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3. Surgical Instruments

3-34. FRACTURES

a. Treatment of Fractures. Definitive treatment and care are normally performed by the oral surgery service of a hospital's department of dentistry. In treating any fractured bone, the objective is to bring the fragments of bone as near to their normal relationship as possible and to immobilize them in that position long enough for a bony union to occur and normal function to return. In most fractures of the jaw, proper apposition of the fragments can be achieved by restoring teeth to their normal occlusal relationship with teeth of the opposing jaw. Immobilization may be achieved by any of several methods. The most common method is to apply wires or special arch bars to the teeth in each jaw to provide hooks for the anchorage of small rubber bands. The rubber bands are stretched from hooks of one jaw to those of the other jaw in such a way as to maintain the correct occlusal relationship of the teeth by elastic traction. Some fractures are immobilized by metallic or acrylic splints made to fit over the teeth. Some are held in position by wires passed through the bone. Other fractures may require complex means of immobilization or even bone grafts or prosthetic restorations to correct defects.

b. Postoperative Treatment. Following fracture reduction, the postoperative treatment during the weeks of immobilization may consist of:

(1) Daily evaluation of the efficiency of the chosen method of immobilization.

(2) Irrigation of the patient's mouth to aid in oral hygiene.

(3) Instruction in methods of good oral hygiene and the use of a device that delivers a pulsating stream of water, if one is available.

(4) Instruction in the use of a child's toothbrush to aid in oral hygiene.


David L. Heiserman, Editor

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Revised: June 06, 2015