The bite has changed
The teeth do not come together as before, or a step or gap has appeared between them.
CONDITION / JAWS, MOUTH AND NECK
Fracture of the body and angle of the lower jaw.
A fracture of the lower jaw in the area of the body or corner is an injury to the part of the jaw where the teeth stand, or the place behind them, where the jaw turns upwards towards the ear. After it, the teeth close incorrectly, it hurts when chewing, the lower lip is often numb. Some of these fractures are treated without surgery, some - with titanium plates.
CONCEPTUAL VISUALIZATION- What it is
- A fracture of the lower jaw in the area of the teeth or behind them, where the jaw turns upwards.
- How common
- In a series of 565 adult patients, the most frequent fracture of the angle was 33.6%.
- Main signs
- The teeth do not close properly, it hurts when chewing, the lower lip is numb.
- Who treats it
- Maxillofacial surgeon; with a head injury - together with a neurosurgeon.
01 / WHAT IS ITWhat is
What is
fracture of the body and angle of the jaw.
The lower jaw is like a horseshoe. Doctors call the part of it where the teeth stand as the body, and the corner is the area behind the last corner teeth, where the jaw bends up to the joint. Jaw fractures are the most common facial fractures requiring surgery.
The nerve responsible for the sensitivity of the lower lip, chin and teeth passes inside the body of the jaw. Therefore, with these fractures, the lip is often numb: in a prospective study of 257 patients, numbness was present in 95.9% of body fractures and 90.1% of angle fractures.
The jaw often breaks in two places at once. In a series of 565 adult patients, 14.2% had simultaneous fractures of the angle and the front, chin part of the jaw. A fracture of the articular (condylar) process near the ear is treated according to other rules - there is a separate page about it.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNShow to understand
how to understand
that the jaw is broken.
The main symptom is that the teeth do not close as before the injury. Swelling can hide the rest, so after a strong blow to the jaw, you should see a doctor.
Pain during chewing
It hurts when you open your mouth, bite or speak; chewing is difficult.
Numb lip
The lower lip or chin on the side of the blow became like someone else's - this is how the nerve inside the jaw suffers.
Debris is moving
Part of the jaw, together with the teeth, moves separately; the tooth at the fracture site wobbles.
Swelling and blood in the mouth
The cheek or area under the angle of the jaw swells, the gum between the teeth bleeds, the mucous membrane is bruised.
03 / REASONSWhy does it break?
Why does it break?
body and angle.
Which part of the jaw is broken often depends on how the injury occurred.
A blow in a fight
In a series of 565 adult patients from South Australia, 58.2% of patients fractured their jaw during an attack; such blows more often broke the corner and the chin. There were 4.5 times more men than women.
Falls and road accidents
In the same series, almost all fractures after falls and road accidents occurred in the condylar or coronal process, and not in the body.
Fractures of the condylar processWisdom tooth
An angular fracture can pass through the socket of a wisdom tooth. Such a tooth in the fracture line is associated with a higher risk of infection after surgery.
Toothless jaw
In elderly people without teeth, the jaw becomes thinner and loses bite resistance - such fractures are more difficult to treat.
Alcohol
A quarter of patients in a series of 565 adults reported drinking alcohol.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
A fresh fracture of the jaw needs help on the same day, and according to some indications, immediately. First, head and neck injuries are ruled out. If you hit your head, do not drive to the hospital. Call 103 if at least one of the following signs is present after the impact:
103 immediately if:
- difficulty breathing or swallowing;
- severe swelling in the mouth, under the tongue or on the neck;
- the bleeding does not stop;
- a large wound on the face or something stuck in the wound, such as glass;
- the person has fainted and does not regain consciousness;
- cannot help falling asleep, eyes close by themselves;
- convulsions;
- a clear watery liquid flows from the nose or ear;
- bleeding from the ear or bruising behind the ear;
- impaired vision or hearing;
- a bruise around the eye, although there was no blow to the eye;
- new numbness or weakness in an arm or leg;
- neck pain or stiff neck with numbness or tingling in the hands;
- gait or balance are disturbed, the person does not understand what is being said or confuses words;
- behavior has changed: irritability, inattention, indifference;
- impact at high speed, such as in a car accident, or falling from a height of more than 1 meter or 5 steps.
Do not delay:
On the same day - to the reception department or to the maxillofacial surgeon: after a blow, the teeth close incorrectly, part of the jaw moves separately, the lower lip or chin is numb, it is not possible to chew. If a person loses consciousness for a short time after a blow, immediately go to the reception room (let them take you away). On the same day - if there was vomiting after the blow to the head, dizziness in the head, you are taking blood-thinning drugs, or the injury occurred while intoxicated. After the operation - immediately to the surgeon who operated, and if it does not work - to the waiting room: increasing pain or swelling of the cheek and jaw. If the swelling grows rapidly in the mouth or neck and it becomes difficult to breathe or swallow, it is already 103. The same day to the surgeon: high temperature, pus or unpleasant taste from the wound in the mouth, the plate protrudes through the gums. Planned: the fracture has long since healed, but the bite has changed, asymmetry or numbness of the lip remains - make an appointment for a consultation.
