Radiographic changes during bone healing after mandibular fractures

The study aimed to find out the best time to undertake radiological follow-up examinations and remove fixation materials after fractures of the mandible through a retrospective study of radiographs. Serial radiographs of 325 fracture sites in 231 patients over a 10-year period were examined. Outcome was measured by radiographic features of healing at less than 2, 2–3, 3–4, and 4 or more months. Osteogenic change (osteogenesis and union) was the best radiographic criterion for evaluating follow-up radiographs. This change started to predominate 1–2 months after injury in patients less than 18 years of age (21/31, 68%) and 2–3 months after injury in older patients (21/25, 84%). Overall, union was noted in 98 of 115 patients (85%) 3 months or more after the fracture. We recommend follow-up radiographic examination to confirm clinical judgement during the fifth week after a mandibular fracture in patients less than 18 years of age, and the ninth week for older patients. The fixation materials should be removed during the fifth month after injury.