Les fractures Mandibulaires et l’implication du chirurgien dentiste

Abstract

Mandibular fractures constitute, within the context of maxillofacial trauma, one of the main reasons for emergency consultations in dentistry. They are frequent and most often affect young, active individuals. Their treatment must be assessed based on the quality of the restoration of occlusion, masticatory function, and the anatomy of the bony contours, both in the short and long term. Primary and complete restoration of mandibular anatomy and function are often possible. Only multifocal fractures with uniconic or bicondylar involvement, compulsive, panfacial, or bone loss fractures should lead to sequelae and secondary interventions. The unique anatomical and functional characteristics of the mandible justify the judicious use of miniplates; after perfect bone and occlusal reduction; placed via a preferably oral approach, respecting the dental roots and mandibular pedicles under antibiotic coverage, the only guarantee of a faster functional recovery. The current concept of osteosynthesis with miniplates has replaced, in the surgical treatment of mandibular fractures, suture with BIM. Its main advantage is to reduce, if not eliminate, this fixation and therefore, improve patient comfort. Finally, it is hoped that social security coverage will be universal so that the cost of treatment does not become a barrier to the follow-up of our patients and thus prevent the almost inevitable progression towards the development of temporomandibular ankylosis. The dentist trained in orthopedic treatments of maxillofacial trauma can contribute to their management and refer patients to specialized services [112] for complicated cases that are no longer within their scope of practice.