ANALYSIS OF MODERN METHODS OF TREATMENT OF MANDIBULAR ANGLE FRACTURES IN CHILDREN
DOI:
https://doi.org/10.35220/2523-420X/2023.4.11Keywords:
lower jaw angle fracture, children, osteosynthesisAbstract
Traumatic injuries to the bones of the facial skeleton occupy the second place after inflammatory diseases among all appeals to the Department of surgical dentistry. Most often, fractures of the maxillofacial region in children occur in the periods of 6–7 years-the time of the beginning of school attendance, 12–14 years – a significant increase in physical activity, participation in sports competitions and training, 16–18 years – hooligan injuries. Despite numerous studies, to date, there is no single recognized protocol for the treatment of mandibular angle fractures in children. Purpose of the study. Analysis of modern approaches to the treatment of fractures of the lower jaw angle in children. Research materials and methods. We have analyzed 27 literature sources devoted to the treatment of various lower jaw fractures in childhood. Research results and their discussion. Conservative orthopedic and surgical methods of treatment are used for fractures of the lower jaw. In case of significant displacement of fragments, double-jaw splinting is additionally performed using inter-maxillary traction. Immobilization is carried out for 3–4 weeks. Regardless of the method of inter-jaw splinting, the following basic principles should be observed: 1. teeth should be fixed in the “usual” bite; 2. immobilization of bone fragments: mobility of bone fragments can lead to the formation of a pathological joint, infectious and other complications of treatment of fractures of the lower jaw; 3. prevention of tooth injury; 4. early functional load, especially in fractures of the articular process, which reduces the risk of ankylosis of the temporomandibular joint (TMJ). Today, in the treatment of traumatic jaw fractures from surgical methods of treatment, functionally stable osteosynthesis is used using bioinert mini-plates of various designs. Conclusions. Based on the analysis of the literature, it can be concluded that for the treatment of fractures of the lower jaw angle, many authors recommend two main methods: double-jaw splinting and open reposition internal fixation (ORIF). For internal fixation, the method of using titanium mini plates with monocortical screws is recommended. The need and timing of maxillary immobilization varies from source to source, and the lack of a single protocol for mandibular angle fractures in childhood encourages the development of new and improvement of existing treatments.
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