Craniomaxillofacial trauma is a common presentation of patients who have suffered trauma. Injuries can range from injuries limited to dentition through complete fracture and displacement of craniomaxillofacial structures and the mandible causing hemorrhage and morbidity for the patient. Intervention and treatment of these injuries should focus on fast return to pain free function. Invasive repair techniques such as plating and interfragmentary wiring can provide many benefits such as immediate rigid stability without compromising function of the jaw as well as allow for primary bone healing without a callus. However, invasive methods are technique sensitive, require access to the fracture and surrounding bone, and can be more traumatic to the surrounding structures as well. Invasive techniques to provide some benefits over non or minimally invasive techniques. Bone healing after injury occurs in two ways, either primary or secondary healing. Primary healing requires 0.01 mm distance between the fragments with <2% interfragmentary strain. Secondary healing occurs via granulation tissue and formation of fibrocartilage which further calcifies and matures into scar free bone. However, this maturation process takes place over 3-6 months. Direct bone healing bypasses the callus formation. With osteons intact, osteoblasts are able to perform transverse bridging of the Haversian system. With invasive techniques, primary bone healing is more likely to occur.

 While there are many benefits to invasive bone stabilization techniques, some research has supported increased risk of infection rates using reconstruction plates, particularly of the lower jaw. In addition, injury to essential structures of the jaw including the neurovascular bundle within the mandibular canal and health tooth roots is a common. Strength studies and retrospective studies of noninvasive to minimally invasive techniques provide adequate support and good long term prognosis. Support of the jaw along the tension side of the mandible also provides a benefit. Noninvasive to minimally invasive techniques are also preferred in the skull/maxilla due to inability to place screws in such thin bone. These techniques should be considered in cases where adequate support can be provided across fracture sites.