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

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.

Penatalaksanaan fraktur mandibula pada anak menggunakan teknik circumferential wiring dengan Gunning splint Management of mandibular fracture in children using circumferential technique with Gunning splint

Fractures of the mandible in children most commonly occur in the condyle and angulus. Circumferential wiring andGunning splint as a supporting tool to strengthen the fixation of the lower jaw. This case reported a 7 year-old-boywho had fracture of his right mandibular corpus. At the time of surgery, it was applied mini plate 5 holes and 4screws on the right mandibular corpus with the using of circumferential wiring on the right and left mandibularcorpus and symphysis, with Gunning splints. The patient was in good condition after surgery without complications

A Novel Technique for Attaining Maxillomandibular Fixation in the Edentulous Mandible Fracture

Edentulous mandible fractures present a unique and challenging surgical problem, particularly because of lack of occlusive dental surfaces to capitalize upon maxillomandibular fixation (MMF). We present a novel technique to achieve MMF using rigid plates spanning the oral cavity to fixate the maxilla to the mandible. The process is rapid and allows stability using the established principles of rigidity, external fixation, and osteosynthesis. This technique allows for a faster MMF than with a Gunning splint and allows for easier oral hygiene. An illustrative case and pre- and postoperative imaging are provided.