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Sobrero F, Roccia F, Omedè M, Merlo F, Dubron K, Politis C, Rabufetti A, Scolozzi P, Ramieri G, Birk A, Vesnaver A, Rizvi AO, Laverick S, Jelovac D, Konstantinovic VS, Vilaplana V, Roig AM, Goetzinger M, Bottini GB, Knežević P, Dediol E, Kordić M, Sivrić A, Derkuş FE, Yilmaz UN, Ganasouli D, Zanakis SN. Current Strategies for Treatment of Mandibular Fractures With Plate Osteosynthesis: A European Prospective Study. J Craniofac Surg 2024; 35:1120-1124. [PMID: 38713082 DOI: 10.1097/scs.0000000000010128] [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: 09/13/2023] [Accepted: 01/22/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE The training and preferences of surgeons influence the type of surgical treatment for mandibular fractures. This multicentre prospective study analyzed the current treatment strategies and outcomes for mandibular fractures with open reduction and internal fixation (ORIF). MATERIAL AND METHODS This prospective study included patients aged ≥16 years who underwent ORIF for mandibular fractures in 12 European maxillofacial centers. Age, sex, pretrauma dental status, fracture cause, site and type, associated facial fractures, surgical approach, plate number and thickness (≤1.4 or ≥1.5 mm), duration of postoperative maxillomandibular fixation, occlusal and infective complications at 6 weeks and 3 months, and revision surgeries were recorded. RESULTS Between May 1, 2021 and April 30, 2022, 425 patients (194 single, 182 double, and 49 triple mandibular fractures) underwent ORIF for 1 or more fractures. Rigid osteosynthesis was performed for 74% of fractures and was significantly associated with displaced ( P =0.01) and comminuted ( P =0.03) fractures and with the number of nonsurgically treated fracture sites ( P =0.002). The angle was the only site associated with nonrigid osteosynthesis ( P <0.001). Malocclusions (5.6%) and infective complications (5.4%) were not associated with osteosynthesis type. CONCLUSION Rigid osteosynthesis was the most frequently performed treatment at all fracture sites, except the mandibular angle, and was significantly associated with displaced and comminuted fractures and the number of nonsurgically treated fracture sites. No significant differences were observed regarding postoperative malocclusion or infections among osteosynthesis types.
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Affiliation(s)
- Federica Sobrero
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - Fabio Roccia
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - Michela Omedè
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - Francesca Merlo
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - 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
| | - 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
| | - Guglielmo Ramieri
- Department Surgical Science, Division of Maxillofacial Surgery, University of Turin, Turin, Italy
| | - 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
| | - Ali O Rizvi
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, United Kingdom
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, United Kingdom
| | - Drago Jelovac
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Vitomir S Konstantinovic
- Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - 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
| | - 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
| | - 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
| | - 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
| | - 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
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Fahy E, Carr R, Moore E, Min A, Harrington CI, Murphy C, Ekanayake K, Kearns G. Mandibular angle fractures: a demographic review, with particular reference to post-operative complications. Ir J Med Sci 2024; 193:533-537. [PMID: 37462894 DOI: 10.1007/s11845-023-03433-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/15/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Mandibular angle fractures (MAF) have a recognized complexity of treatment and an increased risk of incurring complications. METHODS This retrospective study included 45 consecutive patients who were diagnosed with an isolated MAF and no other facial fractures. The average age was 27.3 (SD = 7.7). RESULTS A comparatively low rate of complications (11.1%) and a low rate of reoperation (1.8%) are reported, along with a significant role of smoking in complications (p = 0.022). A non-significant association was noted between complications, male gender and assault as an aetiological factor. CONCLUSIONS Review of the data from this study confirms that complication rates for patients attending the National Maxillofacial Unit are similar to or better than that of international studies. An overview of the aetiology of fracture complications is included.
