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152
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Maxillofacial injuries in patients with major trauma. Br J Oral Maxillofac Surg 2018; 56:496-500. [DOI: 10.1016/j.bjoms.2018.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/02/2018] [Indexed: 11/19/2022]
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153
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Bratteberg M, Thelen DS, Klock KS, Bårdsen A. Traumatic dental injuries-Prevalence and severity among 16-year-old pupils in western Norway. Dent Traumatol 2018; 34:144-150. [DOI: 10.1111/edt.12399] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Magnus Bratteberg
- Department of Clinical Dentistry; Faculty of Medicine; University of Bergen; Bergen Norway
| | | | - Kristin S. Klock
- Department of Clinical Dentistry; Faculty of Medicine; University of Bergen; Bergen Norway
| | - Asgeir Bårdsen
- Department of Clinical Dentistry; Faculty of Medicine; University of Bergen; Bergen Norway
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154
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Zhang Y, Zeng C, Chen J, Guo B. [New type of sutured titanium wire combined with titanium nail internal fixation for correction of serious old medial canthus deformity]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2018; 32:718-721. [PMID: 29905051 PMCID: PMC8413999 DOI: 10.7507/1002-1892.201712046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/26/2018] [Indexed: 02/05/2023]
Abstract
Objective To evaluate the effectiveness of a new type of sutured titanium wire combined with titanium nail internal fixation in correction of serious old medial canthus deformity. Methods Between March 2012 and June 2015, 18 patients with unilateral serious old medial canthus deformity were treated. There were 14 males and 4 females. The patient's age ranged from 23 to 62 years (mean, 42 years). The causes of deformity included accident injury in 10 cases, boxing injury in 4 cases, sharp device scratching in 3 cases, and animal bite in 1 case. All patients had been treated with suture or steel wire fixation in other hospitals to correct the medial canthus deformity and the deformity recurred. The interval between this operation and the first operation was 6 months to 2 years (mean, 16 months). The nasal root or medial canthus skin scar incision was used as the operative approach, and the adhesion of the medial canthus ligament to the adjacent tissues was fully loosened, then the tail end of the new type sutured titanium wire was fixed to the residual end of the medial canthus ligament. After passing through the scar tissue, the needle end of wire was fixed on the titanium nail in the bone wall of anterior lacrimal crest. The position and shape of the medial canthus angle was determined by adjusting the tightness of titanium wire. Results All incisions healed by first intention. All patients were followed up 6-12 months (mean, 10 months). In 16 cases, the medial canthus deformity was obviously corrected, and the appearances of bilateral eyes were basically symmetrical, without exposure of titanium nail and titanium wire. The medial canthus was retreated at 2 mm after 6 months in 2 cases, who were satisfied with their appearance without reoperation. Conclusion Application of the new type of suture titanium wire combined with titanium nail in the correction of serious old medial canthus deformity can achieve good effectiveness with the low recurrence rate.
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Affiliation(s)
- Ying Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Changhong Zeng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Jun Chen
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Bo Guo
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,
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Ibikunle AA, Taiwo AO, Braimah RO. A 5-year audit of major maxillofacial surgeries at Usmanu Danfodiyo university teaching hospital, Nigeria. BMC Health Serv Res 2018; 18:416. [PMID: 29879975 PMCID: PMC5992770 DOI: 10.1186/s12913-018-3236-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/25/2018] [Indexed: 11/10/2022] Open
Abstract
Background There is a paucity of data on the pattern of oral and maxillofacial surgeries done in Nigeria. Despite the rising prominence of oral and maxillofacial surgery as a specialty in our immediate environment, no published audit of the surgeries performed exist. This study aims to present the pattern and types of major surgeries done by oral and maxillofacial surgeons in our hospital as well as the indications for such surgeries. It is hoped that the findings will assist in formulating informed policies and improving healthcare delivery. Methods A review of hospital records of all patients who had major oral and maxillofacial surgeries at Usmanu Danfodiyo University Teaching Hospital from January, 2013 to August, 2017 was done. Descriptive statistics such biodata, indication for surgery and type of surgery were recorded and analyzed using the IBM SPSS statistics for windows version 20 (Armonk, NY: IBM Corp) software. Results One hundred and forty six individuals who underwent 158 major surgeries under general anaesthesia were included. There were 82 males and 64 females, giving a male/female ratio of 1.3: 1. The ages ranged from 3 months to 81 years [median of 33 years]. Tumours and tumour-like lesions were the major indications for surgery [85 (58.2%)]. The most commonly performed surgery was mandibulectomy [31 (19.6%)], followed by Open Reduction and Internal Fixation (ORIF) [29 (18.4%)]. Conclusion Major oral and maxillofacial surgeries are common in our environment. The frequencies of these surgeries can increase with better healthcare financing and universal availability of health insurance schemes. Efforts aimed at reducing the incidence of tumours should be instituted.
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Affiliation(s)
- Adebayo Aremu Ibikunle
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital Sokoto, PMB, Sokoto, 12003, Nigeria.
| | - Abdurrazaq Olanrewaju Taiwo
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital Sokoto, PMB, Sokoto, 12003, Nigeria
| | - Ramat Oyebunmi Braimah
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital Sokoto, PMB, Sokoto, 12003, Nigeria
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Lietz-Kijak D, Kijak E, Krajczy M, Bogacz K, Łuniewski J, Szczegielniak J. The Impact of the Use of Kinesio Taping Method on the Reduction of Swelling in Patients After Orthognathic Surgery: A Pilot Study. Med Sci Monit 2018; 24:3736-3743. [PMID: 29861496 PMCID: PMC6015478 DOI: 10.12659/msm.909915] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Orthognathic surgery (OGS) is associated with extensive surgical intervention within the soft and hard tissues of the facial region of the skull leading to inflammatory reactions. The presence of postoperative swelling indicates the accumulation of exudate or transudate; both these fluids occur in surgery. Massive swelling is a significant problem, because the tension of tissues intensifies pain sensations. The aim of the study was to evaluate the effectiveness of the kinesio taping method (KT) in patients after orthognathic surgery in the area of the facial skull in terms of eliminating postoperative swelling. MATERIAL AND METHODS The study of the impact of kinesiology tape applied after orthognathic surgery to the craniofacial area on the elimination of swelling was performed in sixteen patients who suffered from this complication after bilateral sagittal split osteotomy. RESULTS The swelling was shown to be reduced after KT; within the same study the differences were statistically significant between the left and right sides and for the same side (p<0.05). The application of the lymphatic kinesio taping method led to the reduction of tension in the affected area and restoration of proper lymphatic circulation in the region covered by swelling. This allows for the improvement of the blood and lymph microcirculation and activation of self-healing processes. CONCLUSIONS The analysis of the impact of the practical use of the lymphatic KT on complications after orthognathic surgery revealed that it had a beneficial effect on the reduction of swelling. The use of the KT method seems promising because it is simple to carry out, not traumatic, economical and rarely causes undesirable allergies.
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Affiliation(s)
- Danuta Lietz-Kijak
- Independent Laboratory of Propaedeutic and Dental Physical Diagnostics, Faculty of Medicine and Dentistry, Pomeranian Medical University, Szczecin, Poland
| | - Edward Kijak
- Scientific Laboratory of Dysfunction of the Masticatory System, Chair and Department of Prosthodontics, Faculty of Medicine and Dentistry, Pomeranian Medical University, Szczecin, Poland
| | - Marcin Krajczy
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Katarzyna Bogacz
- Department of Clinical Physiotherapy, Opole University of Technology, Opole, Poland
| | - Jacek Łuniewski
- Department of Clinical Physiotherapy, Opole University of Technology, Opole, Poland
| | - Jan Szczegielniak
- Department of Clinical Physiotherapy, Opole University of Technology, Opole, Poland
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157
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Ahuja SA, Galinde J, Asnani U, Mistry YA. Comparative Evaluation of Clinical Outcomes Using Delta Plates and Conventional Miniplates for Internal Fixation of Mandibular Condylar Fractures in Adults. J Oral Maxillofac Surg 2018; 76:1255-1266. [DOI: 10.1016/j.joms.2017.12.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/20/2017] [Accepted: 12/20/2017] [Indexed: 11/17/2022]
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158
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Rozema R, Doff MH, van Ooijen PM, Postmus D, Westerlaan HE, Boomsma MF, van Minnen B. Diagnostic reliability of low dose multidetector CT and cone beam CT in maxillofacial trauma-an experimental blinded and randomized study. Dentomaxillofac Radiol 2018; 47:20170423. [PMID: 29745761 DOI: 10.1259/dmfr.20170423] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To assess the diagnostic reliability of low dose multidetector CT (MDCT) and cone beam CT (CBCT) for zygomaticomaxillary fracture diagnosis. METHODS Unilateral zygomaticomaxillary fractures were inflicted on four out of six fresh frozen human cadaver head specimens. All specimens were scanned using four MDCT and two CBCT imaging protocols of which the radiation exposure was systematically reduced. A blinded diagnostic routine was simulated at which 16 radiologists and 8 oral and maxillofacial (OMF) surgeons performed randomized image assessments. We considered the findings during an open operative approach of the zygomatic region as the gold standard. RESULTS Zygomaticomaxillary fractures were correctly diagnosed in 90.3% (n = 130) of the image assessments. The zygomatic arch was most often correctly diagnosed (91.0%). The zygomatic alveolar crest showed the lowest degree of correct diagnosis (65.3%). Dose reduction did not significantly affect the objective visualization of fractures of the zygomaticomaxillary complex. The sensitivity and specificity also remained consistent among the low dose scan protocols. Dose reduction did not decrease the ability to assess dislocation, comminution, orbital volume, volume rendering and soft tissues. OMF surgeons considered the low dose protocols sufficient for treatment planning. CONCLUSIONS Dose reduction did not decrease the diagnostic reliability of MDCT and CBCT for the diagnosis of zygomaticomaxillary fractures.
