case_images: PMC10901576_01
case_images: (a) CBCT horizontal view: facial skull with comminuted fracture in the mandible. (b) CBCT vertical view: facial skull with comminuted fracture in the mandible. (c) Buccal view of the clinical situation 12 years after comminuted fracture. (d) Lingual view of the clinical situation 12 years after comminuted fracture.
case_images: CRID2024-1824016.002.jpg
case_images: PMC10901576_01_CRID2024-1824016.002.jpg
case_images: fig2
case_images: Radiological examination shows a comminuted fracture in the mandible with clear dislocation at several levels, fractured teeth in the anterior region from region 33 to 43 (FDI tooth-numbering system) (Figures 2(a) and 2(b)), and dislocation of the lingual cortices in region 43-47 into the floor of the mouth. No pathological symptoms or patient satisfaction issues were identified even after 12 years (Figures 2(c) and 2(d)).
case_images: (a) OPT: postoperative treatment of the comminuted fracture with two osteosynthesis plates and two lag screws. (b) OPT: postoperative restoration of the switching gap with an adhesive bridge. (c) OPT: removal of an osteosynthesis plate at 10 months after the accident. (d) OPT: insertion of three Ankylos  implants with the dimensions 3.5 x 14 mm. (e) OPT: after inserting the three Ankylos  implants, the switching gap was closed again with an adhesive bridge. (f) OPT: definitive restoration of the implants with a metal-ceramic bridge in the anterior part of the mandible.
case_images: CRID2024-1824016.003.jpg
case_images: PMC10901576_01_CRID2024-1824016.003.jpg
case_images: fig3
case_images: Schweiz) were adjusted and fixed with screws. Marginal bone segments were reduced and fixed to the reconstruction plate with screws. Small or nonmarginal bone segments were reduced and fixed to each other. Soft tissue was attached to the periosteum and sutured with Propylene  4.0 (Ethicon, Raritan, New Jersey, USA) (Figure 3(a)). The postoperative course was free of complications, and the edentulous space was closed with an adhesive bridge (Figure 3(b)). Therefore, the lower plate had to remain in place (Figure 3(c)), and in addition, bone loss was observed in the vertical and horizontal dimensions, which was sought to be restored. Ankylos  implants (Dentsply Sirona, Bensheim, Germany) 3.5 x 14 mm could be placed without any problems as there was sufficient bone thickness in the working site. All implants were primarily stable, but in this case, closed healing was chosen to avoid an unnecessary risk for the augmentation (Figure 3(d)). Over the next six months, the patient continued to use the adhesive bridge (Figure 3(e)).