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

Abstract

Several nonsurgical and surgical techniques have been employed to treat fractures of the severely atrophic mandible. The aim of this study was to analyze the repair outcome of these fractures. From 2010 to 2016, patients with fractures of the severely atrophic mandible were included. All files were retrospectively studied. Twelve patients (mean age: 76 years; female, n = 8) with a single ( n = 6) or multiple fracture(s) of the atrophic edentulous mandible (mean height was 10.1 mm) were identified. Fracture occurred following trauma ( n = 9), explantation of dental implants ( n = 2), and placing an overdenture bar ( n = 1). In seven cases, consolidation was successful following open reduction and internal fixation (ORIF) using a load-bearing reconstruction plate. In five cases, the initial treatment was different: conservative treatment, using gunning splint, and performing ORIF using miniplates. In all five cases, additional ORIF using a load-bearing reconstruction plate was needed. In four cases, short dental implants were placed several months following fracture repair. In case of a severely atrophic mandibular fracture, the authors advise ORIF with a load-bearing reconstruction plate. In selected cases, secondary oral rehabilitation with short dental implants and implant-supported prosthesis is feasible.