Definition

By alveolar process fractures we mean fractures of the part of the jawbone that carry the teeth. An alveolar process fracture is often combined with a luxation or partial luxation of the teeth and/ or with a fracture of the jaw body

Therapy Goals

The goal of the therapy is the conservation of the form and function of the alveolar process. Furthermore, to alleviate pain and prevent infections.

Therapy Indications

For the therapy indication, we have to differentiate between dislocated and non-dislocated alveolar process fractures.
Clinical and/ or radiological evidence of an alveolar process fracture
Masticatory dysfunction
Injury of adjacent soft tissue(gingival laceration)
Dysaesthesia
Fracture or mobility of teeth

Examinations

Inspection
Palpation
Vitality test
Aesthesiometry
in 2 planes x-ray
Computer tomography
Casting of the maxilla and the mandible and production of models which serve as setups for repositioning and, if necessary, for the production of individually fitted splints.

Therapy

Conservative Therapy
Surveillance in fractures with little mobility or small dislocation
Soft and fluid food depending on the stability of the fracture
Immobilization

Operative Therapy

Closed repositioning:
- in slightly dislocated fractures
- if there are medical or aesthetic contraindications for an open repositioning

Open repositioning:
- in unstable fractures
- if a closed repositioning in not possible
- in complex injuries with associated soft tissue injuries
- in defect fractures
- in case of  dysaesthesia
- in case of missing teeth (e.g. traumatogenic or in a mixed denture)
- where an exact positioning of the fracture fragments through splinting/ occlusion is not possible (e.g. mixed denture)

Additional Measures

Extraction of teeth and/ or parts of the alveolar process if the vascular supply is not guaranteed
If indicated, antibiotic therapy
Analgesic therapy

Recommendations

An outpatient treatment is sufficient in cases with a low risk of infection and in small alveolar process fractures. Extensive lesions should be treated in hospital.

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