Download PDF
OP-Journal 2017; 33(03): 281-305
DOI: 10.1055/s-0043-118526
Fachwissen
Georg Thieme Verlag KG Stuttgart · New York

Alterstraumatologie im Gesichtsschädelbereich

Carl-Peter Cornelius
,
Gerson Mast
,
Philipp Goetz
,
Michael Ehrenfeld
,
Marc-Christian Metzger
,
Florian Andreas Probst
Further Information

Publication History

Publication Date:
17 January 2018 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

CMF-Traumen im Alter 65+ sind durch besondere Merkmale gekennzeichnet: Lokalisation und Frakturmuster, Stand des Involutionsprozesses mit Abnahme von Knochenquantität und -qualität, Begleitverletzungen, altersassoziierte physische und psychische Funktionseinbußen und präexistente Komorbiditäten. Der Stand des Wissens und aktuelle bevölkerungsbezogene Daten dieser Variablen werden zu Anfang dieser Übersicht dargestellt. Vor diesem Hintergrund wird dann zu den verschiedenen Frakturen und Frakturtypen in den einzelnen Regionen des Gesichtsschädelskeletts Stellung genommen und die Indikation zu einem konservativen oder operativen Prozedere in den Alterspopulationen diskutiert. Spezielle Aufmerksamkeit kommt dabei Fraktursituationen bei Zahnlosigkeit und Atrophie im Ober- und/oder Unterkiefer zu. Innerhalb des weitgesteckten Gesamtspektrums der Frakturszenarien haben schonende, situationsadaptierte, ggf. auch unkonventinelle Lösungen Priorität vor Standardtherapieverfahren. Neue Techniken wie computerassistierte Chirurgie und patientenspezifische Implantate spielen eine immer größere Rolle und werden an Einzelbeispielen demonstriert. Betont werden muss, dass die physischen Reserven und nötigenfalls die geriatrietypische Multimorbidität jedes Patienten individuell einzuschätzen ist und vorrangige Bedeutung vor dem kalendarischen Lebensalter hat.

Abstract

Craniomaxillofacial trauma at advanced age (65+) is characterized by particular features: fracture location and pattern, state of the involution process in terms of bone mass and quality, concomitant injuries, age associated functional deficits and preexisting comorbidities. The available knowledge and the current population-based data of these variables are outlined at the beginning of this review. This provides the background information to consider the varying fracture and fracture types in the specific regions of the facial skeleton in order to discuss the differential indications for conservative or operative treatment in the elderly aging stages. Special attention is given to fracture conditions in the edentulous atrophic maxilla and/or mandible. Within the abundant diversity of fracture scenarios delicate treatment solutions, adapted to the medical condition and unconventional, where applicable, are prioritized over standardized therapeutic procedures. New techniques such as computer assisted surgery and patient-specific implants play a growing role and will be exemplified in selected case reports. Finally it cannot be overemphasized that the physical capacities up to geriatric multimorbidity of a patient are of primary importance above the calender age.

