1
|
Tao YK, Zhao Y, Li Z. A Temporary Intraoperative Fixation Method for the Absorbable Plates Fixation of Condylar Fracture by Retromandibular Transparotid Approach. J Craniofac Surg 2024; 35:e94-e96. [PMID: 37972993 DOI: 10.1097/scs.0000000000009893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 11/19/2023] Open
Abstract
The authors describe a temporary intraoperative fixation method for the absorbable plates' fixation of subcondylar fracture by retromandibular transparotid approach. First, the fracture was temporarily fixed with a 4-hole titanium microplate across the fracture line in the center of the lateral surface of the condyle to maintain the reduction of the fracture. Then, two 4-hole absorbable mini-plates were fixed on the posterior and anterior border of the condylar neck. Finally, the 4-hole titanium microplate and screws were removed before the wound closure. In the absorbable plates' fixation of subcondylar fracture by transparotid approach, the method of temporary intraoperative fixation using a 4-hole titanium microplate offsets the limited exposure of the operative field, smooths the operation, and offers the reliability and validity of the absorbable plates' fixation.
Collapse
Affiliation(s)
- Yan-Kai Tao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration
- Key Laboratory of Oral Biomedicine Ministry of Education
- Hubei Key Laboratory of Stomatology; School & Hospital of Stomatology, Wuhan University
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan
| | - Yang Zhao
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Zhi Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration
- Key Laboratory of Oral Biomedicine Ministry of Education
- Hubei Key Laboratory of Stomatology; School & Hospital of Stomatology, Wuhan University
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan
| |
Collapse
|
2
|
Roccia F, Sobrero F, Raveggi E, Rabufetti A, Scolozzi P, Dubron K, Politis C, Ganasouli D, Zanakis SN, Jelovac D, Konstantinovic VS, Birk A, Vesnaver A, Knežević P, Dediol E, Kordić M, Sivrić A, Rizvi AO, Laverick S, Vilaplana NV, Roig AM, Derkuş FE, Yilmaz UN, Goetzinger M, Bottini GB, Ramieri G. European multicenter prospective analysis of the use of maxillomandibular fixation for mandibular fractures treated with open reduction and internal fixation. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101376. [PMID: 36587846 DOI: 10.1016/j.jormas.2022.101376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The goal of mandibular fracture treatment is to restore static and dynamic occlusal functions. Open reduction and internal fixation (ORIF) of these fractures can be associated with an intraoperative and/or postoperative maxillo-mandibular fixation (MMF). The aim of this study was to analyse the use of perioperative MMF and its effects on occlusal outcomes in the management of mandibular fractures. MATERIAL AND METHODS This multicentric prospective study included adult patients with mandibular fractures treated with ORIF. The following data were collected: age, gender, pre-trauma dental status (dentate, partially dentate), cause of injury, fracture site, associated facial fractures, surgical approach, type of ORIF (rigid, non-rigid or mixed), thickness and number of plates, modality of intraoperative MMF (arch bars, self-tapping and self-drilling screws [STSDSs], manual, other) and duration of postoperative MMF. The primary outcome was malocclusion at 6 weeks and 3 months. Statistical analyses were performed with Fisher's exact test or chi-square test, as appropriate. RESULTS Between 1 May 2021 and 30 April 2022, 336 patients, 264 males and 72 females (median age, 28 years) with mandibular fractures (194 single, 124 double and 18 triple fractures) were hospitalized. Intraoperative MMF was performed in all patients. Osteosynthesis was rigid in 75% of single fractures, and rigid or mixed in 85% and 100% of double and triple fractures, respectively. Excluding patients who underwent manual reduction, postoperative MMF (median duration, 3 weeks) was performed in 140 (64%) patients, without differences by type or number of fractures (p > 0.05). No significant difference was found in the incidence of malocclusion in patients with postoperative MMF (5%, 95% confidence interval [CI], 2-10%) compared to those without (4%; 95% IC, 1-11%) (p > 0.05). CONCLUSION Postoperative MMF was performed in more than half of the patients despite adequate fracture osteosynthesis, with wide variability amongst centers. No evidence of a reduction in the incidence of postoperative malocclusion in patients treated with postoperative MMF was found.
