International Journal of Clinical Pediatric Dentistry

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VOLUME 16 , ISSUE 6 ( November-December, 2023 ) > List of Articles

CASE REPORT

Management of Pediatric Mandibular Fractures Using Orthodontic Archwires and Elastic Traction: An Alternative to Conventional Treatment Methods

Anisha Kakran, Himani Kaushik, Shefali Negi, Asha Rani

Keywords : Case report, Mandibular fractures, Parasymphysis fractures, Pediatric trauma

Citation Information : Kakran A, Kaushik H, Negi S, Rani A. Management of Pediatric Mandibular Fractures Using Orthodontic Archwires and Elastic Traction: An Alternative to Conventional Treatment Methods. Int J Clin Pediatr Dent 2023; 16 (6):864-867.

DOI: 10.5005/jp-journals-10005-2671

License: CC BY-NC 4.0

Published Online: 01-02-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Introduction: Maxillofacial trauma in children consists of >15% of all facial fractures, which is usually associated with sports injuries and falls while playing. Pediatric mandibular fractures are relatively less frequent when compared to adults, and the reason can be attributed to the child's protected anatomic features and infrequent exposure of children to alcohol-related road accidents. Management principles vary in children, and the main concern is about mandibular growth and the development of dentition. Treatment can be done by either closed reduction or open reduction and internal fixation. Case description: A 5-year-old boy reported to the Department of Pediatric and preventive dentistry with the history of falling from a bike. The patient presented with bruise over chin, deviated mouth opening and deranged occlusion. OPG revealed right condylar fracture and left parasymphysis fracture. Treatment with closed reduction was favored over open reduction in order to decrease the risk of any undue trauma to developing tooth buds and to avoid any growth-related injury in children. Hence, a new approach was performed for closed reduction. The patient was kept on follow-up for a period 6 months. Discussion: Earlier treatment options in closed reduction were limited to intraoral cap splints, circummandibular wiring, eyelet wiring, and even bridle wiring. This case report highlights the use of orthodontic archwires and elastic traction in the management of pediatric mandibular fractures, which is something new to conventional treatment methods and can be used as an alternative method.


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  1. Glazer M, Joshua BZ, Woldenberg Y, et al. Mandibular fractures in children: analysis of 61 cases and review of the literature. Int J Pediatr Otorhinolaryngol 2011;75(1):62–64. DOI: 10.1016/j.ijporl.2010.10.008
  2. Zimmermann CE, Troulis MJ, Kaban LB. Pediatric facial fractures: recent advances in prevention, diagnosis and management. Int J Oral Maxillofac Surg 2006;35(1):2–13. DOI: 10.1016/j.ijom.2005.09.014
  3. Haug RH, Foss J. Maxillofacial injuries in the pediatric patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90(2):126–134. DOI: 10.1067/moe.2000.107974
  4. Posnick JC, Goldstein JA. Surgical management of temporomandibular joint ankylosis in the pediatric population. Plast Reconstr Surg 1993;91(5):791–798. DOI: 10.1097/00006534-199304001-00006
  5. Sharma A, Patidar DC, Gandhi G, et al. Mandibular fracture in children: a new approach for management and review of literature. Int J Clin Pediatr Dent 2019;12(4):356–359. DOI: 10.5005/jp-journals-10005-1643
  6. Kaban LB. Diagnosis and treatment of fractures of the facial bones in children 1943-1993. J Oral Maxillofac Surg 1993;51(7):722–729. DOI: 10.1016/s0278-2391(10)80409-4
  7. John B, John RR, Stalin A, et al. Management of mandibular body fractures in pediatric patients: a case report with review of literature. Contemp Clin Dent 2010;1(4):291–296. DOI: 10.4103/0976-237X.76406
  8. Singhal R, Singh V, Bhagol A, et al. Pediatric maxillofacial injuries - if a new look is required? Int J Pediatr Otorhinolaryngol 2013;77(8):1333–1336. DOI: 10.1016/j.ijporl.2013.05.028
  9. Crean ST, Sivarajasingam V, Fardy MJ. Conservative approach in the management of mandibular fractures in the early dentition phase. A case report and review of the literature. Int J Paediatr Dent 2000;10(3):229–233. DOI: 10.1046/j.1365-263x.2000.00196.x
  10. Zimmermann CE, Troulis MJ, Kaban LB. Pediatric facial fractures: recent advances in prevention, diagnosis and management. Int J Oral Maxillofac Surg 2005;34(8):823–833. DOI: 10.1016/j.ijom.2005.06.015
  11. Laster Z, Muska EA, Nagler R. Pediatric mandibular fractures: introduction of a novel therapeutic modality. J Trauma 2008;64(1):225–229. DOI: 10.1097/TA.0b013e318068fc77
  12. Magennis P, Craven P. Modification of orthodontic brackets for use in intermaxillary fixation. Br J Oral Maxillofac Surg 1990;28(2):136–137. DOI: 10.1016/0266-4356(90)90143-9
  13. Aizenbud D, Emodi O, Rachmiel A. Nonsurgical orthodontic splinting of mandibular fracture in a young child: 10-year follow-up. J Oral Maxillofac Surg 2008;66(3):575–577. DOI: 10.1016/j.joms.2007.09.022
  14. Cole P, Kaufman Y, Hollier LH Jr. Managing the pediatric facial fracture. Craniomaxillofac Trauma Reconstr 2009;2(2):77–83. DOI: 10.1055/s-0029-1202592
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