Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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The conservative treatment of mandibular fracture in a child with circummandibular wiring: case report

환악 결찰술을 이용한 소아 하악 골절의 보존적 치료: 증례보고

  • Kim, Hyung-Mo (Department of Dentistry, Oral and Maxillofacial Surgery, Ajou University School of Medicine) ;
  • Kim, Tae-Wan (Department of Dentistry, Oral and Maxillofacial Surgery, Ajou University School of Medicine) ;
  • Song, Seung-Il (Department of Dentistry, Oral and Maxillofacial Surgery, Ajou University School of Medicine) ;
  • Lee, Jeong-Keun (Department of Dentistry, Oral and Maxillofacial Surgery, Ajou University School of Medicine)
  • 김형모 (아주대학교 의과대학 치과학교실 구강악안면외과) ;
  • 김태완 (아주대학교 의과대학 치과학교실 구강악안면외과) ;
  • 송승일 (아주대학교 의과대학 치과학교실 구강악안면외과) ;
  • 이정근 (아주대학교 의과대학 치과학교실 구강악안면외과)
  • Received : 2010.02.19
  • Accepted : 2010.03.31
  • Published : 2010.04.30
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Abstract

Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.

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References

  1. McGraw BL, Cole RR. Pediatric maxillofacial trauma. Age-related variations in injury. Arch Otolaryngol Head Neck Surg 1990; 116:41-5. https://doi.org/10.1001/archotol.1990.01870010045014
  2. Iida S, Matsuya T. Paediatiric maxillofacial fractures: their aetiological characters and fracture patterns. J Craniomaxillofac Surg 2002;30:237-41. https://doi.org/10.1054/jcms.2002.0295
  3. Qadri GW, Mokhtar SM. Paediatric mandibular fractures: report of a case. Dent Traumatol 2008;24:e67-70. https://doi.org/10.1111/j.1600-9657.2008.00700.x
  4. Imola MJ, Hamlar DD, Shao W, Chowdhury K, Tatum S. Resorbable plate fixation in pediatiric craniofacial surgery: longterm outcome. Arch Facial Plast Surg 2001;3:79-90. https://doi.org/10.1001/archfaci.3.2.79
  5. Pyo SW. Circum-mandibular wirng for pediatric mandibular fracture: case report. J Korean Assoc Oral Maxillofac Surg 1995; 21:619-26.
  6. Dodson TB. Mandibular fractures in children. In: Kelly JP, ed. OMS Knowledge Update, Vol. 1, Part II. Chicago: AAOMS Publishing; 1995:95-107.
  7. Adi M, Ogden GR, Chisholm DM. An analysis of mandibular fractures in Dundee, Scotland (1977 to 1985). Br J Oral Maxillofac Surg 1990;28:194-9. https://doi.org/10.1016/0266-4356(90)90088-3
  8. Lehman JA Jr, Saddawi ND. Fractures of the mandible in children. J Trauma 1976;16:773-7. https://doi.org/10.1097/00005373-197610000-00003
  9. Posnick JC, Wells M, Pron GE. Pediatric facial fractures: evolving patterns of treatment. J Oral Maxillofac Surg 1993;51:836- 44. https://doi.org/10.1016/S0278-2391(10)80098-9
  10. MacLennan WD. Fractures of the mandible in children under the age of six years. Br J Plast Surg 1956;9:125-8. https://doi.org/10.1016/S0007-1226(56)80023-4
  11. Gussack GS, Luterman A, Powell RW, Rodgers K, Ramenofsky ML. Pediatric maxillofacial trauma: unique features in diagnosis and treatment. Laryngoscope 1987;97:925-30.
  12. Kaban LB, Troulis MJ. Pediatric oral and maxillofacial surgery. Philadelphia, PA: WB Saunders; 2004.
  13. Anderson PJ. Fractures of the facial skeleton in children. Injury 1995;26:47-50. https://doi.org/10.1016/0020-1383(95)90552-9
  14. Kaban LB, Mulliken JB, Murray JE. Facial fractures in children: an analysis of 122 fractures in 109 patients. Plast Reconstr Surg 1977;59:15-20. https://doi.org/10.1097/00006534-197701000-00002
  15. Alexander R, Su JY, Stark MM. An accurate method for open reduction and internal fixation of high and low condylar process fractures. J Oral Maxillofac Surg 1994;52:808-12. https://doi.org/10.1016/0278-2391(94)90223-2
  16. Re′mi M, Christine MC, Gael P, Soizick P, Joseph-Andre′J. Mandibular fractures in children: long term results. Int J Pediatr Otorhinolaryngol 2003;67:25-30. https://doi.org/10.1016/S0165-5876(02)00288-4