05 / DIAGNOSTICSAs defined,
As defined,
what to treat
- Urgent review
First they check breathing, consciousness, neck and signs of head injury: they are more important than the fracture itself.
- Mouth and bite
The doctor looks at how the teeth close, whether the debris moves, whether there is a wound on the gums, and checks the sensitivity of the lip and chin.
- CT
Computed tomography shows the fracture line, the displacement of the fragments, the teeth in the fracture line, and the second fracture, if present.
- Teeth
They decide whether it is possible to save a tooth in the fracture line, especially a wisdom tooth.
- Control
After the treatment — repeat examinations of the bite and a control picture.
06 / TREATMENTHow we treat
How we treat
fracture of the body and angle.
One method does not fit all: a Cochrane review of 12 studies (689 participants) did not find sufficient evidence in favor of any one approach. The plan is made based on how much the fragments are displaced, how the teeth close and how many fractures there are.
01
Without surgery
The fragments are not displaced, the bite is correct.
- Follow-up
- It is rarely treated without surgery, only under strict selection. In a review of 4 studies (80 patients), 69 patients (86%) did so without intervention; Exactly which fractures it is suitable for remains to be investigated.
- Fixation of the jaws
- The teeth of the upper and lower jaws are temporarily fastened together with tires or wire so that the fragments grow immobile.
02
Surgery
Displaced fragments, broken bite, several fractures.
- Miniplates
- The fragments are aligned, the teeth are set in the correct bite and fixed with titanium plates and screws; where possible - through an incision in the mouth.
- One or two plates per corner
- In a meta-analysis of 17 studies (1,667 patients), infection, malocclusion, and numbness occurred equally frequently with one and two plates; with two, there were more often fracture of the fixator and scars, and separation of the wound - somewhat more often.
- Where is the plate
- In a network meta-analysis of 15 randomized trials, a single plate on the lateral surface of the angle was associated with a lower risk of infection and re-plate removal than on the upper edge.
- A tooth in the fracture line
- In a meta-analysis of 26 studies, when there was no wisdom tooth in the angle fracture line, the chance of postoperative infection was lower (odds ratio 0.55); no difference was found regarding other complications. The surgeon decides individually whether to remove the tooth.
- Toothless jaw
- In a review of 8 studies (382 patients), stronger reconstructive plates were most often placed; bone has grown in at least 74% of patients in various studies, but the quality of the evidence is limited.
03
Terms and risks
What affects the result.
- When to operate
- The data differ. In a prospective study of 215 patients, delay (mean 4.6 days) did not affect outcome. In a cohort of 19,152 adults, the risk of malunion after open surgery increased if the delay was up to 6–7 days (odds ratio 1.84).
- Infection
- According to a meta-analysis of 75 studies (5,825 participants), surgical site infection occurred in 4.2% of cases. Whether antibiotics are needed and according to what scheme has not been unequivocally clarified; a doctor prescribes them - do not refuse and do not take them yourself.
- Smoking
- Among the patient-modifiable factors, the studies cited smoking most often: in three of them, smokers had a higher chance of complications (odds ratio 4.04–8.09).
- Numbness of the lip
- In a study of 257 patients, numbness was significantly reduced from 1 to 6 months. After 6 months, sensation returned in 59.0% of angle fractures and 34.8% of body fractures with numbness.
- Incorrect splicing
- In a cohort of 19,152 adults, 1.3% had malunion or nonunion; more often - with open fractures, body fractures, alcohol abuse and diabetes. Then they do a repeat operation to restore the bite that was before the injury.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Fractures of the lower jaw and their consequences are treated at the Institute of Surgery of Dr. Valikhnovskyi in the "New Face" direction. The clinic is responsible for the bones, bite and contour of the face; a head injury is handled by a neurosurgeon, restoration of teeth after an injury by a dentist.
CLINIC SERVICE
A new face
Form, symmetry, facial expressions and functions after injuries, wounds, burns, removal of tumors and congenital changes.
View service
What we do for this condition
- Without surgery — if the debris is not displaced — observation or closed repositioning; the decision is based on symptoms and CT scan.
- Titanium plates — fragments are aligned in the correct bite and fixed.
- Osteotomy — if the jaw has grown together with displacement, the bone is dissected and rearranged.
- 3D planning and individual implants — surgical templates or individual plates made of titanium or PEEK are printed by CT.
- Fibula flap — if a part of the jaw is lost, for example after an injury, it is reproduced with a leg bone with its own vessels.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Pictures onlineSend CT scans, discharges and photos of the face - the doctor will pre-evaluate the situation.
- ConsultationExamination of the bite, fragments and sensitivity of the lip; if necessary, a new CT scan.
- PlanIs an operation necessary, what to do with the tooth in the fracture line, which plates and from which access.
- TreatmentFixation of fragments with plates or treatment without surgery - depending on the fracture.
