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Surgical management of unilateral body fractures of the edentulous atrophic mandible

Abstract

Introduction

Management of body fractures in patients with edentulous atrophic mandibles represents a challenging task due to patient’s age, medical comorbidities, poor bone quality, and vascularity, as well as reduced contact area between the fracture ends. The aim of the study was to assess the demographic and clinical variables, the surgical technique, and outcomes of unilateral body fractures of the edentulous atrophic mandible managed at several European departments of oral and maxillofacial surgery.

Methods

This study is based on a systematic computer-assisted database that allowed the recording of data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between 2008 and 2017. The following data were recorded for each patient: gender, age, comorbidities, etiology, synchronous body injuries, degree of atrophy of the mandible according to Luhr classification, type of surgical approach and fixation, length of hospitalization, and presence and type of complications.

Results

A total of 43 patients were included in the study: 17 patients’ mandibles were classified as class I according to Luhr, 15 as class II, and 11 as class III. All patients underwent open reduction and internal fixation by extraoral approach in 25 patients, intraoral in 15 patients, and mixed in 3 patients. A single 2.0 miniplate was used in 16 patients, followed by a single 2.4 reconstruction plate in 13 patients, by two 2.0 miniplates, and three 2.0 miniplates. Outcome was considered to be satisfying in 30 patients, with no complications. Complications were observed in 13 cases.

Conclusions

Treatment of unilateral body fractures of the edentulous mandible must still be based on the type of fracture, degree of atrophy, experience of the surgeon, and patients’ preference. An adequate stability can be obtained by different plating techniques that have to be appropriately tailored to every single specific patient.

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Correspondence to Paolo Boffano.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Brucoli, M., Boffano, P., Romeo, I. et al. Surgical management of unilateral body fractures of the edentulous atrophic mandible. Oral Maxillofac Surg 24, 65–71 (2020). https://doi.org/10.1007/s10006-019-00824-8

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Keywords

  • Atrophic mandible
  • Fracture
  • Edentulous
  • Body
  • Management