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Affiliation(s)
- Edward Fahy
- National Maxillofacial Unit, St James Hospital Dublin, Dublin, Ireland.
| | - Richard Carr
- National Maxillofacial Unit, St James Hospital Dublin, Dublin, Ireland
| | - Emma Moore
- National Maxillofacial Unit, St James Hospital Dublin, Dublin, Ireland
| | - Arimie Min
- National Maxillofacial Unit, St James Hospital Dublin, Dublin, Ireland
| | | | - Colm Murphy
- National Maxillofacial Unit, St James Hospital Dublin, Dublin, Ireland
| | - Kumara Ekanayake
- National Maxillofacial Unit, St James Hospital Dublin, Dublin, Ireland
| | - Gerry Kearns
- National Maxillofacial Unit, St James Hospital Dublin, Dublin, Ireland
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Gualtieri M, Scivoletto G, Pisapia F, Priore P, Valentini V. Analysis of Surgical Complications in Mandibular Fractures in the Center of Italy: A Retrospective Study. J Craniofac Surg 2024; 35:e71-e74. [PMID: 37943052 DOI: 10.1097/scs.0000000000009851] [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: 07/03/2023] [Accepted: 10/07/2023] [Indexed: 11/10/2023] Open
Abstract
Mandibular fractures are the second most common maxillofacial fractures. The prevalent treatment for this kind of fractures is either a surgical procedure such as maxillomandibular fixation or open reduction and internal fixation or a combination of both. Sometimes the patients might develop locoregional postoperative complications. The most frequently reported complications are trigeminal V3 injury and surgical site infection. A 4-year retrospective study was performed at the Department of Oral and Maxillofacial Surgery, Policlinico Umberto I of Rome, Italy, and the postoperative complications after mandibular fracture surgical treatment were collected. The authors studied the characteristics of each complication and the correlation with the type of mandibular fracture and the surgical treatment chosen.
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Affiliation(s)
- Matteo Gualtieri
- Department of Odontostomatology and Maxillofacial Surgery, Policlinico Umberto I, "Sapienza" University of Rome, Roma
- Unit of Maxillofacial Surgery and Otolaryngology, Floraspe Renzetti Hospital, Lanciano, Italy
| | - Giulia Scivoletto
- Department of Odontostomatology and Maxillofacial Surgery, Policlinico Umberto I, "Sapienza" University of Rome, Roma
| | - Francesco Pisapia
- Department of Odontostomatology and Maxillofacial Surgery, Policlinico Umberto I, "Sapienza" University of Rome, Roma
| | - Paolo Priore
- Department of Odontostomatology and Maxillofacial Surgery, Policlinico Umberto I, "Sapienza" University of Rome, Roma
| | - Valentino Valentini
- Department of Odontostomatology and Maxillofacial Surgery, Policlinico Umberto I, "Sapienza" University of Rome, Roma
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Regina Momesso N, Cristina Biguetti C, Estevão Costa B, Lucio Calazans Duarte G, Akemi Matsumoto M, Domingos Ribeiro Junior P. Immediate and late inflammatory and bone healing response post implantation of self-tapping and self-drilling osteosynthesis screws. Br J Oral Maxillofac Surg 2023; 61:362-367. [PMID: 37263889 DOI: 10.1016/j.bjoms.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/14/2023] [Accepted: 04/19/2023] [Indexed: 06/03/2023]
Abstract
The aim of this study was to comparatively analyse osseointegration after the implantation of self-tapping screws (STS) and self-drilling screws (SDS). Thus, 24 four-month-old male Wistar rats, received SDS and STS screws in their left and right tibias, respectively. Sample collection was performed immediately at 0 hours (0h), two, seven, and 21 days after implantation (2d, 7d, 21d). Samples from immediately and 21 days after were analysed by micro computed tomography (MicroCT). All time points were evaluated by histology (Haematoxylin and Eoisin and Goldner's Trichrome) and immunohistochemistry for tartrate-acid resistant phosphatase positive (TRAP+) osteoclasts. MicroCT images revealed an intimate contact between bone and each type of screw at 0h. However, SDS group presented decreased bone volume (BV, mm3) at 21 days in comparison with STS. Both SDS and STS post implantation presented areas of suitable new bone formation surrounding screw threads from seven days, and inflammation decreased from two to 21 days. Also, TRAP+ osteoclasts were mainly identified at seven days in both STS and SDS groups, particularly surrounding areas of pressure, with significant differences between groups. In conclusion, differences in shape and insertion technique for SDS and STS screws did not affect immediate and late inflammatory and bone healing response post implantation in this animal model. Both osteosynthesis screws allowed satisfactory post-surgical outcomes.