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Affiliation(s)
- Romke Rozema
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | | | - Peter Ma van Ooijen
- 2 Center for Medical Imaging - North East Netherlands (CMI-NEN2), University Medical Center Groningen, University of Groningen, Groningen , Groningen , The Netherlands.,3 Department of Radiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Douwe Postmus
- 4 Department of Epidemiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Henriëtte E Westerlaan
- 3 Department of Radiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Martijn F Boomsma
- 5 Department of Radiology, Isala Hospital , Zwolle , The Netherlands
| | - Baucke van Minnen
- 1 Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
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A nationwide survey of undergraduate training in oral and maxillofacial surgery. Oral Maxillofac Surg 2018; 22:289-296. [PMID: 29797106 DOI: 10.1007/s10006-018-0703-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/17/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE To investigate the current status of undergraduate training in oral and maxillofacial (OMF) surgery in Germany using a nationwide survey and hence contribute to an educational improvement in the field. METHODS A 39-item questionnaire was sent to all university clinics with an OMF surgery chair in Germany (n = 34). RESULTS Ninety-two percent of OMF clinics are involved in the curricular training in medicine and 100% in dentistry. Eighty-one percent of OMF clinics perform curricular examinations and, respectively, 86% in dentistry. Examinations are mainly performed written with multiple-choice tests (62% medicine, 76% dentistry) and using non-structured oral examinations (57% medicine, 86% dentistry). Objective structured clinical examinations (OSCEs) are only used in 19% of all faculties. CONCLUSION OMF surgery with its involvement both in medical and dental education has a special position as a surgical discipline. Our results show that OMF as a specialty is underrepresented in dental and especially in medical education considering the numerical and health economic importance of OMF consultations. Enhancing curricular integration and developing more structured examination forms is necessary to guarantee a high quality of OMF education.
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160
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Guariza-Filho O, Araujo CMD, Schroder AGD, Tanaka OM, Kern R, Ruellas AC. Prosthetic, orthodontic and implant-supported rehabilitation of five maxillary anterior teeth with alveolar bone loss. Dental Press J Orthod 2018; 23:87-96. [PMID: 29791692 PMCID: PMC5962252 DOI: 10.1590/2177-6709.23.1.087-096.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 10/18/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Treatment of maxillofacial injuries is complex and requires the establishment of a comprehensive and accurate diagnosis and correct treatment planning. OBJECTIVE The objective of this case report was to describe the re-treatment of a 27-year-old woman who was involved in a severe car accident that resulted in the loss of five anterior teeth and alveolar bone, and whose previous orthodontic and surgical treatments had been unsuccessful. CASE REPORT In this case, the space for the missing mandibular molar was reopened to allow for rehabilitation. The positions of the mandibular incisors were improved. The right mandibular canine was moved to the mesial, allowing for correction of the Class II canine relationship on that side, and implants were placed to replace the maxillary anterior teeth. CONCLUSION Anterior aesthetic and functional rehabilitation using a multidisciplinary approach was essential to improve the patient's facial aesthetics, to obtain great improvement in function and to achieve occlusal stability after 2 years of follow-up.
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Affiliation(s)
- Odilon Guariza-Filho
- Departamento de Ortodontia, Faculdade de Odontologia, Pontifícia Universidade Católica, Curitiba, PR, Brazil
| | - Cristiano Miranda de Araujo
- Departamento de Ortodontia, Faculdade de Odontologia, Pontifícia Universidade Católica, Curitiba, PR, Brazil
| | | | - Orlando Motohiro Tanaka
- Departamento de Ortodontia, Faculdade de Odontologia, Pontifícia Universidade Católica, Curitiba, PR, Brazil
| | | | - Antonio Carlos Ruellas
- Departamento de Ortodontia, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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161
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Zhang X, Ye L, Li H, Wang Y, Dilxat D, Liu W, Chen Y, Liu L. Surgical navigation improves reductions accuracy of unilateral complicated zygomaticomaxillary complex fractures: a randomized controlled trial. Sci Rep 2018; 8:6890. [PMID: 29720719 PMCID: PMC5932064 DOI: 10.1038/s41598-018-25053-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 04/05/2018] [Indexed: 02/07/2023] Open
Abstract
Accurate reduction is the key to successful treatment of bone fractures. Complicated zygomaticomaxillary complex fracture, known as one of the most challenging facial bone fractures, is often hard to achieve an accurate reduction, thus leading to facial deformity. In this study, twenty patients with unilateral complicated zygomaticomaxillary complex fractures were included and randomly divided into experimental and control groups, which is with and without the aid of surgical navigation, respectively. The pre- and postoperative imaging data were collected and then analysed using Geomagic Studio 11 software and Brainlab iPlan CMF 3.0. A more precise reduction was showed in the experimental group according to the measurement results of both software programmes than in the control group. In conclusion, surgical navigation showed great value in performing accurate reductions of complicated zygomaticomaxillary complex fractures and restoring facial contour.
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Affiliation(s)
- Xiao Zhang
- Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Lanfeng Ye
- Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, 510140, China
| | - Hui Li
- Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Yi Wang
- Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Dilnur Dilxat
- Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Weilong Liu
- Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Yuanwei Chen
- Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Lei Liu
- Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China.
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Ashrafullah, Pandey RK, Mishra A. The incidence of facial injuries in children in Indian population: A retrospective study. J Oral Biol Craniofac Res 2018; 8:82-85. [PMID: 29892526 PMCID: PMC5993458 DOI: 10.1016/j.jobcr.2017.09.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 09/05/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To determine the incidence and pattern of facial fracture in children of age 0-16 years of age. MATERIAL & METHODS Patients with trauma reporting to department of paediatric and preventive dentistry and department of oral & maxillofacial surgery from January 2011 to December 2011 were selected for the present study. The records of patients treated for maxillofacial injuries were retrospectively retrieved and analyzed for prevalence, pattern, etiology, and management of maxillofacial trauma. The data collected were subjected to statistically analysis. SPSS software version 16.0 was used for the data analysis. RESULTS Total 5049 patients were screened and fifty one was reported to have facial injury. The incidence of facial trauma was 1.01% for the present study. The age wise distribution of the fracture amongst groups (I, II and III) were found 17.65%, 54.9% and 27.45% respectively. The sex-wise distribution of facial fracture was reported twice in male than females. The mandibular fracture was found the most common fracture (0.59%) followed by dento alveolar (0.30%) and midface (0.12%) fractures. Most of the mandibular fractures were found in the para symphysis region. Compound fractures seem to be commonest in the mandible. CONCLUSION The fall was the predominant cause for most of the facial fractures in children followed by road traffic accident. The pattern of facial injury is influenced by the age and the growth of facial skeleton.
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Affiliation(s)
- Ashrafullah
- Department of Dentistry, G.S.V.M. Medical College, Kanpur, India
| | - Ramesh Kumar Pandey
- Department of Pediatric and Preventive Dentistry, Faculty of Dental Sciences, King George Medical University, Lucknow, 226003, U.P., India
| | - Apurva Mishra
- Department of Pediatric and Preventive Dentistry, Faculty of Dental Sciences, King George Medical University, Lucknow, 226003, U.P., India
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163
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Joachim M, Tuizer M, Araidy S, Abu El-Naaj I. Pediatric maxillofacial trauma: Epidemiologic study between the years 2012 and 2015 in an Israeli medical center. Dent Traumatol 2018; 34:221-228. [PMID: 29701325 DOI: 10.1111/edt.12406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND/AIM Trauma is the leading cause of morbidity and mortality in the pediatric population worldwide, and Israel is no different in this aspect. Of these injuries, craniofacial trauma is a significant cause of morbidity in the pediatric population. The high occurrence of pediatric trauma is possibly related to a lower perception for the hazards that surround them, combined with the restless and adventurous nature that is typical of children. The aim was to perform a retrospective, epidemiological study on facial trauma in children examined in the emergency room in order to analyze the different patterns in pediatric maxillofacial trauma, to emphasize this data and educate those involved in preventing and treating children's injuries. MATERIALS AND METHODS The database of pediatric maxillofacial trauma patients younger than 18 years registered at the Department of Oral and Maxillofacial Surgery at the Baruch Padeh Medical Center, Poriya during a period of 4 years (2012-2015) was reviewed and examined. The data collected were analyzed for each year separately and then comparisons and cross sections were made. RESULTS This study examined 3034 files of pediatric maxillofacial and head trauma patients aged under 18. The comparison of frequency of the injuries between seasons reveals more injuries occur in the summer and 69.3% of the injuries occurred in boys. Average age was 6.5 years, with the most prevalent group being 0-5 years. The most common type of injury was blunt head trauma followed by facial lacerations and dental injuries. Most (84.5%) of the injuries occurred outside the education system. The number of injuries at the Arab villages was higher than in the Jewish villages. CONCLUSION There is a marked difference in the injured children population with an increase incidence in the Arab child population and children under the age of 6.
