Aspectos atuais acerca do tratamento das fraturas em mandíbulas atróficas: relato de uma série de casos e revisão de literatura

Abstract

The atrophy process of the mandible is characterized by the progressive loss of alveolar and basal cortical bone, the continuous bone loss modifies biomechanics of the mandible and makes the mandibular bone more susceptible to fractures. The objective of this work is to study a series of three cases of fractures in atrophhic mandibles, treated by means of open reduction, rigid fixation and primary bone graft. In the first case, a male patient, 62 years old, victim of a fall from his own height and evolving with fractures in the regions of the parasymphysis and left mandibular ramus. The treatment applied was based on the adaptation of 2.0mm locking system plate in the parasymphysis fracture and an X plate in the angle. The second case, a male patient, 66 years old, victim of car accident, envolving with fractures in the middle and lower thirds. In the mandible, the patient presented a bilateral mandibular body fracture of the “bucket handle” type, which was treated using rigid fixation and 2.0mm system plates, with subsequent failure and requiring a second surgical procedure, where faixation was performed with reconstruction plates. Of the 2.4mm locking system and autogenous bone graft. In the third case, a male patient, 47 years old, victim of a motorcycle accident, envolving with fractures in the three facial thirds, in the mandible, affecting the symphysis region. The approach chosen was rigid fixation in two points, through a 2.0mm locking system plate in the alveolar region and another 2.0 plate in the mandibular edge. I is concluded that the use of reconstuction plates for thhe treatment of atrophic mandibles is the most effective approach and that the use of primary bone graft depends on the patient’s condition and the factores inherent to the fractures.