Integrated AO-CMF and IADT protocols provide coordinated management for mandibular fractures and traumatic dental injuriesNew coordinated plan for jaw fractures and dental injuries

Frontiers in Medicine Published August 5, 2026 Study authors: Edoardo Staderini, Raffaella Castagnola, Irene Cavalcanti, Marianna Balacco, Anastasio Spera, Cosimo… DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Consider an integrated AO-CMF and IADT approach to coordinate management of mandibular fractures and dental trauma.

This systematic review explores the integration of surgical fracture management and dental trauma care for patients presenting with both mandibular fractures and traumatic dental injuries. The scope focuses on coordinating AO-CMF principles with IADT-based protocols to address complex maxillofacial injuries.

The synthesis highlights specific criteria for tooth retention versus extraction in fracture lines. Retention is favored when teeth are intact, useful for occlusion, and not infected. Extraction is indicated for vertical or root fractures, advanced periodontal disease, severe caries, infection, or interference with reduction and fixation. The review emphasizes the importance of addressing occlusal stability, neurosensory impairment, and temporomandibular joint function.

A primary limitation noted by the authors is that few integrated protocols currently exist in clinical practice. The proposed algorithm serves as a framework for interdisciplinary coordination rather than a report of new trial results. Clinical application should consider these guidelines as a method to harmonize surgical and dental outcomes.

When a person suffers a severe facial injury, doctors often have to treat two problems at once: a fractured jawbone and damaged teeth. Because these issues happen in the same area, treating them separately can lead to complications like poor bite alignment or nerve issues.

This review looks at how to combine specific surgical rules for bone fractures with specialized dental care for trauma. The goal is to create a unified plan so that surgeons and dentists work together from the start. This coordinated approach aims to improve outcomes like jaw stability and the health of the remaining teeth.

While this new framework helps guide doctors, it is important to note that this review summarizes existing knowledge rather than reporting results from a new clinical trial. Currently, there are few integrated protocols available, so this plan serves as a roadmap for teams working together to treat complex facial injuries.

What this means for you:

A new coordinated approach helps doctors better manage both jaw fractures and dental trauma at the same time.

Common questions

When is it better to keep a tooth after a jaw fracture?

Keeping a tooth is usually preferred if the tooth is healthy, not infected, and helps with how the teeth fit together. Doctors may choose to pull a tooth instead if it has a vertical root fracture, severe decay, advanced gum disease, or an infection.

What are the goals of this new treatment plan?

The goal is to combine bone surgery principles with dental trauma care. This helps doctors manage both the jawbone and the teeth together to prevent issues like joint problems, nerve damage, or a misaligned bite.

Is this new method based on a clinical trial?

No, this is not a report of a new clinical trial. It is a review that proposes a new way for doctors to work together based on existing medical knowledge and literature.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedAug 2026

View Original Abstract ↓

Mandibular fractures are among the most common maxillofacial injuries and are frequently associated with traumatic dental injuries (TDIs), creating combined skeletal, occlusal, periodontal, and pulpal treatment priorities. Integrated protocols addressing both the fracture and the dental component remain limited. The present literature review was conducted by means of a structured search of PubMed/MEDLINE, Scopus, and Web of Science Core Collection from 2000 to 2026, complemented by manual reference-list screening. A structured Population, Intervention/Exposure, Comparison, and Outcomes (PICO) framework and predefined eligibility criteria were added, and an overall assessment of methodological quality was undertaken for the included primary studies to improve transparency. Mandibular fractures range from minimally displaced injuries with preserved occlusion to complex patterns associated with malocclusion, neurosensory impairment, temporomandibular joint dysfunction, and concomitant TDIs. The evidence supports individualized decision-making based on fracture displacement, occlusal stability, patient age, dentition status, tooth prognosis, and biological priorities of periodontal and pulpal healing. Teeth in the fracture line should not be extracted routinely; retention is generally favored when the tooth is intact, strategically useful for occlusion, and not infected, whereas extraction is indicated in cases of vertical/root fracture, advanced periodontal disease, severe caries, infection, or interference with reduction/fixation. Combined dento-mandibular trauma requires coordinated interdisciplinary management. A revised algorithm is proposed to integrate AO-CMF fracture principles with International Association of Dental Traumatology (IADT)-based dental trauma care, emphasizing systematic dental screening, selective imaging, safe fixation planning, biologically appropriate splinting, staged endodontic decision-making, and long-term follow-up for pulp necrosis, resorption, ankylosis, malocclusion, and neurosensory complications.

Integrated AO-CMF and IADT protocols provide coordinated management for mandibular fractures and traumatic dental injuriesNew coordinated plan for jaw fractures and dental injuries

Common questions

Study Details

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Integrated AO-CMF and IADT protocols provide coordinated management for mandibular fractures and traumatic dental injuriesNew coordinated plan for jaw fractures and dental injuries

Common questions

Study Details

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