Suspended circummandibular wire fixation for mixed-dentition pediatric mandible fractures

To introduce and evaluate the technique of cirummandibular wires with piriform rim suspension (CMW-PRS) combined with arch bars and a fracture site bridle in the treatment of mixed-dentition pediatric mandible fractures.

Five male patients (mean age, 8.2 years [age range, 7-10 years]) with an isolated mixed-dentition mandible fracture were treated with the CMW-PRS technique at the University of Texas Health Science Center, San Antonio, from 1985 to 1987 and at the University of Missouri, Columbia, from 1992 to 1995. Clinical and radiographic fracture healing, somatosensory status, and complications were evaluated.

All patients demonstrated clinical union to their preinjury occlusion by 3 or 4 weeks. They remained without complications until they were no longer available for follow-up. Panoramic radiographs supported the findings of clinical examinations throughout the study, and no radiographic abnormalities were found. There were no somatosensory disturbances of the lingual or mental/inferior alveolar nerves. One patient required a tracheostomy unrelated to the procedure.

The CMW-PRS technique combined with arch bars and a fracture site bridle wire achieved equivalent historical results when compared with the dental splint. The potential advantages and disadvantages of the CMW-PRS technique compared with those of monocortical bone plating, as well as the significant advantages of the CMW-PRS over the dental splint, are discussed in the text.