PANORAMIC XRAY SERIES

MSCT has sensitivity around 100% in the detection of mandibular fractures. Multislice spiral computed tomography (MSCT) represents the reference survey in complex fractures because it benefits from thin-layer thicknesses (0.5–1.0 mm), native images, and three-dimensional multiplanar reformat reconstructions with no overlap between the different anatomic structures. This is the reason why two-dimensional imaging of mandibular fractures is usually limited to isolated lesions. Unfortunately, both PAN and X-ray views are affected by the typical disadvantages of two-dimensional imaging -difficulty in the patient’s positioning, anatomic noise, superimposition, geometric distortion, X-ray angulations, and radiographic contrast-and may be burdened by the slight movements of the mandible, resulting in artefacts.

PANORAMIC XRAY SERIES

It has much higher sensitivity than the three aforementioned X-ray view series for the detection of mandibular fractures (70–92% and 66%, respectively). Panoramic radiography (PAN) is a zonography of upper and lower jaws. Three different X-ray views can be performed for mandibular fractures: a postero-anterior view, generally used for angle and ramus fractures an angled antero-posterior view called reverse Towne view, useful in case of displacement of condylar fragments bilateral oblique view, used to analyse the angle and horizontal branch of the mandible. Radiography represents the first level imaging technique in patients with traumatic injury of the mandible. The treatment varies depending on the anatomic area and type of fracture. Knowledge of the action of masticatory muscles is crucial for recognising bone fragment displacements. X-ray films, including panoramic radiography, are usually limited to mild traumatic events.Ĭomputed tomography is the tool of choice for the assessment of mandibular fractures. Mandibular fractures represent two thirds of all maxillofacial fractures. The main purpose of this pictorial review is to illustrate a practical description of the pathophysiology of mandibular fractures and describe both the imaging techniques to recognise them and the therapeutic indications. Therapeutic options include a conservative approach or surgical treatment based on the anatomic area and the severity of fracture. No reference standard classification system for the different types of mandibular fractures is defined. Panoramic radiography is usually limited to isolated lesions, whereas computed tomography is the tool of choice for all other facial traumatic events.

The clinical features of mandibular fractures include malocclusion and loss of mandibular function. Mandibular fractures are among the most common maxillofacial fractures observed in emergency rooms and are mainly caused by road accidents.

Panoramic xray