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Oral Surgery/fractures in.mandible//2fractures


QUESTION: met with an accident resulting in angled blow to chin resulting in multiple fractures in mandible.I have got undisplaced fracture in left parasymphasis and displaced fracture in right sub condylar region.My surgeon is treating it with closed reduction with tie wires and all..But the thing is my occlusion is not proper because she is saying your left and midline occlusion is perfect and and you have posterior unilateral edge to edge bite on the right side.She asked from me whether you have croosbite before trauma.Actually,i said i dont't know what she done she took impressions of my upper jaw and lower jaw(like denture) and said i think you have posterior crossbite before trauma as well.But ,i told her i never felt that because i usually eat from my croosbite met with an accide whether i opt for jaw surgery or first wait for the results of IMF(closed reduction)...and and after reduction of fracture as well...she havent took any x ray or ct scan to check whether alignment of bones is correct or not....i met with an accident a mnth ago...but due to delayed treatment i got tie wires on first week of march....can u please adivise me....
1..what is the best way to check alignment of bones? there way to check my prior occlusion before denture technique is fine??
3.whether i opt for surgery or wait for healing and then see the results??

ANSWER: Vaibhav - The best way to chest alignment of bones is with a simple facial xray.  A CT scan can help define the quality of the alignment.

The only way to evaluate the occlusion before your trauma is by taking impressions of the upper and lower jaws and the impressions then made into plaster models.  With the models, the proper alignment can be determined and any changes from the trauma can be evaluated.  

You need a skilled oral and maxillofacial surgeon to evaluate the alignment of the jaw.  If the surgeon you are working with feels that surgery is appropriate now, he might feel that the alignment of the bones is incorrect and he wants to correct it.

I wish I could be more specific, but I would need more information.

---------- FOLLOW-UP ----------

QUESTION: Hello doctor.

Thanks for the opinion.....actually i went for imf for six weeks but my occlusion is disturbed very much and my bite is not suggested to go for osteotomy....i just want to have few questions for you...
1.they are not doing any x ray // ct scan for osteotomy?
2.these plates would cause any  or not?
3.what is the best way to check the alignment of bones......beacuse after releasing of tie wures by fracture collapsed resulting in open bite in opposite side???

Doctor please help me and give me please good suggestion....i hvent eat anything fron 2 mnthss???
These guys do only x rays and dont fo ctscan nd all....please suggest me in d best way you can.....??

I really need you advice....

Thanks in advance

Vaibhav - If your occlusion is far different from before, it is obvious that the bones were not properly aligned or they slipped during the healing.  Any knowledgeable doctor would know that facial and jaw xrays are important to determine the present position of the bones.  Bone plates are good for stabilization during the healing,  but if the jaw was not properly aligned, then the healing would produce a misaligned jaw.

So what you now need is xrays, but also a skilled oral and maxillofacial surgeon to evaluate the results of the xrays.  A CT scan could be beneficial to disclose poor healing of the bone, but the regular facial and jaw xrays would be the best evaluators of alignment.  

The most important thing is to find a skilled and knowledgeable oral and maxillofacial surgeon.  I wish you well and hope you can find that skilled doctor.

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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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