Management of Pediatric Mandibular Fractures: A Narrative Review and Retrospective Analytical Study of 15 Years

The management of mandibular fractures in young children is one of the most contradictory themes of oral and maxillofacial surgery and offers several unique challenges for the oral surgeon. No literature criteria have been established to determine the best treatment modality for these fractures. Important aspects determining treatment planning of these fractures are age, stage of tooth development, and nature of the fracture.

An electronic search of the literature directly relating to pediatric mandibular fracture and its management was conducted. Multiple words and combinations of words were used to search on different databases. The articles included were original research papers, case reports, and review articles published from 1984 through 2022.

We are presenting our experience of 36 pediatric mandibular fractures managed in our department between May 2007 and March 2022, a period of fifteen years along with a review of the literature. The incidence of fractures was 22% in deciduous dentition group while the mixed and permanent dentition groups showed 36% and 42%, respectively. In our study, 23 out of 36 (64%) were parasymphysis fractures being most common followed by 10 (28%) body fractures, the second most common. In our records, prominent etiologies, 31 out of 36 were sports injuries and bicycle falls. Out of 36, we did splinting in 14 cases, 5 cemented, and 9 using circummandibular wiring. Open reduction and fixation were performed in 19 cases, having a single case with resorbable plates and screws. We, the authors, feel there is a relatively clearer opinion in the literature about the management of incomplete, greenstick, and simple pediatric mandibular fractures. Controversies increase gradually when questions come to the management of complex fractures, whether displaced or comminuted.

We feel that this review of the literature will guide us about the importance of preventive measures also. Supervising adults, like coaches, administrators, teachers, and parents, should be educated. Children should be encouraged to develop appropriate habits to decrease the incidence and severity of sports-related injuries. Also, we should invigorate the use of seat restraints, conventional seat belts, protective helmets, mouth guards, and other measures.