 

  • Literatur

  • 1 Almasri M, El-Hakim M. Fracture of the anterior segment of the atrophic mandible related to dental implants. Internat J Oral Maxillofac Surg 2012; 41: 646-649
    PubMedGoogle Scholar
  • 2 Al-Qamachi LH, Laverick S, Jones DC. A clinico-demographic analysis of maxillofacial trauma in the elderly. Gerodontology 2012; 29: e147-e149
    CrossrefPubMedGoogle Scholar
  • 3 Andrades P, Hernandez D, Falguera MI. et al. Degrees of tolerance in post-traumatic orbital volume correction: the role of prefabricated mesh. J Oral Maxillofac Surg 2009; 67: 2404-2411
    CrossrefPubMedGoogle Scholar
  • 4 Arangio P, Leonardi A, Torre U. et al. Management of facial trauma in patients older than 75 years. J Craniofac Surg 2012; 23: 1690-1692
    CrossrefPubMedGoogle Scholar
  • 5 Atisha DM, Burr T, Allori AC. et al. Facial fractures in the aging population. Plast Reconstr Surg 2016; 137: 587-593
    CrossrefPubMedGoogle Scholar
  • 6 Ayali A, Bilginaylar K. Evaluating the biomechanical effects of implant diameter in case of facial trauma to an edentulous atrophic mandible: a 3D finite element analysis. Head Face Med 2017; 13: 5
    CrossrefPubMedGoogle Scholar
  • 7 Benech A, Nicolotti M, Brucoli M. et al. Intraoral extra-mucosal fixation of fractures in the atrophic edentulous mandible. Int J Oral Maxillofac Surg 2013; 42: 460-463
    CrossrefPubMedGoogle Scholar
  • 8 Berg BI, Juergens P, Soerensen Y. et al. Traumatology of the facial skeleton in octogenarian patients: a retrospective analysis of 96 cases. J Craniomaxillofac Surg 2014; 42: 870-873
    CrossrefPubMedGoogle Scholar
  • 9 Blume O, Seper L, Meyer U. et al. Experimentelle und klinische Studie zur Stabilität einer Osteosyntheseplatte für den atrophen Unterkiefer. Mund Kiefer Gesichtschir 2003; 7: 323-329
    CrossrefPubMedGoogle Scholar
  • 10 Bobian M, El-Kashlan N, Hanba CJ. et al. Traumatic facial injuries among elderly nursing home residents: never event or frequent occurrence?. JAMA Otolaryngol Head Neck Surg 2017; 143: 569-573
    CrossrefPubMedGoogle Scholar
  • 11 Borumandi F, Hammer B, Noser H. et al. Classification of orbital morphology for decompression surgery in Gravesʼ orbitopathy: two-dimensional versus three-dimensional orbital parameters. Br J Ophthalmol 2013; 97: 659-662
    CrossrefPubMedGoogle Scholar
  • 12 Bosbach G, Korff JJ. Die Zahlentrickser. Das Märchen von den aussterbenden Deutschen und andere Statistiklügen. München: Wilhelm Heyne; 2017
    Google Scholar
  • 13 Burnstine MA. Clinical recommendations for repair of orbital facial fractures. Curr Opin Ophthalmol 2003; 14: 236-240
    CrossrefPubMedGoogle Scholar
  • 14 Burnstine MA. Clinical recommendations for repair of isolated orbital floor fractures: an evidence-based analysis. Ophthalmology 2002; 109: 1207-1210
    CrossrefPubMedGoogle Scholar
  • 15 Carter TG, Brar PS, Tolas A. et al. Off-label use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for reconstruction of mandibular bone defects in humans. J Oral Maxillofac Surg 2008; 66: 1417-1425
    CrossrefPubMedGoogle Scholar
  • 16 Chaudhary Z, Sharma R, Krishnan S. Maxillo mandibular fixation in edentulous scenarios: combined MMF screws and gunning splints. J Maxillofac Oral Surg 2014; 13: 213-214
    CrossrefPubMedGoogle Scholar
  • 17 Cillo jr. JE, Holmes TM. Interpersonal violence i associated with increased severity of geriatric facial trauma. J Maxillofac Oral Surg 2016; 74: 1023.e1-7
    CrossrefPubMedGoogle Scholar
  • 18 Clavijo-Alvarez JA, Deleyiannis FW, Peitzman AB. et al. Risk factors for death in elderly patients with facial fractures secondary to falls. J Craniofac Surg 2012; 23: 494-498
    CrossrefPubMedGoogle Scholar
  • 19 Clayman L, Rossi E. Fixation of atrophic edentulous mandible fractures by bone plating at the inferior border. J Oral Maxillofac Surg 2012; 70: 883-889
    CrossrefPubMedGoogle Scholar
  • 20 Cohen O, Warman M, Fried M. et al. Volumetric analysis of the maxillary, sphenoid and frontal sinuses: a comparative computerized tomography based study. Auris Nasus Larynx 2017; DOI: 10.1016/j.anl.2017.03.003.