Collapse
Affiliation(s)
- Fabio Roccia
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy
| | - Federica Sobrero
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy.
| | - Elisa Raveggi
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy
| | - Alessandro Rabufetti
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Kathia Dubron
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Constantinus Politis
- Department Oral and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
| | - Dimitra Ganasouli
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Stylianos N Zanakis
- Department of Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Drago Jelovac
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Serbia
| | | | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Aleš Vesnaver
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Predrag Knežević
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Mario Kordić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Anamaria Sivrić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Ali O Rizvi
- Department of Oral and Maxillofacial Surgery, University of Dundee, United Kingdom
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, University of Dundee, United Kingdom
| | - Nil Valentines Vilaplana
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Antonio Mari Roig
- Department of Oral and Maxillofacial Surgery, University Hospital of Bellvitge, Barcelona, Spain
| | - Fatma Eriş Derkuş
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Utku Nezih Yilmaz
- Department of Oral and Maxillofacial Surgery, Dicle University, Diyarbakir, Turkey
| | - Maximilian Goetzinger
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Gian Battista Bottini
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Guglielmo Ramieri
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Città della Salute e delle Scienze Hospital, Via Genova 3, Torino 10131, Italy
| |
Collapse
|
3
|
Bhushan K, Unakalkar S, Sahu R, Sharma ML. Compare the Efficacy of Open Reduction and Internal Fixation of Mandibular Fractures With and Without Use of Intra-Operative Inter-Maxillary Fixation. Indian J Otolaryngol Head Neck Surg 2022; 74:4096-4099. [PMID: 36742617 PMCID: PMC9895336 DOI: 10.1007/s12070-021-02830-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/14/2021] [Indexed: 02/07/2023] Open
Abstract
Mandible fractures are regularly encountered by maxillofacial surgeons and various treatment protocols are available for the management of these fractures. The aim of study compares the efficacy of open reduction and internal fixation of mandibular fractures with and without use of intra-operative inter-maxillary fixation. Twenty patients between age group ranging l8-65 years who reported with single mandibular fracture in Dental college in India, during Oct 2012-March 2015 were the study subjects. These patients were divided into two groups. In one group fracture reduction was done by using inter-maxillary fixation and miniplate fixation was done. In other group fracture reduction was done manually and then fractured fragments were held in position by the assistant and miniplate fixation was done. Post-operatively patients were evaluated for occlusion, bone alignment and soft tissue/hard tissue infection at 1st, 4th, 8th, 12th weeks in both the groups. Statistics done by using Spearman's Rank correlation coefficient and Mann-Whitney U test. It was observed thatthere was no statistically significant difference seen in both the groups in terms of post-operative occlusion, radiological alignment and soft/hard tissue infection. Statistically significant difference was seen when the mean operating time was compared. The Group A showed mean difference of 35.50 min more time than Group B. The results of our study suggested that, use of intra-operative IMF does not show any advantages in terms of post-operative occlusion, bone alignment and soft/hard tissue infection. We have concluded from the study that the increased intra-operative time for the placement of IMF increases the cost of the surgery in regard to equipment and theatre time. There is no benefit in terms of radiographic and clinical outcome. Hence use of intra-operative IMF can be avoided for ORIF of single mandibular fracture.
Collapse
|
4
|
Weill P, Garmi R, Thobie A, Benateau H, Veyssiere A. Focus on the use of maxillomandibular fixation in mandibular fracture oseosynthesis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e614-e618. [PMID: 35093587 DOI: 10.1016/j.jormas.2022.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/07/2021] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate the efficiency of three methods of isolated mandibular fracture intraoperative reduction. MATERIALS AND METHODS This 6-year retrospective study included patients with isolated extra-articular mandibular fractures who would benefit from osteosynthesis. The endpoint was postoperative occlusion according to the type of intraoperative immobilization: screws, arch, or manual reduction. RESULTS A total of 145 patients were included, with 233 fractures. Forty-five patients underwent manual reduction without maxillo-mandibular fixation (MMF), 51 MMF with screws, and 49 MMF with arch, with 11.1%, 5.9% and 4.1% of patients in these groups experiencing postoperative malocclusion, respectively. The overall malocclusion rate was 6.9%. There was no significant difference among the 3 methods according to univariate statistical analysis (p = 0.42) or after comparing MMF (grouping screws and arches) to manual reduction without MMF (p = 0.29). CONCLUSION This study did not show a significant difference between the different methods of intraoperative reduction of isolated extra-articular mandibular fractures, even though intraoperative MMF was much more commonly used for complex fractures. However, there is a non-significant tendency to get a better post-operative occlusal result with MMF, which remains the reference traitement. Intraoperative manual reduction without MMF may be used within trained teams in some instances.
