# Complicated Mandible Fracture Treatment with Xenogenic Bone Graft
## 4 Discussion  
According to the literature and our own experience, mandibular fractures are the most common fractures of the facial bones. Patients with fractured mandibles present with significant biting, chewing, and speaking function disorders [11]. The treatment of mandibular angle fractures presents a challenge, due to their higher rate of complications; there is currently no agreement on an optimal treatment [12]. Many studies show that patients with mandibular fractures demand an individual approach in the choice of treatment method, due to the possible combination of bone lesions of different nature, odontogenic infections, fractures in different areas of the mandible or facile skeleton, etc. [5; 6; 7; 8; 9; 10; 13]. In all these cases, a collagen osteotropic material was used to fill the bone defect. Even though the authors do not indicate the timing of full bone tissue regeneration, we can assume preliminary conclusions about the positive effect of the osteotropic material used in this study on the timing of full bone regeneration. Currently, the mechanisms of bone regeneration are well studied, but there are several factors that affect, or delay, the bone healing process; some are inherent to the patient, others to the fracture itself, and others to the medical management of the patient. The size of the gap or bone defect is an important factor for the use of bone grafts, considering endochondral ossification [14; 15]. Despite the high efficiency of modern methods of treatment, the bone tissue cannot be restored in full volume in all cases. For example, harvesting bone grafts from the anterior iliac crest for intraoral augmentation is a safe procedure for both young and elderly patients. Although a few cases of postoperative complications have been reported, such as gait disturbances, hypesthesia, scar formation, or delayed wound healing at the donor site, the incidence of these minor complications is low, and they mostly occur for a short duration. Major complications, such as fractures or incision hernias, are very rare. However, the volume of the bone graft was associated with a prolonged hospital stay, which should be considered when planning iliac crest bone graft procedures [16]. Therefore xenogenic materials are used to accelerate the reparative processes [17]. The basics of regeneration stimulation are laid in induction, conduction, and regeneration, due to the introduction of osteoprogenic cellular elements (stimulation by substitution). Every potency can be used to stimulate reparative osteogenesis, both independently and in combination [18]. Guided bone regeneration is a common method of treating bone defects of the jaws. The principles are based on a combination of bone graft materials and a barrier membrane, which covers and stabilizes the augmented zone. The results of [PERSON] et al. 's study showed that higher levels of enzyme activity indicate more intense bone remodeling. Furthermore, guided bone regeneration, with bone substitute particles and a collagen membrane, show desirable, significantly earlier bone remodeling activity, when compared to regeneration procedures with bone substitute particles only. The membrane potentially acts as a bioactive compartment, rather than just a passive barrier [19]. [PERSON] et al. concluded that bovine bone particulates offer a purely osteoconductive material, with no anabolic advantage. However, abundant growth factors clearly appear to produce an anabolic bone effect. In this regard, the development of new materials could provide a clear benefit for surgeons faced with large bone defects, which, if left, fail to heal and reduce the integrity of the surrounding bone [20]. In our study, a patient with a fracture of the mandible within the dentition was under observation for 8 years. The mandibular bone defect was filled with xenogenic bone material. The results of our study indicate a decrease in the timing of the osteoreparative processes and rehabilitation when using collagen osteotropic material in combination with a collagen membrane.