Maxillofacial trauma in the gulf countries: a systematic review

Automated detection and classification of mandibular fractures on multislice spiral computed tomography using modified convolutional neural networks

OBJECTIVE

To evaluate the performance of convolutional neural networks (CNNs) for the automated detection and classification of mandibular fractures on multislice spiral computed tomography (MSCT).

STUDY DESIGN

MSCT data from 361 patients with mandibular fractures were retrospectively collected. Two experienced maxillofacial surgeons annotated the images as ground truth. Fractures were detected utilizing the following models: YOLOv3, YOLOv4, Faster R-CNN, CenterNet, and YOLOv5-TRS. Fracture sites were classified by the following models: AlexNet, GoogLeNet, ResNet50, original DenseNet-121, and modified DenseNet-121. The performance was evaluated for accuracy, sensitivity, specificity, and area under the curve (AUC). AUC values were compared using the Z-test and P values <.05 were considered to be statistically significant.

RESULTS

Of all of the detection models, YOLOv5-TRS obtained the greatest mean accuracy (96.68%). Among all of the fracture subregions, body fractures were the most reliably detected (with accuracies of 88.59%-99.01%). For classification models, the AUCs for body fractures were higher than those of condyle and angle fractures, and they were all above 0.75, with the highest AUC at 0.903. Modified DenseNet-121 had the best overall classification performance with a mean AUC of 0.814.

CONCLUSIONS

The modified CNN-based models demonstrated high reliability for the diagnosis of mandibular fractures on MSCT.

Patterns and Characteristics of Midface Fractures in North-Eastern Romania

Midface fractures are common injuries that are the result of interpersonal violence, traffic accidents, falls, work-related accidents, sports-related accidents, or animal aggression. In the northeastern part of Romania, these injuries are a significant health concern that, if left untreated, may lead to functional and esthetic sequelae. Background and Objectives: This study aims to update the statistical data available to help promote a different lifestyle, with awareness campaigns to prevent aggression, accidents, and domestic violence. Materials and Methods: This research was conducted over five years and included 651 patients of both sexes, with ages between 3 and 95 years, that addressed our center for midface fracture treatment. Results: The authors of this study found that men are more predisposed to fractures of the middle third of the face, with anterior laterofacial fractures being the most common type of fracture. Interpersonal violence was the most incriminated etiology for all midface fractures. Conclusions: The present study regarding midfacial fractures shows similar results compared to the medical literature. These findings could help promote a different lifestyle, with awareness campaigns to prevent aggression, accidents, and domestic violence.

Etiology, Epidemiology, and Treatment Type of Maxillofacial Traumas in Razavi Khorasan Province with Certain Insurance between 2016 and 2021

Background

Trauma is a leading cause of death and disability in developing countries, with maxillofacial fractures being a significant part of such cases. This study focuses on maxillofacial traumas among insured patients in Razavi Khorasan province (2016-2021), exploring the impact of gender, age, and trauma causes on injury prevalence and treatment approaches.

Methods

This retrospective cross-sectional study utilized the records of the patients who were treated for maxillofacial fractures in Mashhad Shahid Kamyab Hospital or a Private Trauma Center, from 2016 to 2021. Demographic characteristics of the patients (age and gender), educational backgrounds of surgeons, accident causes, year and location of the fractures, and reasons for referrals were recorded. The data were statistically analyzed using SPSS 20, and the significance level was set at 0.05.

Results

We examined the records of 60 patients (44 males, 16 females). Males (73.4%) exhibited a significantly higher prevalence of maxillofacial traumas compared to females (26%) (P Value < 0.05). Falling was identified as the most common cause of fractures (51.7%), followed by impacts from hard objects and motor vehicle accidents (MVA) (P Value = 0.63). Mandible fractures were observed in 48% of patients, followed by zygomaticomaxillary and panfacial fractures, subsequently (P Value < 0.05).

Conclusion

The study findings highlight the impact of age, gender, and trauma causes on maxillofacial fractures and treatments among patients with certain insurance. Understanding the origins and patterns of these fractures offers crucial insights for shaping effective health policies, providing valuable guidance for addressing such injuries in this population.

Epidemiology of maxillofacial injuries in "Heratsi" No 1 university hospital in Yerevan, Armenia: a retrospective study

Background

The aim of this study was to perform a retrospective analysis of the prevalence, etiologies, types of maxillofacial injuries (MFIs), sites of maxillofacial fractures (MFFs) and their management in Yerevan, Armenia.

Methods

A retrospective cross-sectional study was conducted. The extracted data included age, sex, date of referral, mode of injury, etiology, radiology records and treatment methods. Study outcomes were measured using percentages, means, standard deviations and tests of proportions. P < .05 was considered significant.

Results

A total of 204 patients had a mean age of 36.26 ± 1.08 years (156 males and 48 females), and a total of 259 MFIs were recorded between 2017 and 2020. Interpersonal violence was found to be the most common etiology of MFFs in this study (42.1%), followed by road traffic accidents (RTAs) (27.9%) and falls (18.6%). The nasal bone was the most common injury site (47.5%), followed by the mandible (31.4%) and zygomatic complex (11.7%). The most common fracture site was the mandibular angle (37.9%), followed by the symphysis/parasymphysis (28.1%) and body (12.6%). Isolated soft tissue injuries were reported in 5.9% of the cases. The majority of MFFs were treated by open reduction and internal fixation.

Conclusion

Interpersonal violence, followed by RTAs and falls, was the most common cause of MFIs. Males in the 21–30 years age group had the highest MFI incidence rate. The nasal bone was the most common injury site, followed by the mandible and zygomatic complex. Social education with the objective of reducing aggression and interpersonal conflict should be improved, and appropriate RTA prevention strategies should be strengthened and implemented.