Seven patients who had previously received mandibular endosseous implants sustained mandibular fractures and were treated. Three patients had advanced bone resorption and developed stress fractures through previous endosseous implant sites. Two patients sustained fractures through implant sites via trauma. Two patients sustained fractures anatomically separated from the implants, which caused an alteration in the dental occlusion. This report describes the treatment approach for these seven patients and reviews the treatment philosophy and procedures involved. A conservative treatment approach is advised when the fracture transverses through a stable or a recently failed implant site. Keywords: endosseous implants, mandibular fractures