An unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: Case report

Fractures of severely atrophic (height < 10 mm) edentulous mandibles are infrequent and challenging to manage. Factors such as sclerotic bone and decreased vascularity combined with systemic diseases complicate the management of such fractures. Osteogenesis imperfecta (OI) is a heterogeneous grou...

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Main Authors: Abdulrahman Al-Osaimi, Mahmood Samman, Mohammad Al-Shakhs, Faisal Al-Suhaim, Sundar Ramalingam
Format: Article
Language:English
Published: Elsevier 2014-04-01
Series:Saudi Dental Journal
Online Access:http://www.sciencedirect.com/science/article/pii/S1013905214000157
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spelling doaj-78c8002eb5954307b360efe182784baf2020-11-25T01:14:57ZengElsevierSaudi Dental Journal1013-90522014-04-012626873An unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: Case reportAbdulrahman Al-Osaimi0Mahmood Samman1Mohammad Al-Shakhs2Faisal Al-Suhaim3Sundar Ramalingam4Department of Oral and Maxillofacial Surgery, King Saud Medical Complex, Riyadh, Saudi ArabiaDepartment of Oral and Maxillofacial Surgery, King Fahd Hospital, Al Madinah, Saudi ArabiaDepartment of Oral and Maxillofacial Surgery, King Saud Medical Complex, Riyadh, Saudi ArabiaDepartment of Oral and Maxillofacial Surgery, King Saud Medical Complex, Riyadh, Saudi ArabiaDepartment of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia; Corresponding author. Address: Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia. Tel.: +966 532092386.Fractures of severely atrophic (height < 10 mm) edentulous mandibles are infrequent and challenging to manage. Factors such as sclerotic bone and decreased vascularity combined with systemic diseases complicate the management of such fractures. Osteogenesis imperfecta (OI) is a heterogeneous group of inherited disorders of type I collagen metabolism. Patients with OI characteristically present with histories of long bone fractures, deformities, blue sclerae, and opalescent dentin. However, fractures of the facial skeleton are rare. Bisphosphonate therapy has been proven to effectively reduce the fracture risk in patients with OI. The purpose of this clinical report is to present an unusual case of spontaneous fracture of the atrophic mandible in a patient with OI. Despite open reduction and internal fixation (ORIF) with miniplate osteosynthesis, the patient developed a second fracture at a screw placement site distal to the first fracture. The patient was successfully treated with ORIF using locking reconstruction plates fixed in the symphyseal and angle regions. Bone healing following ORIF was normal, and no clinical sign of osteonecrosis as a result of bisphosphonate therapy was observed. Patients with OI can present with spontaneous fractures of already weakened mandibles. Although such fractures can be managed with care using established protocols, further research is required to examine the effects of concomitant medication, such as bisphosphonates. Keywords: Atrophic mandible, Mandible fracture, Osteogenesis imperfecta, Bisphosphonateshttp://www.sciencedirect.com/science/article/pii/S1013905214000157
collection DOAJ
language English
format Article
sources DOAJ
author Abdulrahman Al-Osaimi
Mahmood Samman
Mohammad Al-Shakhs
Faisal Al-Suhaim
Sundar Ramalingam
spellingShingle Abdulrahman Al-Osaimi
Mahmood Samman
Mohammad Al-Shakhs
Faisal Al-Suhaim
Sundar Ramalingam
An unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: Case report
Saudi Dental Journal
author_facet Abdulrahman Al-Osaimi
Mahmood Samman
Mohammad Al-Shakhs
Faisal Al-Suhaim
Sundar Ramalingam
author_sort Abdulrahman Al-Osaimi
title An unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: Case report
title_short An unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: Case report
title_full An unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: Case report
title_fullStr An unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: Case report
title_full_unstemmed An unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: Case report
title_sort unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: case report
publisher Elsevier
series Saudi Dental Journal
issn 1013-9052
publishDate 2014-04-01
description Fractures of severely atrophic (height < 10 mm) edentulous mandibles are infrequent and challenging to manage. Factors such as sclerotic bone and decreased vascularity combined with systemic diseases complicate the management of such fractures. Osteogenesis imperfecta (OI) is a heterogeneous group of inherited disorders of type I collagen metabolism. Patients with OI characteristically present with histories of long bone fractures, deformities, blue sclerae, and opalescent dentin. However, fractures of the facial skeleton are rare. Bisphosphonate therapy has been proven to effectively reduce the fracture risk in patients with OI. The purpose of this clinical report is to present an unusual case of spontaneous fracture of the atrophic mandible in a patient with OI. Despite open reduction and internal fixation (ORIF) with miniplate osteosynthesis, the patient developed a second fracture at a screw placement site distal to the first fracture. The patient was successfully treated with ORIF using locking reconstruction plates fixed in the symphyseal and angle regions. Bone healing following ORIF was normal, and no clinical sign of osteonecrosis as a result of bisphosphonate therapy was observed. Patients with OI can present with spontaneous fractures of already weakened mandibles. Although such fractures can be managed with care using established protocols, further research is required to examine the effects of concomitant medication, such as bisphosphonates. Keywords: Atrophic mandible, Mandible fracture, Osteogenesis imperfecta, Bisphosphonates
url http://www.sciencedirect.com/science/article/pii/S1013905214000157
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