The Surgical Management of Triple Mandibular Fractures: A Challenging Task

Overview

Journal J Clin Exp Dent

Specialty Dentistry

Date 2024 Nov 15

PMID 39544203

Authors

Paolo Boffano

Francesca Neirotti

Panagiotis Stathopoulos

Muhammad Ruslin

Matteo Brucoli

Affiliations

Soon will be listed here.

Abstract

Background: The treatment of multiple mandibular fractures may often be challenging. The aim of this study was to evaluate the characteristics and outcomes of multiple mandibular fractures, with a focus on triple mandibular fractures.

Material And Methods: Patients with multiple (triple) mandibular fractures were included. The following data were recorded for each patient: age; gender; cause of injury; sites of mandibular fractures; presence of complications. Facial width was esthetically evaluated through a clinical examination considering the inferior facial width, postoperative asymmetries, and facial esthetic harmony.

Results: From January 1, 2010, to December 31, 2018, 25 patients (15 men, 10 women) underwent surgery for triple mandibular fractures and were included in the study. A predominance of symphysis/parasymphysis fracture associated with bilateral condylar/ramus fractures was observed, followed by symphysis/ parasymphysis fracture combined with mandibular angle fracture and condyle fracture. Most patients did not show any type of complications. An optimal esthetic outcome was obtained in 20 patients.

Conclusions: A successful treatment of trifocal mandibular fractures may be achieved by different techniques, although it remains challenging. The re-establishment of the transversal bigonial dimension by a correct reconstruction of the mandibular arch should guide surgeons. The aim of the treatment should always be the successful rehabilitation of patients' pretraumatic occlusion and function. Mandibular fractures, multiple, treatment, management, mandible.

References

Boffano P, Roccia F, Gallesio C, Karagozoglu K, Forouzanfar T . Diplopia and orbital wall fractures. J Craniofac Surg. 2014; 25(2):e183-5. DOI: 10.1097/SCS.0000000000000437. View

Gerbino G, Boffano P, Bosco G . Symphyseal mandibular fractures associated with bicondylar fractures: a retrospective analysis. J Oral Maxillofac Surg. 2009; 67(8):1656-60. DOI: 10.1016/j.joms.2009.03.069. View

Choi T, Chung Y, Cho J, Burm J . The Use of Microplates for Internal Fixation of Comminuted Mandibular Fractures. Ann Plast Surg. 2018; 82(1):55-61. DOI: 10.1097/SAP.0000000000001623. View

Brucoli M, Boffano P, Pezzana A, Benech A, Corre P, Bertin H . The "European Mandibular Angle" Research Project: The Epidemiologic Results From a Multicenter European Collaboration. J Oral Maxillofac Surg. 2019; 77(4):791.e1-791.e7. DOI: 10.1016/j.joms.2018.12.013. View

Boffano P, Kommers S, Karagozoglu K, Gallesio C, Forouzanfar T . Mandibular trauma: a two-centre study. Int J Oral Maxillofac Surg. 2015; 44(8):998-1004. DOI: 10.1016/j.ijom.2015.02.022. View

Brucoli M, Boffano P, Romeo I, Corio C, Benech A, Ruslin M . The epidemiology of edentulous atrophic mandibular fractures in Europe. J Craniomaxillofac Surg. 2019; 47(12):1929-1934. DOI: 10.1016/j.jcms.2019.11.021. View

Brucoli M, Boffano P, Franchi S, Pezzana A, Baragiotta N, Benech A . The use of teleradiology for triaging of maxillofacial trauma. J Craniomaxillofac Surg. 2019; 47(10):1535-1541. DOI: 10.1016/j.jcms.2019.07.007. View

Kommers S, Boffano P, Forouzanfar T . Consensus or controversy? The classification and treatment decision-making by 491 maxillofacial surgeons from around the world in three cases of a unilateral mandibular condyle fracture. J Craniomaxillofac Surg. 2015; 43(10):1952-60. DOI: 10.1016/j.jcms.2015.08.031. View

Brucoli M, Boffano P, Romeo I, Corio C, Benech A, Ruslin M . Management of maxillofacial trauma in the elderly: A European multicenter study. Dent Traumatol. 2019; 36(3):241-246. DOI: 10.1111/edt.12536. View

10.

Ruslin M, Wolff J, Boffano P, Brand H, Forouzanfar T . Dental trauma in association with maxillofacial fractures: an epidemiological study. Dent Traumatol. 2015; 31(4):318-23. DOI: 10.1111/edt.12176. View

11.

Bins A, Oomens M, Boffano P, Forouzanfar T . Is There Enough Evidence to Regularly Apply Bone Screws for Intermaxillary Fixation in Mandibular Fractures?. J Oral Maxillofac Surg. 2015; 73(10):1963-9. DOI: 10.1016/j.joms.2015.03.072. View

12.

Brucoli M, Boccafoschi F, Boffano P, Broccardo E, Benech A . The Anatomage Table and the placement of titanium mesh for the management of orbital floor fractures. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 126(4):317-321. DOI: 10.1016/j.oooo.2018.04.006. View

13.

Moura L, Trento G, Carvalho P, Granucci M, de Oliveira J, Pereira-Filho V . Double unilateral, bilateral, and multiple mandibular fractures: an observational study. Oral Maxillofac Surg. 2018; 22(3):315-321. DOI: 10.1007/s10006-018-0713-y. View

14.

Boffano P, Benech R, Gallesio C, Arcuri F, Benech A . Current opinions on surgical treatment of fractures of the condylar head. Craniomaxillofac Trauma Reconstr. 2014; 7(2):92-100. PMC: 4078111. DOI: 10.1055/s-0034-1371772. View

15.

Salentijn E, Collin J, Boffano P, Forouzanfar T . A ten year analysis of the traumatic maxillofacial and brain injury patient in Amsterdam: complications and treatment. J Craniomaxillofac Surg. 2014; 42(8):1717-22. DOI: 10.1016/j.jcms.2014.06.005. View

16.

Boffano P, Boffano M, Gallesio C, Roccia F, Cignetti R, Piana R . Rugby athletes' awareness and compliance in the use of mouthguards in the North West of Italy. Dent Traumatol. 2011; 28(3):210-3. DOI: 10.1111/j.1600-9657.2011.01067.x. View

17.

Boffano P, Kommers S, Roccia F, Gallesio C, Forouzanfar T . Fractures of the mandibular coronoid process: a two centres study. J Craniomaxillofac Surg. 2014; 42(7):1352-5. DOI: 10.1016/j.jcms.2014.03.025. View

18.

Brucoli M, Boffano P, Broccardo E, Benech A, Corre P, Bertin H . The "European zygomatic fracture" research project: The epidemiological results from a multicenter European collaboration. J Craniomaxillofac Surg. 2019; 47(4):616-621. DOI: 10.1016/j.jcms.2019.01.026. View

19.

Ruslin M, Brucoli M, Boffano P, Benech A, Dediol E, Uglesic V . Motor vehicle accidents-related maxillofacial injuries: a multicentre and prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019; 128(3):199-204. DOI: 10.1016/j.oooo.2018.12.009. View

20.

Brucoli M, Boffano P, Pezzana A, Benech A, Corre P, Bertin H . The "European Mandibular Angle" research project: the analysis of complications after unilateral angle fractures. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019; 128(1):14-17. DOI: 10.1016/j.oooo.2019.02.027. View