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Affiliation(s)
- Michael Joachim
- Department of Oral and Maxillofacial Surgery, Baruch Padeh Medical Center, Poriya, Israel
| | - Moti Tuizer
- Unit of Oral and Maxillofacial Surgery, Meir Medical Center, Kfar-Saba, Israel
| | - Shareef Araidy
- Department of Oral and Maxillofacial Surgery, Baruch Padeh Medical Center, Poriya, Israel
| | - Imad Abu El-Naaj
- Department of Oral and Maxillofacial Surgery, Baruch Padeh Medical Center, Poriya, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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164
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Elarabi MS, Bataineh AB. Changing pattern and etiology of maxillofacial fractures during the civil uprising in Western Libya. Med Oral Patol Oral Cir Bucal 2018; 23:e248-e255. [PMID: 29476683 PMCID: PMC5911362 DOI: 10.4317/medoral.22268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 12/06/2017] [Indexed: 11/24/2022] Open
Abstract
Background The purpose of the present study was to evaluate changing pattern in characteristics of maxillofacial fractures and concomitant injuries in Western Libya During revolution and to assess the association between mechanism of injury and fracture patterns. Material and Methods A retrospective review of medical records and radiographs of 187 patients treated for maxillofacial fractures from January 2010 to December 2012 was performed, there were 326 fractures in 187 patients. Results The male: female ratio was 6:1. Most fractures occurred in patients aged 11 to 40 years, and few injuries occurred in patients aged > 50 years. Most fractures occurred from motor vehicle accidents, and other most frequent causes included assault, gunshot, and fall injuries. Most maxillofacial fractures involved the mandible, zygomatic complex, or maxilla. Most mandibular fractures occurred at the parasymphysis, angle, or condyle. Associated injuries most frequently involved the head, chest, and extremities. Most patients were treated with open reduction (132 patients [71%]), and 26 patients (14%) were treated nonoperatively. There were 21 complications (11%). Conclusions In summary, motor vehicle accidents were the most frequent cause of maxillofacial fracture in western Libya, possibly because of the lack of seat belt legislation. Interpersonal violence was a less frequent cause of maxillofacial fracture, possibly because of the religious restriction on alcohol consumption. Key words:Tauma, mandible, zygomatic complex, maxilla, treatment, complications.
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Affiliation(s)
- M-S Elarabi
- Department of Oral Medicine and Surgery, Faculty of Dentistry, Jordan University of Science and Technology, B.O.Box 3030, Irbid-Jordan,
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165
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Jain MK, Kerur P. Bite Force as a Parameter for Comparison Between Three-Dimensional and Standard Titanium Miniplates for the Management of Anterior Mandibular Fractures: A Prospective Randomized Double-Blinded Clinical Trial. J Maxillofac Oral Surg 2018; 18:249-255. [PMID: 30996547 DOI: 10.1007/s12663-018-1091-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 02/05/2018] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives To compare the efficacy of three-dimensional (3D) miniplates with standard miniplates in the osteosynthesis of anterior mandibular fractures on the basis of bite force recordings and other clinical parameters. Methods A prospective randomized double-blinded clinical trial was carried out for the treatment of anterior mandibular fractures. In total, 20 patients were randomly divided into two groups of 2-mm 3D and standard titanium miniplates. The assessment of patients was done at weekly intervals for 6 weeks using bite force recordings and other clinical parameters. Results A statistically significant difference was found in the duration of surgery which was less in group A as compared to group B (p = 0.03). No significant difference was found in other clinical parameters. Interpretation and Conclusion The clinical outcome of both the 3D and standard miniplate systems in the present study was similar; however, the following advantages with the use of 3D miniplates can be highlighted:Relatively lesser operating time.Three-dimensional stability of the fracture site and simultaneous stabilization at superior and inferior borders in the fixation of mandibular fractures.
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Affiliation(s)
- Manoj Kumar Jain
- 1Department of Oral and Maxillofacial Surgery, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka 573201 India
- Nuface/Sumukha Clinic, Benaka Complex 1st Floor, Sankar Matt Road 5th Cross, KR Puram, Hassan, Karnataka 573201 India
| | - Priyadarshini Kerur
- Department of Oral and Maxillofacial Surgery, Inderprastha Dental College and Hospital, Sahibabad, Ghaziabad, Uttar Pradesh 201010 India
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166
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Petti S. Elder neglect-Oral diseases and injuries. Oral Dis 2018; 24:891-899. [PMID: 29029370 DOI: 10.1111/odi.12797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 12/11/2022]
Abstract
Elder neglect (EN) is the failure of a designated caregiver to meet the needs of a dependent older person. World EN prevalence, meta-analyzed in this study, is 1.0% or 1.8% according to different statistical methods. Referring alleged EN cases to Adult Protective Services (APSs) by healthcare workers (HCWs) is mandatory in many countries. However, only few claims are substantiated, as EN could be confused with Self-Neglect, and neglect could be unintentional or due to caregiver unawareness. Screening tools are inaccurate, and their use is discouraged by public health organizations, because they lead to too many false positives, which engulf the already overwhelmed APSs. HCWs need effective tools with objective judgments, which do not hamper the HCW-caregiver-patient rapport and prevent lawsuits when allegations are unfounded. Orofacial EN manifestations (poor oral/denture hygiene, lack of needed/improper dentures, dry mouth, skin/mucosal rashes) are essential Forensic Markers of EN. I classified EN-associated oral diseases according to the unmet needs into four groups: (1) traumatic injuries due to lack of caregiver vigilance (e.g., maxillofacial fractures); (2) diseases due to oral hygiene deficiency (e.g., root caries); (3) diseases typical of the elderly with late/no diagnosis (e.g., oral cancer); and (4) diseases typical of the elderly exacerbated by psychological distress (e.g., oral lichen planus).
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Affiliation(s)
- S Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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167
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Girod S, Schvartzman SC, Gaudilliere D, Salisbury K, Silva R. Haptic feedback improves surgeons' user experience and fracture reduction in facial trauma simulation. ACTA ACUST UNITED AC 2018; 53:561-570. [PMID: 27898160 DOI: 10.1682/jrrd.2015.03.0043] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 10/29/2015] [Indexed: 11/05/2022]
Abstract
Computer-assisted surgical (CAS) planning tools are available for craniofacial surgery, but are usually based on computer-aided design (CAD) tools that lack the ability to detect the collision of virtual objects (i.e., fractured bone segments). We developed a CAS system featuring a sense of touch (haptic) that enables surgeons to physically interact with individual, patient-specific anatomy and immerse in a three-dimensional virtual environment. In this study, we evaluated initial user experience with our novel system compared to an existing CAD system. Ten surgery resident trainees received a brief verbal introduction to both the haptic and CAD systems. Users simulated mandibular fracture reduction in three clinical cases within a 15 min time limit for each system and completed a questionnaire to assess their subjective experience. We compared standard landmarks and linear and angular measurements between the simulated results and the actual surgical outcome and found that haptic simulation results were not significantly different from actual postoperative outcomes. In contrast, CAD results significantly differed from both the haptic simulation and actual postoperative results. In addition to enabling a more accurate fracture repair, the haptic system provided a better user experience than the CAD system in terms of intuitiveness and self-reported quality of repair.
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Affiliation(s)
- Sabine Girod
- Departments of Surgery, Oral Medicine & Maxillofacial Surgery Section, and
| | | | - Dyani Gaudilliere
- Departments of Surgery, Oral Medicine & Maxillofacial Surgery Section, and
| | | | - Rebeka Silva
- San Francisco Department of Veterans Affairs Health Care System, Dental Service, San Francisco, CA
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168
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Esses DFS, Costa FWG, Sá CDL, Silva PGB, Bezerra TMM, Carvalho FSR, de Medeiros JR, Soares ECS. Occupational group, educational level, marital status and deleterious habits among individuals with maxillofacial fractures: retrospective study. Med Oral Patol Oral Cir Bucal 2018; 23:e13-e22. [PMID: 29274150 PMCID: PMC5822534 DOI: 10.4317/medoral.21969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 09/05/2017] [Indexed: 11/24/2022] Open
Abstract
Background To investigate the occupational profile, educational level, marital status and deleterious habits to the health of patients with maxillofacial fractures of a population of northeastern Brazil. Material and Methods A retrospective study of patients records admitted to the Division of Oral and Maxillofacial Surgery at the Walter Cantídio University Hospital (Fortaleza, Brazil) who sustained maxillofacial fractures was conducted in the period between 2006 and 2015. Results A total of 338 patients rendered 355 fractures. Males were the most affected (p<0.001), with prevalence in the third decade of life (p<0.001). There was a predominance of motorcycle accidents (p<0.001), home workers (p<0.001), low educational status (p = 0.032), and no cigarette use (p<0.001) or alcohol (p = 0.023). Fractures of the zygomatic-orbital complex were the most prevalent in the sample (p<0.001). Conclusions The sociodemographic profile exerted a significant influence on the epidemiological profile of maxillofacial fractures in a Brazilian population during the study period. Key words:Epidemiological studies, trauma, facial bones.
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Affiliation(s)
- D-F-S Esses
- Rua Alexandre Barauna 949 - Rodolfo Teofilo, Postal Code: 60430-160 Fortaleza, Ceara, Brazil,
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Rupani R, Singh M, Kumar V, Singh R, Kumar S, Yadav P. The maxillofacial injuries: A postmortem study. Natl J Maxillofac Surg 2018; 9:48-51. [PMID: 29937658 PMCID: PMC5996648 DOI: 10.4103/0975-5950.233295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives: The aim of our study is to evaluate the incidence and etiology of maxillofacial fractures in autopsy cases of KGMU, Lucknow. Materials and Methods: The sample consisted of 444 autopsy cases with maxillofacial injuries, who were brought to the mortuary of KGMU, Lucknow, for postmortem in the last year. Parameters such as gender, age, cause, type, and site of injury are evaluated. Result: The results of this study show that road traffic accidents are the main reason for maxillofacial injuries in the deceased, followed by railway accidents. Maxillofacial injuries are more common in adult males than in females. Majority cases also involved maxilla and zygomatic along with mandible. The most common type of facial fracture was Le Fort-2 fracture. Conclusion: Maxillofacial injuries are commonly seen in adult males, due to RTA, involving maxilla, zygomatic and mandible and presenting as Le Fort-2 fracture.