    CrossrefPubMedGoogle Scholar
  • 21 Cooter RD, Dunaway DJ, David DJ. The influence of maxillary dentures on mid-facial fracture patterns. Brit J Plast Surg 1996; 49: 379-382
    CrossrefPubMedGoogle Scholar
  • 22 Cornelius CP, Audigé L, Kunz C. et al. Die neue AO-CMF-Traumaklassifikation für Erwachsene: Überblick, Präzisions-Level und anatomische Module für Unterkiefer, Kiefergelenkfortsätze, Mittelgesicht und Orbita. OP-JOURNAL 2013; 29: 109-129
    PubMedGoogle Scholar
  • 23 Cornelius CP, Audigé L, Kunz C. et al. The comprehensive AOCMF classification system: mandible fractures – Level 3 Tutorial. Craniomaxillofac Trauma Reconstr 2014; 7 (Suppl. 01) S031-S043
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Cornelius CP, Audigé L, Kunz C. et al. The comprehensive AO Classification System for fractures of the craniomaxillofaxial skeleton: Midface fractures Level 3. Craniomaxillofac Trauma Reconstr 2014; 7 (Suppl. 01) S068-S091
    CrossrefPubMedGoogle Scholar
  • 25 Cornelius CP, Probst FA, Rathgeber JPC. et al. Zur Osteosynthese bei Frakturen im zahnlosen atrophen Unterkiefer – Möglichkeiten zum Hardware Downsizing, Lingual Plating. OP-JOURNAL 2013; 29: 164-174
    PubMedGoogle Scholar
  • 26 Crawley WA, Azman P, Clark N. et al. The edentulous Le Fort fracture. J Craniofacial Surg 1997; 8: 298-307
    CrossrefPubMedGoogle Scholar
  • 27 Darcy SJ, Miller TA, Goldberg RA. et al. Magnetic resonance imaging characterization of orbital changes with age and associated contributions to lower eyelid prominence. Plast Reconstr Surg 2008; 122: 921-929
    CrossrefPubMedGoogle Scholar
  • 28 Eckelt U, Schneider M, Erasmus F. et al. Open versus closed treatment of fractures of the mandibular condylar process – a prospective randomized multi-centre study. J Cranio Maxillofac Surg 2006; 34: 306-314
    CrossrefPubMedGoogle Scholar
  • 29 Ellis 3rd E, Price C. Treatment protocol for fractures of the atrophic mandible. J Oral Maxillofac 2008; 66: 421-435
    CrossrefPubMedGoogle Scholar
  • 30 Ellis 3rd E, Throckmorton GS, Palmieri C. Open treatment of condylar process fractures: assessment of adequacy of repositioning and maintenance of stability. J Oral Maxillofac 2000; 58: 27-34
    PubMedGoogle Scholar
  • 31 Franciosi E, Mazzaro E, Larranaga J. et al. Treatment of edentulous mandibular fractures with rigid internal fixation: case series and literature review. Craniomaxillofac Trauma Reconstr 2014; 7: 35-42
    CrossrefPubMedGoogle Scholar
  • 32 Gehrke G, Eckelt U. Management älterer Patienten. MKG-Chirurg 2017; 10: 153-161
    PubMedGoogle Scholar
  • 33 Gehrke G. Altersmedizin in der MKG-Chirurgie. MKG-Chirurg 2015; 8: 7
    PubMedGoogle Scholar
  • 34 Gehrke G, Arokiasamy T. Zahnärztlich-chirurgische Behandlung älterer Menschen. MKG-Chirurg 2015; 8: 8-13
    PubMedGoogle Scholar
  • 35 Gerbino G, Roccia F, De Gioanni PP. et al. Maxillofacial trauma in the elderly. J Oral Maxillofac Surg 1999; 57: 777-782
    CrossrefPubMedGoogle Scholar
  • 36 Gerhards F, Kuffner HD, Wagner W. Pathological fractures of the mandible. A review of the etiology and treatment. Int J Oral Maxillofac Surg 1998; 27: 186-190
    CrossrefPubMedGoogle Scholar
  • 37 Gray E, Dierks E, Homer L. et al. Survey of trauma patients requiring maxillofacial intervention, ages 56 to 91 years, with length of stay analysis. J Oral Maxillofac Surg 2002; 60: 1114-1125
    CrossrefPubMedGoogle Scholar
  • 38 Hachleitner J, Enzinger S, Brandtner C. et al. The role of the titanium functionally dynamic bridging plate for the treatment of the atrophic mandible fractures. J Craniomaxillofac Surg 2014; 42: 438-442
    CrossrefPubMedGoogle Scholar
  • 39 Hanba C, Gupta A, Svider PF. et al. Forgetful but not forgotten: bathroom-related craniofacial trauma among the elderly. Laryngoscope 2017; 127: 820-827
    CrossrefPubMedGoogle Scholar
