RT Book, Section A1 Stark, Christopher L. A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181488665 T1 Mandibular Fractures T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessmedicine.mhmedical.com/content.aspx?aid=1181488665 RD 2024/10/12 AB Blunt trauma, mandibular pain, and malocclusion are typically seen in patients with mandibular fractures. A step-off in the dental line or ecchymosis or hematoma to the floor of the mouth is often present. Mandibular fractures may be open to the oral cavity, as manifested by gum lacerations. Dental trauma is frequently seen. Other clinical features include inferior alveolar or mental nerve paresthesia, loose or missing teeth, dysphagia, trismus, or ecchymosis of the floor of the mouth (considered pathognomonic). Multiple mandibular fractures are present in more than 50% of cases because of the ringlike structure of the mandible. Mandibular fractures are often classified as “favorable” or “unfavorable.” Fractures displaced by masseter muscle contraction are unfavorable and inevitably require fixation, whereas fractures that are not displaced by masseter contraction are favorable and, in most cases, will not require fixation. Injuries creating unstable mandibular fractures may create airway obstruction because the support for the tongue is lost. Mandibular fractures are also classified based on the anatomic location of the fracture. Dislocation of the mandibular condyles may also result from blunt trauma and will always have associated malocclusion, typified by an inability to close the mouth.