Mandible, malunion of refers to a broken (fractured) mandibular bone that has healed in an unacceptable position that causes significant impairment in function. Malunion can be caused by movement of the bone during the healing process, poor blood supply or infection.

Malunion results from either failure to ideally align fractured segments of bone or failure to maintain proper bone alignment during the healing process. Factors contributing to malunion are severity of the fracture, location of the fracture, absence of enough teeth to guide alignment and aid stabilization, mandibular resorption (small size), and poor patient cooperation and compliance.

Signs and symptoms of this condition may include: facial deformities, restrictions in opening the mouth, restrictions or loss of masticatory function (chewing), malocclusion, loss of weight, and nutritional deficiencies.

Clinical examination for alignment of bones and teeth as well as dental occlusion (fit of the upper and lower teeth) are performed. X-rays may be done to show the faulty position that forms the imperfect union.

Treatment may include: surgery, tooth alignment by orthodontics, fabrication or remake of dental appliances, and proper nutritional management.

Deformity or dysfunction of the mandible may occur. Inadequate or improper eating processes, inadequate nutritional status, and facial deformities are long-term effects of the disorder.

• None.

• For VA compensation purposes, diagnostic imaging studies include, but are not limited to, conventional radiography (X-ray), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), radionuclide bone scanning, or ultrasonography

• Separately evaluate loss of vocal articulation, loss of smell, loss of taste, neurological impairment, respiratory dysfunction, and other impairments under the appropriate diagnostic code and combine under 38 CFR 4.25 for each separately rated condition