  • 40 Herford AS, Boyne PJ. Reconstruction of mandibular continuity defects with bone morphogenetic protein-2 (rhBMP-2). J Oral Maxillofac Surg 2008; 66: 616-624
    CrossrefPubMedGoogle Scholar
  • 41 Iida S, Hassfeld S, Reuther T. et al. Maxillofacial fractures resulting from falls. J Cranio Maxillofac Surg 2003; 31: 278-283
    CrossrefPubMedGoogle Scholar
  • 42 Imholz B, Combescure C, Scolozzi P. Is age of the patient an independent predictor influencing the management of cranio-maxillo-facial trauma? A retrospective study of 308 patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117: 690-696
    CrossrefPubMedGoogle Scholar
  • 43 Jordan AR, Micheelis W. Institut der Deutschen Zahnärzte (IDZ). Hrsg. Fünfte Deutsche Mundgesundheitsstudie (DMS V). Köln: Deutscher Ärzteverlag; 2016
    Google Scholar
  • 44 Jun BC, Song SW, Park CS. et al. The analysis of maxillary sinus aeration according to aging process; volume assessment by 3-dimensional reconstruction by high-resolutional CT scanning. Otolaryngol Head Neck Surg 2005; 132: 429-434
    CrossrefPubMedGoogle Scholar
  • 45 Kahn DM, Shaw jr. RB. Aging of the bony orbit: a three-dimensional computed tomographic study. Aesthetic Surg Journal 2008; 28: 258-264
    PubMedGoogle Scholar
  • 46 Kamer L, Noser H, Schramm A. et al. Orbital form analysis: problems with design and positioning of precontoured orbital implants: a serial study using post-processed clinical CT data in unaffected orbits. Int J Oral Maxillofac Surg 2010; 39: 666-672
    CrossrefPubMedGoogle Scholar
  • 47 Kamer L, Noser H, Schramm A. et al. Anatomy based surgical concepts for individualized orbital decompression surgery in graves orbitopathy. I. Orbital size and geometry. Ophthal Plast Reconstr Surg 2010; 26: 348-352
    CrossrefPubMedGoogle Scholar
  • 48 Kim YJ, Ahn S, Seo DW. et al. Patterns and injuries associated with orbital wall fractures in elderly patients who visited the emergency room: a retrospective case-control study. BMJ Open 2016; 6: e011110
    CrossrefPubMedGoogle Scholar
  • 49 Kloss FR, Tuli T, Hachl O. et al. The impact of ageing on cranio-maxillofacial trauma-a comparative investigation. Int J Oral Maxillofac Surg 2007; 36: 1158-1163
    CrossrefPubMedGoogle Scholar
  • 50 Kloss FR, Gassner R. Bone and aging: effects on the maxillofacial skeleton. Experimental Gerontol 2006; 41: 123-129
    PubMedGoogle Scholar
  • 51 Kokemueller H, Zizelmann C, Tavassol F. et al. A comprehensive approach to objective quantification of orbital dimensions. J Oral Maxillofac Surg 2008; 66: 401-407
    CrossrefPubMedGoogle Scholar
  • 52 Kunz C, Sigron GR, Jaquiery C. Functional outcome after non-surgical management of orbital fractures–the bias of decision-making according to size of defect: critical review of 48 patients. Brit J Oral Maxillofac Surg 2013; 51: 486-492
    CrossrefPubMedGoogle Scholar
  • 53 Kunz C, Hammer B, Prein J. Frakturen des zahnlosen atrophischen Unterkiefers. Frakturversorgung und Komplikationen. Mund Kiefer Gesichtschir 2001; 5: 227-232
    CrossrefPubMedGoogle Scholar
  • 54 Kunze S. Altern wie ein Gentleman – Zwischen Müßiggang und Engagement. München: C. Bertelsmann; 2011
    Google Scholar
  • 55 Luhr HG, Reidick T, Merten HA. Frakturen des atrophischen Unterkiefers – eine Herausforderung für die Therapie. Fortschr Kiefer Gesichtschir 1996; 41: 151-154
    PubMedGoogle Scholar
  • 56 Madsen MJ, Haug RH. A biomechanical comparison of 2 techniques for reconstructing atrophic edentulous mandible fractures. J Oral Maxillofac Surg 2006; 64: 457-465
    CrossrefPubMedGoogle Scholar
  • 57 Madsen MJ, Haug RH, Christensen BS. et al. Management of atrophic mandible fractures. Oral Maxillofac Surg Clin North Am 2009; 21: 175-183
    CrossrefPubMedGoogle Scholar
