Mandibular fractures associated with endosteal implants.
OBJECTIVE
The purpose of this study is to report four cases of mandibular fractures associated with endosteal implants and to discuss prevention and treatment of these types of fractures.


CONCLUSIONS
To evaluate whether the patient's anatomy allows insertion of implants, radiological exams that demonstrate the height and the labial-lingual width are needed. To reduce the potential fracture problem, the mandible can be restrengthened with bone grafting techniques. The treatment of a fracture in an atrophic mandible is always a challenge because of the diminished central blood supply, the depressed vitality of the bone, and the dependence on the periosteal blood supply. The basic principles in fracture treatment are reduction and immobilization of the fractured site for restoration of form and function.


CONCLUSIONS
If implants are placed in severe atrophic mandible, iatrogenic fracture of the mandible may occur during or after implant surgery because implant placement weakens the already-compromised mandible. A few millimeters of cortical bone should remain on both the labial and the lingual sites after the hole for insertion of an implant has been drilled. A 3-D surgical planning should be recommended at least in severe atrophic mandibles in order to prevent a severe reduction of bone tissue.
brunochrcanovic@hotmail.com
Bruno Ramos
BR
Chrcanovic
Antônio Luís Neto
AL
Custódio
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000150:complications; D001860:Bone Plates; D003758:Dental Implantation, Endosseous / Q000009:adverse effects*; D015921:Dental Implants / Q000009:adverse effects*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation; D008336:Mandibular Diseases / Q000150:complications* / Q000209:etiology; D008337:Mandibular Fractures / Q000209:etiology* / Q000601:surgery; D008340:Mandibular Nerve / Q000601:surgery; D008875:Middle Aged; D010019:Osteomyelitis / Q000150:complications* / Q000209:etiology
D015921:Dental Implants