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

Bender, Céline A.; Wolvius, Eppo B.

doi:10.1055/s-0038-1667295

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…Consideramos que el futuro es alentador y podrán utilizarse recursos que faciliten el tratamiento de estas lesiones, mejoren su pronóstico y disminuyan la morbilidad de los procedimientos de reconstrucción mediante recursos como la proteína ósea morfogenética, la planificación virtual y el uso de sistemas bloqueados, estos siguiendo el tipo de osteosíntesis de carga absorbida [10][11][12][13] .…”

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Tratamiento de fracturas en mandíbula atrófica

Cienfuegos¹

2023

CIRU

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Antecedentes. Las fracturas en mandíbula atrófica han sido tratadas desde con fijación intermaxilar hasta con osteosíntesis. Pueden requerir injertos óseos. La clasificación de Luhr es una guía para orientar el tratamiento . Objetivo. Mostrar el tratamiento de fracturas en mandíbula atrófica con placas y tornillos y las posibles indicaciones de uso de injerto óseo en este tipo de fracturas. Método. Se presenta una serie de 17 pacientes con mandíbula atrófica fracturada tratada con placas y tornillos, algunas con sistemas no bloqueados y otros bloqueados. En las de clase II and III se aplicó injerto óseo esponjoso para mejorar la capacidad osteogénica. El injerto se tomó del tercio proximal de la tibia, previa evaluación radiológica. Resultados. La evolución en general fue satisfactoria. Se inició la vía oral con papillas y los pacientes deambularon a las 24 h de posoperatorio. Se observó consolidación en 17 pacientes. Hubo una defunción por enfermedad vascular cerebral antes de 6 meses. Una paciente tuvo retardo de consolidación diagnosticado al tercer mes, pero no aceptó tratamiento secundario. Conclusiones. El tratamiento de las fracturas mandibulares atróficas con placa y tornillos bajo concepto de carga absorbida es un procedimiento confiable.

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Section: Conclusionesunclassified

Tratamiento de fracturas en mandíbula atrófica

Cienfuegos¹

2023

CIRU

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Rehabilitation of extremely atrophic edentulous mandible in elderly patients with associated comorbidities: a case report and proof of concept

2021

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Background Oral rehabilitation of the atrophic mandible is, most of the time, a challenging procedure, especially in elderly patients with associated comorbidities. Case presentation This clinical report describes the rehabilitation of an extremely atrophic mandible using an overdenture supported by four splinted implants, two of which are placed in the interforaminal region and the other two bypassing the inferior alveolar nerve at the level of the antegonial notch. A passive-fit bar structure splinting the four inserted implants was designed to compensate for mandibular flexure, to reduce the amount of strain on the implants, and avoid bone resorption and prosthetic failure. The 14-month postoperative cone-beam computed tomography (CBCT) and the clinical follow-up showed the bilateral integrity of the inferior alveolar nerve and the successful restoration of the atrophic edentulous mandible with a significant improvement in the patient’s quality of life. Conclusions The applied technique depicts several benefits such as a minimally invasive approach, reduced number of surgical interventions, reduced total treatment time, reduced treatment costs, and higher psychological acceptability.

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Biomechanical grounding of the transalveolar osteosynthesis of еdentulous мandible fractures

et al. 2021

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The purpose of the work is improvement of the effectiveness of the mandibular fractures treatment in patients with partial or complete adentia by developing and experimentally testing transalveolar osteosynthesis technique. An experimental study was carried out by 3D computer simulation modeling by the final element analysis to assess the efficiency of mandibular fractures fixation at partial or complete adentia using the Ш-shaped plate, which we developed for the transalveolar osteosynthesis method. Calculations of the immobilized fractures for static (own weight) and dynamic (functional) loads were performed according to the author's method, taking into account pronounced resorptive processes in the bone from the beginning of the reparative reaction to assess the rigidity of fragments fixation during the entire period of the fractures healing. Under the conditions of the same three-dimensional model of the mandible, calculations were performed when the fracture was fixed with ordinary linear titanium osseous plates. It is proved that at functional load the new plate provides a compression effect in the fractures region, as evidenced by the negative displacements in the final elements of the mental region according to the results of design load combination 2- 3. The maximum efforts in the screws of the calculation model with a conventional bone plate were 136.955 N, which is almost ten times more than on the model with a Ш-shaped titanium retainer (12.656 N).

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

Cited by 3 publications

References 30 publications

Tratamiento de fracturas en mandíbula atrófica

Tratamiento de fracturas en mandíbula atrófica

Rehabilitation of extremely atrophic edentulous mandible in elderly patients with associated comorbidities: a case report and proof of concept

Biomechanical grounding of the transalveolar osteosynthesis of еdentulous мandible fractures

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