The fate of developing teeth in facial trauma: tooth buds in the line of mandibular fractures in children.

Mandibular fractures in children present the surgeon with a unique set of considerations. Tooth buds within the body and ramus of the mandible restrict the type of surgical intervention that may be used. In addition, the fate of nonerupted dentition in the direct line of the fracture remains unclear. Between July 1985 and June 1990, 30 patients in deciduous or mixed dentition presented with a total of 45 mandibular fractures. Of these 45 fractures, 33% (n = 15) involved 16 nonerupted teeth. Age at the time of fracture was 6.0 +/- 2.3 years (mean +/- SD). Thirty-three percent of patients were treated with open reduction and internal fixation of fractures; 67% of patients were treated with closed reduction and either intermaxillary fixation or a lingual splint. Normal eruption was exhibited by 82% (n = 9) of the tooth buds in the line of mandibular fracture. The results of this study indicate the following: (1) Mandibular fractures in children involve unerupted teeth directly in one-third of cases. (2) The majority of tooth buds (82%) in the line of mandibular fractures eventually erupt normally. And (3) a significant percentage of dentition (18%) may exhibit either delayed eruption or noneruption with resorption of the tooth bud if directly involved in the line of fracture.