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Affiliation(s)
- N Regina Momesso
- Department of Maxillofacial Surgery, University of the Holy Heart (USC), Rua Irmã Arminda, 10-50, 17011-160 Bauru, SP, Brazil.
| | - C Cristina Biguetti
- Laboratory of Regenerative Medicine, Department of Surgery and Biomechanics, UTRGV School of Podiatric Medicine, 2102 treasure Hills Blvd. Harlingen, TX 78550, USA.
| | - B Estevão Costa
- Department of Maxillofacial Surgery, University of the Holy Heart (USC), Rua Irmã Arminda, 10-50, 17011-160 Bauru, SP, Brazil.
| | - G Lucio Calazans Duarte
- Department of Maxillofacial Surgery, University of the Holy Heart (USC), Rua Irmã Arminda, 10-50, 17011-160 Bauru, SP, Brazil.
| | - M Akemi Matsumoto
- Department of Diagnosis and Surgery, Aracatuba Dental School, UNESP, Rua José Bonifácio, 1193, 16015050 Araçatuba, SP, Brazil.
| | - P Domingos Ribeiro Junior
- Department of Maxillofacial Surgery, University of the Holy Heart (USC), Rua Irmã Arminda, 10-50, 17011-160 Bauru, SP, Brazil.
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Can Frailty Indices Predict Surgical Risk in Open Reduction and Fixation of Facial Fractures? J Craniofac Surg 2022; 33:2573-2577. [DOI: 10.1097/scs.0000000000008825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/10/2022] [Indexed: 11/05/2022] Open
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Said M, Voora RS, Hom DB. Is a Tooth Extraction Required If Dentition Lies Within a Mandible Fracture? Laryngoscope 2021; 132:1701-1703. [PMID: 34846067 DOI: 10.1002/lary.29962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Mena Said
- Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - Rohith S Voora
- Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - David B Hom
- Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Diego, San Diego, California, U.S.A
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Mohammad OAH, Ashour EM, Hassanein FAEA. Evaluation of condylar position in anterior mandibular fractures using 3 dimensional miniplate osteosynthesis versus conventional miniplates: Randomized clinical trial. J Craniomaxillofac Surg 2021; 50:61-69. [PMID: 34756733 DOI: 10.1016/j.jcms.2021.09.014] [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: 11/23/2020] [Revised: 07/16/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022] Open
Abstract
To compare clinically and radiographically between the 3-D plates and the conventional two Champy's miniplates in the treatment of anterior mandibular fractures. It is a randomized clinical and radiographic comparative study between 2 equal groups of patients with isolated anterior mandibular fractures. Open reduction and internal rigid fixation was accomplished in the study group using 3D miniplates fixation while in the control group using the two Champy's miniplates. The 3D miniplate osteosynthesis consumed less operative time than the two miniplates osteosynthesis. Independent t-test revealed that the difference between the 2 groups was 8.4 ± 3.11 min. This difference was statistically significant (p=0.012). Occlusion was slightly disturbed in two patients in the study group in comparison to three patients in the control group. The difference between the 2 groups was not statistically significant (p=0.62). None of the cases of both groups showed mobility between the reduced and fixed fractured segments, immediately post-operatively and at the end of follow-up intervals. The 3D miniplate osteosynthesis (study group) recorded less intercondylar distance than two miniplates osteosynthesis (control group) immediately post-operatively and after 3 months. Independent t-test revealed that the difference between the 2 groups was not statistically significant, immediately postoperative (p=0.322) and after 3 months (p=0.263). Pre-operatively to 3 months postoperatively, the 3D miniplate osteosynthesis (study group) recorded a lower median percent increase in the intercondylar distance than the two miniplates osteosynthesis (control group). The difference between the 2 groups was not statistically significant (p=0.917). Regarding the intercondylar angle, the3D miniplate osteosynthesis (study group) recorded higher intercondylar angle than the two miniplates osteosynthesis (control group) immediately post-operative (p=0.333) and after 3 months (p=0.255). Independent t-test revealed that the difference between the 2 groups was not statistically significant. The 3-Dimensional strut miniplates should be considered an alternative for internal rigid fixation of anterior mandibular fractures for their ease of adaptation and insertion, while providing the advantage of reduced operative time compared to the conventional two Champy's miniplates.
