Integrated management of mandibular fractures and traumatic dental injuries: a literature review and clinical algorithm proposal.

Authors

Edoardo Staderini, Raffaella Castagnola, Irene Cavalcanti, Marianna Balacco, Anastasio Spera, Cosimo Rupe, Gioele Gioco, Massimo Cordaro

Published in

Frontiers in oral health. Volume 7. Pages 1887405. Epub Aug 03, 2026.

Abstract

Mandibular fractures are among the most common maxillofacial injuries and are frequently associated with traumatic dental injuries (TDIs), creating combined skeletal, occlusal, periodontal, and pulpal treatment priorities. Integrated protocols addressing both the fracture and the dental component remain limited.
The present literature review was conducted by means of a structured search of PubMed/MEDLINE, Scopus, and Web of Science Core Collection from 2000 to 2026, complemented by manual reference-list screening. A structured Population, Intervention/Exposure, Comparison, and Outcomes (PICO) framework and predefined eligibility criteria were added, and an overall assessment of methodological quality was undertaken for the included primary studies to improve transparency.
Mandibular fractures range from minimally displaced injuries with preserved occlusion to complex patterns associated with malocclusion, neurosensory impairment, temporomandibular joint dysfunction, and concomitant TDIs. The evidence supports individualized decision-making based on fracture displacement, occlusal stability, patient age, dentition status, tooth prognosis, and biological priorities of periodontal and pulpal healing. Teeth in the fracture line should not be extracted routinely; retention is generally favored when the tooth is intact, strategically useful for occlusion, and not infected, whereas extraction is indicated in cases of vertical/root fracture, advanced periodontal disease, severe caries, infection, or interference with reduction/fixation.
Combined dento-mandibular trauma requires coordinated interdisciplinary management. A revised algorithm is proposed to integrate AO-CMF fracture principles with International Association of Dental Traumatology (IADT)-based dental trauma care, emphasizing systematic dental screening, selective imaging, safe fixation planning, biologically appropriate splinting, staged endodontic decision-making, and long-term follow-up for pulp necrosis, resorption, ankylosis, malocclusion, and neurosensory complications.

PMID:
42609492
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.