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We aimed at proposing a classification with treatment algorithm of each category for CMFs. Patients with CMFs were retrospectively reviewed and classified into five categories: Type I: relatively good occlusion, no or slightly displaced fragments, no continuity destruction or bone defect; Type II: relatively good occlusion, damaged morphology, low comminution degree but intact continuity without bone defect; Type III: damaged morphology and higher comminution degree with intact continuity and relatively good occlusion; Type IV: high comminution, impaired continuity and poor occlusion without segmental bone defect; Type V: segmental bone defect. Conservative treatment, open reduction and internal fixation or microvascular osteocutaneous free flap transplantation was performed, accordingly. Demographics, perioperative data, complications and reasons for reoperations were recorded. The chi-square test was used for statistical analysis. In total, 109 patients were included in the study. After surgery, in the following group, 5 manifested infections, 1 manifested bone non-union, and 2 experienced reoperations, while in the unfollowing group, 10 manifested infections, 5 manifested bone non-union and 8 experienced reoperations. The OCCS classification and algorithm for CMFs achieve better outcomes and with lower complication rate.<\/jats:p>","DOI":"10.3390\/jcm11216301","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T09:59:37Z","timestamp":1666778377000},"page":"6301","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["OCCS Classification and Treatment Algorithm for Comminuted Mandibular Fractures Based on 109 Patients and 11 Years Experiences: A Retrospective Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Xiaofeng","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"},{"name":"College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China"},{"name":"National Center for Stomatology, Shanghai 200011, 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Medicine, Shanghai 200011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengshuai","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China"},{"name":"College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China"},{"name":"National Center for Stomatology, Shanghai 200011, China"},{"name":"National Clinical Research Center for Oral Diseases, Shanghai 200011, China"},{"name":"Shanghai Key Laboratory of Stomatology, Shanghai 200011, China"},{"name":"Shanghai Research Institute of Stomatology, Shanghai 200011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bing","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of 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