Surgical treatment of pediatric mandibular fractures

Abstract

Objective To explore the effectiveness of the individualized surgical fixation for the treatment of mandibular fractures in children. Methods The individualized mandibular fixation methods were used to treat mandibular fractures in 85 children in Department of Plastic and Reconstructive Surgery in Xijing Hospital from April 2010 to July 2015. Depending on the fracture types and 3D pre simulation with stress and tension band fixation, six methods of treatment were used, including titanium plate, titanium plate-dental arch bars, biodegradable plate-dentalarch bars, biodegradable plate- occlusal splint, occlusal splint, and anchorage devices. Postoperative occlusal relationship, mouth opening and masticatory function were evaluated. Results Fixation of titanium plate was used in 10 cases, titanium plate-dental arch bars in 25 cases, biodegradable plate-dentalarch bars in 20 cases, biodegradable plate- occlusal splint 15 cases, individualized occlusal splint in 3 cases and anchorage devices in 12 cases. The treatment outcomes were good in the combined methods of open reduction with personalized fixation for children with mandibular fractures, and the reduction was satisfactory. Occlusal relationship had a good recovery after operation. Eating and functional training started earlier in these pediatric patients after operation. Conclusions For pediatric mandibular fractures, open reduction and fixation with appropriate methods can lead to favorable anatomic morphology and occlusion relationship. The application of 3D imaging technology in analyzing the fracture and showing tooth germ in the jaw helps the improvement of surgical efficiency and avoidance of unwanted tooth germ injuries. Personalized dental arch bar and splint provide good strength for external fixation or assist fixation on strain band. Key words: Mandibular fractures; Open fracture reduction; Fracture fixation; Dental arch splints; Children