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

This study presents 2 cases of elderly edentulous patients with infected, impacted mandibular third molars in severely atrophic mandibles. Both cases were managed surgically with tooth extraction and prophylactic internal fixation to prevent pathologic fracture. The first case involved a 62-year-old woman with a class III atrophic mandible and chronic infection. Surgical treatment included intraoral drainage, odontossection, extraction, and placement of a 2.4 mm osteosynthesis plate aided by a stereolithographic model. The second case, a 70-year-old woman with facial cellulitis, was treated initially with drainage and antibiotics, followed by delayed extraction and internal fixation using the intraoral approach. Both cases had favorable outcomes without postoperative complications. Prophylactic osteosynthesis is a safe and effective technique in high-risk cases involving atrophic mandibles and the need for third molar removal. The intraoral approach, combined with 3D planning, enhances surgical precision and minimizes morbidity.