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Affiliation(s)
- Omar Al-Husseiny Mohammad
- Resident of Oral and Maxillofacial Surgery, Faculty of Dentistry, October 6 University, Giza, Egypt; M.Sc. of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - Essam Mohamed Ashour
- Associate Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, October 6 University, Giza, Egypt
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Mandibular Fractures Epidemiology and Treatment Plans in the Center of Italy: A Retrospective Study. J Craniofac Surg 2021; 32:e346-e349. [PMID: 33170830 DOI: 10.1097/scs.0000000000007118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT The epidemiology of maxillofacial fractures is variable in different geographic regions. Economic and social conditions, laws and types of behavior can be considered the most important factors influencing these differences.Mandibular fractures were first cited in 1650 BC in an Egyptian papyrus. Today, these fractures are one of the most prevalent facial skeletal injuries.A 4-year retrospective study was performed and the trauma - related data were collected from medical and radiological archives. The analysis comprised patients admitted for mandibular fracture at Sapienza University of Rome - Policlinico Umberto I between January 1, 2016 and December 31, 2019. The data include age, sex, etiology, anatomical sites of the fractures, eventual maxillofacial associated fractures and treatment.We collected 172 patients, 138 males (80.2%) and 34 females (19.8%) with 270 mandibular fractures. The average age was 35.4 years. The youngest and oldest patients were aged 6 and 90 years, respectively. The age group 20 to 29 years was the most represented with 52 patients (30.2% of the total sample). Assaults were the most common etiology (n = 53, 30.8%), followed by falls (n = 45, 26.2%). The condyle was the most involved region (n = 86, 32%), followed by parasymphysis region (n = 72, 26.6%) and angle (n = 62, 23%).154 patients (89.5%) reported only mandibular fractures. Eighteen patients (10.5%) had other associated maxillofacial fractures; the most frequently encountered maxillofacial fractures associated with mandibular fractures were the zygomatic complex fractures (n = 9, 5.2%). Open reduction and internal fixation was the most preferred surgical treatment (n = 115, 66.9%).This study showed that mandibular fractures predominate in 20 to 29 years group and in the male sex. Assaults are the most frequent cause. The prevalent fracturing site is condylar process. Orbital - maxillary - zygomatic complex fractures were the most common associated maxillofacial fractures and open reduction and internal fixation was the preferred surgical strategy.The results of this analysis agree to other studies and provide important clinical information that will help in study of these injuries.
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Time-Lapse Between Presentation and Treatment of Mandibular Fractures: Is There a Correlation With Sensory Loss Recovery or No Recovery? J Craniofac Surg 2021; 32:e369-e373. [PMID: 33235168 DOI: 10.1097/scs.0000000000007261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
ABSTRACT A prospective cohort study composed of 43 patients treated for unilateral mandibular fracture. The primary study variables were the post-traumatic IAN neurosensory score and the score after fracture reduction in two different groups on the basis of time lapse between presentation and treatment and displacement of mandible fracture. Appropriate descriptive and bivariate statistics were computed. The sample was analyzed over a one year period. It was observed that the recovery percentage (80%) was good in Group-A (n = 20) patients as compared to Group-B (n = 23) patients (43.47%) with significant P value of 0.015. Patients with displacement of ≥9 mm have neurosensory deficit of 80% while fracture displacement ≥ 5 mm to 8 mm have the neurosensory deficit of 34.21% which is significant with P value of 0.049. With each millimeter increase of displacement of fracture segments, more neurosensory deficit will be manifested. Delay in seeking in the treatment increases the risk because of continued movement. Where the injury is more severe, excessive displacement with increased time lapse from injury to surgical intervention, there is a higher possibility neurosensory deficit or no recovery. Early management can reduce the risk of permanent neurosensory deficits.
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Application of Inverse Neural Networks for Optimal Pretension of Absorbable Mini Plate and Screw System. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11031350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mandibular fractures are common facial lesions typically treated with titanium plate and screw systems; nevertheless, this material is associated with secondary effects. Absorbable material for implants is an alternative to titanium, but there are also problems such as incomplete screw insertion and screw breakage due to high pretension in the screw caused by the insertion torque. The purpose of this paper is to find the optimal screw pretension (SP) in absorbable plate and screw systems by means of artificial neural network (ANN) and its inverse (ANNi). This optimal SP must satisfy a desired maximum von Mises strain (MVMS). For training the ANN, a database was generated by means of a design of experiments (DOE). Each DOE configuration was solved by means of finite element method (FEM) calculations. To obtain the optimal value for (SP) in the mini absorbable screw for fracture fixation, a strategy to invert the ANN is developed. Using the ANN coefficients, a sensitive study was performed to identify the influence of the design parameters in the MVMS. The optimal SP obtained was 14.9742 N. The MVMS condition was satisfied with an error less than 1.1% in comparison with FEM and ANN results. The screw shaft length is the most influencing MVMS parameter.
