Management of fractures of the atrophic mandible: a case series

Flores-Hidalgo, Andres; Altay, Mehmet Ali; Atencio, Isabel; Manlove, Ashley E.; Schneider, Keith M.; Baur, Dale A.; Quereshy, Faisal A.

doi:10.1016/j.oooo.2015.01.016

Cited by 27 publications

(24 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite improvements in surgical fixation instruments, because of decreased vascularization, limited bone quality and quantity and absence of teeth in a patient with a fractured atrophic mandible, current procedures of fracture immobilization continues to be difficult and have been shown to be insufficient. Furthermore, fracture treatment is often complicated due to the poor health status and complex medical problems of older patients [21]. Clinicians involved in dental implant rehabilitation should realize that prevention is the best treatment for implant related mandibular fracture.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the biomechanical effects of implant diameter in case of facial trauma to an edentulous atrophic mandible: a 3D finite element analysis

Ayalı

Bilginaylar

2017

Head Face Med

View full text Add to dashboard Cite

BackgroundRehabilitation using an implant supported overdenture with two implants inserted in the interforaminal region is the easiest and currently accepted treatment modality to increase prosthetic stabilization and patient satisfaction in edentulous patients. The insertion of implants to the weakend mandibular bone decreases the strength of the bone and may lead to fractures either during or after implant placement. The aim of this three dimensional finite element analysis (3D FEA) study was to evaluate the biomechanical effects of implant diameter in case of facial trauma (2000 N) to an edentulous atrophic mandible with two implant supported overdenture.MethodsThree 3D FEA models were simulated; Model 1 (M1) is edentulous atrophic mandible, Model 2 (M2), 3.5x11.5 mm implants were inserted into lateral incisors area of same edentulous atrophic mandible, Model 3 (M3), 4.3x11.5 mm implants were inserted into lateral incisors area of same edentulous atrophic mandible.ResultsIn M1 and M2 highest stress levels were observed in condylar neck, whereas highest stress values in M3 were calculated in symphyseal area.ConclusionsTo reduce the risk of bone fracture and to preserve biomechanical behavior of the atrophic mandible from frontal traumatic loads, implants should be inserted monocortically into spongious bone of lateral incisors area.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluating the biomechanical effects of implant diameter in case of facial trauma to an edentulous atrophic mandible: a 3D finite element analysis

Ayalı

Bilginaylar

2017

Head Face Med

View full text Add to dashboard Cite

show abstract

“…Long periods of edentulism result in atrophy of mandibular height and width, which disproportionately affects the body region (7,78). The incidence of edentulous atrophic mandible has increased with the demographic shift toward an elderly population (79,80). Patients with endentulous atrophic mandibles frequently have osteoporosis, and the osteogenic potential of the bone is markedly impaired.…”

Section: Edentulous Atrophic Mandiblementioning

confidence: 99%

“…Patients with endentulous atrophic mandibles frequently have osteoporosis, and the osteogenic potential of the bone is markedly impaired. Rates of nonunion are much higher in these patients than in dentate adults (79). Luhr et al (81) developed a classification system based on the height of the mandibular body.…”

Section: Edentulous Atrophic Mandiblementioning

confidence: 99%

“…Plate contouring is difficult, but placement along the inferior border is an option. The advantage of using reconstruction plates is that screws can be placed in regions with adequate bone stock, such as the angle and parasymphysis (35,79). Success has been reported in series in which miniplates were placed along the inferior border of the mandibular body (82).…”

Section: Edentulous Atrophic Mandiblementioning

confidence: 99%

“…If bone union is unsuccessful, the titanium union that follows ultimately leads to miniplate fatigue and facture (44), with "wishboning"-that is, downward rotation of the anterior mandible caused by suprahyoid muscle pull (79) (Fig 23). Additional open techniques include the use of titanium mesh and, as a last resort, the use of dentures as a scaffold for circummandibular wiring (5,79), which does not provide rigid fixation (Fig 24). Simultaneous bone grafting is sometimes performed to promote healing and increase bulk for subsequent implant placement, although this technique is rarely feasible ultimately.…”

Section: Edentulous Atrophic Mandiblementioning

confidence: 99%

See 2 more Smart Citations

Multidetector CT of Mandibular Fractures, Reductions, and Complications: A Clinically Relevant Primer for the Radiologist

Dreizin¹,

Nam²,

Tirada³

et al. 2016

RadioGraphics

View full text Add to dashboard Cite

After the nasal bones, the mandible is the second most common site of facial fractures, and mandibular fractures frequently require open reduction. In the trauma injury setting, multidetector computed tomography (CT) has become the cornerstone imaging modality for determining the most appropriate treatment management, fixation method, and surgical approach. Multidetector CT is also used to assess the adequacy of the reduction and evaluate potential complications in the postoperative period. For successful restoration of the mandible's form and function, as well as management of posttraumatic and postoperative complications, reconstructive surgeons are required to have a detailed understanding of mandibular biomechanics, occlusion, and anatomy. To provide added value in the diagnosis, treatment planning, and follow-up of mandibular fractures, radiologists should be aware of these concepts. Knowledge of the techniques commonly used to achieve occlusal and anatomic reduction and of the rationale behind the range of available treatment options for different injury patterns-from isolated and nondisplaced fractures to multisite and comminuted fractures-also is essential. This article focuses on the use of multidetector CT for pre- and postoperative evaluation of mandibular fractures and outlines fundamental concepts of diagnosis and management-beginning with an explanation of common fracture patterns and their biomechanical underpinnings, and followed by a review of the common postoperative appearances of these fractures after semirigid and rigid fixation procedures. Specific considerations regarding fractures in different regions of the tooth-bearing and non-tooth-bearing mandible and the unique issues pertaining to the edentulous atrophic mandible are reviewed, and key features that distinguish major from minor complications are described. (©)RSNA, 2016.

show abstract

Materials Used Intraoperatively During Oral and Maxillofacial Surgery Procedures

Fahmy

Gupta²,

Guentsch

et al. 2019

Applications of Biomedical Engineering in Dentistry

View full text Add to dashboard Cite

Management of fractures of the atrophic mandible: a case series

Cited by 27 publications

References 19 publications

Evaluating the biomechanical effects of implant diameter in case of facial trauma to an edentulous atrophic mandible: a 3D finite element analysis

Evaluating the biomechanical effects of implant diameter in case of facial trauma to an edentulous atrophic mandible: a 3D finite element analysis

Multidetector CT of Mandibular Fractures, Reductions, and Complications: A Clinically Relevant Primer for the Radiologist

Materials Used Intraoperatively During Oral and Maxillofacial Surgery Procedures

Contact Info

Product

Resources

About