ideal, they are alternative mediums that are preferred over water or worse allowing the root surface to air dry ( Fig 105.5 ) The patient should proceed directly to the dentist for radiographs, final alignment, splinting, and close followup JAW FRACTURES CLINICAL PEARLS AND PITFALLS Trauma to the chin may result in a condylar fracture Because the jaw is a ring structure, identification of a single fracture warrants careful examination for an accompanying injury Mandibular fractures can lead to airway compromise, most commonly secondary to tongue and soft tissue falling against the posterior pharyngeal wall Current Evidence Mandibular fractures are the third most common facial fractures in children (behind frontal and nasal bones) Whenever a facial fracture is present, the cervical spine, CNS, orbits, and teeth need to be carefully evaluated for associated injuries The majority of mandibular fractures occur at the level of the condyle, which often results after trauma to the chin Other areas of the jaw that are predisposed to fracture include the angle of the mandible where deep impacted teeth or unerupted 6-year molars make the mandible more vulnerable Symphyseal and parasymphyseal fractures can also accompany upper mandibular fractures, as part of the closed ring of the jaw Goals of Treatment History, physical examination, and appropriate radiographic evaluation should be used to establish the diagnosis of mandibular fracture Patients should be rapidly evaluated for airway compromise and appropriate management initiated when identified Diagnosed jaw fractures are commonly referred for outpatient treatment, although some injuries may require more urgent intervention Mandibular Fractures/Dislocations Clinical recognition The mandible can be compared with an archery bow, which is strongest at its center and weakest at its ends Thus, most fractures occur at the neck of the condyles Patients may present with pain or limitation when opening the mouth, or swelling at the TMJ