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Affiliation(s)
- Raja Rupani
- Department of Forensic Medicine and Toxicology, KGMU, Lucknow, Uttar Pradesh, India
| | - Mousami Singh
- Department of Forensic Medicine and Toxicology, KGMU, Lucknow, Uttar Pradesh, India
| | - Vijay Kumar
- Department of Plastic Surgery, KGMU, Lucknow, Uttar Pradesh, India
| | - Raghvendra Singh
- Department of Forensic Medicine and Toxicology, KGMU, Lucknow, Uttar Pradesh, India
| | - Sachil Kumar
- Department of Forensic Chemistry, College of Forensic Sciences, Naif Arab University for Security Sciences, Riyadh, Saudi Arabia
| | - Pradeep Yadav
- Department of Forensic Medicine and Toxicology, KGMU, Lucknow, Uttar Pradesh, India
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170
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Possebon APDR, Granke G, Faot F, Pinto LDR, Leite FRM, Torriani MA. Etiology, diagnosis, and demographic analysis of maxillofacial trauma in elderly persons: A 10-year investigation. J Craniomaxillofac Surg 2017; 45:1921-1926. [DOI: 10.1016/j.jcms.2017.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/28/2017] [Accepted: 09/11/2017] [Indexed: 10/18/2022] Open
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171
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A retrospective analysis of zygomatic fracture etiologies. JPRAS Open 2017. [DOI: 10.1016/j.jpra.2017.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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172
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Rachmiel A, Shilo D, Aizenbud D, Pen M, Rachmiel D, Emodi O. Three-Dimensional Reconstruction of Post-Traumatic Deficient Anterior Maxilla. J Oral Maxillofac Surg 2017; 75:2689-2700. [DOI: 10.1016/j.joms.2017.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 05/06/2017] [Accepted: 05/07/2017] [Indexed: 12/28/2022]
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173
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Gaviria L, Pearson JJ, Montelongo SA, Guda T, Ong JL. Three-dimensional printing for craniomaxillofacial regeneration. J Korean Assoc Oral Maxillofac Surg 2017; 43:288-298. [PMID: 29142862 PMCID: PMC5685857 DOI: 10.5125/jkaoms.2017.43.5.288] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 09/11/2017] [Indexed: 12/23/2022] Open
Abstract
Craniomaxillofacial injuries produce complex wound environments involving various tissue types and treatment strategies. In a clinical setting, care is taken to properly irrigate and stabilize the injury, while grafts are molded in an attempt to maintain physiological functionality and cosmesis. This often requires multiple surgeries and grafts leading to added discomfort, pain and financial burden. Many of these injuries can lead to disfigurement and resultant loss of system function including mastication, respiration, and articulation, and these can lead to acute and long-term psychological impact on the patient. A main causality of these issues is the lack of an ability to spatially control pre-injury morphology while maintaining shape and function. With the advent of additive manufacturing (three-dimensional printing) and its use in conjunction with biomaterial regenerative strategies and stem cell research, there is an increased potential capacity to alleviate such limitations. This review focuses on the current capabilities of additive manufacturing platforms, completed research and potential for future uses in the treatment of craniomaxillofacial injuries, with an in-depth discussion of regeneration of the periodontal complex and teeth.
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Affiliation(s)
- Laura Gaviria
- Department of Biomedical Engineering, College of Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Joseph J Pearson
- Department of Biomedical Engineering, College of Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Sergio A Montelongo
- Department of Biomedical Engineering, College of Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Teja Guda
- Department of Biomedical Engineering, College of Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Joo L Ong
- Department of Biomedical Engineering, College of Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
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174
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Krause M, Hümpfner-Hierl H, Völker L, Hierl T, Pausch NC. A new approach to treat bone gaps after midfacial and zygomatic fractures with a collagen membrane. Oral Maxillofac Surg 2017; 21:439-446. [PMID: 29022165 DOI: 10.1007/s10006-017-0652-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 09/13/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of the study was to analyze the eligibility of resorbable collagen membrane in the treatment of midfacial fractures to prevent gap formation and subsequent cheek tissue retraction. MATERIAL AND METHODS We included nine patients (six males, three females; mean age 51; range 20-73 years; mean bone gap size 8.03 × 13.12 mm) in a retrospective study design. The defect size was assessed by ultrasound. RESULTS After a healing period of 4 to 55 weeks, treatment resulted in a significant reduction of gap size (residual mean bone gap size 6.14 × 7.32 mm). CONCLUSIONS Native resorbable collagen membrane is a promising tool to reduce the size of bony gap in midfacial defects.
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Affiliation(s)
- Matthias Krause
- Private Practice of Maxillofacial Surgery, Berlin, Germany.,Department of Oral and Maxillofacial Plastic Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Heike Hümpfner-Hierl
- Department of Oral and Maxillofacial Plastic Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Lutz Völker
- Department of Radiology, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - Thomas Hierl
- Department of Oral and Maxillofacial Plastic Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Niels Christian Pausch
- Department of Oral and Maxillofacial Plastic Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.
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175
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Yang CS, Chen SCC, Yang YC, Huang LC, Guo HR, Yang HY. Epidemiology and patterns of facial fractures due to road traffic accidents in Taiwan: A 15-year retrospective study. TRAFFIC INJURY PREVENTION 2017; 18:724-729. [PMID: 28340303 DOI: 10.1080/15389588.2017.1309650] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 03/18/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The facial region is a commonly fractured site, but the etiology varies widely by country and geographic region. To date, there are no population-based studies of facial fractures in Taiwan. METHODS We conducted a retrospective study of patients diagnosed with facial fracture and registered in the National Health Insurance Research Database of Taiwan between 1997 and 2011. The epidemiological characteristics of this cohort were analyzed, including the etiology, fracture site, associated injuries, and sex and age distributions. RESULTS A total of 6,013 cases were identified that involved facial fractures. Most patients were male (69.8%), aged 18-29 years (35.8%), and had fractures caused by road traffic accidents (RTAs; 55.2%), particularly motorcycle accidents (31.5%). Falls increased in frequency with advancing age, reaching 23.9% among the elderly (age > 65 years). The most common sites of involvement were the malar and maxillary bones (54.0%), but nasal bone fractures were more common among those younger than 18 years. CONCLUSION Most facial injuries in Taiwan occur in young males and typically result from RTAs, particularly involving motorcycles. However, with increasing age, there is an increase in the proportion of facial injuries due to falls.
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Affiliation(s)
- Cheng-San Yang
- a Department of Plastic Surgery, Ditmanson Medical Foundation , Chia-Yi Christian Hospital , Taiwan , Republic of China
- b Department of Leisure , Recreation, and Tourism Management, Tatung Institute of Technology , Taiwan , Republic of China
| | - Solomon Chih-Cheng Chen
- c Department of Pediatrics , Ditmanson Medical Foundation Chia-Yi Christian Hospital , Chia-Yi, Taiwan , Republic of China
- d Department of Medical Research , Ditmanson Medical Foundation Chia-Yi Christian Hospital , Chia-Yi, Taiwan , Republic of China
- e School of Medicine , Taipei Medical University , Taipei , Taiwan , Republic of China
| | - Yung-Cheng Yang
- f Department of Surgery , Ditmanson Medical Foundation Chia-Yi Christian Hospital , Taiwan , Republic of China
| | - Li-Chung Huang
- g Department of Psychiatry , Chia-Yi Branch, Taichung, Veterans General Hospital , Chia-Yi, Taiwan , Republic of China
| | - How-Ran Guo
- h Department of Environmental and Occupational Health, College of Medicine , National Cheng Kung University , Taiwan , Republic of China
- i Department of Occupational and Environmental Medicine , National Cheng Kung University Hospital , Taiwan , Republic of China
| | - Hsin-Yi Yang
- d Department of Medical Research , Ditmanson Medical Foundation Chia-Yi Christian Hospital , Chia-Yi, Taiwan , Republic of China
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176
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Eva Vacuum-Formed Alternative Splinting of Alveolar Fractures in Primary Dentition: A Case Report. J Clin Pediatr Dent 2017; 41:327-331. [PMID: 28872995 DOI: 10.17796/1053-4628-41.5.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED Alveolar fractures treatment includes repositioning of displaced segments and splinting. In children, splinting procedures may occasionally present clinical problems resulting from fewer teeth available for splinting or presence of occlusal disturbances. An alternative clinical approach for splinting in alveolar fractures of primary dentition is described. CLINICAL CASE A 4.5-year-old girl was referred to our clinic 8 hours after a fall accident. Clinical examination revealed mandibular alveolar process segmental fracture in the right canine area with frontal dislodgement of the labial cortical bone resulting to occluding inability. The area was anaesthetized, cleaned and the dislodged bone was manually repositioned, followed by an EVA copolymer splint for fixation as a result of patient's deep bite impeding regular wire-composite splint. The cap splint that was fabricated on a cast made after an alginate impression, was set on the mandibular dentition and immobilized in the primary molars with acid-etch adhesive and flowable resin composite. Following splint removal after 4 weeks and follow-up visits, successful healing was observed clinically and radiographically with no pathological signs and symptoms. CONCLUSION The described alternative splinting method in alveolar fractures of primary dentition is a valuable clinical tool for peediatric dentists, easily accepted by children in cases where regular splinting methods cannot be used.
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177
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Samieirad S, Aboutorabzade MR, Tohidi E, Shaban B, Khalife H, Hashemipour MA, Salami HR. Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran: A retrospective study. Med Oral Patol Oral Cir Bucal 2017; 22:e616-e624. [PMID: 28809369 PMCID: PMC5694185 DOI: 10.4317/medoral.21809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 07/10/2017] [Indexed: 11/30/2022] Open
Abstract
Background The epidemiology of facial injuries varies based on lifestyle, cultural background and socioeconomic status in different countries and geographic zones. This study evaluated the epidemiology of maxillofacial fractures and treatment plans in hospitalized patients in Northeast of Iran (2015-2016). Material and Methods In this retrospective study, the medical records of 502 hospitalized patients were evaluated in the Department of Maxillofacial Surgery in Kamyab Hospital in Mashhad, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. Data were analyzed with Mann–Whitney test, chi-squared test and Fisher’s exact test, using SPSS 21. Results The majority of patients were male (80.3%). Most subjects were in 20-30-year age range (43.2%). The fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the body of the mandible. There was a significant association between the type of treatment and age. In fact, the age range of 16-59 years underwent open reduction internal fixation (ORIF) more than other age ranges (P=0.001). Also, there was a significant association between gender and fractures (P=0.002). Conclusions It was concluded that patient age and gender and trauma significantly affected the prevalence of maxillofacial traumas, fracture types and treatment plans. This information would be useful for making better health policy strategies. Key words:Epidemiology, treatment, facial injuries, maxillofacial fractures, trauma.