  • 58 Mannelli G, Arcuri F, Conti M. et al. The role of bone marrow aspirate cells in the management of atrophic mandibular fractures by mini-invasive surgical approach: single-institution experience. J Craniomaxillofac Surg 2017; 45: 694-703
    CrossrefPubMedGoogle Scholar
  • 59 Mason ME, Triplett RG, Van Sickels JE. et al. Mandibular fractures through endosseous cylinder implants: report of cases and review. J Oral Maxillofac Surg 1990; 48: 311-317
    CrossrefPubMedGoogle Scholar
  • 60 Mendelson B, Wong CH. Anatomy of the aging Face. In: Neligan PC, Warren RJ, Van Beek AL. eds. Plastic Surgery, Volume 2, Aesthetic. 3rd ed.. London, New York, Oxford, St. Louis, Sydney, Toronto: Elsevier Saunders; 2013
    Google Scholar
  • 61 Mendelson B, Wong CH. Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation. Aesthet Plast Surg 2012; 36: 753-760
    CrossrefPubMedGoogle Scholar
  • 62 Mendelson BC, Hartley W, Scott M. et al. Age-related changes of the orbit and midcheek and the implications for facial rejuvenation. Aesthet Plast Surg 2007; 31: 419-423
    CrossrefPubMedGoogle Scholar
  • 63 Metzger MC, Schön R, Tetzlaf R. et al. Topographical CT-data analysis of the human orbital floor. Int J Oral Maxillofac Surg 2007; 36: 45-53
    CrossrefPubMedGoogle Scholar
  • 64 Metzger MC, Schön R, Weyer N. et al. Anatomical 3-dimensional pre-bent titanium implant for orbital floor fractures. Ophthalmology 2006; 113: 1863-1868
    CrossrefPubMedGoogle Scholar
  • 65 Müller S, Burgers R, Ehrenfeld M. et al. Macroplate fixation of fractures of the edentulous atrophic mandible: immediate function and masticatory rehabilitation. Clin Oral Investig 2011; 15: 151-156
    CrossrefPubMedGoogle Scholar
  • 66 Mundinger GS, Bellamy JL, Miller DT. et al. Defining population-specific craniofacial fracture patterns and resource use in geriatric patients: a comparative study of blunt craniofacial fractures in geriatric versus nongeriatric adult patients. Plast Reconstr Surg 2016; 137: 386e-393e
    CrossrefPubMedGoogle Scholar
  • 67 Murphy K, Waa S, Jaffer H. et al. A literature review of findings in physical elder abuse. Can Assoc Radiol J 2013; 64: 10-14
    CrossrefPubMedGoogle Scholar
  • 68 Nagasao T, Hikosaka M, Morotomi T. et al. Analysis of the orbital floor morphology. J Craniomaxillofac Surg 2007; 35: 112-119
    CrossrefPubMedGoogle Scholar
  • 69 Newman L. The role of autogenous primary rib grafts in treating fractures of the atrophic edentulous mandible. Brit J Oral Maxillofac Surg 1995; 33: 381-386
    CrossrefPubMedGoogle Scholar
  • 70 Nogami S, Yamauchi K, Yamashita T. et al. Elderly patients with maxillofacial trauma: study of mandibular condyle fractures. Dent Traumatol 2015; 31: 73-76
    CrossrefPubMedGoogle Scholar
  • 71 Noser H, Hammer B, Kamer L. A method for assessing 3D shape variations of fuzzy regions and its application on human bony orbits. J Digit Imaging 2010; 23: 422-429
    CrossrefPubMedGoogle Scholar
  • 72 Otto S, Pautke C, Hafner S. et al. Pathologic fractures in bisphosphonate-related osteonecrosis of the jaw-review of the literature and review of our own cases. Craniomaxillofac Trauma Reconstr 2013; 6: 147-154
    CrossrefPubMedGoogle Scholar
  • 73 Pessa JE, Slice DE, Hanz KR. et al. Aging and the shape of the mandible. Plast Reconstr Surg 2008; 121: 196-200
    CrossrefPubMedGoogle Scholar
  • 74 Pessa JE, Chen Y. Curve analysis of the aging orbital aperture. Plast Reconstr Surg 2002; 109: 751-755
    CrossrefPubMedGoogle Scholar
  • 75 Pessa JE, Zadoo VP, Mutimer KL. et al. Relative maxillary retrusion as a natural consequence of aging: combining skeletal and soft-tissue changes into an integrated model of midfacial aging. Plast Reconstr Surg 1998; 102: 205-212
    CrossrefPubMedGoogle Scholar
  • 76 Plawecki A, Bobian M, Kandinov A. et al. Recreational activity and facial trauma among older adults. JAMA Facial Plast Surg 2017; DOI: 10.1001/jamafacial.2017.0332.
