Matteo Brucoli1, Paolo Boffano2, Irene Romeo1, Chiara Corio1, Arnaldo Benech1, Muhammad Ruslin3, Tymour Forouzanfar4, Tanía Rodríguez-Santamarta5, Juan Carlos de Vicente5, Marko Tarle6, Emil Dediol6, Petia Pechalova7, Nikolai Pavlov8, Hristo Daskalov7, Iva Doykova9, Kadri Kelemith10, Tiia Tamme11, Andrey Kopchak12, Ievgen Shumynskyi13, Pierre Corre14, Helios Bertin14, Maeva Bourry14, Pierre Guyonvarc'h14, Tadej Dovšak15, David Vozlič15, Anže Birk15, Boban Aničić16, Vitomir S Konstantinovic16, Thomas Starch-Jensen17. 1. Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy. 2. Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy. Electronic address: paolo.boffano@gmail.com. 3. Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia. 4. Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, the Netherlands. 5. Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain. 6. Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia. 7. Department of Oral Surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria. 8. Private Practice of Oral Surgery, Plovdiv, Bulgaria. 9. Department of Maxillofacial Surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria. 10. Department of Maxillo-facial Surgery, North Estonia Medical Centre Foundation, Tallinn, Estonia. 11. Faculty of Medicine, University of Tartu, Tartu, Estonia. 12. Bogomolets National Medical University, Stomatological Medical Center, Kyiv, Ukraine. 13. Bogomolets National Medical University, Kyiv City Clinical Emergency Hospital, Kyiv, Ukraine. 14. Division of Maxillofacial Surgery, Chu de Nantes, Nantes, France. 15. Department of Maxillofacial and Oral Surgery of the University Medical Centre, Ljubljana, Slovenia. 16. Department of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Serbia. 17. Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.
Abstract
INTRODUCTION: The objective of the present study was to assess the demographic variables, causes, and patterns of edentulous atrophic fractures of the mandible managed at several European departments of oral and maxillofacial surgery. The results of this multicenter collaboration over a 10-year period are presented. METHODS: The data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between January 1, 2008, and December 31, 2017 were recorded: gender; age; voluptuary habits; comorbidities; etiology; fracture sites; synchronous body injuries; atrophy of the mandible according to Luhr classification; eventual type of treatment; timing of the eventual surgery; length of hospital stay. RESULTS: A total of 197 patients (86 male and 111 female patients) with 285 mandibular fractures were included in the study. Mean age of the study population was 75 years. Statistically significant associations were found between Luhr classes I - II and condylar fractures on one hand (p < .0005), and between Luhr class III and body and parasymphyseal fractures on the other hand (p < .05). Finally, 135 patients underwent open reduction and internal fixation, 56 patients did not undergo any intervention, and 6 patients underwent closed reduction. No statistically significant association was observed between treatment, timing of treatment, comorbidities, and concomitant injuries. CONCLUSIONS: The management of edentulous atrophic mandibular fractures remains challenging. Treatment decisions should continue to be based on the clinician's previous experience and on the degree of bone resorption in edentulous mandible in relation to fracture subsites.
INTRODUCTION: The objective of the present study was to assess the demographic variables, causes, and patterns of edentulous atrophic fractures of the mandible managed at several European departments of oral and maxillofacial surgery. The results of this multicenter collaboration over a 10-year period are presented. METHODS: The data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between January 1, 2008, and December 31, 2017 were recorded: gender; age; voluptuary habits; comorbidities; etiology; fracture sites; synchronous body injuries; atrophy of the mandible according to Luhr classification; eventual type of treatment; timing of the eventual surgery; length of hospital stay. RESULTS: A total of 197 patients (86 male and 111 female patients) with 285 mandibular fractures were included in the study. Mean age of the study population was 75 years. Statistically significant associations were found between Luhr classes I - II and condylar fractures on one hand (p < .0005), and between Luhr class III and body and parasymphyseal fractures on the other hand (p < .05). Finally, 135 patients underwent open reduction and internal fixation, 56 patients did not undergo any intervention, and 6 patients underwent closed reduction. No statistically significant association was observed between treatment, timing of treatment, comorbidities, and concomitant injuries. CONCLUSIONS: The management of edentulous atrophic mandibular fractures remains challenging. Treatment decisions should continue to be based on the clinician's previous experience and on the degree of bone resorption in edentulous mandible in relation to fracture subsites.