Results of treatment of fractures of the atrophic edentulous mandible by compression plating: a retrospective evaluation of 84 consecutive cases

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
H G LuhrH A Merten

Abstract

This article introduces a simple and reproducible classification of the degree of atrophy in fractures of the atrophic edentulous mandible, and evaluates the results of treatment in 84 consecutive fractures based on this classification. Eight-four fractures of the edentulous mandible, with a height at the fracture site of < or = 20 mm, were included. Using the ratio of actual plate width to plate width on the postoperative radiograph, the actual height of the mandible at the fracture site was calculated. Twenty-five fractures (30%) were in the Class I atrophy group (height at the fracture site 16 to 20 mm), 33 fractures (39%) occurred in Class II atrophic mandibles (height 11 to 15 mm), and 26 fractures (31%) were seen in extremely atrophic Class III mandibles (height < or = 10 mm). The treatment was performed by compression plating without any postoperative MMF. Primary bone grafting was used in six cases (7%) because a partial bone defect was present at the fracture site. In 81 (96.5%) of the 84 fractures an uncomplicated, solid, bony union was achieved. Three major complications occurred: one osteomyelitis and two nonunions. The two nonunions occurred in bilateral fracture of an extremely atrophied mandible (Class III atroph...Continue Reading

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