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Affiliation(s)
- S Samieirad
- Department of Oral Medicine, School of Dentistry Kerman University of Medical Sciences, Kerman, Iran,
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178
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Open Versus Closed Reduction of Maxillary Fractures: Complications and Resource Utilization. J Craniofac Surg 2017; 28:1797-1802. [PMID: 28834837 DOI: 10.1097/scs.0000000000003776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Maxillary fractures are frequently managed depending on the surgeon's preferences, nature of the injury, presence of associated injuries, and comorbidities. Current literature advocates open reduction with plating versus closed techniques. However, data defining associated costs and complications comparing the 2 approaches remains lacking. METHODS National Inpatient Sample (2006-2011) was examined for patients undergoing closed or open (76.73-76.74) reduction of maxillary fractures. Treatment-related complications were regarded as re-exploration of surgical site, hemorrhage, hematoma, seroma, wound infection, and dehiscence. RESULTS Overall, 22,157 patients were identified. There were 18,874 closed and 3283 open procedures. Median age was 35 (interquartile range 27). Median length of stay (LOS) was 4 days. Median total charges were reported as 51486.80 USD. Males comprised 77% of the cohort. 68% of patients were Caucasian. Private payer/HMO accounted for the largest source of health care coverage (43.5%). On risk-adjusted multivariate analysis, there was no difference in surgical approach regarding incidence of postoperative complications. Males (2.73), nonprivate insurer payer (P = 0.002), South region (2.49), and transferred patients (2.55) had higher incidence of complications. Presence of chronic pulmonary disease (2.87) and coagulopathy (6.62) also increased risk of complications. Length of stay was shorter for open reduction (0.68) versus closed. Total charges were also less for open approach (0.37). CONCLUSION While surgical approach did not affect complications, open approach favorably affected LOS and total charges. Future studies should focus on comorbidities, demographics, and associated injuries in relation to resource utilization for maxillary fractures. In current economic environment, such information might further dictate management options.
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179
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Malik S, Singh G, Kaur G, Yadav S, Mittal HC. Orofacial trauma in rural India: A clinical study. Chin J Traumatol 2017; 20:216-221. [PMID: 28330802 PMCID: PMC5555248 DOI: 10.1016/j.cjtee.2016.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/08/2016] [Accepted: 10/17/2016] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Orofacial trauma is becoming a leading medical problem worldwide. Most of the studies pertaining to orofacial trauma have been done in urban areas but very little scientific literature is available for rural areas. METHODS A prospective medical institute-based study of orofacial injury patients was carried out from May 2013 to April 2016 (36 Months). Data regarding incidence, age and sex distribution, causes, types and site of injury, treatment modalities and trauma associated complications were collected and analysed. RESULTS A total of 784 patients were studied. Males outnumbered females by a ratio of 2.9:1. Age range was 9 months-75 years with the peak incidence in the age-group of 18-34 years. Most injuries were caused by road-side accidents (72.7%), followed by assault and falls in 11.6% and 8% respectively. Soft tissue injuries and mandibular fractures were the most common type of injuries. Head/neck (50.29%) and limb injuries (27.2%) were the most prevalent associated injuries. Surgical debridement and soft tissue suturing was the most common emergency procedure. Closed reduction was performed in 61% of patients and open reduction and internal fixation in 30% of cases and 9% were managed conservatively. Complications occurred in 6.88% of patients, mainly due to infection and malocclusion. The mean duration of hospital stay was (10.12 ± 6.24) days. CONCLUSION This study highlights the importance of department of dental surgery along with other disciplinaries in the management of orofacial injuries. Road-side accident remains the major etiological factor of orofacial injuries in our setting.
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Affiliation(s)
- Sunita Malik
- BPS Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India,Corresponding author.
| | - Gurdarshan Singh
- BPS Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India
| | - Gagandeep Kaur
- Aadesh Institute of Dental Sciences and Research, Bathinda, Punjab, India
| | - Sunil Yadav
- BPS Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India
| | - Hitesh C. Mittal
- BPS Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India
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180
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Giudice G L, A A, F L, A L, F L, G C, M C. The Coronal Tooth Fractures: Preliminary Evaluation of a Three-Year Follow-Up of the Anterior Teeth Direct Fragment Reattachment Technique Without Additional Preparation. Open Dent J 2017; 11:266-275. [PMID: 28839475 PMCID: PMC5543613 DOI: 10.2174/1874210601711010266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/23/2017] [Accepted: 05/18/2017] [Indexed: 12/02/2022] Open
Abstract
Objective: The aim of this research is to describe and to analyse the long-term results and the clinical steps of direct fragment reattachment technique with no additional tooth preparation, used to treat crown fracture. This technique achieves the clinical success, combining satisfactory aesthetic and functional results with a minimally invasive approach. Methods: The 3 years follow-up included 9 patients (5 males, 4 females) with coronal fracture. In all the cases the fragment was available and intact. The authors illustrate the adhesive procedure used. Under local anaesthesia and after positioning the rubber dam, both the tooth and the fragment surface were etched, rinsed and applied by the adhesive system in order to obtain the retention of the fractured part to the tooth without additional tooth preparation or resin cement. Results: The statistical analysis shows the good performances of direct fragment reattachment technique. After 36 months, in 22.2% of the cases, the detachment was observed of the bonded fragment and in 11.1% of patients, complications were recorded. Conclusion: Our clinical experience shows how the ultra-conservative procedure used is fast, easy and offers a long term predictability; it also allows good functional and aesthetic outcomes.
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Affiliation(s)
- Lo Giudice G
- Department of Clinical and Experimental Medicine, Messina University, Cannizzaro, Messina, Italy
| | - Alibrandi A
- Department. of Economics, Statistics, Mathematics and Sociology, Messina University, Messina,Italy
| | - Lipari F
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, AOU Policlinico "G. Martino" Messina, Italy
| | - Lizio A
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, AOU Policlinico "G. Martino" Messina, Italy
| | - Lauritano F
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, AOU Policlinico "G. Martino" Messina, Italy
| | - Cervino G
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, AOU Policlinico "G. Martino" Messina, Italy
| | - Cicciù M
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, AOU Policlinico "G. Martino" Messina, Italy
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181
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Thapa S, Wang J, Hu HT, Zhang FG, Ji P. Epidemiology of Surgically Managed Mandibular Condylar Fractures at a Tertiary Referral Hospital in Urban Southwest China. Open Dent J 2017; 11:294-300. [PMID: 28839478 PMCID: PMC5543664 DOI: 10.2174/1874210601711010294] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 03/31/2017] [Accepted: 05/15/2017] [Indexed: 12/02/2022] Open
Abstract
Background: Mandibular condylar fracture is one of the commonest maxillofacial fractures treated by maxillofacial surgeons. Demography of the patients, causation, and characteristics of the fracture depends on various socio-economic factors. Hence, maxillofacial surgeons should be familiar with epidemiology of mandibular condylar fracture. Objective: This study retrospectively describes the demography, etiology, fracture characteristics, and hospital utilization of surgically treated mandibular condylar fractures in a tertiary referral hospital in urban China in past five years. Methods: Data of all patients who underwent surgical management between 2011 and 2015 were collected. This included aetiology, characteristics of fracture, time, age, sex, associated injuries, and hospital utilization of 166 patients with 208 mandibular condylar fractures. These patients had undergone open reduction and internal fixation with either miniplates or lag screws. Among the fracture of head of mandibular condyle, 21.28% of the patients had the fracture segments removed. These data were statistically analyzed to describe the epidemiology of mandibular condylar fracture. Results: Most of the patients had unilateral mandibular condylar fractures (74.7%). Male patients (76.51%) outnumbered female patients (23.49%) in this cohort. The average age of the patients was 37 years. The fractures were mostly caused by fall from height (60.84%) and were located at the condylar neck (53.61%). Most of the patients had other associated maxillofacial injuries (71.08%) which were mostly located at symphysis and parasymphysis (44.59%). It took 12.58 +/- 0.35 days of hospitalization for the treatment. Conclusion: Fall from height was the most prevalent cause of mandibular condylar injury in mountainous urban China. The people at highest risk were middle-aged men. Mandibular condylar fracture was mostly located at the condylar neck and was usually associated with fracture at the symphysis and parasymphysis.
