Major clinical considerations and treatment of mandible fracture: a concise systematic review

Abstract

Introduction: In the scenario of mandible fractures, traumas are the main reasons for these events. In this context, the rates of mandible fracture complications vary from 7 to 29% and were correlated with the severity of the fracture. Motor vehicle assaults and collisions significantly outperformed all other causes of mandibular injury. Most consultations for mandible fractures begin with a diagnosis of computed tomography imaging (CT). CT scans were 100 percent sensitive for fractures of the mandible compared to 86 percent for panoramic radiographs. Despite this, radiographic images are not a substitute for a complete history and clinical examination. Objective: To carry out a narrative and systematic review of the literature, to explore the main literary findings and clinical results on fractures of the mandibles. Methods: It followed a systematic literature review model on the main clinical findings of mandible fractures, according to the rules of PRISMA. The research was carried out from January 2021 to May 2021 and developed based on Google Scholar, Scopus, PubMed, Scielo, and Cochrane Library. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 170 studies were analyzed, with only 34 studies of medium and high quality being selected, according to GRADE standards, and with risks of bias that do not compromise scientific development. Most mandible fractures require stabilization for proper treatment and to restore pre-injury occlusion. Although mandible fractures with good dentition on both sides of the fracture line can be treated in some cases by a period of intermaxillary fixation, most surgeons and patients prefer open reduction and internal fixation, as the process is faster. The use of two mini-plates results in better results with minimal complications. The treatment of mandibular fractures should aim to restore functional occlusion and mandibular continuity with the lowest possible risk. Open treatment of unilateral mandibular condyle fractures results in better functional results, especially in terms of mandible mobility. Finally, the application of low-intensity pulsed ultrasound can reduce postoperative pain and facilitated fracture healing in patients with impaired healing potential.