Management of Pediatric Maxillofacial Trauma Using Acrylic Cap Splint Followed by Circummandibular Wiring: A Single Centric Study

Abstract

Introduction: Facial fractures in children account for 15% of all facial fractures in the general population. Children are more likely to have mandibular fractures than midface fractures, with condylar fractures being the most prevalent, followed by parasymphysis, angle, and body fractures. The low prevalence of mandibular fractures in children can be linked to the safe environment they are provided with as well as their unique growing patterns. Pediatric patients present a unique challenge to maxillofacial surgeons in terms of their treatment planning and in their functional needs. Materials and Methods: A prospective analysis of pediatric patients with mandibular symphysis/parasymphysis/body fractures operated from January 2016 to October 2021 was performed. Clinical photographs and orthopantomogram assessment at the time of presentation, after treatment, and at 6 months postoperatively were evaluated. Result: All 17 patients were followed up until the period of 6 months, and none of them had any major complications. Postoperatively, there was satisfactory healing and union of fracture fragments in all the patients. Only 1 patient developed an infection in the submental region. In each case, the surgical splint was removed during 15 to 21 postoperative days. The 6-month follow-up showed good occlusion, without interference in teeth eruption, and no signs of temporomandibular joint problems. Conclusions: In our study, because of the sheer ease of fabrication, maintenance of periodontal tissue integrity, patient compliance, and convenience of measuring the occlusion following reduction, we chose an acrylic cap splint followed by circummandibular wiring.