Implants in atrophic mandible: potential fracture complication?

I am a general dentist just beginning to place implants.  My patient was planned for a mandibular implant retained overdenture. Recently, I placed 4 regular implants (3.6mm X 10mm) on the atrophic mandible and realized the implants looked rather deep. I have read that mandibular fractures are a potential complication in such cases.  However, if this does not occur during the surgery, will it occur in the future? Do you recommend any treatment? When should I load these implants? Would deeply appreciate if I can get some comments on this case please. Thank you

10 thoughts on “Implants in atrophic mandible: potential fracture complication?

  1. Gregori M Kurtzman DDS says:

    If mandibular fracture is going to occur it will be in the premolar area since this is the thinnest portion of the resorbed mandible. Since this patient lower will oppose a full denture I would not worry about fracture related to normal function where it could happen is in trauma to the mandible with a fall or such. But even without the implants that can happen.

    I would wait 3 months from placement to restore. Will this be fixed or a bar overdenture?

  2. Dr. Gerald Rudick says:

    I have placed implants in lower jaws a lot more fragile than what you are showing….. with no fractures over many years….what concerns me in this case is the radiolucency that appears around the most central of the implants…perhaps a Cone Beat CT scan can give more information.
    In any case, I would advice the patient to give up boxing or mixed martial arts…not a good idea for this patient.

    • Ban says:

      The pre op radiograph does not have the radiolucency as noted. I am guessing it might be an artefact.. Patient is too old for martial arts! 😉

  3. Mwjohnson dds, ms says:

    I would not consider this a resorbed mandible. This is a normal edentulous ridge. I agree with the above comment about the radiolucency. Also, what’s your over denture plan? Why do 4 for an over denture? Making a bar and clip? Only need two implants for locators. If you’re only planning locators then the patient overspent on the surgery. Make sure you have a firm restorative plan before ever placing the implants.

    • Ban says:

      I am planning for a mini ball attachment over denture. I have read up online and most surgeons recommend placing 4 implants for better retention AND stability. Many liken the number of implants to the legs of a chair, ie 4 legs will be more stable than 2. Also, having 4 implants will allow patient to have enough “backup” if any fails. As I am only a novice in this field, I have made concessions in the cost so patient is paying only slightly more than cost price for the implants… Please correct me if i am wrong.. Thank you for your comments!

  4. David Dinoni says:

    I agree with previous comments. More, the bone in lateral mandible will increase in quality, and quantity, thanks to function. Your mandible will soon be stronger than before treatment.

  5. Dr. Bob says:

    Should work well. In the early years of implants placement to the inferior cortical bone in the anterior mandible was common and was even suggested.

    Have you taken a course for mini implants? The one piece “O” ring implants sized 2mm – 3mm diameter would have worked very well in this case and most likely could have been loaded into immediate function with soft liner or “O” rings.

    If you decide to use a mini implant take a course first. The surgical protocol is not the same as for the larger implants.

  6. Dr Uttom shet says:

    Did you hear about transmandibular implant? where the lower cortical bone engage as well to get support. your case is perfect for the overdenture or Bar supported denture. Don’t worry about fracture until you have harmed to the buccal or lingual plate.

Leave a Comment:

Comment Guidelines: Be Yourself. Be Respectful. Add Value. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

Posted in Clinical Cases, Surgical.
Bookmark Implants in atrophic mandible: potential fracture complication?

Videos to Watch:

Dental Implant for Lower Right Second Molar

This video shows implant placement on the lower right second molar.[...]

Watch Now!
Saving a Bridge with Periodontal Therapy

This video shows a case involving a 48-year-old male who was referred for periodontal treatment[...]

Watch Now!
Immediate Loading Full Arch

This video shows a case of Immediate loading of a full arch with simultaneous guided[...]

Watch Now!
Apically Repositioned Flap Technique Around Implants

The apically positioned flap is a commonly used surgical approach, that may help the long[...]

Watch Now!
Digitally Planned Bone Augmentation and Immediate Implantation

This video shows a case using the Ring technique to provide bone augmentation along with[...]

Watch Now!
AnyRidge Implants: Replacement of Upper Left Molars

This video shows the replacement of maxillary upper left molars with Megagen AnyRidge Implants.[...]

1 Comment

Watch Now!
Guided Implant Surgery & Immediate Temporisation

This video demonstrates the placement of a missing pre-molar using computer-guided surgery and immediate temporization.[...]

1 Comment

Watch Now!
Implantoplasty to Treat Peri-implantitis

This video shows the use of the Implantoplasty technique to treat peri-implantits. Granulation tissue and[...]


Watch Now!
Placement of Implant Using EZ Devices

This video demonstrates the placement of a dental implant in the upper jaw using the[...]

Watch Now!
BonePen: Improve Positioning of Implants

A short video demonstrating close up the use of the BonePen Kit, a set of[...]

Watch Now!
Vertical and Horizontal Bone Augmentation with Khoury Bone Plates

This video shows a way to utilize thin autogenous bone plates to create stunning bone.[...]


Watch Now!
Maxgraft bonering: immediate implant placement

This video shows a live surgery using the maxgraft bonering, which is a pre-fabricated[...]

1 Comment

Watch Now!