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Ji YD, Resnick CM, Peacock ZS. Idiopathic condylar resorption: A systematic review of etiology and management. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:632-639. [DOI: 10.1016/j.oooo.2020.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/21/2020] [Accepted: 07/15/2020] [Indexed: 12/18/2022]
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Kumar AS, Saravanan B, Balaji J, Rohini T, Prasad C, Amirtha J. Six-hole versus Four-hole Miniplates in Isolated, Unilateral Angle Fracture of the Mandible. Ann Maxillofac Surg 2020; 10:16-24. [PMID: 32855909 PMCID: PMC7433977 DOI: 10.4103/ams.ams_168_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/27/2019] [Accepted: 01/14/2020] [Indexed: 11/27/2022] Open
Abstract
Aim: The aim of the study was to find the suitable situation for the fixation of “six” hole miniplates in open reduction and internal fixation of displaced and nondisplaced unilateral angle of the mandible fractures. Subjects and Methods: Displaced, nondisplaced, simple, compound (linear and noncomminuted) isolated unilateral angle fractures with or without occlusal derangement were included in this study. Statistical Analysis Used: Chi-square test was used for the statistical analysis. Results: The parameters assessed preoperatively and postoperatively were mouth opening, occlusion, neurosensory deficit such as paresthesia, intraoperative time, stability of fragments, and access to the retromolar trigone which showed that the six-hole titanium miniplate was clinically useful in special clinical situations when compared to four-hole titanium miniplate. Conclusion: To conclude, six-hole titanium miniplate was clinically useful when compared to four-hole titanium miniplate in the following special clinical situations such as bone loss following extraction of third molar, no posterior occlusion and instability of fracture moderately displaced fracture needs more stability.
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Affiliation(s)
- A Senthil Kumar
- Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - B Saravanan
- Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - J Balaji
- Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - T Rohini
- Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - C Prasad
- Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
| | - J Amirtha
- Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, Chennai, Tamil Nadu, India
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Khan M, Vishal, Kumar A, Khaitan T, Sinha DK, Kumar C. Comparative Evaluation of 3d Locking Versus Non-Locking Titanium Miniplates in the Treatment of Mandibular Fracture. Indian J Otolaryngol Head Neck Surg 2020; 72:363-369. [PMID: 32714854 DOI: 10.1007/s12070-020-01884-z] [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: 03/31/2020] [Accepted: 05/11/2020] [Indexed: 11/30/2022] Open
Abstract
The introduction of 3-dimension systems for the treatment of mandibular fractures and continuity has offered certain advantages over other plating system. The present study was undertaken to compare 2.0 mm 3D titanium locking and non-locking miniplates in the management of mandibular fractures. A prospective study was conducted on 40 patients (20 in each group) of mandibular fractures treated by open reduction and internal fixation. Group A patients underwent osteosynthesis using 2.0 mm 3-D titanium locking miniplates while Group B used non-locking miniplates. Subsequent follow-up was assessed for pain, swelling, infection, paresthesia, malocclusion, mobility between fracture fragments and hardware failure in these patients. Functional occlusion was achieved postoperatively in all the patients. At 12 weeks of the time intervals, significant pain was observed in group B. At 1 week interval, 6 (30%) patients in both groups reported with swelling. Only one (10%) patient in each group had paresthesia which got resolved gradually over a period of 3 months. Infection was observed in only 2 (10%) patient in Group B at 3 months. Only 2 (10%) patient in Group B had hardware failure at 3 months interval. Statistically, there was no significant difference between both the groups at any time interval (p > 0.05). 3D titanium locking miniplates are effective in the treatment of mandibular fractures with lesser overall complications as compared to non-locking miniplates.
