The jaw fracture is one of the most common fractures of the jaw and mouth area. Often falls or sports injuries cause broken jaw.
What is a broken jaw?
We define a broken jaw as a disruption of the bony structure of the jaw. A distinction is primarily made between the upper jaw fracture and the lower jaw fracture. This extremely painful injury is caused by sudden and strong mechanical forces. Accidents in traffic, violent impacts with fists, or falls from great heights are manifested by fractures in the midface area – mostly in the fracture of the upper jaw.
The lower jaw fracture occurs more often because of sports injuries, as are typical in ice hockey. But also (tripping) falls are among the causes of lower jaw fractures. Besides the effects of force, massive bone loss also leads to risk factors. Since bones are primarily nourished by compressive and tensile forces, bone regresses quickly in the event of long-term unsupervised tooth gaps. Because of this bone loss, the bone height and width decrease, the upper and lower jaw are more susceptible to fractures. Additional changes in metabolism, such with osteoporosis, add to the risk.
The symptoms of a broken jaw are clear
- The feeling that the teeth suddenly no longer fit together
- Misaligned teeth
- Loosening of teeth
- Palpable new step formation in the jawbone – the safest symptom
- Parasitic sensations around the upper or lower jaw
- Jaw pain when moving (chewing, speaking)
Other symptoms include:
- Bone rubbing
How is a broken jaw diagnosed?
A broken jaw does not always classically express itself with visible step formation. An extensive examination and diagnosis of the injury are essential. Imaging will follow if a broken jaw is suspected.
The examination is first carried out by a dentist or doctor. This looks for palpable bone levels, checks loosening or even loss of teeth, and examines the patient for bleeding in the face and mouth area. They also check sensitivity abnormalities in the teeth and face. They also record detection of the mobility of the lower jaw, or even newly created mobility of the otherwise rigidly fixed upper jaw. After this examination, X-ray diagnostics are necessary.
The X-ray takes place in two planes so that a second X-ray is necessary to better reflect the bone progression. In more complicated cases, it makes 3D diagnostics with the help of a digital volume tomography (DVT). This diagnosis allows a three-dimensional and comprehensive representation of the jaw. This enables an optimal assessment of the breaking point. They also check sensitivity abnormalities in the teeth and face.
Sudden forces of force on the chin increasingly transfer the forces to the process of the mandibular joint. In the event of falls or blows to the chin, it is therefore important to check the temporomandibular joint processes and temporomandibular joint heads for fractures on both sides and, if possible, to exclude them.
How is a broken jaw treated?
The primary initial treatment of the fracture site in the bone is carried out with a splint as far as possible and includes the fixation of the current situation and acute hemostasis. Besides, we use pain medication for short-term and temporary relief from pain. Surgical treatment is essential!
The primary first aid
In primary first aid, it is important not only to treat pain but also to maintain the airways to ensure stable breathing. If this is not possible, emergency intubation takes place at the scene of the accident with transport to the nearest hospital with subsequent surgical treatment.
We can treat simple jaw fracture cases with splints for better stabilization by the doctor until the planned surgery date.
The operative supply
The surgical treatment serves to restore anatomical bone continuity. The step formations in the bone are straightened and then fixed with the help of (mini) plate osteosynthesis. This plate fixation serves as a functionally stable restoration. These plates are firmly screwed to the jawbone. An originally positionally correct and anatomical growth of the interrupted jawbone is thus made possible again.
The active mouth opening, and the movement of the lower jaw are not restricted by the plate fixation. Speaking and eating initially soft and passed food is also possible with plate osteosynthesis after the swelling in the soft tissue has declined. In the long term, there is an increase in diet so that normal food is possible again in the long term.
To support the operation, prophylactic antibiotic shielding with an antibiotic is carried out over the vascular system, since long-term interventions on the bone otherwise quickly lead to inflammation in the bone and the membranes surrounding the bone. The duration of the antibiotic depends on the severity of the broken jaw.
Duration of treatment
However, since new bone is formed very slowly, the splinting with the plate osteosynthesis plates takes an average of 3 – 6 months. Afterward, once they have completed the treatment, the plate materials are usually removed again in a minor surgical procedure. Complicated fractures with massive bone loss can cause permanent retention of the osteosynthesis plates.
Complications in the treatment of broken jaws
Depending on the severity and extent of the injury, complications can arise when treating fractures.
The most common complications include:
- Redness, bleeding, inflammation, secondary bleeding
- Postoperative soft tissue swelling, injuries
- Parasitic sensations of teeth, gums, skin, and cheek areas
- (permanent) sensitivity disorders
- (permanent) nerve injuries
- Inadequate healing of the fracture gap