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The purpose of this essay is to present the multiple patterns of the duplication sign at the mandibular fracture line/gap visualized at the panoramic radiography as two-line fracture gap or pseudocomminuted fracture. We retrospectively reviewed the orthopantomography of patients with mandible fractures and presented nine patients with 12 duplication signs (also known as lambda course fracture line). On panoramic radiographs the fracture line/gap with duplication sign is visualized as two-line cortical bone discontinuity with or without dislocation due to the fact that the fracture gap runs asymmetrically on the external and internal cortical plates of the jaw. Knowledge of duplication sign patterns, artifacts is also crucial for the precise diagnosis and choice of correct management strategy.

Mandibular Fractures: Pre-Operative Panoramic Radiography and Duplication Sign Patterns