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Affiliation(s)
- Mohsin Khan
- Department of Oral and Maxillofacial Surgery, Teerthanker Mahaveer Dental College and Hospital, Uttar Pradesh- 244001, Moradabad, India
| | - Vishal
- Department of Oral and Maxillofacial Surgery, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand 834009 India
| | - Ashish Kumar
- Department of Oral and Maxillofacial Surgery, Awadh Dental College and Hospital, Jamshedpur, Jharkhand 831001 India
| | - Tanya Khaitan
- Department of Oral Medicine and Radiology Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand 834009 India
| | - Dharmendra Kumar Sinha
- Department of Prosthodontics, Crown and Bridge & Oral Implantology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand 834009 India
| | - Chandan Kumar
- Department of Dentistry Patliputra Medical College and Hospital, Dhanbad, Jharkhand 826001 India
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Ribeiro-Junior PD, Senko RA, Momesso NR, Izidoro JH, Padovan LEM, Viswanath A. Occlusal Instability Results in Increased Complication Rates After Treatment of Mandibular Fractures. J Oral Maxillofac Surg 2020; 78:1163.e1-1163.e7. [PMID: 32173333 DOI: 10.1016/j.joms.2020.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE It is important to understand the factors that can increase the incidence of complications after mandibular fracture (MF) treatment. The objective of the present study was to investigate whether occlusal stability influences the occurrence of postoperative complications in MFs treated with internal rigid fixation. PATIENTS AND METHODS We performed a prospective cohort study of patients treated for MF by osteosynthesis with plate and screw fixation. The primary predictor variable was the occlusal stability (yes vs no). Occlusion was scored as stable (group 1) if the patients had all their teeth and no free ends in either dental arch. Occlusion was coded as unstable (group 2) if the patients were partially edentulous with free ends in either dental arch or had edentulism involving more than 6 dental elements. The primary outcome variable was postoperative complication (yes vs no). The secondary outcome variables were the osteosynthesis system used (2.0 or 2.4 mm), local factors, age, and gender. Statistical analysis was performed using the χ2 statistical test at 5% significance. RESULTS Of 115 patients with 121 MFs, 73 (63.48%) had stable occlusion (group 1) and 42 (36.52%) had unstable occlusion (group 2). The mean age was 34.11 years, and 71.3% were men. The postoperative complication rate was 8.70% (10 patients). Of the 10 patients with complications, 3 (2.6%) were in group 1 and 7 (6.1%) were in group 2 (P = .021 and P < .05, respectively). The 2.0-mm system was used in 107 cases (93%). All the complications were associated with use of the 2.0-mm osteosynthesis plates, occurring in 3 of 69 patients in group 1 (4.34%) and 7 of 38 patients in group 2 (18.42%; P = .032 and P < .05, respectively). The greatest number of complications was associated with unilateral MF (9 of 109). The occurrence of postoperative complications in angle and symphysis/parasymphysis fracture sites was equal. CONCLUSIONS The results of the present study suggest that unstable occlusion could increase the rate of postoperative complications in MFs treated with plates and screws. Future studies are required with occlusal stability included as a variable.
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Affiliation(s)
| | - Ricardo Alexandre Senko
- Master Student, Department of Oral and Maxillofacial Surgery, Sagrado Coração University, Bauru, Brazil
| | - Nataira Regina Momesso
- Master Student, Department of Oral and Maxillofacial Surgery, Sagrado Coração University, Bauru, Brazil
| | | | - Luis Eduardo M Padovan
- Professor and Head, Instituto Latino Americano e Pesquisa Odontológica, Curitiba, Brazil
| | - Archana Viswanath
- Assistant Professor and Director of Clinical Research, Department of Oral and Maxillofacial Surgery, Tufts University School of Dental Medicine, Boston, MA
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Kaushik S, Ali I, Dubey M, Bajpai N. 2 mm Conventional Miniplates with Three-Dimensional Strut Plate in Mandibular Fractures. Ann Maxillofac Surg 2020; 10:10-15. [PMID: 32855908 PMCID: PMC7433946 DOI: 10.4103/ams.ams_73_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/05/2019] [Accepted: 04/07/2020] [Indexed: 11/26/2022] Open
Abstract
AIM The aim of this study was to compare 2 mm conventional miniplates with three-dimensional (3D) strut plates in the treatment of mandibular fractures treated in the Department of Oral and Maxillofacial Surgery of a college in India, during 2012-2015. MATERIALS AND METHODS All 20 patients with mandible fracture requiring open reduction and internal fixation of the fracture were reported and reviewed in the Department of Oral and Maxillofacial Surgery of the same dental college in India, during 2012-2015. We classified the data according to the gender, age, etiology, fracture site, and method of treatment of the fractures. Fixation done in 10 patients with 2 mm conventional miniplates kept in Group I, while 10 patients with 3D strut miniplate system considered in Group II. RESULTS Assessment of patient was done under the following parameters with follow-up at regular intervals at 2nd day postoperatively and at 1st, 3rd, and 6th weeks postoperatively: pain, swelling, infection, interincisal mouth opening in millimeters, paresthesia/anesthesia, mobility between fracture fragments, overall occlusion, need for any supplemental fixation, fate of implant, and complications. CONCLUSIONS 3D titanium miniplates showed similar results when compared to standard titanium miniplates with advantages such as reduction in operative time, ease of placement, and cost-effective over the conventional plate system.