    CrossrefPubMedGoogle Scholar
  • 77 Pötzsch O, Rößger F. Bevölkerung Deutschlands bis 2060. 13. koordinierte Bevölkerungsvorausberechnung. Wiesbaden: Statistisches Bundesamt; 2015
    Google Scholar
  • 78 Probst FA, Metzger M, Ehrenfeld M. et al. Computer-assisted designed and manufactured procedures facilitate the lingual application of mandible reconstruction plates. J Oral Maxillofac 2016; 74: 1879-1895
    CrossrefPubMedGoogle Scholar
  • 79 Rapp K, Freiberger E, Todd C. et al. Fall incidence in Germany: results of two population-based studies, and comparison of retrospective and prospective falls data collection methods. BMC Geriatr 2014; 14: 105
    CrossrefPubMedGoogle Scholar
  • 80 Rana M, Singh B, Gellrich NC. Einsatz von im Laserschmelzverfahren hergestellten patientenspezifischen Implantaten in der Mund-, Kiefer und Gesichtschirurgie. OP-JOURNAL 2016; 32: 241-246
    PubMedGoogle Scholar
  • 81 Rana M, Chui CH, Wagner M. et al. Increasing the accuracy of orbital reconstruction with selective laser-melted patient-specific implants combined with intraoperative navigation. J Oral and Maxillofac Surg 2015; 73: 1113-1118
    CrossrefPubMedGoogle Scholar
  • 82 Rastogi S, Sharma S, Kumar S. et al. Fracture of mandibular condyle-to open or not to open: an attempt to settle the controversy. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119: 608-613
    CrossrefPubMedGoogle Scholar
  • 83 Rehman K, Edmondson H. The causes and consequences of maxillofacial injuries in elderly people. Gerodontology 2002; 19: 60-64
    CrossrefPubMedGoogle Scholar
  • 84 Richard MJ, Morris C, Deen BF. et al. Analysis of the anatomic changes of the aging facial skeleton using computer-assisted tomography. Ophthal Plast Reconstr Surg 2009; 25: 382-386
    CrossrefPubMedGoogle Scholar
  • 85 Robert Koch-Institut (RKI). Gesundheit in Deutschland 2015. Kapitel 08: Wie gesund sind die älteren Menschen? Gesundheitsberichterstattung des Bundes. Berlin; November 2015.
