Leandro Benetti de Oliveira1, Marisa Aparecida Cabrini Gabrielli2, Mario Francisco Real Gabrielli2, Valfrido Antonio Pereira Pereira-Filho2. 1. Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, Dental School at Araraquara-Unesp, Rua Humaitá, 1680, Centro, Araraquara, SP, Brazil, CEP: 14801-903. le_benetti@yahoo.com.br. 2. Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, Dental School at Araraquara-Unesp, Rua Humaitá, 1680, Centro, Araraquara, SP, Brazil, CEP: 14801-903.
Abstract
OBJECTIVE: The objective of this article is to present options of rehabilitation with dental implants in two cases of severely atrophic mandibles (<10 mm) after rigid internal fixation of fractures. PATIENTS AND METHOD: Two patients who sustained fractures in severely atrophic mandibles with less than 10 mm of bone height were treated by open reduction and internal fixation through a transcervical access. Internal fixation was obtained with 2.4-mm locking reconstruction plates. The first patient presented satisfactory bone height at the area between the mental foramens and after 2 years, received flapless guided implants in the anterior mandible and an immediate protocol prosthesis. The second patient received a tent pole iliac crest autogenous graft after 2 years of fracture treatment and immediate implants. After 5 months, a protocol prosthesis was installed in the second patient. RESULTS: In both cases, the internal fixation followed AO principles for load-bearing osteosynthesis. Both prosthetic devices were Branemark protocol prosthesis. The mandibular reconstruction plates were not removed. Both patients are rehabilitated without complications and satisfied with esthetic and functional results. CONCLUSION: With the current techniques of internal fixation, grafting, and guided implants, the treatment of atrophic mandible fractures can achieve very good results, which were previously not possible.
OBJECTIVE: The objective of this article is to present options of rehabilitation with dental implants in two cases of severely atrophic mandibles (<10 mm) after rigid internal fixation of fractures. PATIENTS AND METHOD: Two patients who sustained fractures in severely atrophic mandibles with less than 10 mm of bone height were treated by open reduction and internal fixation through a transcervical access. Internal fixation was obtained with 2.4-mm locking reconstruction plates. The first patient presented satisfactory bone height at the area between the mental foramens and after 2 years, received flapless guided implants in the anterior mandible and an immediate protocol prosthesis. The second patient received a tent pole iliac crest autogenous graft after 2 years of fracture treatment and immediate implants. After 5 months, a protocol prosthesis was installed in the second patient. RESULTS: In both cases, the internal fixation followed AO principles for load-bearing osteosynthesis. Both prosthetic devices were Branemark protocol prosthesis. The mandibular reconstruction plates were not removed. Both patients are rehabilitated without complications and satisfied with esthetic and functional results. CONCLUSION: With the current techniques of internal fixation, grafting, and guided implants, the treatment of atrophic mandible fractures can achieve very good results, which were previously not possible.
Authors: Johannes Hachleitner; Simon Enzinger; Christian Brandtner; Alexander Gaggl Journal: J Craniomaxillofac Surg Date: 2013-08-06 Impact factor: 2.078