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. 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, University of Eastern Piedmont, 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, University Medical Centre, Ljubljana, Slovenia. 16. Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia. 17. Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.
Abstract
INTRODUCTION: Management of body fractures in patients with edentulous atrophic mandibles represents a challenging task due to patient's age, medical comorbidities, poor bone quality, and vascularity, as well as reduced contact area between the fracture ends. The aim of the study was to assess the demographic and clinical variables, the surgical technique, and outcomes of unilateral body fractures of the edentulous atrophic mandible managed at several European departments of oral and maxillofacial surgery. METHODS: This study is based on a systematic computer-assisted database that allowed the recording of data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between 2008 and 2017. The following data were recorded for each patient: gender, age, comorbidities, etiology, synchronous body injuries, degree of atrophy of the mandible according to Luhr classification, type of surgical approach and fixation, length of hospitalization, and presence and type of complications. RESULTS: A total of 43 patients were included in the study: 17 patients' mandibles were classified as class I according to Luhr, 15 as class II, and 11 as class III. All patients underwent open reduction and internal fixation by extraoral approach in 25 patients, intraoral in 15 patients, and mixed in 3 patients. A single 2.0 miniplate was used in 16 patients, followed by a single 2.4 reconstruction plate in 13 patients, by two 2.0 miniplates, and three 2.0 miniplates. Outcome was considered to be satisfying in 30 patients, with no complications. Complications were observed in 13 cases. CONCLUSIONS: Treatment of unilateral body fractures of the edentulous mandible must still be based on the type of fracture, degree of atrophy, experience of the surgeon, and patients' preference. An adequate stability can be obtained by different plating techniques that have to be appropriately tailored to every single specific patient.
INTRODUCTION: Management of body fractures in patients with edentulous atrophic mandibles represents a challenging task due to patient's age, medical comorbidities, poor bone quality, and vascularity, as well as reduced contact area between the fracture ends. The aim of the study was to assess the demographic and clinical variables, the surgical technique, and outcomes of unilateral body fractures of the edentulous atrophic mandible managed at several European departments of oral and maxillofacial surgery. METHODS: This study is based on a systematic computer-assisted database that allowed the recording of data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between 2008 and 2017. The following data were recorded for each patient: gender, age, comorbidities, etiology, synchronous body injuries, degree of atrophy of the mandible according to Luhr classification, type of surgical approach and fixation, length of hospitalization, and presence and type of complications. RESULTS: A total of 43 patients were included in the study: 17 patients' mandibles were classified as class I according to Luhr, 15 as class II, and 11 as class III. All patients underwent open reduction and internal fixation by extraoral approach in 25 patients, intraoral in 15 patients, and mixed in 3 patients. A single 2.0 miniplate was used in 16 patients, followed by a single 2.4 reconstruction plate in 13 patients, by two 2.0 miniplates, and three 2.0 miniplates. Outcome was considered to be satisfying in 30 patients, with no complications. Complications were observed in 13 cases. CONCLUSIONS: Treatment of unilateral body fractures of the edentulous mandible must still be based on the type of fracture, degree of atrophy, experience of the surgeon, and patients' preference. An adequate stability can be obtained by different plating techniques that have to be appropriately tailored to every single specific patient.
Authors: M Brucoli; P Boffano; I Romeo; C Corio; A Benech; M Ruslin; T Forouzanfar; T Starch-Jensen; T Rodríguez-Santamarta; J C de Vicente; J Snäll; H Thorén; B Aničić; V S Konstantinovic; P Pechalova; N Pavlov; H Daskalov; I Doykova; K Kelemith; T Tamme; A Kopchak; I Shumynskyi; P Corre; H Bertin; Q Goguet; M Anquetil; A Louvrier; C Meyer; T Dovšak; D Vozlič; A Birk; M Tarle; E Dediol Journal: J Stomatol Oral Maxillofac Surg Date: 2019-09-15 Impact factor: 1.569
Authors: Layla Louise de Amorim Rocha; Matheus Francisco Barros Rodrigues; Rodrigo da Franca Acioly; Daniel do Carmo Carvalho; Cristofe Coelho Lopes da Rocha Journal: Case Rep Dent Date: 2020-06-28