A multicentric prospective analysis of the management of edentulous jaw fractures in the elderly population: a World Oral Maxillofacial Trauma (WORMAT) project

Purpose Data on edentulous jaw fractures in elderly patients are limited, particularly for maxillary injuries. This prospective multicentre observational study aimed to evaluate the characteristics, management, and outcomes of edentulous maxillary and mandibular fractures in elderly patients. Methods Patients aged ≥ 60 years with edentulous maxillary and/or mandibular fractures admitted to 17 centres participating in the World Oral and Maxillofacial Trauma (WORMAT) project between March 2024 and March 2025 were prospectively enrolled. The following data were collected: age, sex, cause, fracture site and type, grade of bone atrophy, Facial Injury Severity Scale (FISS), associated injuries, surgical approach, type of treatment, use of a bone graft, length of hospitalisation. Clinical outcomes were assessed at 6 weeks and 3 months. Results Among 364 elderly patients with maxillofacial trauma, 93 (25.5%) were edentulous and 69 sustained jaw fractures. Falls were the most common mechanism of injury. Maxillary fractures mainly involved the zygomaticomaxillary complex and were frequently managed conservatively, whereas mandibular fractures predominantly affected the body and symphysis/parasymphysis and were treated with open reduction and internal fixation in 89% of cases, usually with rigid fixation. Fracture site displacement was statistically associated with ORIF, both for maxillary ( p = 0.010) and mandibular fractures ( p = 0.026). Complications were mainly plate exposure in three patients with mandibular fractures. Conclusion Edentulous jaw fractures in the elderly are rare and typically result from low-energy trauma. Displaced fractures, especially of the atrophic mandible, are mainly managed surgically, with a clear tendency to employ rigid fixation.