a complex fracture, Tigerstedt splints are used - this is a single or paired design with loops. It is applied for medical reasons and be sure to adhere to a gentle diet at all stages of recovery. How long the jaw heals depends on a number of factors: the age of the victim, the complexity of the injury, and the condition of the skeletal system. In children, the recovery process is many times faster, and complications are much less. However, small patients have a hard time with jaw splinting and more often violate doctor’s orders due to physical inconvenience.

No displacement should be allowed during the procedure. For this reason, preliminary fixation is carried out with aluminum wire. There should be no visible compression at the tire mounting points. Otherwise, it will be difficult for the patient to wear the splint for a long time.

Types of splinting

The design of the splint for immobilizing the jaw during a fracture is selected taking into account the nature of the injury. Plates and screws are often used to secure jaw fragments. In the future, shunting with a ligature wire can immobilize the jaw during a fracture.

There are many types of splinting. Varieties of metal structures allow you to choose the optimal method of jaw immobilization. In this case, there are compact types of splints that are installed on a small area and paired structures that cover both jaws.

Among the methods of treating mandibular fractures, immobilization with dental splints has proven itself well. Splinting the anterior teeth provides the necessary immobility for linear fractures. In the case of a toothless jaw, open osteosynthesis may be recommended: the application of bone sutures, the use of Kirschner wires. It is also possible to secure the fragments using titanium screws.

Unilateral

Traumatologists recommend unilateral splinting for a fracture of the lower jaw. This is an effective and safe method of immobilization that provides sufficient immobility for proper fusion. Dentists practice temporary splinting techniques - various methods of ligature connection. These structures are not considered therapeutic and are suitable exclusively for transport immobilization.

To splint teeth for therapeutic purposes in case of a jaw fracture, bent wire structures are used. They are fixed on the neck of the teeth and hold part of the jaw in the correct position. Unilateral splinting maintains sufficient mobility of the masticatory apparatus, which eliminates discomfort during treatment.

Two-way

A common type of splint for treating a jaw fracture is a bent ligature wire using the Tigerstedt method. They are bent individually and installed after preliminary fixation of the teeth in the fracture area. The Vasilyev tape splint is no less popular in double-sided splinting. It is installed on the jaw if the required number of fixed teeth is present. For linear injuries with stable teeth in the amount of at least 3-5, a smooth splint-brace is used.

No less popular are splints with spacers, which create resistance and prevent deformation of the lower jaw and teeth intersecting with each other. Such designs are recommended for certain types of fractures accompanied by displacement.

Bimaxillary

To splint the jaw, paired elements are often used that firmly fix both jaws, pressing them against each other. Tigerstedt's double-sided design is equipped with hooks and rubber rings, which ensures tightening.

Alloy tires for fractures are considered reliable, safe and easy to install. During the application of the splint, a preliminary fitting is carried out to avoid possible deformations and improper fusion. During splinting, the injured jaw is immobilized in any available way.

The two-jaw design is indicated for complete fractures of the upper jaw, multiple injuries to the masticatory apparatus, and a high risk of intracranial disorders due to the fracture.

What types of tires are there?

The most affordable and proven in practice remains the ligature wire for splinting the jaw. Copper wire is also used, which is suitable for tightening the dentition when the lower jaw is damaged.

In case of a displaced jaw fracture, osteosynthesis is performed with plates. Products made from titanium-nickel alloy have proven themselves well. Titanium plates for fractures are installed mainly on the upper jaw, which eliminates the need to immobilize the entire jaw apparatus. Splinting also involves the use of metal staples, screws, and mini-plates.

For jaw fractures, plastic splints are often used, which are characterized by rapid hardening. In essence, the design is a prosthesis with hooks for subsequent fixation with rubber rings.

The splint is selected individually for each patient. In dentistry, structures made of polymers, fiberglass, and aramid threads have been used. The products are distinguished by a wide range of prices, special operating conditions, and the ability to be combined with other dental structures.

Splinting with an elastic band is suitable for complicated jaw fractures in which there is a high risk of tooth dislocation. If screws can be placed in the jaw, then this fixation method will provide a tight grip on the upper and lower teeth. After a period of immobilization, the screws are removed. This splinting method is combined with other methods of therapeutic immobilization.

