The mandible is repaired in much the same way as the maxilla. In addition to figure eighting, wire and acrylic cerclage and interosseous wires are used to create additional planes of support. Anterior mandibular fractures are stabilized using wire and acrylic. Regardless of the fracture pattern wire is figure eighted from the premolars rostrally to the incisors. An acrylic splint is placed on the lingual surface of the reaming teeth incorporating the preplaced wires.
Attention is made to ensure noninterference with the maxillary arcades.
When drilling holes for interosseous placement of wire it is mandatory to identify the roots of the remaining teeth radiographically and by palpation. If tooth roots are inadvertently penetrated, endodontic therapy is required to preserve the tooth. Disaster cases are managed by bonding the jaws partially and temporarily closed as in maxillary fractures. Muzzles are used to provide support to the mandible and protect it from excessive occlusal forces. Complications encountered with mandibular and maxillary fractures include alveolar fractures and pulpal exposures.