Maxillofacial injuries and dental trauma in patients aged 19-80 years, Recife, Brazil

Epidemiological aspects of dental trauma associated with maxillofacial injures: Ten years of clinical experience in Trieste, Italy

BACKGROUND/AIMS

The prevalence of dental injuries in patients with facial fractures is relevant. Epidemiologically, dental trauma in association with facial fractures generally affects the age group between 20 and 40 years old, with a higher prevalence in males. The aim of this retrospective study was to identify the incidence and etiology of dental trauma associated with facial fractures over a 10-year period.

METHODS

From January 2009 to April 2019, among 381 patients with facial fractures, 353 were included in this study. Age, gender, trauma etiology, injured teeth and dental treatment were investigated.

RESULTS

From 353 patients, with a mean age of 49.7 ± 19.9 years, 247 (70%) were males and 106 (30%) were females. Accidental falls were the most common type of injury (n = 118, 33.4%), followed by road accidents (n = 90, 25.5%), assaults (n = 60, 17%) and sports trauma (n = 37, 10.5%). Fifty-five subjects (15.60%) had dental injuries associated with facial fractures. Of the 145 teeth involved, 48 (33.1%) were diagnosed with luxation, 22 teeth (15.2%) were avulsed, 11 teeth (7.5%) suffered a concussion and there were 10 (6.8%) alveolar wall fractures.Uncomplicated enamel-dentin fracture was the more frequent hard tissue injury (n = 21, 14.5%), followed by complicated crown-root fracture (n = 10, 6.9%), infraction (n = 8, 5.5%), enamel fracture (n = 3, 2%) and complicated enamel-dentin fracture (n = 3, 2%). There was a peak in incidence between 21 and 40 years (42%). Males had a significantly higher risk of facial fractures with dental injury (75%). Maxillary incisors and canines (62.8%) were the most affected teeth.

CONCLUSIONS

There was a high prevalence of dental injuries associated with facial fractures. Maxillary incisors were the most injured teeth, with a higher prevalence in males.

Aetiology, prevalence, fracture site and management of maxillofacial trauma

INTRODUCTION

Maxillofacial fractures are often associated with severe morbidity, functional deficit, disfigurement and significant financial implications. The aim of this review was to investigate whether the aetiology, prevalence and management modalities of facial trauma can identify the common causes of facial trauma with a view to recommending measures to the appropriate governing bodies to change the current practice wherever possible.

METHODS

The records of 1,112 patients referred to our oral and maxillofacial unit in Andhra Pradesh, India, between February 2008 and October 2017 were analysed retrospectively. Data including age, sex, aetiology, fracture site and treatment were evaluated.

RESULTS

Men aged 20-40 years were the most common victims of facial trauma. Road traffic accidents (RTAs) were responsible in 70% of cases. Mandibular fractures constituted 47% of the overall fractures, and 55% of the total fractures were treated with open reduction and internal fixation.

CONCLUSIONS

The main cause of maxillofacial injury among patients reporting to our hospital was RTAs. Mandibular fractures were the most common, accounting for almost half of the cases. Over half (55%) of all maxillofacial fractures were treated with open reduction and internal fixation. Reasons for this high frequency may include the large number of poorly maintained, overloaded vehicles on unsuitable roads, violation of traffic regulations (particularly by inexperienced young drivers), abuse of alcohol or other intoxicating agents and the sociocultural behaviours of some drivers.

Involvement of orbit in maxillofacial fractures: "Evaluation of its spectrum, characteristics, and treatment in 200 patients"-Prospective study

BACKGROUND

To evaluate the orbital involvement epidemiology in facial fractures, the clinical distribution and effects of orbital involvement in these patients, the frequency and nature of treatment procedures performed for these involvements, and the immediate- and intermediate-term effects of these treatment procedures.

METHODS

Two hundred patients with hard tissue maxillofacial injuries were included in this study. Clinical examination was performed in-depth. Images were taken to determine and confirm clinical observations and to finalize treatment modality. Orbital involvement in patients was noted as present or absent. The clinical effects and features in postoperative imaging studies were noted until 3 months after trauma in each patient.

RESULTS

Out of 200 patients, about one-third patients (58;29%) had orbital involvement and out of which 49 were males. Regarding clinical-radiological signs in orbit involved fractures, the incidences were variable, that is, periorbital ecchymosis (77.6%), periorbital edema (74.1%), subconjunctival hemorrhage (67.2%), palpable step/crepitus in orbital rim (62.1%), infraorbital nerve paresthesia (46.6%), restricted globe movement (5.2%), orbital rim discontinuity/step (72.4%), maxillary sinuses (51.7%), orbital wall/floor/roof rupture (55.2%), and infraorbital foramen involvement (36.2%). Palpable step/crepitus in orbital rim was recovered remarkably earlier in patients of open reduction internal fixation (ORIF) group, and features of restricted globe movements, orbital rim discontinuity/step, orbital wall/floor/roof rupture, and infraorbital foramen involvement in patients were recovered immediately after open reduction and internal fixation treatment.

CONCLUSION

Early repair of the maxillofacial injuries with orbital involvement has better functional and esthetic outcome.

Dental injuries in patients associated with fracture of facial bones

PURPOSE

To assess different types of dental injuries associated with facial bone fractures.

METHOD

One hundred dentate patients were selected randomly of all age and gender who had maxillofacial trauma only and having dental injury in association with facial bones fractures were included. They were thoroughly examined for injury/fracture to facial region as well as for dental injuries (teeth). Tooth injuries were noted according to Ellis classification. The data was collected, compiled, and put to statistical analysis.