    PubMedGoogle Scholar
  • 86 Santos LS, Rossi AC, Freire AR. et al. Finite-element analysis of 3 situations of trauma in the human edentulous mandible. J Oral Maxillofac Surg 2015; 73: 683-691
    CrossrefPubMedGoogle Scholar
  • 87 Schneider M, Erasmus F, Gerlach KL. et al. Open reduction and internal fixation versus closed treatment and mandibulomaxillary fixation of fractures of the mandibular condylar process: a randomized, prospective, multicenter study with special evaluation of fracture level. J Oral Maxillofac Surg 2008; 66: 2537-2544
    CrossrefPubMedGoogle Scholar
  • 88 Schön R, Metzger MC, Zizelmann C. et al. Individually preformed titanium mesh implants for a true-to-original repair of orbital fractures. Internat J Oral Maxillofac Surg 2006; 35: 990-995
    PubMedGoogle Scholar
  • 89 Schonauer F, De Luca S, Razzano S. et al. Do the ears grow with age?. Eur Arch Otorhinolaryngol 2012; 269: 1307-1308
    CrossrefPubMedGoogle Scholar
  • 90 Schramm A, Wilde F. Die computerassistierte Gesichtsschädelrekonstruktion. HNO 2011; 59: 1-7
    PubMedGoogle Scholar
  • 91 Seper L, Piffko J, Joos U. et al. Treatment of fractures of the atrophic mandible in the elderly. J Am Geriatr Soc 2004; 52: 1583-1584
    CrossrefPubMedGoogle Scholar
  • 92 Sharabi SE, Hatef DA, Koshy JC. et al. Mechanotransduction: the missing link in the facial aging puzzle?. Aesthetic Plast Surg 2010; 34: 603-611
    CrossrefPubMedGoogle Scholar
  • 93 Shaw jr. RB, Katzel EB, Koltz PF. et al. Aging of the facial skeleton: aesthetic implications and rejuvenation strategies. Plast Reconstr Surg 2011; 127: 374-383
    CrossrefPubMedGoogle Scholar
  • 94 Shaw jr. RB, Katzel EB, Koltz PF. et al. Aging of the mandible and its aesthetic implications. Plast Reconstr Surg 2010; 125: 332-342
    CrossrefPubMedGoogle Scholar
  • 95 Shaw jr. RB, Kahn DM. Aging of the midface bony elements: a three-dimensional computed tomographic study. Plast Reconstr Surg 2007; 119: 675-681
    CrossrefPubMedGoogle Scholar
  • 96 Sieber CC. Der ältere Patient – Wer ist das?. Internist (Berl) 2007; 48: 1190 1192–1194
    CrossrefPubMedGoogle Scholar
  • 97 Singh V, Bhagol A, Dhingra R. A comparative clinical evaluation of the outcome of patients treated for bilateral fracture of the mandibular condyles. J Cranio Maxillofac Surg 2012; 40: 464-466
    CrossrefPubMedGoogle Scholar
  • 98 Soehardi A, Meijer GJ, Manders R. et al. An inventory of mandibular fractures associated with implants in atrophic edentulous mandibles: a survey of Dutch oral and maxillofacial surgeons. Internat J Oral Maxillofac Impl 2011; 26: 1087-1093
    PubMedGoogle Scholar
  • 99 Statistisches Bundesamt. Fortschreibung des Bevölkerungsstandes, Bevölkerung zum Stichtag 31.12. des jeweiligen Jahres (2014). Im Internet: http://www.gbe-bund.de Stand: 06.2017
    PubMedGoogle Scholar
  • 100 Statistisches Bundesamt. Verkehrsunfälle – Unfälle von Senioren im Straßenverkehr 2015. Wiesbaden 2016. Im Internet: http://www.destatis.de Stand: 06.2017
    PubMedGoogle Scholar
  • 101 Sugisaki M, Agematsu H, Matsunaga S. et al. Three-dimensional analysis of the internal structure of the mandibular condyle in dentulous and edentulous jaws using micro-CT. Cranio: The journal of craniomandibular practice 2009; 27: 78-87
    PubMedGoogle Scholar
  • 102 Tiwana PS, Abraham MS, Kushner GM. et al. Management of atrophic edentulous mandibular fractures: the case for primary reconstruction with immediate bone grafting. J Oral Maxillofaci Surg 2009; 67: 882-887
    PubMedGoogle Scholar
