Spontaneous fracture of an atrophic endentulous mandible treated without fixation.

The positive clinical decision to treat a spontaneously fractured edentulous mandible passively depends on a careful evaluation of local and general factors pertaining. These include: (1) Preferably simple fractures with minimal displacement and an intact periosteal sheath. (2) Elderly and infirm patients and others in whom surgery is contra-indicated. (3) Case in which discomfort and inconvenience with fixation is likely to be worse than without, bearing in mind that fixation does not guarantee firm bony union and that many patients wear dentures and masticate successfully in the presence of complete failure of fragments to unite. It must be stressed that it is not suggested that this line of treatment be followed routinely, but that is is valid in certain selected cases.