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Oral rehabilitation of a patient suffering mal-union of a fractured mandible
From Volume 45, Issue 7, July 2018 | Pages 647-654
Article
Mandibular fractures normally heal by the formation of an osseous bridge between the fractured components, followed by remodelling and maturation. Inflammatory-, osteoblast-, osteoclast- and periosteal-cells all play a role in the healing process that can be simplified into four phases:
The fractured mandible experiences opposing tensile and compressive forces from the supra hyoid and masticatory muscles, respectively. Such forces may cause movement of the fractured bony portions, if inadequate fixation has been undertaken, and also influence healing at a cellular level. Whilst tensile forces encourage bone deposition via osteoblasts, compression forces initiate osteoclasts and subsequent removal of bony matrix.
The anatomic location of mandibular fractures varies (Table 1), with several studies demonstrating that the site of fracture correlates with mechanism of injury.1,2 Whilst anterior forces, such as in a head-on motor vehicle collision, will usually result in fracture of the symphysis and condyle, applied lateral forces (eg from a punch) will likely result in fracture of the angle and body of the mandible.1,2 Other contributing factors to mandibular fracture include:
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