Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 3 , Pages 421-435, March 2008

Treatment Protocol for Fractures of the Atrophic Mandible

  • Edward Ellis III, DDS, MS

      Affiliations

    • Professor, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
    • Corresponding Author InformationAddress correspondence to Dr Ellis: Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9109
  • ,
  • Chris Price, DDS, MD

      Affiliations

    • Resident, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center, Dallas, TX.

Purpose

This study was conducted to evaluate the outcomes after treatment of fractures through the atrophic mandible using open reduction, internal fixation, and immediate bone grafting.

Patients and Methods

All patients treated surgically for fractures through an atrophic (<15 mm at the fracture site) mandible over a 17-year period were included if their records contained adequate information. Demographic data and details of treatment were tabulated, as were outcomes.

Results

A total of 32 patients (19 males, 13 females; age range, 43 to 92 years) met the inclusion criteria. Of the 32 cases, 26 were bilateral fractures, and most occurred through the region of the body of the mandible. Most patients had significant medical comorbidities. Most of the fractures were treated through an extraoral approach with a rigid internal fixation technique. Immediate bone grafts were used in 23 of the 32 patients. No intraoperative or postoperative complications occurred. All patients healed uneventfully. In 4 patients, plates had to be removed for various reasons after fracture healing was complete.

Conclusions

The use of a seemingly more aggressive approach for managing fractures through the atrophic mandible produced healing in all patients and, in the end, may be more “conservative” than a less aggressive approach. Despite the advanced age and medical comorbidities of most of the patients, all patients tolerated the surgery and did well postoperatively.

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0278-2391(07)01945-3

doi:10.1016/j.joms.2007.08.042

Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 3 , Pages 421-435, March 2008