Introduction: The treatment of complex fractures with miniplates is often difficult and unsatisfactory. Such fractures include extremely atrophic mandibles, discontinuity defects, and marked comminuted fractures. Aim: With this paper me want to call to mind once more that titanium mesh is useful for the treatment of such fractures and its use can reduce the number of complications. Patients: Between January 1996 and December 1998 we treated with titanium mesh 17 patients with fractures of extremely atrophic mandibles, mandibular discontinuity defects or comminuted fractures. Results: Union occurred without complication in 70% of fractures treated with titanium mesh. In 20% there were minor complications such as postoperative haematoma, In only one case did infection occur, a more severe complication. Conclusion: Because of its geometry and the excellent physical and biomechanical properties, titanium mesh helps to achieve better stabilization of complex mandibular fractures than conventional miniplates do, Complications such as infection and non union can largely be avoided and bony continuity of the mandible can be restored. (C) 2000 European Association for Cranio-Maxillofacial Surgery.