Repair of complicated mandibular defects.

In most instances, the injured mandible can be successfully repaired with arch bars and intermaxillary fixation. However, it is important to identify certain potential problem situations early and apply special techniques for their treatment. Potential management problems, such as the non-compliant patient, the edentulous patient, gunshot wounds, radiated mandibles, tumors, and osteomyelitis, are reviewed. The use of special techniques, eg, the dynamic compression plate, the Morris biphase apparatus, the cobalt-chromium alloy (Vitallium) basket, a suction-irrigation apparatus, and the mandibular reconstruction plate, are described to show how they may be effectively applied to these special situations. With early recognition of these management problems and proper application of these more sophisticated techniques, the quality of care for patients, with mandibular injuries can be enhanced.