Management of Atrophic Edentulous Mandibular Fractures: The Case for Primary Reconstruction With Immediate Bone Grafting

Tiwana, Paul S.; Abraham, Matthew S.; Kushner, George M.; Alpert, Brian

doi:10.1016/j.joms.2007.11.038

Cited by 44 publications

(27 citation statements)

References 8 publications

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“…10 Tiwana et al, in 2009, suggested that for ideal healing of edentulous/atrophic mandible fractures, bone grafting is needed in addition to a large reconstruction plate and a bone graft. 21 Nonunion and fibrous union were and are a well-recognized complication when treating these patients. 6 Bruce and Strachan stated that there was a 20% incidence of nonunion after treatment of these types of fractures.…”

Section: Discussionmentioning

confidence: 99%

Concepts and Challenges in the Surgical Management of Edentulous Mandible Fractures: A Case Series

Anehosur

Thakker

Nagraj

et al. 2019

Craniomaxillofacial Trauma & Reconstruction Open

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Functional rehabilitation of complex edentulous or atrophic mandibular fractures is surgically demanding. The high incidence of bone fractures in geriatric age group is secondary to the loss of bone mineral content with age. So far, there is no consensus regarding the best treatment for repair of fractures of the severely atrophic mandible. Thus, the choice of treatment for such fractures should be based on the degree of atrophy, considering its inverse relationship to the amount of rigid fixation required. Hence, open reduction and internal fixation (ORIF) is considered to be a reliable method for treating the edentulous mandible fractures. The authors present a case series of patients treated with ORIF with load bearing (LB; reconstruction plate) and load sharing (LS; miniplates) principles. No complications related to infection, plate exposure, fibrous union, nonunion, and trismus, were observed.

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Section: Discussionmentioning

confidence: 99%

Concepts and Challenges in the Surgical Management of Edentulous Mandible Fractures: A Case Series

Anehosur

Thakker

Nagraj

et al. 2019

Craniomaxillofacial Trauma & Reconstruction Open

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“…O enxerto de osso autógeno é utilizado para o tratamento da não união e má união de fraturas mandibulares bem como nos casos de fraturas de mandíbulas atróficas, pois fornece células osteoblásticas, células mesenquimais indiferenciadas, osteoclastos e fatores de crescimento 10,11 . Seu uso facilita a união óssea, promove mais estabilidade ao osso após o reparo ósseo e permite a possibilidade de restauração protética 3 .…”

Section: Discussionunclassified

Tratamento cirúrgico da fratura de mandibula atrófica pela técnica AO: relato de caso

