title: The Comprehensive AOCMF Classification System: Mandible Fractures-Level 3 Tutorial.
abstract: This tutorial outlines the details of the AOCMF image-based classification system for fractures of the mandibular arch (i.e. the non-condylar mandible) at the precision level 3. It is the logical expansion of the fracture allocation to topographic mandibular sites outlined in level 2, and is based on three-dimensional (3D) imaging techniques/computed tomography (CT)/cone beam CT). Level 3 allows an anatomical description of the individual conditions of the mandibular arch such as the preinjury dental state and the degree of alveolar atrophy. Trauma sequelae are then addressed: (1) tooth injuries and periodontal trauma, (2) fracture involvement of the alveolar process, (3) the degree of fracture fragmentation in three categories (none, minor, and major), and (4) the presence of bone loss. The grading of fragmentation needs a 3D evaluation of the fracture area, allowing visualization of the outer and inner mandibular cortices. To document these fracture features beyond topography the alphanumeric codes are supplied with distinctive appendices. This level 3 tutorial is accompanied by a brief survey of the peculiarities of the edentulous atrophic mandible. Illustrations and a few case examples serve as instruction and reference to improve the understanding and application of the presented features.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ludwig Maximilians Universität, München, Germany.
authors.forename: Carl-Peter
authors.initials: CP
authors.lastname: Cornelius
authors.affiliation: AO Clinical Investigation and Documentation, AO Foundation, Dübendorf, Switzerland ; Research and Development Department, Schulthess Clinic, Zürich, Switzerland.
authors.forename: Laurent
authors.initials: L
authors.lastname: Audigé
authors.affiliation: Clinic for Oral and Craniomaxillofacial Surgery, University Hospital Basel, Basel, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Kunz
authors.affiliation: Plastic, Reconstruction and Maxillofacial Surgery, Alpharetta, Georgia.
authors.forename: Randal
authors.initials: R
authors.lastname: Rudderman
authors.affiliation: Institute of Radiology Zofingen Hospital, Mühletalstrasse, Zofingen, Switzerland ; Hightech Research Center for CMF Surgery, University of Basel, Switzerland.
authors.forename: Carlos H
authors.initials: CH
authors.lastname: Buitrago-Téllez
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Region of Facial Plastic Surgery, Danville, Pennsylvania.
authors.forename: John
authors.initials: J
authors.lastname: Frodel
authors.affiliation: Clinic for Oral and Craniomaxillofacial Surgery, University Hospital Basel, Basel, Switzerland.
authors.forename: Joachim
authors.initials: J
authors.lastname: Prein
keywords: degrees of alveolar atrophy; dentition; fracture classification; fracture morphology; mandible