Surgical treatment of severely displaced atrophic jaw fracture: a case report

Authors

DOI:

https://doi.org/10.33448/rsd-v9i9.7391

Keywords:

Mandible; Edentulous Jaw; Aged; Oral Surgery; Oral Surgical Procedures.

Abstract

Atrophic mandible fractures usually occur in elderly individuals, in which osteogenesis is decreased, cortical bone is dense and blood supply is decreased. There is a consensus in the literature that the treatment of atrophic mandible fractures remains a major challenge for maxillofacial traumatology, considering the low availability of bone and the morphological and biomechanical characteristics of a toothless mandible. This paper aims to report a case of surgical treatment of bilateral atrophic mandible fracture. The male patient, 61 years old, attended the Oral and Maxillofacial Surgery service, after being the victim of a motorcycle accident, without the use of individual protection materials, evolving with bilateral mandible fracture. On physical examination, the patient had diastasis in the bilateral mandibular body area and in the intraoral examination, ecchymosis was observed in the floor of the mouth. The treatment consisted of an extraoral surgical approach, under general anesthesia, transcervical access, reduction and osteosynthesis of fractured jaw with a 2.4mm locking system plate in each fracture. The therapy allowed the patient to resume his chewing functions with a gain in quality of life. It is concluded that atrophic mandible fractures are uncommon, but with the increase in the elderly population in the coming years, it is expected that its incidence will increase, and it is essential for the maxillofacial surgeon to recognize the available treatment possibilities.

References

Antes, D. L., Schneider, I. J. C., & d'Orsi, E. (2015). Mortality caused by accidental falls among the elderly: a time series analysis. Revista Brasileira de Geriatria e Gerontologia, 18(4), 769-778. https://doi.org/10.1590/1809-9823.2015.14202

Brucoli, M., Boffano, P., Romeo, I., Corio, C., Benech, A., Ruslin, M., ... & Dediol, E. (2020). Surgical management of unilateral body fractures of the edentulous atrophic mandible. Oral and Maxillofacial Surgery, 24(1), 65-71.

Caldas, A. F. J., Caldas, K. U., Oliveira, M. R. M., Amorim, A. A., & Barros, P. M. F. (2005). O impacto do edentulismo na qualidade de vida de idosos. Rev. Ciências médicas, Campinas, 14(3), 229-238.

Carvalho, G. A. O., Ribeiro, A. D. O. P., Câmara, J. V. F., & Pierote, J. J. A. (2020). Abordagem odontológica e alterações bucais em idosos: uma revisão de literatura. Research, Society and Development, 9(7), e938975142-e938975142.

Castro-Núñez, J., Cunningham, L. L., & Van Sickels, J. E. (2017). A historical perspective with current opinion on the management of atrophic mandibular fractures. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 124(6), e276-e282.

Coll, P. P., Lindsay, A., Meng, J., Gopalakrishna, A., Raghavendra, S., Bysani, P., & O'Brien, D. (2020). The Prevention of Infections in Older Adults: Oral Health. Journal of the American Geriatrics Society, 68(2), 411–416. https://doi.org/10.1111/jgs.16154

Ehrenfeld, M., Manson, P. N., & Prein, J. (2012). Principles of internal fixation of the craniomaxillofacial skeleton. Thieme.

Ellis III, E., & Price, C. (2008). Treatment protocol for fractures of the atrophic mandible. Journal of oral and maxillofacial surgery, 66(3), 421-435.

Emam, H. A., Ferguson, H. W., & Jatana, C. A. (2018). Management of atrophic mandible fractures: an updated comprehensive review. Oral Surgery, 11(1), 79-87.

Gerbino, G., Cocis, S., Roccia, F., Novelli, G., Canzi, G., & Sozzi, D. (2018). Management of atrophic mandibular fractures: An Italian multicentric retrospective study. Journal of Cranio-Maxillofacial Surgery, 46(12), 2176-2181.

Gerbino, G., Roccia, F., De Gioanni, P. P., & Berrone, S. (1999). Maxillofacial trauma in the elderly. Journal of oral and maxillofacial surgery, 57(7), 777-782.

IBGE. Coordenação de População e Indicadores Sociais. Projeção da população do Brasil por idade e sexo 1980 – 2050. Rio de Janeiro, 2008. Recuperado em 05 agosto, 2020 de: http://www.ibge.gov.br/home/estatistica/populacao/projecao_da_populacao/2008

Luhr, H. G., Reidick, T., & Merten, H. A. (1996). 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, 54(3), 250-254.

Madsen, M. J., & Haug, R. H. (2006). A biomechanical comparison of 2 techniques for reconstructing atrophic edentulous mandible fractures. Journal of oral and maxillofacial surgery, 64(3), 457-465.

Marinho, K., Guevara, H. A. G., Piva, F. H., Rocha, B., Gonzalez, D., & Leandro, L. F. L. (2015). Epidemiological analysis of mandibular fractures treated in Sao Paulo, Brazil. Revista Española de Cirugía Oral y Maxilofacial, 37(4), 175-181.

Paula, A. C. S. F., Abreu, D. P. G., & Jantara, R. D. (2020). Scientific production of Nursing on bone fractures in elderly people: an integrative review. Research, Society and Development, 9(7), 68973825.

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia do trabalho científico. [e-Book]. Santa Maria. Ed. UAB/NTE/UFSM. Available at: https://repositorio. ufsm. br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica. pdf.

Shokri, T., Misch, E., Ducic, Y., & Sokoya, M. (2019). Management of Complex Mandible Fractures. Facial Plastic Surgery, 35(06), 602-606.

Toma, V. S., Mathog, R. H., Toma, R. S., & Meleca, R. J. (2003). Transoral versus extraoral reduction of mandible fractures: a comparison of complication rates and other factors. Otolaryngology—Head and Neck Surgery, 128(2), 215-219.

Wittwer, G., Adeyemo, W. L., Turhani, D., & Ploder, O. (2006). Treatment of atrophic mandibular fractures based on the degree of atrophy—experience with different plating systems: a retrospective study. Journal of oral and maxillofacial surgery, 64(2), 230-234.

Published

20/08/2020

How to Cite

Almeida Neto, L. F. de, Marcelino, K. P. ., Souza, J. A. N. de, Silva, J. L. R., Souza, B. B. de, Moreira Junior, L. C., Germano, A. R., Dantas, W. R. M., & Gondim, A. L. M. F. (2020). Surgical treatment of severely displaced atrophic jaw fracture: a case report. Research, Society and Development, 9(9), e305997391. https://doi.org/10.33448/rsd-v9i9.7391

Issue

Section

Health Sciences