MANDIBULAR ANGLE FRACTURES INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
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ANGLE FRACTURES Classification: Horizontally favorable Horizontally unfavorable Vertically favorable Vertically unfavorable
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• FAVORABLE FRACTURE : When the muscle pull resists the displacement of fractured fragments then the fracture line is considered favorable. • UNFAVORABLE FRACTURE: When the muscle pull distracts the fragments away from eachother,resul ting in displacement then it is called unfavorable. www.indiandentalacademy.com
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• Fractures at ANGLE of mandible are influenced by MEDIAL PTERYGOID—MASSETER sling of which medial pterygoid is the stronger component.
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Horizontally favorable/unfavorable • Radiographs: Lateral Oblique, OPG. When the fracture line passes from the alveolar margin, downward and Forward,then upward displacement of Posterior segment is prevented by physical Obstruction caused by body of mandible. “ HORIZONTALLY FAVORABLE # “ www.indiandentalacademy.com
• If the fracture line passes downward nd backward,then the upward displacement of the posterior segment is unopposed which is “HORIZONTALLY UNFAVORABLE” Sometimes the upward displacement can be prevented by the presence of a tooth on the posterior segment which comes into contact with maxillary tooth. www.indiandentalacademy.com
HORIZONTALLY UNFAVORABLE
HORIZONTALLY FAVORABLE
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VERTICALLY FAVORABLE / UNFAVORABLE • Radiographs: Occlusal view. Angle fracture is viewed from the occlusal surface(vertical plane), then the buccolingual direction of the fracture can be studied.
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VERTICALLY FAVORABLE • Here the fracture line passes from the outer or buccal plate obliquely backward nd lingually,will tend to resist the muscle pull .
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VERTICALLY UNFAVORABLE
VERTICALLY FAVORABLE
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Treatment of angle # Approaches to Angle: • Intraoral (trans oral) • Submandibular incision (RISDONS) • Retromandibular incision (HINDS) www.indiandentalacademy.com
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Fixation / Immobilization • • • •
Maxillomandibular fixation Transosseous wiring Lag Screw osteosynthesis Plating (noncompression) plating done to the superior border i.e ext.oblique ridge in most cases bases on CHAMPY’S principle of ideal osteosynthesis lines. www.indiandentalacademy.com
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