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Affiliation(s)
- Shishir Kaushik
- Department of Oral and Maxillofacial Surgery, ITS Dental College, Greater Noida, Lucknow, Uttar Pradesh, India
| | - Iqbal Ali
- Department of Oral and Maxillofacial Surgery, Career Post Graduate Institute of Dental Sciences and Hospital, Lucknow, Uttar Pradesh, India
| | - Manish Dubey
- Department of Dentistry, TS Misra Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Neha Bajpai
- Department of Dentistry, TS Misra Medical College and Hospital, Lucknow, Uttar Pradesh, India
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Buron C, Mounier C, Guiavarc'h C, Lansonneur C, Conan M, Bouillon K, Le Toux G. Management of jaw fractures in oral surgery in public and private practice: a retrospective study from 2006 to 2017. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2019035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: To date, no epidemiological studies on jaw fracture have examined its characteristics according to hospital status (public vs private). The aim of this study was to examine their differences in terms of patient- and injury-related variables. Methods: A retrospective study was conducted using patients' medical records in 2 types of hospital located in the northern area of Brittany (France). All patients hospitalized for jaw fracture between 2006 and 2017 were eligible. Comparisons between centres according to age, gender, anatomic location of fracture, mechanism of injury, and length of stay were undertaken using χ2, Fisher exact test, t-test, and Cochrane-Armitage trend test. Results: A total of 142 patients were included: 45.1% in the public and 54.9% in the private hospitals. Of them, 84.5% were men and the mean age was 32.0. Main causes of fractures were assault (56.3%), fall (30.3%) and road traffic accident (10%). A small number of patients had polytrauma (4.2%). The mean duration of stay was less than 2 days. Compared to patients who were admitted in private hospital, those who were likely to be admitted in public hospital were those: who had a jaw fracture in context of road traffic accident (18.8% vs 2.6%), with polytrauma (9.4% vs 0.0%) and maxilla fracture (9.4% vs 1.3%), and who had a longer stay (2.2 vs 1.1 days). Conclusion: This study showed that differences observed in characteristics of jaw fractures between public and private hospitals may be due to recruitment process: more severely affected patients are likely to be admitted in the public hospital.
