Management of Edentulous Mandible Fracture
The fracture of the edentulous mandible/jaw is special because there is no or very minimum vertical height of the patient.
The treatment is mainly tissue borne. Here gunning splint is used. Gunning splint is of 2 types:
1) Modified gunning splint
2) gunning splint
Modified gunning splint:
It is done when the patient has already been using a complete denture. Here 3 modifications are done in the denture-
a. incisor teeth are trimmed for creation of feeding space
b. Trimming of the basal part of the denture at the fracture site & the space is filled with black gutta percha for cushion like effect.
c. Placement of hooks in both jaws for IMF.
It is used when the patient does not have any complete denture to modify. The steps of construction of gunning splint are as follows-
a. L.A. & impression taking
b. Preparation of the model
c. Model surgery
d. Alignment of model in its position using sticky wax
e. Preparation of splint by self cure acrylic resin for both jaws
f. Occlusal rim preparation
g. On the occlusal rim, anterior space is created for feeding purpose
h. Space is created for hook insertion too
j. Trimming of the basal part of the denture at the fracture site & the space is filled with black gutta percha for cushion like effect.
k. Placement of hooks in both jaws for IMF.
• Immobilization for few weeks
• Gradual mobilization & physiotherapy.