title: Pathologic mandibular fracture after biting crab shells following ramal bone graft.
abstract: The mandibular ramus is considered an appropriate choice for reconstruction of maxillofacial defects because of sufficient amounts of material and fewer donor site complications. Although bone harvesting from the mandibular ramus has many advantages, in rare cases it can result in pathologic fracture of the mandible. Here, we present a case of 59-year-old man who suffered a pathologic mandible fracture related to biting hard foods, such as crab shells, after a sinus bone lifting with ramal bone graft procedure performed 2 weeks prior. He underwent closed reduction by intermaxillary fixation with an arch bar over the course of 4 weeks. Three months later, the patients had a stable occlusion with normal mouth opening and sensation. To prevent this complication, the osteotomy should be performed in such a way that it is not too vertical during ramal bone harvesting. Furthermore, we wish to emphasize the importance of patients being instructed to avoid chewing hard foods for at least 4 weeks after ramal bone harvesting.
authors: Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
authors: Ik Jae
authors: IJ
authors: Kwon
authors: Seoul Dental Clinic, Ansan, Korea.
authors: Byung Ho
authors: BH
authors: Lee
authors: Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
authors: Mi Young
authors: MY
authors: Eo
authors: Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea. smin5@snu.ac.kr.
authors: Soung Min
authors: SM
authors: Kim
authors: Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
authors: Jong Ho
authors: JH
authors: Lee
authors: Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea.
authors: Suk Keun
authors: SK
authors: Lee
mesh_terms: D000818:Animals; D016025:Bone Transplantation; D003386:Brachyura; D003766:Dental Occlusion; D005247:Feeding Behavior; D006801:Humans; D008297:Male; D008334:Mandible; D008337:Mandibular Fractures / Q000209:etiology*; D008875:Middle Aged
keywords: closed reduction; crab shell; mandibular angle fracture; pathologic fracture; ramal bone graft