Optimization of surgical treatment of mandibular fracture in children with a variable bite

Children aged 6 to 12 are characterized by increased activity, begin to engage in active sports and this increases the risk of traumatic injuries of the facial skeleton. Among such lesions, fractures of the mandible rank first. Using acrylic mandibular splints and mandibulomaxillary fixation are considered to be a traditional method of treating mandibular fractures in children. In the period of variable occlusion due to physiological changes of teeth, caries and its complications, loss of teeth due to traumatic injuries and unexpressed equatorial teeth, mandibulomaxillary fixation is difficult or impossible and using acrylic mandibular splints is ineffective when line of fracture goes out of dental arc. Due to these and other circumstances, there is a need for open reposition and internal fixation of fragments with miniplates. Children have a risk of damage to the rudiments and roots of permanent teeth or mandibular canal when miniplates are fixed with screws. In order to prevent complications in the surgical treatment of mandibular fractures during variable occlusion in children, we analyzed cone-beam computerized tomograms and identified areas for safe fixation of screws, established a safe depth of immersion of screws in bone tissue.