Mandible Fractures | ScienceGate

Due to the high biotolerance, favourable mechanical properties, and osseointegration ability, titanium is the basic biomaterial used in maxillofacial surgery. The passive layer of titanium dioxide on the surface of the implant effectively provides anticorrosive properties, but it can be damaged, resulting in the release of titanium ions to the surrounding tissues. The aim of our work was to evaluate the influence of Ti6Al4V titanium alloy on redox balance and oxidative damage in the periosteum surrounding the titanium miniplates and screws as well as in plasma and erythrocytes of patients with mandibular fractures. The study included 31 previously implanted patients (aged 21–29) treated for mandibular fractures and 31 healthy controls. We have demonstrated increased activity/concentration of antioxidants both in the mandibular periosteum and plasma/erythrocytes of patients with titanium mandibular fixations. However, increased concentrations of the products of oxidative protein and lipid modifications were only observed in the periosteum of the study group patients. The correlation between the products of oxidative modification of the mandible and antioxidants in plasma/erythrocytes suggests a relationship between the increase of oxidative damage at the implantation site and central redox disorders in patients with titanium miniplates and screws.

Download Full-text

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

Craniomaxillofacial Trauma & Reconstruction Open ◽

10.1055/s-0038-1667295 ◽

2018 ◽

Vol 2 (1) ◽

pp. s-0038-1667295

Author(s):

Celine A. Van der Kolk - Bender ◽

Maarten J. Koudstaal ◽

Eppo B. Wolvius

Keyword(s):

Dental Implants ◽

Surgical Techniques ◽

Fracture Repair ◽

Multiple Fracture ◽

Reconstruction Plate ◽

Oral Rehabilitation ◽

Load Bearing ◽

Edentulous Mandible ◽

Gunning Splint ◽

Mandible Fractures

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.

Download Full-text