Following mandibular fracture a number of complications may occur. The severity and extent of the fracture(s) combined with the symptoms may suggest which complications to look for first.



malocclusion from malalignment of bone

temporomandibular joint dysfunction; dental malalignment and erosion; chronic pain; difficulty chewing

fracture nonunion

mandibular pain; difficulty chewing


mandibular pain, anesthesia or hypoesthesia, trismus, swelling, sinus tract, low grade fever

injury to alveolar nerve

numbness of lower lip (temporary if blunt, may be permanent if transection and displacement)

injury to teeth and gums

dental root pain, gingival lesions


Physical examination:

(1) Examine teeth for alignment, stability and new erosions.

(2) Examine gingiva for swellings or defects.

(3) Palpate the mandible for tenderness or fracture.

(4) Examine for distribution of any anesthesia or hypoesthesia.


Radiographic examinations to consider:

(1) panoramic views of dentition

(2) lateral obliques of mandible (condylar and coronoid processes, ascending ramus and body)

(3) modified Towne (condyle and condylar neck)

(4) posteroanterior of mandible (body and ascending rami)

(5) occlusal of anterior mandible (anterior arch)


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