RESULTS

Dental injuries were more in females than males found to be statistically significant with (p < 0.05).Crown fracture of maxillary teeth was more as compared to mandibular except molars found to be statistically significant (p < 0.05). Root fracture was more in maxillary incisors followed by canine as compared to mandibular incisors and canines found to be insignificant. Avulsion, extrusion and luxation were more in maxilla as compared to mandible found to be significant.

CONCLUSION

Different types of tooth injuries associated with facial bone fracture found more in females and maxillary teeth.

The incidence of facial injuries in children in Indian population: A retrospective study

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.

Two years retrospective study of maxillofacial trauma at a tertiary center in North West Ethiopia

BACKGROUND

Maxillofacial injury poses a challenge to oral and maxillofacial surgeons working in developing countries with limited resource and human power. The present study aimed to determine the etiology, pattern, and management of maxillofacial trauma in Gondar university of Gondar hospital.

METHODS

A retrospective descriptive study design was used. Medical registration retrieving of patients with maxillofacial trauma visited dental center of University of Gondar Hospital from September 2013 to August 2015 was done. During data collection, etiology of trauma, pattern of fracture, treatment modality and complications were recorded using predesigned data collection template and analyzed using SPSS computer software version 20. Statistical analysis was done to show the sex distribution of maxillofacial trauma and the effect of alcohol intake on the incidence of trauma.

RESULTS

During 2-year period, September 2013-August 2015, 326 patients of maxillofacial trauma were treated in the dental center of university of Gondar hospital. The mean age was 29.12 (± 8.62) with age range of 11-75 years. Majority of the study participants (47.2%) were within the age group of 21-30 years. Eighty percent of the participants were male with a male to female ratio of 4.02:1. Interpersonal violence (75.8%) and Road traffic accident (21.5%) were the leading causes. Males are at high risk of maxillofacial trauma relative to females (P < 0.0001). There was high incidence of trauma in the weekend, rural residents, December to February, mandibular fractures and soft tissue injuries were the most common injuries. There was an associated injury in 79 (24.2%) patients in head and neck area, thoracic, abdominal and extremities. Half of the patients were managed conservatively (49.7%) with debridement and suture, while 45.7% of the patients were closed reduction and 4.6% were surgical open reduction. There were 25 post procedure complications especially in mandibular fractures.

CONCLUSION

Interpersonal violence was the major cause of maxillofacial trauma, while mandible and soft tissue were the most affected maxillofacial areas. The federal ministry of health, Ethiopia should have well-organized maxillofacial center in tertiary hospitals for emergency management to avoid morbidity and mortality.

Primary W-Plasty Closure for Surgical Repair of the Injured Lip

PURPOSE

To describe the results obtained using the primary W-plasty closure technique for the surgical repair of lip defects of traumatic etiology.

PATIENTS AND METHODS

This study followed both the Declaration of Helsinki on medical protocol and ethics and the Ethical Guidelines of Hospital San Francisco de Asis institutional review board. A retrospective case series study was designed and implemented. The medical status, demographic, etiology, complications, and outcomes associated to the primary W-plasty technique in patients with lip injuries seen at Hospital San Francisco de Asis Oral and Maxillofacial Surgery Department in Quibdó, Colombia between 2010 and 2013 were assessed. Data were collected and analyzed using a statistic package.

RESULTS

Eighteen patients were treated, 8 women and 10 men, with ages ranging from 2 to 38 years. Patients presented lip avulsion injuries associated to different etiologies. They underwent surgery under general anesthesia after prophylactic antibiotic therapy and tetanus booster vaccination. Defect repair was performed using the primary W-plasty closure technique, obtaining satisfactory esthetic and functional results.

CONCLUSIONS

Primary W-plasty closure is a surgical option that allows the safe and practical restoration of the injured lip, even in lesions exceeding 50% of the normal lip.

Etiology, incidence and patterns of mid-face fractures and associated ocular injuries

A prospective study on mid-face fractures was carried out in the Department of Oral and Maxillofacial Surgery at College of Dentistry, Indore, from August 2007 to September 2009 to analyze etiology, incidence and patterns of midface fractures and associated ocular injuries. Two hundred patients were included in this study, amongst those who reported to the Department of OMFS, College of Dentistry, Indore. After confirmed diagnosis of mid face fracture all the patients were stratified according to age, sex, cause of the accident, influence of alcohol, location, type of fractures and associated ocular injuries. The study included 200 patients with a mean age of 29.6 years. The most frequently injured patients belonged to the 21-30 year-old age group. The male predilection was 76 %. Road traffic accident was the most common causative factor (64 %), followed by assault (21 %), cases of fall (9.5 %) and other causes (5.5 %). The most common fracture in this study was found to be zygomatic complex fractures (62.5 %) (more in the age group of 21-30 years). This was followed by Lefort II fractures (23 %), multiple fractures (10 %) and Lefort I fractures (6 %), Lefort III fractures (4.5 %) and Naso-ethmoidal fractures (4 %) in descending order. 84.5 % subjects were having ocular involvement. Subconjunctival hemorrhage was present mostly in 83.5 % followed by remaining as corneal injury 15 %, reduced acuity 11.5 %, diplopia 10.5 %, enophthalmos 8.5 %, telecanthus 5 %, hyphema 3.5 %, blindness 3 % and proptosis 0.5 %. Zygomatic complex fractures were the most frequent type of injury that was complicated by blindness or a serious eye injury (61 %). Collection of data regarding the epidemiology of maxillofacial fractures is important because it may assist healthcare providers to provide necessary information for the development and evaluation of preventive measures. Ocular injuries should have an early ophthalmological examination at the time of trauma to detect any kind of ocular dysfunction.