Evaluation of surgical retreatment of mandibular fractures

Use of the locking 2.0-mm fixation system for treating mandibular fractures with the potential for complications

“…A previous study demonstrated a greater frequency of partially edentulous individuals in a series of nonunion following mandibular fractures [5]. The possibility of malocclusion, inducing postoperative instability in partially edentulous individuals, has been reported [4].…”

“…Smoking is considered a contributing factor to the development of postoperative complications [9,23]. It is known that smoking reduces vascularization, which is associated with a slower bone repair process [4].…”

“…Our experience with the use of conventional systems to treat mandibular fractures have demonstrated an incidence of 4.7% of the cases requiring a second surgery, regardless of whether 2.0-mm or 2.4-mm plates were used [4]. Also, the occurrence of postoperative infections, which were treated with antibiotic therapy and drainage, is described as 9.5% of the cases, with more cases related to the 2.4-mm system [12].…”

“…Rigid fixation is a more cost-effective treatment than non-rigid methods, which is in part because of the decreased probability of postoperative complications that could necessitate further surgery [2]. The consequences of retreatment include greater patient morbidity, additional hospitalization and hospital costs and a longer period of absence from work, leading to high social costs [3,4].…”

“…The primary postoperative complications requiring surgical retreatment are nonunion, soft tissue infection associated with screw loosening, osteomyelitis and malunion [4,5]. Although there is no consensus in the literature, factors including substance abuse, age, dental condition, location of fracture, degree of fragmentation, fracture exposure and time between trauma and treatment should be considered as those that contribute to the occurrence of such complications [5][6][7][8][9].…”