Background and objectives: Incidence of atrophic edentulous mandibular fractures is less than 1% of facial fractures. The fixation system may be the only way to enhance the outcome of treatment. The purpose of this study was to compare the outcomes of different plating system used for stabilization.

Methods: Our sample included 23 patients treated for fractures of completely edentulous atrophic mandibles between 2004 and 2013. All patients had a panoramic X-rays and computed tomographic scans that allowed us to evaluate the class of atrophy according to the Luhr’s classification. 12 patients underwent open reduction and internal rigid fixation using 2.0 mm large profile locking bone plates, 11 patients were treated by 2.4 mm locking plates. Postoperative follow up was managed by clinical and radiographic revaluations.

Results: Both patient groups achieved a complete fracture healing represented by clinical and radiographic union of fractured fragments.

Conclusions: 2.0 mm large locking plate is thinner, less likely to expose through soft tissue, easier to adapt to the mandibular anatomy than 2.4 mm locking plate. However, according to the principle of load bearing fixation, 2.4 mm locking plate system still represents the reference hardware in severe mandibular atrophy.

Key words: mandible; atrophy; fractures; plate system; edentulous