Implant-supported rehabilitation after treatment of atrophic mandibular fractures: report of two cases

Extraoral approach to a bilateral unfavourable mandibular fracture under local anaesthesia: A case report

OBJECTIVE

To present a feasible treatment method for fractures of severely atrophic mandibles in high-risk patients undergoing general anaesthesia (GA).

CASE REPORT

A 77-year-old man presented with bilateral unfavourable fractures in an atrophic mandible. Pre-anaesthetic consultation revealed that the patient was at high risk for GA due to significant medical comorbid conditions of the patient, such as advanced age, chronic obstructive respiratory disease, diabetes mellitus and atherosclerosis. Thus, a modified treatment, consisting of open reduction and internal fixation using a combination of reconstruction plates and miniplates via an extraoral approach, was planned under local anaesthesia. The patient tolerated the surgical procedure well, without the need for sedation, and uneventful healing was achieved during postoperative period.

CONCLUSION

Local anaesthesia may be considered as the anaesthetic technique of choice when managing atrophic mandible fractures to reduce the risk of complications and shorten the time needed for recovery, especially in elders with significant medical comorbidities.

[Current therapy of atrophic edentulous mandibular fractures among elderly people]

The cases of mandible fractures among elderly people, especially those with atrophic mandibles, are increasing. Atrophic mandibular fractures among elderly people require specific treatment because of the differences between the anatomicophysiologies of elderly people and those of normal adults. This paper serves as a literature review on the characteristics, selection of the treatment method, and complication of atrophic edentulous mandibular fractures among elderly people.

Multidisciplinary approach to oral rehabilitation with dental implants after gunshot injury: A clinical report

This clinical report describes a multidisciplinary approach to treat a patient with edentulism and a severe anatomic defect in the mandible caused by a gunshot injury by using an implant-fixed complete dental prosthesis. An immediate loading interim implant-fixed complete dental prosthesis in the mandible associated with a maxillary removable complete denture prosthesis was initially provided to restore the intermaxillary relation. Nasal floor elevation and maxillary sinus augmentation were subsequently performed to increase the maxillary bone volume. Definitive implant-fixed complete dental prostheses were placed in both arches in order to rehabilitate this initially compromised anatomic condition, which ensured patient satisfaction and improvement in masticatory function and esthetics.