Collapse
Affiliation(s)
- Pierre Weill
- Department of Maxillo-facial and Plastic Surgery, Caen University Hospital, Caen 14000, France; Medecine Faculty of CAEN, University of Caen Basse-Normandie, Caen 14032 Cedex 5, France.
| | - Rachid Garmi
- Department of Maxillo-facial and Plastic Surgery, Caen University Hospital, Caen 14000, France
| | - Alexandre Thobie
- Department of Visceral Surgery, Caen University Hospital, Caen 14000, France
| | - Hervé Benateau
- Department of Maxillo-facial and Plastic Surgery, Caen University Hospital, Caen 14000, France; Department of Visceral Surgery, Caen University Hospital, Caen 14000, France
| | - Alexis Veyssiere
- Department of Maxillo-facial and Plastic Surgery, Caen University Hospital, Caen 14000, France; Medecine Faculty of CAEN, University of Caen Basse-Normandie, Caen 14032 Cedex 5, France; Unicaen, Bioconnect, Normandie Université, CAEN 14000, France
| |
Collapse
|
5
|
Ingole PD, Rajguru JG, Budhraja NJ, Shenoi RS, Karmarkar JS, Dahake RN. ATOM technique: Anatomic reduction using screw-wire Traction for Open reduction and internal fixation of Mandibular fractures. J Korean Assoc Oral Maxillofac Surg 2022; 48:122-124. [PMID: 35491144 PMCID: PMC9065645 DOI: 10.5125/jkaoms.2022.48.2.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Pranav D. Ingole
- Department of Oral and Maxillofacial Surgery, VSPM’s Dental College & Research Centre, Nagpur, India
| | - Jignesh G. Rajguru
- Consultant Oral and Maxillofacial Surgeon, Private Clinic, Mumbai, India
| | - Nilima J. Budhraja
- Department of Oral and Maxillofacial Surgery, VSPM’s Dental College & Research Centre, Nagpur, India
| | - Ramakrishna S. Shenoi
- Department of Oral and Maxillofacial Surgery, VSPM’s Dental College & Research Centre, Nagpur, India
| | | | - Rahul N. Dahake
- Department of Oral and Maxillofacial Surgery, VSPM’s Dental College & Research Centre, Nagpur, India
| |
Collapse
|
6
|
Batbayar EO, de Beij J, Bos RR, van Minnen B. Development and feasibility of a new reduction forceps for mandibular fractures: A technical innovation. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
7
|
Singh AK, Dahal S, Singh S, Krishna KC, Chaulagain R. Is manual reduction adequate for intraoperative control of occlusion during fixation of mandibular fractures? A systematic review and meta-analysis. Br J Oral Maxillofac Surg 2021; 60:271-278. [PMID: 35248408 DOI: 10.1016/j.bjoms.2021.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/22/2021] [Indexed: 11/28/2022]
Abstract
The aim of this systematic review was to find out if manual intraoperative control of occlusion is adequate for the reduction of mandibular fractures in comparison with intermaxillary fixation (IMF). We searched PubMed, Embase, the Cochrane Library and Clinical Trials Registry, and the references of included trials. Our primary outcomes of interest were the reduction of fracture anatomically and radiographically, occlusal disturbances, and the incidence of revision procedures due to poor occlusion or reduction. Our secondary outcomes of interest were operating time and infective complications. Of the 257 studies retrieved (manual reduction = 136, IMF = 121), four were included. The studies had an unclear risk of bias. Nevertheless, the overall effect was statistically significant and in favour of manual reduction, with a lower number of adverse events in the manual reduction group (n = 43) than in the IMF group (n = 78), odds ratio 0.42 (95% CI 0.27 to 0.64). An absolute reduction in adverse events was seen in occlusion disturbances (120 fewer/1000), revision procedures (164 fewer/1000), and infective complications (178 fewer/1000). The evidence to support manual reduction over IMF for the intraoperative control of fracture fragments and occlusion was derived from few studies with an unclear risk of bias, and the quality was low. The results were not different when condylar fractures were present. The overall certainty of evidence was moderate. Clinicians should select the appropriate technique based on the injury pattern, and the treating surgeon's experience and available resources.