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Affiliation(s)
- Swosti Thapa
- Department of Oral and Maxillofacial Surgery, Chongqing Medical University, Chongqing 401147, China
| | - Jun Wang
- Department of Oral and Maxillofacial Surgery, Chongqing Medical University, Chongqing 401147, China
| | - Hong-Tao Hu
- Department of Oral and Maxillofacial Surgery, Chongqing Medical University, Chongqing 401147, China
| | - Fu-Gui Zhang
- Department of Oral and Maxillofacial Surgery, Chongqing Medical University, Chongqing 401147, China
| | - Ping Ji
- Department of Oral and Maxillofacial Surgery, Chongqing Medical University, Chongqing 401147, China
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182
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Abdul Razak N, Nordin R, Abd Rahman N, Ramli R. A retrospective analysis of the relationship between facial injury and mild traumatic brain injury. Dent Traumatol 2017. [PMID: 28649703 DOI: 10.1111/edt.12355] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS The association between facial injury characteristics and mild traumatic brain injury (mTBI) is unclear. The aim of this study was to determine the association between facial injury characteristics and mTBI. METHODS A retrospective review utilizing patients' medical records at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia, was performed. Records of subjects with a history of facial trauma from 1 April 2012 to 31 December 2012 were selected. Various levels and surgical speciality records were reviewed to ascertain the diagnoses of facial injuries and mTBI. RESULTS A total of 348 medical records with the diagnosis of facial injuries were included. The prevalence of mTBI among these patients was 41.4% (95% CI 36.2-46.6). The majority of the patients with mTBI were in the age group of 18-25 years old. Patients with or without facial lacerations that were located on the lower face had a significant association with mTBI, P=.001, compared to other types of soft tissue injury. In addition, a statistically significant association was observed between facial fractures occurring to the middle face and mTBI, P=.018. Pearson chi-square test also showed statistically significant association between the severity of facial injuries and mTBI, P=.018. CONCLUSIONS Mild traumatic brain injury should be suspected in patients with facial injuries and particularly those with lower face lacerations, midface fractures, moderate to severe facial injury and presence of multiple injuries.
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Affiliation(s)
- Nurliza Abdul Razak
- Oral and Maxillofacial Surgery, Hospital Teluk Intan, Teluk Intan, Perak, Malaysia
| | - Rifqah Nordin
- Department of Oral & Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | | | - Roszalina Ramli
- Department of Oral & Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Abstract
INTRODUCTION Motor vehicle accidents (MVA) and falls are major causes of maxillofacial injuries posing real challenges for the medical staff. PURPOSE To describe the demographic and injury characteristics, as well as the treatment procedures of casualties diagnosed with maxillofacial injuries. METHODS The investigators implemented a multicenter retrospective study composed of hospitalized maxillofacial trauma patients recorded in the Israel Trauma Registry for 2000 to 2011. The predictor variable was mechanism of injury and the outcome variable was type of injury, severity, and hospital resources utilization. Descriptive and bivariate statistics with P values was set at 0.05. RESULTS The study included 11,592 reported hospitalized maxillofacial trauma patients (39.4% of them were MVA, 33.5% were falls), with a male predominance of a 3:1 ratio. The high-risk age groups were the first 3 decades of life in both etiologies, while age groups above 75 years were also frequent in falls. Severity of maxillofacial injuries, multiple injuries, admission to intensive care units, hospitalization for more than 15 days, inpatient mortality, and rehabilitation after discharge was significantly higher in MVA compared with falls. Conversely, maxillofacial surgeries were performed slightly more among patients injured in falls (34.1% and 31.1% respectively), as tongue and mouth are more prone targets in falls, compared with zygoma, maxilla, mandible, and teeth in MVA. CONCLUSION The results of this study suggest that the etiologies present an entire separate pattern of trauma. A better understanding and proper identification of their high-risk groups should lead to appropriate prevention programs and treatment protocols.
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184
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Silva T, Grenho L, Barros J, Silva JC, Pinto RV, Matos A, Colaço B, Fernandes MH, Bettencourt A, Gomes PS. A minocycline-releasing PMMA system as a space maintainer for staged bone reconstructions-in vitro antibacterial, cytocompatibility and anti-inflammatory characterization. ACTA ACUST UNITED AC 2017; 12:035009. [PMID: 28333042 DOI: 10.1088/1748-605x/aa68b8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In the present work, we study the development and biological characterization of a polymethyl methacrylate (PMMA)-based minocycline delivery system, to be used as a space maintainer within craniofacial staged regenerative interventions. The developed delivery systems were characterized regarding solid state characteristics and assayed in vitro for antibacterial and anti-inflammatory activity, and cytocompatibility with human bone cells. A drug release profile allowed for an initial burst release and a more sustained and controlled release over time, with minimum inhibitory concentrations for the assayed and relevant pathogenic bacteria (i.e., Staphylococcus aureus, slime-producer Staphylococcus epidermidis and Escherichia coli) being easily attained in the early time points, and sustained up to 72 h. Furthermore, an improved osteoblastic cell response-with enhancement of cell adhesion and cell proliferation-and increased anti-inflammatory activity were verified in developed systems, compared to a control (non minocycline-loaded PMMA cement). The obtained results converge to support the possible efficacy of the developed PMMA-based minocycline delivery systems for the clinical management of complex craniofacial trauma. Here, biomaterials with space maintenance properties are necessary for the management of staged reconstructive approaches, thus minimizing the risk of peri-operative infections and enhancing the local tissue healing and early stages of regeneration.
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Affiliation(s)
- Tiago Silva
- Laboratory for Bone Metabolism and Regeneration-Faculty of Dental Medicine, U. Porto-Porto, Portugal
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185
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Anslem O, Eyituoyo O, Olabode OV, Ademola OA, Adesina AO. A comparative study of intermaxillary fixation screws and noncompression miniplates in the treatment of mandibular fractures: a prospective clinical study. Oral Maxillofac Surg 2017; 21:233-240. [PMID: 28386782 DOI: 10.1007/s10006-017-0622-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 03/28/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The main goal of treatment of mandibular fractures is to restore normal dental occlusion and promote appropriate bone healing and a normal mouth opening. Recently, there has been a resurgent interest in the use of screws for intermaxillary fixation of mandibular fractures. This study was therefore designed to determine how the clinical outcomes of the use of screws for intermaxillary fixation compare with the use of miniplates in the treatment of mandibular fractures in Nigeria. OBJECTIVES The objectives of this study are as follows: 1. To compare the clinical outcomes of the use of 2.0 mm × 9.0 mm screws for intermaxillary fixation with 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures in Lagos, Nigeria 2. To determine the clinical outcomes in the use of 2.0 mm × 9.0 mm screws for intermaxillary fixation (IMF) and 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures 3. To compare the complications associated with the use of 2.0 mm × 9.0 mm screws for IMF and 2.0 mm noncompression miniplates in the treatment of mandibular fractures METHODOLOGY: This randomized controlled clinical study was carried out at the Department of Oral and Maxillofacial Surgery of the study institution. Subjects with simple unilateral mandibular fractures who met the inclusion criteria were randomly allocated into the study (intermaxillary fixation screw) and control (miniplate) groups through balloting. Factors assessed and compared during and after the procedures included intraoperative pain, postoperative nerve impairment, postoperative occlusion, limitation of mouth opening, incidence of hardware failure, incidence of infection and non-union. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 20. RESULTS A total of 56 subjects participated in the study, with 28 subjects in each group. Majority (91%) of the subjects were male. Road traffic crash was the highest aetiological factor while sport was the least (3.6%). A higher proportion (25.0%) of subjects in the miniplate group had major complications compared with 14.3% in the IMF screw group. There was no statistically significant association between site of mandibular fracture, time elapsed before treatment and complications (p < 0.05). All cases of mandibular fractures healed successfully at 6 weeks. CONCLUSION The use of screws for IMF is as effective as 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures.
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Affiliation(s)
- Osasuyi Anslem
- Oral and Maxillofacial Surgery, Nigerian Air Force Hospital, Nigerian Air Force Base, Kaduna, Nigeria
| | - Okoturo Eyituoyo
- Head and Neck Surgical Oncology Division, Oral and Maxillofacial Surgery Department, Lagos State University College of Medicine/Teaching Hospital, Lagos, Nigeria.
| | - Ogunbanjo V Olabode
- Oral and Maxillofacial Surgery Department, Lagos State University College of Medicine/Teaching Hospital, Lagos, Nigeria
| | - Olaitan A Ademola
- Oral and Maxillofacial Surgery Department, Lagos State University College of Medicine/Teaching Hospital, Lagos, Nigeria
| | - Ayodele O Adesina
- Oral and Maxillofacial Surgery Department, General Hospital, Lagos, Nigeria
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186
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Abstract
BACKGROUND Intermaxillary fixation (IMF) techniques are commonly used in mandibular fracture treatment to reduce bone fragments and re-establish normal occlusion. However, non-IMF reduction techniques such as repositioning forceps may be preferable due to their quick yet adequate reduction. The purpose of this paper is to assess which non-IMF reduction techniques and reduction forceps are available for fracture reduction in the mandible. METHODS A systematic search was performed in the databases of Pubmed and EMBASE. The search was updated until February 2016 and no initial date and language preference was set. RESULTS 14 articles were selected for this review, among them ten articles related to reduction forceps and four articles describing other techniques. Thus, modification and design of reduction forceps and other reduction techniques are qualitatively described. CONCLUSION Few designs of repositioning forceps have been proposed in the literature. Quick and adequate reduction of fractures seems possible with non-IMF techniques resulting in anatomic repositioning and shorter operation time, especially in cases with good interfragmentary stability. Further development and clinical testing of reduction forceps is necessary to establish their future role in maxillofacial fracture treatment.
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187
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Bonavolontà P, Dell'aversana Orabona G, Abbate V, Vaira LA, Lo Faro C, Petrocelli M, Attanasi F, De Riu G, Iaconetta G, Califano L. The epidemiological analysis of maxillofacial fractures in Italy: The experience of a single tertiary center with 1720 patients. J Craniomaxillofac Surg 2017; 45:1319-1326. [PMID: 28606439 DOI: 10.1016/j.jcms.2017.05.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/06/2017] [Accepted: 05/11/2017] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Maxillofacial fractures represent a serious public health problem. Their epidemiology is extremely variable, and its analysis is crucial to establish effective treatment and prevention of these injuries. However only two works have been published about maxillofacial fracture epidemiology in Italy. MATERIALS AND METHODS The records of 1720 patients diagnosed with maxillofacial fractures in a 15-years period (2001-2015) in our department were retrospectively reviewed. RESULTS A total of 1108 male and 612 female patients were included in the study. The most frequent aetiology of fracture was road traffic injuries (57.1%), followed by assault (21.7%), falls (14.2%), work accidents (3.5%), sport accidents (3.3%) and other causes (0.2%). Significant variations of aetiology were detected between males and females and between Italians and individuals from other countries. The most frequently observed fracture involved the mandible (861 cases, 36%), followed by zygoma (489 cases, 20.4%), orbital walls (386 cases, 16.1%) and maxilla (282 cases, 11.8%). CONCLUSION Road traffic legislation enforcement and continuous public education regarding the use of security devices remain an ongoing problem in our region and should be encouraged. In the same way, as migration flows influence and change the epidemiology of facial traumas, it is crucial to establish social support programs that avoid these disadvantaged categories of victims of violence and crime.
