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Fractures: Bone Repair

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...

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Atrophic Jaws With Infected Third Molars: The Role of Prophylactic Internal Fixation.

Gabriel C Brito¹, Maria J A V Calori, Luciana Asprino

¹Division of Oral and Maxillofacial Surgery, Universidade Estadual de Campinas, São Paulo, Brazil.

The Journal of Craniofacial Surgery

|November 24, 2025

Summary

This study shows that prophylactic osteosynthesis is a safe and effective surgical technique for elderly patients with impacted mandibular third molars in atrophic mandibles, preventing fractures.

Keywords:

Atrophic mandible mandibular fracture odontogenic infection prophylactic fixation third molar

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Area of Science:

Oral and Maxillofacial Surgery
Dental Implantology
Geriatric Dentistry

Background:

Elderly edentulous patients present unique challenges for managing impacted mandibular third molars.
Severely atrophic mandibles increase the risk of pathologic fracture during surgical extraction.

Purpose of the Study:

To present a surgical management strategy for infected, impacted mandibular third molars in elderly patients with severely atrophic mandibles.
To evaluate the efficacy and safety of prophylactic internal fixation to prevent fractures.

Main Methods:

Two cases of elderly edentulous patients with infected, impacted mandibular third molars were surgically treated.
Management included tooth extraction and prophylactic internal fixation (osteosynthesis) using an intraoral approach.
3D planning and stereolithographic models were utilized for enhanced surgical precision.

Main Results:

Both patients experienced favorable outcomes with no postoperative complications.
The prophylactic osteosynthesis technique successfully prevented pathologic fractures.
The intraoral approach minimized patient morbidity.

Conclusions:

Prophylactic osteosynthesis is a safe and effective technique for high-risk patients requiring third molar removal from atrophic mandibles.
Combining the intraoral approach with 3D planning improves surgical precision and reduces complications.