- RecoveryFor some time - only soft or liquid food, careful oral hygiene, no smoking; bite control examinations.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
Is surgery always necessary for a fractured jaw?
No. If the fragments are not displaced and the teeth close correctly, some fractures are treated without surgery. But this is done rarely and only after examination and CT scan.
How long can you wait for treatment?
You should go to the doctor on the same day. Whether surgery is needed right away is up to the surgeon: Data on the effect of delay are mixed, but in one large study, the risk of malunion increased if surgery was delayed for up to a week.
Why is the lip numb and will it go away?
The nerve responsible for the sensitivity of the lip and chin passes through the jaw, and a fracture injures it. In a study of 257 patients, the numbness noticeably weakened from the 1st to the 6th month, but after half a year, some disturbance of sensitivity still remained in 23.9% of cases.
Will a wisdom tooth be removed if a fracture has passed through it?
Not always. A tooth in the fracture line is associated with a higher risk of infection, but the decision is made by the surgeon on a tooth-by-tooth basis.
What can you eat after treatment?
For some time — only soft or liquid food, as the surgeon advises. Reviews recommend a bland diet and not smoking among things the patient can do on their own to reduce the risk of complications.
Will there be a scar on the face?
Where possible, the body and angle of the jaws are approached through an incision in the mouth, and there is no incision on the face. When the angle is broken, a small puncture is sometimes added on the cheek.
Do I need to remove the plates afterwards?
Not always. Sometimes the plate has to be removed; in a network meta-analysis, the risk of this depended on where it was placed.
Sources
18 sources · Cochrane, systematic reviews, meta-analyses, cohorts and NHSshowCollapse
- Interventions for the management of mandibular fracturesCochrane Database of Systematic Reviews, 2013doi:10.1002/14651858.CD006087.pub3 ↗
- Outcomes of non-surgical management of non-condylar mandibular fractures: a systematic review and meta-analysisBritish Journal of Oral and Maxillofacial Surgery, 2024doi:10.1016/j.bjoms.2024.04.016 ↗
- One miniplate versus two miniplates in the fixation of mandibular angle fractures. An updated systematic review and meta-analysisJournal of Stomatology, Oral and Maxillofacial Surgery, 2022doi:10.1016/j.jormas.2022.07.008 ↗
- Complications after different methods for fixation of mandibular angle fractures: network meta-analysis of randomized controlled trialsInternational Journal of Oral and Maxillofacial Surgery, 2021doi:10.1016/j.ijom.2021.02.009 ↗
- Effect of third molars in the line of mandibular angle fractures on postoperative complications: systematic review and meta-analysisInternational Journal of Oral and Maxillofacial Surgery, 2020doi:10.1016/j.ijom.2019.09.017 ↗
- Use of antibiotics in traumatic mandibular fractures: a systematic review and meta-analysisBritish Journal of Oral and Maxillofacial Surgery, 2021doi:10.1016/j.bjoms.2021.01.018 ↗
- Prevalence of surgical site infections after open reduction and internal fixation for mandibular fractures: a systematic review and meta-analysisScientific Reports, 2023doi:10.1038/s41598-023-37652-6 ↗
- Potentially modifiable patient factors in mandible fracture complications: a systematic review and meta-analysisBritish Journal of Oral and Maxillofacial Surgery, 2022doi:10.1016/j.bjoms.2021.07.005 ↗
- Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort studyJournal of the Korean Association of Oral and Maxillofacial Surgeons, 2021doi:10.5125/jkaoms.2021.47.3.183 ↗
- The Impact of Treatment Delay on Malunion and Nonunion After Open Reduction of Mandible FracturesFacial Plastic Surgery & Aesthetic Medicine, 2021doi:10.1089/fpsam.2020.0607 ↗
- A prospective study examining the effects of treatment timing in the management of mandible fracturesInternational Journal of Oral and Maxillofacial Surgery, 2018doi:10.1016/j.ijom.2018.03.017 ↗
- Analysis of factors that influence quality of life of individuals undergoing treatment for mandibular fractures: A systematic review and meta-analysisOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2022doi:10.1016/j.oooo.2022.01.012 ↗
- Patterns of Mandibular Fractures in South Australia: Epidemiology, Treatment, and Clinical OutcomesJournal of Craniofacial Surgery, 2022doi:10.1097/SCS.0000000000008244 ↗
- Secondary Management of Mandible FracturesFacial Plastic Surgery, 2019doi:10.1055/s-0039-1700887 ↗
- Management of Edentulous and Atrophic Mandibular Fractures: A Systematic Review of Treatment Modalities and OutcomesCureus, 2025doi:10.7759/cureus.85164 ↗
- Head injury and concussionNHS, 2025nhs.uk/conditions/head-injury-and-concussion ↗
- Dental abscessNHS, 2026nhs.uk/conditions/dental-abscess ↗
- Broken noseNHS, 2023nhs.uk/conditions/broken-nose ↗
The figures on the page are from these sources.
After impact teeth
close wrong?
Submit CT scans, discharges, and facial photos. The doctor will tell if an operation is needed and which one.