# Complicated Mandible Fracture Treatment with Xenogenic Bone Graft
###### Abstract  
The problem of filling bone cavities remains relevant in maxillofacial and oral surgery. There is a large selection of osteotropic materials, of various natures, for filling bone defects of different etiologies. The aim of our research was to improve the outcome of surgical treatment in a patient with a complicated mandibular fracture, with the use of a collagenic xenograft during osteosynthesis. In this article, we share our experience of the treatment of a patient with a complicated mandibular angle fracture, in combination with a follicular cyst. The obligate steps of treatment included stabilization of the bone fragments, decreasing the risk of fracture line malposition, using titan mini-plates, and shortening the time of bone regeneration, by filling the bone defect with osteotropic material. This approach allowed us to reduce the rehabilitation period and further prosthetic treatment after 4-5 months, without additional bone grafting manipulations. Thus, the use of collagen osteoporopic materials, possessing osteoconductive properties, can improve the treatment of patients with mandibular fractures.  
Keywords:follicular cyst; fracture; mandible; osteoporosis; mini-plate; collagenic xenograft; case report  
2 nd stage: the bone does not function at the site of the original fracture, but there is hard tissue with great rigidity.  
3 rd stage: the bone is partially non-functional at the site of the original fracture, and on the unaffected part of the bone, there is hard tissue with high rigidity.  
4 th stage: the site of failure does not correspond to the site of the original fracture. Failure occurs with high rigidity.  
These changes correspond to cellular changes, depending on the time and on the type of extracellular matrix at the site of tissue repair. The strength of the healing fracture increases significantly when mineralization of the osteoid occurs, approximately 4-6 months after the onset of healing.  
The choice of treatment helps to prevent possible displacement of the bone fragments, which can delay, or interfere with, the healing of the fracture line.  
Grafts of different nature are widely used in traumatology, oncology and surgery, as well as in oral and maxillofacial surgery [5,6]. There are specific requirements for the properties of grafts, such as biological compatibility, absence of unpleasant reactions (allergy and \"transplant against host\" reactions), availability, and others [5].  
The \"golden\" standard for jaw reconstruction during bone plasty, guided bone regeneration, and dental implantation is considered to be an autograft, because of a combination of bone conductive (\"matrix\" role) and inductive (direct osteogenesis stimulation) properties [7]. Additionally, rather often, xenogenic materials (collagen, hydroxyapatite, and their combinations) are used, but they only possess bone conductive properties; however, in comparison, with autogenous materials, there is no need for new trauma creation, which is obligate for harvesting [8,9].  
However, the properties of pointed grafts have barely been studied for jaw fracture treatment. In addition, a fair amount of literature on the jaw fraction complications of harvesting can be found [10].  
The aim of our case report was to improve the results of surgical treatment in a complicated mandibular fracture, with the use of collagen xenograft during osteosynthesis.