Management and subsequent 13-year progress of a mandibular fracture with malocclusion in a child--case report.

Under acute conditions, maxillofacial injuries may be treated without the opportunity for an assessment of occlusal irregularities, even when there are mandibular fractures, because life-threatening injuries have priority over occlusion. Consequently, mandibular fractures may result in post-trauma malocclusion and facial deformity. The case history reported is of a male patient who had been involved in a traffic accident in childhood and suffered mandibular fractures. The initial incomplete management resulted in persistent deformation of the mandible, disturbance of dental occlusion and difficulty in mastication. These irregularities were corrected during childhood by non-operative orthodontic treatment. When the patient reached adulthood, some permanent teeth were malformed because the fractures had damaged some tooth germs. However, the permanent dentition in general was almost normal as a result of the corrected primary dentition. Although the alveolar deformity due to the injury remained, the mandibular base was satisfactorily remodelled. The case reported supports the view that early restoration of normal dental occlusion before the eruption of permanent teeth contributes to the establishment of good functional dental occlusion of the permanent teeth.