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Affiliation(s)
- Paola Bonavolontà
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
| | - Giovanni Dell'aversana Orabona
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy.
| | - Carmelo Lo Faro
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
| | - Marzia Petrocelli
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
| | | | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit (Head: Dott. Giacomo De Riu), University Hospital of Sassari, Viale San Pietro 43B, 07100 Sassari, Italy
| | - Giorgio Iaconetta
- Neurosurgery Operative Unit (Head: Prof. Giorigio Iaconetta), University Hospital of Salerno, Via Allende, 84081 Baronissi, Salerno, Italy
| | - Luigi Califano
- Maxillofacial Surgery Operative Unit (Head: Prof. Luigi Califano), University Hospital of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy
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188
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Abstract
The management of soft tissue injury after facial trauma poses unique challenges to the plastic surgeon, given the specialized nature of facial tissue and the aesthetic importance of the face. The general principles of trauma management and wound care are applied in all cases. The management of severe injuries to the face is discussed in relation to the location and the mechanism of injury. Facial transplants have arisen in the past decade for the management of catastrophic soft tissue defects, although high morbidity and mortality after these non-life-saving operations must be considered in patient selection.
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Affiliation(s)
- Tara L Braun
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Renata S Maricevich
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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189
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Abstract
The consequences of facial trauma remain of great significance both functionally and esthetically. Traffic accident-related facial trauma is a frequent and significant cause of maxillofacial injury. The purpose of this study was to determine the natural history of traffic accident-related facial injuries in 846 patients over a 10-year period at a regional emergency center. The authors report a retrospective study of 846 patients with facial trauma from traffic accidents. The medical records of these patients were reviewed and analyzed to determine clinical characteristics, treatments, and outcomes of traffic accident-related facial trauma. In total, 687 of the 846 patients (81.2%) had fractures of the face, and nasal bone fractures were the most common followed by zygomatic complex fractures, blow-out fractures, and maxilla fractures. About 51.2% patients had open wounds on the face, such as lacerations, abrasions, skin or soft tissue defects, and friction burns. Only 7.4% of patients were treated conservatively and the others underwent repair or closed and open reduction. The complication rate was 46.3%, and scars were the most common followed by nose-related complication, hypoesthesia, and eyelid deformities. In addition, 47.6% of complication patients underwent secondary operations. Almost 15% of drivers were drunk, and about 8.7% were confessed drowsy during drive. Almost 30% of pedestrians were hit when they jaywalked across the street. Epidemiological data regarding traffic accident-related facial trauma are important and useful not only for decisions about patient care and developing optimal treatment regimens but to develop new methods to prevent injuries.
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190
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An Analysis of Independent Variables Affecting Surgical Outcomes in Patients Undergoing Repair of Maxillofacial Trauma. J Craniofac Surg 2017; 28:596-599. [DOI: 10.1097/scs.0000000000003545] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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191
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Obimakinde OS, Ogundipe KO, Rabiu TB, Okoje VN. Maxillofacial fractures in a budding teaching hospital: a study of pattern of presentation and care. Pan Afr Med J 2017; 26:218. [PMID: 28690732 PMCID: PMC5491718 DOI: 10.11604/pamj.2017.26.218.11621] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/26/2017] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Previous reports indicated that there is geographic and sociodemographic variation in the epidemiology of maxillofacial fractures. Audit of maxillofacial injuries managed at any institution is therefore necessary to understand the trends and proffer strategies for prevention. We therefore embarked on this study to determine the pattern of maxillofacial fractures and concomitant injuries in our institution. METHODS We carried out a retrospective review of information on demography, aetiology and type of maxillofacial fracture, patients' status, type of crash, level of consciousness and concomitant injuries. The data collected was analysed with SPSS Version 20. RESULTS A total of 233 patients aged 2 to 66 years were reviewed. A higher male preponderance (M:F 3.4:1) was observed. Road traffic crashes (RTC) accounted for 78.5% of injuries. Motorcycle related crashes were responsible for 69.4% of RTC and 54.5% of all fractures. Fracture of the mandible (63.2% n=172) was the most predominant skeletal injury and the body (25% n=43) was the most common site of fracture while the zygoma (29%) was predominantly affected in the midface. Ninety three patients (40%) suffered loss of consciousness. The relationship between aetiology of injuries and consciousness level of the patients was statistically significant (p=0.001). Of the 43 patients who had concomitant injuries, craniocerebral affectation (60.5%) was the commonest. CONCLUSION RTC remains the major aetiology of maxillofacial fractures. The mandible was mostly affected and nearly half of the patients have associated loss of consciousness. There is need for continual advocacy and enforcement of laws on preventive measures among road users.
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192
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Castro-Núñez J, Shelton JM, Snyder S, Sickels JV. Virtual Surgical Planning for the Management of Severe Atrophic Mandible Fractures. Craniomaxillofac Trauma Reconstr 2017; 11:150-156. [PMID: 29892332 DOI: 10.1055/s-0037-1601865] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 02/05/2017] [Indexed: 10/19/2022] Open
Abstract
Severely atrophic mandible fractures are frequently a challenge to treat. Virtual surgical planning (VSP) uses three-dimensional computed tomographic (CT) scans that can be translated into stereolithographic models to fabricate surgical templates, facilitating intraoperative procedures. The purpose of this article is to describe the reconstruction of two cases of severe atrophic mandible fracture using VSP. Two elderly edentulous/partially dentate patients who presented with fractures of their mandibles and who underwent reconstruction using VSP were included. Both had Class III atrophy at the region of the fracture. While both fractures were complex, the mechanism of injury differed with one being a tractor accident and the other being a pathologic fracture. Both patients presented with critical medical conditions. CT scans were obtained on both. The displaced segments were aligned virtually using mirror images and the midline of the maxilla. Three-dimensional models were fabricated to allow preoperative contouring of 2.5-mm reconstruction plates. Patients were operated under general anesthesia and fractures reduced and stabilized with 2.5-mm reconstruction plates placed at the lateral border of the mandible. Average treatment time for both patients was a little over 2 hours. There was good reduction with both. VSP is a valuable tool to assess and reduce complex fractures with less surgical time and predictable results.
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Affiliation(s)
- Jaime Castro-Núñez
- Division of Oral and Maxillofacial Surgery, University of Kentucky, Lexington, Kentucky.,Institución Universitaria Colegios de Colombia. Bogotá, Colombia
| | - Jared M Shelton
- Division of Oral and Maxillofacial Surgery, University of Kentucky, Lexington, Kentucky
| | - Susan Snyder
- Division of Oral and Maxillofacial Surgery, University of Kentucky, Lexington, Kentucky
| | - Joseph Van Sickels
- Division of Oral and Maxillofacial Surgery, University of Kentucky, Lexington, Kentucky
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193
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Gutmacher Z, Peled E, Norman D, Lin S. Alveolar Bone Fracture: Pathognomonic Sign for Clinical Diagnosis. Open Dent J 2017; 11:8-14. [PMID: 28400864 PMCID: PMC5362980 DOI: 10.2174/1874210601711010008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/28/2016] [Accepted: 01/08/2017] [Indexed: 11/22/2022] Open
Abstract
Aim: Dental injuries, especially luxation and avulsion, are common. Dental trauma can cause alveolar bone fracture that can lead to tooth loss and malocclusion. Single tooth alveolar bone fractures are difficult to identify unless it protrudes through the overlying mucosa and can be visualized. Pain, malocclusion, and tooth mobility provide signs of suspected alveolar bone fractures. Integrity of the proximate alveolar bone should be examined for fractures where avulsion, luxation, or other tooth trauma is detected. Any suggestion of alveolar fractures should be further investigated with an appropriate radiograph. Summary: This case report shows a pathognomonic sign that detects and diagnosis single tooth alveolar bone fractures, i.e., a localized hematoma crossing the attached gingiva from the free gingival margin to the vestibular mucosa. This should serve as a warning for localized alveolar bone fracture. A visualized hematoma and gentle, careful palpation may help detect covered fractures when the overlying mucosa is not perforated.
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Affiliation(s)
- Zvi Gutmacher
- Department of Maxillofacial Rehabilitation, Rambam Health Care Campus, Haifa, Israel
| | - Eli Peled
- Department of Orthopedic Surgery B, Rambam Health Care Campus, Haifa, Israel; The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Doron Norman
- Department of Orthopedic Surgery B, Rambam Health Care Campus, Haifa, Israel; The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Shaul Lin
- The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Endodontic and Dental Trauma Department, Rambam Health Care Campus, Haifa, Israel
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194
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Abstract
From 2000 to 2010, 720 patients with facial trauma were admitted in Plastic Surgery Service of Argerich Hospital, Buenos Aires, Argentina; 58 of them with panfacial fractures were included in this study. Height velocity impact is the principal etiology, and most concomitant extrafacial injuries are neurocranium and cervical spine. Common affected areas were orbits, nose, and malar-zygoma. The timing of the treatment was airway evaluation, control of bleeding and consciousness, treatment of associated injuries, and finally facial reconstruction. The applications of craniofacial surgical techniques complete facial treatment in only operatory time by means of standard approaches like coronal, subciliar palpebral, upper and lower vestibular. The treatment was exploration to open sky; reduction and fijation with titanium plates; replacement of comminuted bones with bone autografts harvested iliac crest, calvary, and costal bones. The results were classificated acceptables in 48 (85%) and not acceptables in 9 (15%) according to successful reconstruction of the both form and armony facial, persistent esthetic and functional sequels, and postoperative complications. Postoperative complications were detected in 18 patients. According to most authors the use of internal rigid fixation and bone autograf permits obtaining the best aesthetic and functional results decreasing complications and sequels. The recuperation of tridimensional aspect of the face and aesthetic and functional pretrauma state must be the goal standard.