  • 103 Toivari M, Suominen AL, Lindqvist C. et al. Among patients with facial fractures, geriatric patients have an increased risk for associated injuries. J Oral Maxillofac Surg 2016; 74: 1403-1409
    CrossrefPubMedGoogle Scholar
  • 104 Vajgel A, Camargo IB, Willmersdorf RB. et al. Comparative finite element analysis of the biomechanical stability of 2.0 fixation plates in atrophic mandibular fractures. J Oral Maxillofac Surg 2013; 71: 335-342
    CrossrefPubMedGoogle Scholar
  • 105 van Leeuwen AC, van der Meij EH, de Visscher JG. Fracture of the genial tubercles of the mandible: case report and review of the literature. J Oral Maxillofac Surg 2014; 72: 1994.e1-6
    CrossrefPubMedGoogle Scholar
  • 106 Van Sickels JE, Cunningham LL. Management of atrophic mandible fractures: are bone grafts necessary?. J Oral Maxillofac Surg 2010; 68: 1392-1395
    CrossrefPubMedGoogle Scholar
  • 107 Velayutham L, Sivanandarajasingam A, OʼMeara C. et al. Elderly patients with maxillofacial trauma: the effect of an ageing population on a maxillofacial unitʼs workload. Br J Oral Maxillofac Surg 2013; 51: 128-132
    CrossrefPubMedGoogle Scholar
  • 108 Werning JW, Downey NM, Brinker RA. et al. The impact of osteoporosis on patients with maxillofacial trauma. Arch Otolaryngol Head Neck Surg 2004; 130: 353-356
    CrossrefPubMedGoogle Scholar
  • 109 Wilde F, Schramm A. Intraoperative Navigation und computerassistierte Chirurgie in der MKG-Chirurgie – Allgemeines und Traumatologie. OP-JOURNAL 2011; 27: 124-129
    PubMedGoogle Scholar
  • 110 Wilde F, Schramm A. Computerassistierte Gesichtsschädelrekonstruktion – Planung und Umsetzung in der klinischen Routine. HNO 2016; 64: 641-649
    CrossrefPubMedGoogle Scholar
  • 111 Yamamoto K, Matsusue Y, Murakami K. et al. Maxillofacial fractures in older patients. J Oral Maxillofac Surg 2011; 69: 2204-2210
    CrossrefPubMedGoogle Scholar
  • 112 Zachariades N, Papavassiliou D, Triantafyllou D. et al. Fractures of the facial skeleton in the edentulous patient. J Oral Maxillofac Surg 1984; 12: 262-266
    PubMedGoogle Scholar
  • 113 Zadoo VP, Pessa JE. Biological arches and changes to the curvilinear form of the aging maxilla. Plast Reconstr Surg 2000; 106: 460-466
    CrossrefPubMedGoogle Scholar
  • 114 Zakhary KE, Thakker JS. Emerging biomaterials in trauma. Oral Maxillofac Surg Clin North Am 2017; 29: 51-62
    CrossrefPubMedGoogle Scholar
  • 115 Zelken JA, Khalifian S, Mundinger GS. et al. Defining predictable patterns of craniomaxillofacial injury in the elderly: analysis of 1,047 patients. J Oral Maxillofac Surg 2014; 72: 352-361
    CrossrefPubMedGoogle Scholar
  • 116 Gehrke G. Unterkieferfrakturen. MKG Chirurg 2014; 7: 17-25
    PubMedGoogle Scholar
  • 117 Schiel S, Schmolka W, Leiggener C. et al. Open Book Frakturen des Mandibularbogens: Bilaterale Gelenkfortsatzfrakturen in Kombination mit Paramedian-/Medianfrakturen des Unterkiefers. Operative Behandlungsstrategien. OP-JOURNAL 2012; 28: 1-17
    PubMedGoogle Scholar
  • 118 Neff A, Cornelius CP, Rasse M. et al. The Comprehensive AOCMF Classification System: Condylar Process Fractures – Level 3 Tutorial. Craniomaxillofac Trauma Reconstr 2014; 7 (Suppl. 01) S044-S058
    Article in Thieme ConnectPubMedGoogle Scholar
  • 119 Neff A, Cornelius CP, Rasse M. et al. Kiefergelenkfortsatzfrakturen nach der AO-CMF-Trauma-Klassifikation. MKG-Chirurg 2017; 10: 113-126
    PubMedGoogle Scholar
  • 120 Gassner R, Tuli T, Hachl O. et al. Cranio-maxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries. J Craniomaxillofac Surg 2003; 31: 51-61
    CrossrefPubMedGoogle Scholar
  • 121 Codner M. Modifying the subperiosteal cheek lift. Aesthet Surg J 2003; 23: 203-204
    CrossrefPubMedGoogle Scholar