Treatment of Edentulous Mandibular Fractures with Rigid Internal Fixation: Case Series and Literature Review

Abstract

The aim of the study is to analyze the effectiveness of rigid internal fixation (RIF) for treating edentulous mandibular fractures. Because of the low incidence of fractures in edentulous mandible, there is no consensus of the optimal treatment for it. This study included all edentulous patients with mandibular fracture diagnosis, who were treated with internal fixation at the Hospital Italiano de Buenos Aires from November 1991 to July 2011. Data such as age, gender, etiology and location of fracture, surgical approach, type of osteosynthesis used, and postoperative complications were analyzed. A total of 18 patients, 76.2 years mean age, 12 females (66.6%), presented a total of 35 mandibular fractures. The mandibular body was the most common localization of the fractures. Twenty-five fractures received surgical treatment with RIF, mainly approached extraorally. Reconstruction plates were the most common type of fixation used. Fracture reduction was considered satisfactory in 96.5%, with 22.2% of complications and 11.1% of reoperations needed. Open reduction and RIF demonstrated to be a reliable method for treating edentulous mandibular fractures. Nevertheless, there is lack of high-level recommendation publication to support this.

Treatment of Severely Atrophic Edentulous Mandible Fractures: Load-Bearing or Load-Sharing?

“…Our case series and review of the literature show that using a load-bearing reconstruction plate with locking screws from an extraoral approach leads to a good consolidation of a fractured severely atrophic mandible. 2,6,7,10 Complications following ORIF using a reconstruction plate occurred in four patients (permanent hypoesthesia mental nerve). No nonunion or malunion was seen in our case series.…”

A Technique for Reduction of Edentulous Fractures Using Dentures and SMARTLock Hybrid Fixation System

“…The management of mandibular fractures in the edentulous patient is challenging due to the presence of atrophic, poorly vascularized bone, diminished capacity for bone regeneration, and the lack of dental surfaces to guide anatomic fracture reduction. 3 , 7 , 8 …”

Systematic method for initial rapid analysis of maxillofacial computed tomography scans for surgeons in training

“…Finally, the management of edentulous mandible fractures differs considerably from those with full dentition and as such must be considered in the treatment plan. 3 Our method for systematic facial CT analysis always starts with the coronal scan. On the first scroll through, the resident is instructed to follow the mandible, take note of normal foraminae and check condyle location as well as the status of the condylar neck.…”