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195
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Monnazzi MS, Gabrielli MAC, Gabrielli MFR, Trivellato AE. Treatment of mandibular condyle fractures. A 20-year review. Dent Traumatol 2017; 33:175-180. [DOI: 10.1111/edt.12326] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Marcelo S. Monnazzi
- Dental School of Araraquara; UNESP; Araraquara Brazil
- Periodontology and Maxillofacial Surgery Department; Dental School of Ribeirão Preto; USP; Ribeirão Preto Brazil
| | - Marisa A. C. Gabrielli
- Diagnosis and Maxillofacial Surgery Department; Dental School of Araraquara; UNESP; Araraquara Brazil
| | - Mário F. R. Gabrielli
- Diagnosis and Maxillofacial Surgery Department; Dental School of Araraquara; UNESP; Araraquara Brazil
| | - Alexandre E. Trivellato
- Periodontology and Maxillofacial Surgery Department; Dental School of Ribeirão Preto; USP; Ribeirão Preto Brazil
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196
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Halsey JN, Hoppe IC, Granick MS, Lee ES. A Single-Center Review of Radiologically Diagnosed Maxillofacial Fractures: Etiology and Distribution. Craniomaxillofac Trauma Reconstr 2017; 10:44-47. [PMID: 28210407 PMCID: PMC5305313 DOI: 10.1055/s-0036-1597582] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 09/17/2016] [Indexed: 10/20/2022] Open
Abstract
The etiology of fractures of the maxillofacial skeleton varies among studies, with motor vehicle accidents and assaults oftentimes the most common. The number of males outnumbers females throughout most studies. Fractures of the zygoma, orbit, and mandible are usually cited as most common fracture types. This study examines a single center's experience with regards to etiology and distribution of fractures. A retrospective review of all radiologically confirmed facial fractures in a level 1 trauma center in an urban environment was performed for the years 2000 to 2012. Patient demographics, etiology of injury, and location of fractures were collected. During this time period, 2,998 patients were identified as having sustained a fracture of the facial skeleton. The average age was 36.9 years, with a strong male predominance (81.5%). The most common etiologies of injury were assault (44.9%) and motor vehicle accidents (14.9%). Throughout the study period, the number of fractures as a result of assault remained relatively constant, whereas the number as a result of motor vehicle accidents decreased slightly. The most common fracture observed was of the orbit, followed by mandible, nasal bones, zygoma, and frontal sinus. Patients sustaining a fracture as a result of assault were more likely to have a mandible fracture. Patients in motor vehicle accidents were more likely to suffer fractures of the maxilla, orbit, and frontal sinus. Mandible fractures are more common in cases of assault. Motor vehicle accidents convey a large force, which, when directed at the craniofacial skeleton, can cause a variety of fracture patterns. The decreasing number of fractures as a result of motor vehicle accidents may represent improved safety devices such as airbags.
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Affiliation(s)
- Jordan N. Halsey
- Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Ian C. Hoppe
- Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Mark S. Granick
- Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Edward S. Lee
- Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
- Department of Plastic Surgery, VA New Jersey Health Care System, East Orange, New Jersey
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197
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Rezaei M, Jamshidi S, Jalilian T, Falahi N. Epidemiology of maxillofacial trauma in a university hospital of Kermanshah, Iran. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2017. [DOI: 10.1016/j.ajoms.2016.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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198
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Han L, Long T, Tang W, Liu L, Jing W, Tian WD, Long J. Correlation between Condylar Fracture Pattern after Parasymphyseal Impact and Condyle Morphological Features: A Retrospective Analysis of 107 Chinese Patients. Chin Med J (Engl) 2017; 130:420-427. [PMID: 28218215 PMCID: PMC5324378 DOI: 10.4103/0366-6999.199836] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: The treatment of the condylar fractures is difficult. Factors that result in the fractures are complex. The objective of this morphometric study was to investigate the relationship between condylar fracture patterns and condylar morphological characteristics. Methods: We conducted a retrospective analysis of 107 patients admitted to the West China Hospital of Stomatology for bilateral condylar fractures caused by parasymphyseal impact. The patients were divided into five groups according to the type of condylar fracture. Ten parameters were evaluated on three-dimensional (3D) reconstruction mandible models through the Mimics 16.0 (Materialize Leuven, Belgium) anthropometry toolkit. Each parameter of the 3D models was analyzed using multivariate analysis. Multinomial logistic regression analyses were used to examine the relationships between the five groups. Results: The results showed that the differences of condylar head width (M1), condylar neck width (M3), the ratio of condylar head width to condylar anteroposterior diameter (M1/M2), the ratio of condylar head width to condylar neck width (M1/M3), the ratio of condylar height to ramus height (M8/M7), and mandibular angle (M10) were statistically significant (p < 0.05). Type A condylar head fractures were positively associated with M1 (compared to Type B: OR =1.627, 95% CI: 1.123, 2.359; compared to Type C: OR = 1.705, 95% CI: 1.170, 2.484) and M1/M2 (compared to Type B: OR =1.034, 95% CI: 0.879, 2.484). Type B condylar head fractures were negatively associated with M10 (compared to Type C: OR = 0.909, 95% CI: 0.821, 1.007). Condylar neck fractures were negatively associated with M3 (compared to condylar head: OR = 0.382, CI: 0.203, 0.720; compared to condylar base: OR = 0.436, 95% CI: 0.218, 0.874), and positively associated with M1/M3 (compared to condylar head: OR = 1.229, 95% CI: 1.063, 1.420 compared to condylar base: OR = 1.223, 95% CI: 1.034, 1.447). Condylar base fractures were positively associated with M10 (OR = 1.095, 95% CI: 1.008, 1.189) and negatively associated with M8/M7 (OR = 0.855, 95% CI: 0.763, 0.959) as compared with condylar head fractures. Conclusions: Condylar fracture pattern is associated with the anatomical features of the condyles when a fracture occurs from parasymphyseal impact.
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Affiliation(s)
- Lu Han
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, Sichuan 610041; Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ting Long
- Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Tang
- Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Lei Liu
- Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Jing
- Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei-Dong Tian
- Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jie Long
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, Sichuan 610041; Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
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199
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Fama F, Cicciu M, Sindoni A, Nastro-Siniscalchi E, Falzea R, Cervino G, Polito F, De Ponte F, Gioffre-Florio M. Maxillofacial and concomitant serious injuries: An eight-year single center experience. Chin J Traumatol 2017; 20:4-8. [PMID: 28209449 PMCID: PMC5343103 DOI: 10.1016/j.cjtee.2016.11.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 12/31/2016] [Accepted: 01/03/2017] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Maxillofacial injuries are frequently associated with multiple trauma and can determine functional and aesthetic bad outcomes. The severity of maxillofacial injuries may be considerable and can divert clinicians' attention from other concomitant injuries which is less evident but potentially life-threatening. The aim of this study was to find out the concomitant injuries in patients referred to the Emergency Department (ED) of the University Hospital of Messina (North-East Sicily, Italy) for maxillofacial traumas. METHODS We retrospectively evaluated data of 240,833 patients admitted at the ED of the University Hospital of Messina from January 2008 to December 2015 because of maxillofacial injuries leading to hospitalization and surgical treatment. Patients who primarily received treatment care at different institutions, pediatric trauma patients and adult patients who were transferred in accordance with pre-existing agreements in case of paucity of beds were excluded. Finally we included 447 (0.2%) patients over the 8 years. Data were evaluated with emphasis on epidemiology (age, gender, mechanism of trauma), primary survey and abnormalities and pattern of trauma. RESULTS The most frequent cause of maxillofacial trauma was road accidents (319 patients, 71.4%), among which motorcycle ones were prevalent. The maxillofacial injured who presented major lesions were 98 patients and minor lesions occurred in 349 patients; 443 (99.1%) patients underwent maxillofacial surgery, immediate or delayed depending on the severity of concomitant injuries (χ2 = 557.2, p < 0.0001). Five concomitant neglected lesions were found to be associated with severe maxillofacial traumas (χ2 = 17.13, p < 0.0001 vs minor lesions). All of the neglected lesions occurred in paucisymptomatic patients who showed painless abdomen, no hemodynamic instability, no signs of hematoma of anterior and posterior abdominal wall or other suspicious clinical signs and symptoms. CONCLUSION Among the patients admitted firstly in other surgical wards different from the Maxillofacial Surgery Unit, diagnosis was more difficult, especially for blunt abdominal traumas, in which patients showed only vague and nonspecific symptoms concealing serious and life-threatening injuries. We recommend the routine use of whole body CT scan, when the maxillofacial injuries appear prevalent, mainly in patients affected by maxillofacial major lesions.
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Affiliation(s)
- Fausto Fama
- Department of Human Pathology, University Hospital of Messina, 98125 Messina, Italy,Corresponding author. Fax: +39 0902212801.
| | - Marco Cicciu
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Alessandro Sindoni
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Enrico Nastro-Siniscalchi
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Roberto Falzea
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Francesca Polito
- Department of Clinical and Experimental Medicine, University Hospital of Messina, 98125 Messina, Italy
| | - Francesco De Ponte
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98125 Messina, Italy
| | - Maria Gioffre-Florio
- Department of Human Pathology, University Hospital of Messina, 98125 Messina, Italy
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200
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Facial trauma and associated factors among Brazilian victims of motorcycle accidents. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-016-0758-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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