Collapse
Affiliation(s)
- Ashutosh Kumar Singh
- Department of Oral and Maxillofacial Surgery, TU dental Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal.
| | - Samarika Dahal
- Department of Oral Pathology, TU dental Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | - Sumit Singh
- Department of Oral and Maxillofacial Surgery, Kantipur Dental College, Kathmandu, Nepal
| | - K C Krishna
- Department of Oral and Maxillofacial Surgery, TU dental Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
| | | |
Collapse
|
8
|
Bhargava A, Subash P, Singh A. Novel method for mandibular fracture reduction using inter-fragmentary screw - report of a surgical technique. Br J Oral Maxillofac Surg 2020; 58:e328-e329. [PMID: 32819748 DOI: 10.1016/j.bjoms.2020.07.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 07/21/2020] [Indexed: 11/15/2022]
Affiliation(s)
- A Bhargava
- Global SNG Hospital, Indore, M.P., India
| | - P Subash
- Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - A Singh
- Manipal College of Dental Sciences, Manipal, Karnataka, India.
| |
Collapse
|
9
|
Ramanathan M, Panneerselvam E, Ganesh SK, Raja KK. The Use of a Novel CAD-CAM Splint to Simplify Open Reduction and Internal Fixation of Mandibular Angle Fracture: A Technical Note. Craniomaxillofac Trauma Reconstr 2020; 14:74-78. [PMID: 33613840 DOI: 10.1177/1943387520904897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Mandibular angle fractures are frequently encountered as they constitute an area of weakness. Complications after open reduction and internal fixation (ORIF) of angle fractures commonly arise due to improper reduction and fixation methods that fail to counteract the dynamic muscle forces present in this region. Conventional reduction methods such as digital manipulation, intermaxillary fixation, towel clip traction, and wiring are associated with various limitations. This technical note highlights the fabrication and use of a computer-aided designing/computer-aided manufacturing-generated splint for ORIF of a superiorly displaced mandibular angle fracture. The splint consisted of 2 components: (1) a distal tooth-borne component to guide the teeth into maximum intercuspation and (2) a proximal bone-borne component to reduce the angle fracture. This composite splint facilitates simultaneous restoration of occlusion as well as reduction of mandibular angle fractures. The advantages of this technique include the following: (1) easy fabrication of splint, (2) easy and precise anatomical reduction of angle fracture, and (3) less operative time.
Collapse
Affiliation(s)
- Mrunalini Ramanathan
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, Tamil Nadu, India
| | - Elavenil Panneerselvam
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, Tamil Nadu, India
| | - Sriraam Kasi Ganesh
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, Tamil Nadu, India
| | - Krishna Kumar Raja
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram Campus, Ramapuram, Chennai, Tamil Nadu, India
| |
Collapse
|
10
|
Ramanathan M, Panneerselvam E, Krishna Kumar Raja V. 3D planning in mandibular fractures using CAD/CAM surgical splints — A prospective randomized controlled clinical trial. J Craniomaxillofac Surg 2020; 48:405-412. [DOI: 10.1016/j.jcms.2020.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/18/2020] [Accepted: 02/10/2020] [Indexed: 10/25/2022] Open
|
11
|
Pabst AM, Blatt S, Epperlein P, Schmidtmann I, Krüger M, Schiegnitz E, Goetze E, Ziebart T, Al-Nawas B. The risk of tooth root injuries using cortical screws for intermaxillary fixation and osteosynthesis plates - A retrospective analysis. J Craniomaxillofac Surg 2019; 47:1767-1778. [PMID: 31711997 DOI: 10.1016/j.jcms.2019.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/28/2019] [Accepted: 08/27/2019] [Indexed: 11/29/2022] Open
Abstract
Intermaxillary fixation (IMF) and osteosynthesis plates (OP) are widely used for the non-surgical and surgical treatment of mandible and condyle fractures. The aim of this retrospective study was to analyze the frequency of tooth root injuries by IMF and OP screws. Electronic patient reports (2004-2013) were screened for patients treated with either IMF screws and/or OP in the Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Germany. The frequency and the position of endangered and injured teeth were analyzed by orthopantomogram (OPTG) and cone beam computer tomography (CBCT). Next, possible predictive factors for tooth root injuries, namely interdental- and crestal distance, screw length and distance between tooth root and screw were evaluated. Further, the accuracy of OPTG vs. CBCT concerning the diagnosis of tooth root injuries was analyzed. Three-hundred sixty-six patients were included and 3388 teeth were defined as endangered by IMF- and OP screws. Overall, 16 injured teeth (0.5%) in 13 patients (3.55%) were detected. Nine injuries (56.3%) were caused by IMF- and seven injuries (43.8%) by OP screws. Three teeth were non-vital, one tooth had to be extracted. No correlation between the predictive factors crestal distance, screw length and tooth root injuries was found. If tooth injury occurred, a significant correlation between the interdental distance and the distance between tooth root and screw was found (κ = 0.48; p < 0,0001). Comparison between OPTG vs. CBCT demonstrated that many of the injuries that were seen in the OPTG (n = 230) could not be verified in the CBCT scans (n = 16) (κ = 0.12). To conclude, screws for IMF and OP can be considered as a safe procedure concerning the risk of tooth root injuries.
