Characteristics and Surgical Management of Bilateral Body Mandibular Fractures: A 23-Year Experience

Overview

Journal J Clin Med

Date 2025 Jan 11

PMID 39797243

Authors

Fabio Roccia

Paolo Cena

Giulia Cremona

Paolo Garzino Demo

Federica Sobrero

Affiliations

Soon will be listed here.

Abstract

: Mandibular fractures are among the most common facial injuries. Bilateral fractures of the mandibular body region (BBMFs), however, are rare. The aim of this retrospective study was to analyze the characteristics, surgical management, and outcomes of BBMFs in a third-level trauma center in northern Italy. : Between 1 January 2001 and 31 December 2023, the following data were collected about patients hospitalized for BBMFs: age, sex, cause of fracture, dental status, degree of mandibular atrophy, surgical approach, number and thickness of plates used, concomitant maxillofacial fractures, length of hospital stay, and outcomes. Statistical analysis was performed using SPSS software. : During the study period, 26 patients (11 males and 15 females) presented with BBMFs, of which five were dentate (median age, 19 years) and 21 edentulous (median age, 80 years). The primary cause of trauma was road traffic accidents (RTAs) in dentate patients and falls in edentulous patients. In most dentate patients, fractures were treated using an intraoral approach with rigid or mixed fixation, using ≤1.4 mm thick plates. Edentulous patients were primarily treated using an extraoral approach and rigid fixation with ≥1.5 mm plates. The use of plates ≥ 1.5 mm was statistically associated with edentulous patients ( = 0.042) and with increasing degrees of atrophy ( = 0.020). : This study shows that BBMFs are uncommon injuries, associated with high-impact trauma in dentate patients and medium- or low-impact trauma, such as falls, in edentulous patients. Internal fixation was predominantly rigid, with thicker plates used as the degree of mandibular atrophy increased.

References

LUHR H . [On the stable osteosynthesis in mandibular fractures]. Dtsch Zahnarztl Z. 1968; 23(7):754. View

Eyrich G, Gratz K, Sailer H . Surgical treatment of fractures of the edentulous mandible. J Oral Maxillofac Surg. 1997; 55(10):1081-7; discussion 1087-8. DOI: 10.1016/s0278-2391(97)90284-6. View

Champy M, Lodde J . [Mandibular synthesis. Placement of the synthesis as a function of mandibular stress]. Rev Stomatol Chir Maxillofac. 1976; 77(8):971-6. View

de Matos F, Arnez M, Sverzut C, Trivellato A . A retrospective study of mandibular fracture in a 40-month period. Int J Oral Maxillofac Surg. 2009; 39(1):10-5. DOI: 10.1016/j.ijom.2009.10.005. View

Sikes Jr J, Smith B, Mukherjee D . An in vitro study of the effect of bony buttressing on fixation strength of a fractured atrophic edentulous mandible model. J Oral Maxillofac Surg. 2000; 58(1):56-61; discussion 62. DOI: 10.1016/s0278-2391(00)80017-8. View

Zhang Z, Xie L, Li Z . Global, regional, and national burdens of facial fractures: a systematic analysis of the global burden of Disease 2019. BMC Oral Health. 2024; 24(1):282. PMC: 10900718. DOI: 10.1186/s12903-024-04048-5. View

Gerbino G, Cocis S, Roccia F, Novelli G, Canzi G, Sozzi D . Management of atrophic mandibular fractures: An Italian multicentric retrospective study. J Craniomaxillofac Surg. 2018; 46(12):2176-2181. DOI: 10.1016/j.jcms.2018.09.020. View

Bell R . The role of oral and maxillofacial surgery in the trauma care center. J Oral Maxillofac Surg. 2007; 65(12):2544-53. DOI: 10.1016/j.joms.2007.02.003. View

Cillo Jr J, Ellis 3rd E . Management of bilateral mandibular angle fractures with combined rigid and nonrigid fixation. J Oral Maxillofac Surg. 2013; 72(1):106-11. DOI: 10.1016/j.joms.2013.07.008. View

10.

Afrooz P, Bykowski M, James I, Daniali L, Clavijo-Alvarez J . The Epidemiology of Mandibular Fractures in the United States, Part 1: A Review of 13,142 Cases from the US National Trauma Data Bank. J Oral Maxillofac Surg. 2015; 73(12):2361-6. DOI: 10.1016/j.joms.2015.04.032. View

11.

Halazonetis J . The 'weak' regions of the mandible. Br J Oral Surg. 1968; 6(1):37-48. DOI: 10.1016/s0007-117x(68)80025-3. View

12.

Tallgren A . The continuing reduction of the residual alveolar ridges in complete denture wearers: a mixed-longitudinal study covering 25 years. 1972. J Prosthet Dent. 2003; 89(5):427-35. DOI: 10.1016/s0022-3913(03)00158-6. View

13.

Wolff J . The classic: on the inner architecture of bones and its importance for bone growth. 1870. Clin Orthop Relat Res. 2010; 468(4):1056-65. PMC: 2835576. DOI: 10.1007/s11999-010-1239-2. View

14.

Atwood D . Some clinical factors related to rate of resorption of residual ridges. 1962. J Prosthet Dent. 2001; 86(2):119-25. DOI: 10.1067/mpr.2001.117609. View

15.

Bojino A, Roccia F, Carlaw K, Aquilina P, Rae E, Laverick S . A multicentric prospective analysis of maxillofacial trauma in the elderly population. Dent Traumatol. 2022; 38(3):185-195. DOI: 10.1111/edt.12736. View

16.

Kidwai S, Lu G . Mandibular Body Fractures. Facial Plast Surg Clin North Am. 2021; 30(1):99-108. DOI: 10.1016/j.fsc.2021.08.008. View

17.

Ellis 3rd E, Price C . Treatment protocol for fractures of the atrophic mandible. J Oral Maxillofac Surg. 2008; 66(3):421-35. DOI: 10.1016/j.joms.2007.08.042. View

18.

Ellis 3rd E . An algorithm for the treatment of noncondylar mandibular fractures. J Oral Maxillofac Surg. 2014; 72(5):939-49. DOI: 10.1016/j.joms.2013.11.026. View

19.

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

20.

Krishnaraj S, Chinnasamy R . A 4-year retrospective study of mandibular fractures in a South Indian city. J Craniofac Surg. 2007; 18(4):776-80. DOI: 10.1097/scs.0b013e318069005d. View