Pereira¹,

Bonardi²,

Silva³

et al. 2017

Arch Health Invest

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ResumoAs fraturas das mandíbulas atróficas são de difícil tratamento, pois necessitam de um vasto conhecimento por parte do cirurgião maxilofacial. Como é uma injuria incomum, muitos profissionais não possuem a experiência necessária para trata-las. O objetivo deste artigo é demonstrar um caso clínico onde foi empregada a técnica cirúrgica errada para tratar uma fratura de mandíbula atrófica bilateral e seu retratamento através da filosofia preconizada pela AO Foundation empregando uma placa de reconstrução 2.4 mm e enxertia com osso autógeno particulado da crista ilíaca anterior. Após 1 e 7 meses conclui-se que, apesar de ser uma técnica mais agressiva, proporciona os resultados mais satisfatórios e previsíveis. Descritores: Fixação Interna de Fraturas; Técnicas de Fixação da Arcada Osseodentária; Arcada Edêntula. AbstractFractures of atrophic mandibles are difficult to resolve because requires a large knowledge by oral & maxillofacial surgeons. As it is an unusual injury, many surgeons don't have experience to treat them. The aim of this article is to report a clinical case where a wrong technique to fix the mandible was used and its treatment by AO Foundation philosophy with a recon 2.4 mm plate and the grafted with autogenous bone graft from anterior crest of iliac bone. After 1 year and 7 months we concluded that it is an aggressive technique but provides a satisfactory and predictable outcome. Descriptors: Fracture Fixation, Internal; Jaw Fixation Techniques; Jaw, Edentulous. ResumenLas fracturas de los maxilares atróficos son difíciles de tratar debido a que necesitan un amplio conocimiento por parte del cirujano maxilofacial. ¿Cómo es una lesión poco frecuente, muchos profesionales no tienen la experiencia necesaria para tratarlos? El propósito de este artículo es mostrar un caso en el que se empleó la técnica quirúrgica equivocada para tratar una fractura de mandíbula atrófica bilateral y la repetición del tratamiento a través de la técnica recomendada por la Fundación AO empleando una placa de reconstrucción de 2,4 mm y el injerto con partículas de hueso autógeno de la cresta ilíaca arriba. Después de 1 y 7 meses han llegado a la conclusión de que, a pesar de una técnica más agresiva proporciona los resultados más satisfactorios y predecibles. Descriptores: Fijación Interna de Fracturas; Técnicas de Fijación de Maxilares; Arcada Edéntula. INTRODUÇÃOO tratamento da fratura mandibular possui o objetivo de reestabelecer a anatomia óssea, devolver a função, as condições estéticas além de ter evoluído desde o tratamento com bloqueio maxilomandibular até a redução aberta e a fixação com placas e parafusos 1,2 . O maior resultado da técnica de fixação interna rígida foi eliminar o período de bloqueio maxilomandibular por 6 semanas, permitindo que o paciente tenha o imediato retorno as suas funções.A escolha do tratamento dependerá das características das fraturas e das condições clínicas do paciente. Os diferentes sistemas de placas e parafusos utilizados na região maxilofacial podem ser classificados em "Loa...

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“…The mandibular bone mass decreases over time as a result of the loss of bone function, increasing the rate of mandibular fracture that is more critical in the mandibular body area. Furthermore, the screws must be placed in areas of adequate bone quality, which, in a severely resorbed mandible, are the symphysis and angle (19,20). If the single plate is sectioned at the symphysis area or two plates are applied, it will be impossible to place an adequate number of screws on the anterior portion of each plate.…”

Section: Discussionmentioning

confidence: 99%

Retained Third Molars Removal in a Severely Resorbed Edentulous Mandible. A Case Report

Sverzut¹,

Trivellato²,

Sverzut³

et al. 2013

Braz. Dent. J.

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The presence of asymptomatic third molars can represent a potential problem in the mandible when these teeth are retained and the patient has lost all normally erupted teeth. Once the mandibular first and second molars are removed, the mandibular body becomes weaker with time, increasing the complexity, morbidity and incidence of complication in the surgical procedure to remove the retained third molar. This paper reports a case where the mandibular third molars retained in a severely resorbed mandible were removed in a 54-year-old female patient. The treatment plan was based on the safe surgical removal of the teeth and prosthetic rehabilitation with an implant-supported milled bar overdenture and a bone-mucous-supported complete denture in the mandibular and maxillary arch, respectively. If the removal of a retained third molar is indicated in a severely resorbed edentulous mandible, the treatment plan must involve not only preventive measures in order to avoid mandible fracture during or after tooth removal, but also alternatives that allow an adequate mandibular rehabilitation.

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Management of Atrophic Edentulous Mandibular Fractures: The Case for Primary Reconstruction With Immediate Bone Grafting

Cited by 44 publications

References 8 publications

Concepts and Challenges in the Surgical Management of Edentulous Mandible Fractures: A Case Series

Concepts and Challenges in the Surgical Management of Edentulous Mandible Fractures: A Case Series

Tratamento cirúrgico da fratura de mandibula atrófica pela técnica AO: relato de caso

Retained Third Molars Removal in a Severely Resorbed Edentulous Mandible. A Case Report

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