Collapse
Affiliation(s)
- Andreas Max Pabst
- Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, (Head: Prof. Dr. Dr. R. Werkmeister), Rübenacherstrasse 170, 56072 Koblenz, Germany; Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany.
| | - Sebastian Blatt
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| | - Pia Epperlein
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biometry, Epidemiology and Informatics (IMBEI), University Medical Center, (Head: Prof. Dr. S. Singer), Obere Zahlbacherstr. 69, 55131 Mainz, Germany
| | - Maximilian Krüger
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| | - Elisabeth Goetze
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| | - Thomas Ziebart
- Department of Oral- and Maxillofacial Surgery, University Hospital Giessen and Marburg, Campus Marburg, (Head: Univ.-Prof. Dr. Dr. Andreas Neff), Baldingerstrasse, 35043 Marburg, Germany
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| |
Collapse
|
12
|
Batbayar EO, Malwand S, Dijkstra PU, Bos RRM, van Minnen B. Accuracy and outcome of mandibular fracture reduction without and with an aid of a repositioning forceps. Oral Maxillofac Surg 2019; 23:201-208. [PMID: 31055659 PMCID: PMC6531395 DOI: 10.1007/s10006-019-00759-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/12/2019] [Indexed: 11/28/2022]
Abstract
Purpose It is presumed that adequate reduction of a fracture of the mandible favors bone healing and diminishes the risk of complications. In this retrospective study, we compared the accuracy of fracture alignment and complication rate of mandibular fractures reduced without or with aid of a repositioning forceps. Methods Retrospective analysis of consecutive 252 patients with mandibular fractures treated between January 2010 and December 2016. Eligible for this study were patients with isolated mandibular fractures needing open reduction and internal fixation in whom pre- and postoperative radiographs and patient records were available. In total, 131 (252 fractures) patients fulfilled the inclusion criteria. Results Seventy-one (54%) patients were men. Mean age of the patients was 33 ± 16.5 years, and the median and interquartile range of age was 25 (20;41). In 54 patients, mandibular fractures were reduced without the aid of repositioning forceps, and in the remaining 77 patients, the fractures were reduced with the aid of the repositioning forceps. Anatomical alignment of the fractures was poor in the non-forceps-aided group (48%) compared to the forceps-aided group (58%) (P = .067). Overall complication rate was higher in the group of fractures reduced without the aid of forceps (17%) than in the forceps-aided group (7%) (P = .045; OR, 2.7; 95% CI, 1.0–7.4). Conclusions Mandibular fractures reduced with the aid of repositioning forceps are accompanied by a lower complication rate and better alignment. This is an important observation as better alignment of the fracture fragments favors bone healing and reduces complications.
Collapse
Affiliation(s)
- Enkh-Orchlon Batbayar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700RB, Groningen, The Netherlands.
| | - Somaia Malwand
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700RB, Groningen, The Netherlands
| | - Pieter U Dijkstra
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700RB, Groningen, The Netherlands.,Department of Rehabilitation, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700RB, Groningen, The Netherlands
| | - Ruud R M Bos
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700RB, Groningen, The Netherlands
| | - Baucke van Minnen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700RB, Groningen, The Netherlands
| |
Collapse
|