Mandible Fractures: Types, Causes, Treatment

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The mandible is one of the fourteen facial bones in the skull and is also known as the lower jaw and alongside the maxilla helps forms the mouth. Both mandible and maxilla uses movements that opens and closes to help chew food. There are four muscles that are connected to the mandible that helps enable the movement. These muscles are known as the temporalis, the masseter, the medial pterygoid, and the lateral pterygoid. These muscles combine and work together to achieve the movement of the up and down and side to side motion. In an infant, the mandible is broken up into two bony structures that don’t later fuse into one around the age of one year old.

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The mandible is made up of the body, ramus, gonion, symphysis, alveolar process, coronoid process, and condyloid process and two condyles on each side. In the frontal view of the mandible, the midline of the mandible shows the symphysis also known as the symphysis menti. This is where both lateral halves are joined together to become one. Below the symphysis menti is a flat triangular area where the mental prominence lies. In between the two mental prominences is the mental point. The general term for the mental point is called the chin. On each half of the body of the mandible lies the mental foramina which acts as a gateway for veins, arteries and nerves that articulate with the lower jaw. The lateral view of the mandible can be broken up into two halves. The area which is superior to the gonion is called the ramus. Above the ramus you can find the neck and condyle and condyloid process which is located most posterior on the mandible. The condyle of the condyloid process fits into the TM fossa to form the Temporomandibular Joint (TMJ).

Different Types of Fractures

There are many different types of fractures when it comes to the mandible. There are simple or closed fractures, which means that the fracture did not break the skin and is not exposed to the outside environment. A greenstick fracture is a fracture where only a part of the jawbone is broken apart from the other parts of the mandible. Most of the time in a greenstick fracture the condyles are more likely to be fractured. A compound or open fracture is a fracture that is exposed to the environment. A comminuted fracture is when the region is broken into many small bones.

Causes and Symptoms

The most common causes of a mandibular body fracture is when there is force blunt trauma to the area. Automobile accidents which can be caused when the victim hits their face against the steering wheel. Other causes of a fracture consist of sport related injuries that includes getting hit in the face like football and boxing and MMA, Assaults which can relate to facial injuries, and falls where the victim lands face first. A gunshot wound may also be a cause of fracture. An ASRT article states “A bullet penetrating the orbit often exits through the contralateral temporomandibular joint region. In the lower face, damage to the intraoral lining and comminuted fractures of the mandible are significant issues. Many mandibular fractures are accompanied by extensive soft-tissue trauma caused by a tumbling bullet and bone and teeth fragments.”

The symptoms of a mandibular body fracture can be composed of jaw pain right after trauma. You may experience malocclusion which is when you feel like your teeth do not fit into place with problems like having trouble opening your mouth all the way and difficulty speaking and chewing and swelling around the affected area. The mental point and lower lip may feel numb which can indicate nerve damage that runs through the mental foramina. You can experience drooling due to the ability of not being able to close your mouth. Inside the mouth, you may see bleeding and your teeth shifting. You may notice some bruising under the tongue and there may be a cut in your ear canal due to the posterior movement of the jaw during trauma. When experiencing these symptoms, go seek medical care right away.


The doctor may ask for x-rays or a CT scan to diagnose exactly what is wrong and determine what fracture is may be. Above we have a panoramic x-ray and a CT axial scan showing a mandibular simple body fracture. You may also get a normal x-ray; in that case the technologist will perform the following projections.

Axiolateral oblique with a 30-degree rotation towards the image receptor to best demonstrate the body and PA or PA axial and a lateral. In most cases you will get a panoramic x ray to get an image of your whole mouth and easily identify where the fracture is. To treat a simple mandibular body fracture can either be invasive or evasive. The doctor can order a non-invasive way of treating the fracture by just observation hoping that the fracture will heal by itself. This requires the patient to follow a diet that restricts them from chewing and staying away from physical exercise for the healing period which should be around 6-7 weeks. The physician may also take a different approach by using circumdental wiring which can be compared to braces. This is when the doctor applies arch bars to the mandible and maxilla and the patient has to keep them on for about 6 weeks. This procedure prevents damage to the periodontal soft tissues.

Now here are some ORIFs, or open reduction internal fixations. The surgeon can perform a lag screw procedure, this is when the screws are inserted into the mandibular body. The mandibular body is well suited for lag screws because of the thickness of the bony cortices which provide extremely secure fixation when the screws are properly inserted, providing compression. Another procedure that you can get is two miniplates inserted or one large plate. Locking plate systems works because they do not disrupt the cortical bone perfusion as much as conventional plates, which compress the undersurface of the plate to the cortical bone.

Long Term Effects

The most common long term effect of a mandibular body fracture is malocclusion. Malocclusion is the abnormal alignment of your teeth when it is closed, condylar fractures has increased risk of malocclusion. According to an article written by Dr. Pramod Kerkar (2017), he states that “There is increased risk of late-term osteoarthritis if the mandible fracture is intracapsular. Condylar fractures in children have higher rates of ankylosis with chances of disturbance in growth. In very rare cases, mandibular fracture or broken jaw can lead to Frey's syndrome”. Frey’s syndrome is a rare disorder where you have sweating and flushing occurring on the cheek after eating certain foods.


To summarize, the mandible is one of the largest and strongest facial bone and it is a very common site for a fracture. The mandible can be fractured due to blunt force trauma to the area. This means automobile accidents, sport injuries like boxing and football, falls, and assaults. Symptoms of a mandibular body fracture can result in jaw pain, malocclusion, and difficulty speaking and chewing. You may also feel numbness in your lower lip due to nerve damage. The doctor may order many test like either an x-ray or CT scan to detect what type of fracture it is. Then the doctor will proceed with either a invasive or evasive procedure. You can either get arch wires or get plates and screws inserted. If not treated corrected it can lead to many long term effects.

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