Removing tires

The timing of immobilization with a splint after a jaw fracture depends on the rate of healing. Only a doctor can remove the structure and only after a preliminary assessment of the condition of the bone structures. To do this, take a photo. If there is a formed callus, you no longer need to wear a splint. On average, jaw splinting for uncomplicated fractures is carried out for a period of 1.5 months.

Splints should be removed using dental instruments. First, remove the elastic bands, then unbend the metal elements. If the procedure is performed correctly, it is not painful. However, in case of fixation with metal structures directly into the bone, anesthesia is necessary.

The procedure is not performed at home even with an uncomplicated injury. The dentist should examine the oral cavity and prescribe further treatment. Typically, when splints are removed, gum inflammation occurs. The specialist will explain what to do in this case, and will also prescribe medications to sanitize and relieve the symptoms of inflammation.

The duration of the fusion period can be accelerated with the help of preparations with collagen, calcium, and vitamin D3. But in old age, the formation of callus slows down, then the structure remains in place for a long time, and removal of the splints is postponed until callus appears. How long the splint is worn depends on the extent of the damage and the risk of complications. If fusion still does not occur, the splint must be removed and surgical treatment of the fracture is performed.

Only the doctor decides how long to walk with the structure and when to start developing it. Early removal of the fixator leads to complications of the injury.

Nutrition after splinting

After the splint is fixed on the jaw, chewing is impossible. All that remains is to eat soft and liquid food, which is fed through a straw. You can eat fully only after the structure is removed. But this does not mean that the patient is experiencing a deficiency of nutrients. Nutrition for a jaw fracture should be balanced and varied. For this purpose, protein shakes, vegetable and fruit purees, porridge mousses, and fermented milk products are introduced into the diet.

A splint installed for a fracture of the lower jaw significantly complicates the chewing process, but does not completely eliminate the chewing apparatus from working. In this case, it is allowed to eat slimy dishes, soufflés made from meat, potatoes, and cottage cheese. Be careful when using meatballs and steamed cutlets when splinting. Although they are soft, they require chewing, which is not always desirable. It is better to consume protein foods in the form of purees, similar to baby food.

The patient’s diet should include:

foods high in calcium;
protein shakes;
chopped vegetables, herbs and fruits rich in vitamin C;
fruit drinks and compotes.

Alcohol is completely excluded during the treatment period. Firstly, it impairs the effectiveness of therapy and conflicts with most medications. Secondly, alcohol can cause nausea and vomiting, which is dangerous during double-jaw splinting.

Recovery period

Long-term splinting after a fracture of the lower jaw leads to disruption of chewing and speech functions. The dentist will tell you how to develop the jaw and restore its functionality without harm to health. For rehabilitation, simple exercises and physical procedures are recommended. Coarser foods are gradually introduced into the diet. It takes a long time to recover from tire removal. It is especially difficult to restore the functionality of the device after damage to the two jaws. The chewing apparatus should be developed gradually, otherwise problems with diction and chewing may occur.

Retainers will be beneficial during the rehabilitation period - they are used after prosthetics and orthodontic treatment and are aimed at improving the bite of teeth and adapting to subsequent loads.

Possible complications and consequences

In dentistry, it is not uncommon for problems to arise even with early consultation and the development of an optimal treatment plan after immobilization. Possible complications are indicated by unpleasant symptoms that appear even before the structure is removed. Thus, after splinting, teeth often become loose, especially in older people.

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Possible complications and negative consequences arise even with proper therapy. The injury itself is difficult to treat, due to the inconvenience of localizing the fracture.

Other complications of the injury include:

bite pathology– negatively affect chewing and speech functions. If the teeth are crooked and serious problems occur, tooth extraction is required;
injury to facial tissues– provokes the development of sinusitis and inflammation of the facial nerve;
false joint– a condition in which the fracture site does not heal and has pathological mobility;
osteonecrosis– due to prolonged wearing of the structure, bone tissues die. Surgical treatment is required.

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