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Khiabani K, Keyhan SO, Ahmadi P, Gholamian A, Cheshmi B. Effect of using different methods of plate fixation in maxillary Lefort one fractures. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2019. [DOI: 10.1016/j.ajoms.2019.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Tükel HC, Benlidayı ME. Mandibula kırıklarının prevalansı, tedavisi ve komplikasyonları. CUKUROVA MEDICAL JOURNAL 2019. [DOI: 10.17826/cumj.469210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Finite Element Simulation of Displacement of the Broken Zygoma and Forces Exerted to the Complex After Fixation with Resorbable and Non-Resorbable One-Point Mini-Plates and Applying Normal or Severe Occlusal Loads. Trauma Mon 2019. [DOI: 10.5812/traumamon.85586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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20
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Jariod Ferrer ÚM, Blanco Sanfrutos S, Gavin Clavero MA, Simon Sanz MV, Uson Bouthelier T, Nadal Cristobal B. Epidemiological Study of the Socioeconomic Impact of Mandible Fractures in a Spanish Tertiary Hospital: Review of the Literature. J Maxillofac Oral Surg 2019; 18:217-223. [PMID: 30996541 DOI: 10.1007/s12663-018-1148-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/23/2018] [Indexed: 10/28/2022] Open
Abstract
Introduction Mandibles fractures are one of the most frequent pathologies treated in an Oral and Maxillofacial Department and represent a serious public health problem. Materials and Methods We present a retrospective study of patients treated for mandible fractures by the Oral and Maxillofacial Surgery Department in a Spanish tertiary hospital during 2010-2012. Results One hundred and thirty-nine patients with 201 mandible fracture sites were assisted in our department; 15% were female and 85% were male, with a male-to-female ratio of 5.5:1. The observed mean age was 35 years with a range between 15 and 89 years. The most frequent etiology of fractures was the assault (43%) followed by falls (32%). The most common fracture site was the mandibular angle (35%), followed by the parasymphysis (30%). Concerning combined fractures (60%), the most repeated association was the angle and the parasymphysis. The principal imaging test for diagnosis was the orthopantomography. The intermaxillary fixation was performed in the 25% of cases, and the rest of mandible fractures were fixed by osteosynthesis. The surgical treatment had an average of 4.2 days after the trauma, and the mean time of hospitalization was 6.5 days. Conclusion The principal aim of the treatment of mandible fractures is to restore the function of the patient occlusion. A malocclusion after surgery may decrease the patient quality of life, so a correct fracture reduction could shrink health spending. After the result shown in the present study, the social education should be improved in the developed countries with the objective of decline in the amount of aggressiveness.
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Affiliation(s)
- Úrsula M Jariod Ferrer
- 1Oral and Maxillofacial Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain.,2Faculty of Medicina, Zaragoza University, C/Domingo Miral s/n, 50009 Zaragoza, Spain
| | - Sara Blanco Sanfrutos
- Oral and Maxillofacial Department, Can Misses Hospital, Carrer de Corona 11, 07800 Eivissa, Ibiza (Illes Balears) Spain
| | - Marina A Gavin Clavero
- 1Oral and Maxillofacial Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
| | - Maria Victoria Simon Sanz
- 1Oral and Maxillofacial Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
| | - Tomas Uson Bouthelier
- 1Oral and Maxillofacial Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
| | - Bartolomeu Nadal Cristobal
- 1Oral and Maxillofacial Department, Miguel Servet University Hospital, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
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Desai V, Jain MK. Locking Miniplate Osteosynthesis of Anterior Mandibular Fractures-Quo Vadis? J Oral Maxillofac Surg 2019; 77:1041.e1-1041.e9. [PMID: 30796907 DOI: 10.1016/j.joms.2019.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/08/2019] [Accepted: 01/08/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE This study compared the clinical stability and efficacy of locking miniplates with those of standard miniplates in the osteosynthesis of anterior mandibular fractures using bite force recordings and other clinical parameters. MATERIALS AND METHODS A prospective randomized double-blinded clinical trial was carried out in patients from various hospitals of Hassan (India). Patients were randomly divided into 2 groups of locking (test) and standard (control) miniplate osteosynthesis. Bite force measurements were performed preoperatively and postoperatively at weekly intervals for 6 weeks using a bite force recorder. As a secondary outcome, patients also were assessed for other clinical parameters that might interfere with successful osteosynthesis at the fracture site. Appropriate statistical testing for intra- and intergroup measurements was carried out. RESULTS Forty-eight men 28 ± 12.3 years old met the inclusion criteria (24 patients in each group). A statistically significant difference (P < .05) was found in the incisor bite force between the 2 groups, with values in the locking group exceeding those in the standard group at postoperative weeks 2 and 5. Duration of surgery was shorter in the locking group (P = .015). No relevant difference was found for the other clinical parameters. CONCLUSIONS Bite force statistically increased at progressive follow-up visits compared with the preoperative recording in the locking group. Bite force recordings of patients treated with locking plates were higher and statistically relevant compared with those of patients treated with standard miniplates at the incisor region at postoperative weeks 2 and 5. The clinical outcomes of the 2 miniplate systems in the present study were similar; however, the locking miniplates required a relatively shorter operating time, produced less trauma to the periosteum and soft tissues with less hardware, and can be used as a "1-plate-for-all" system.
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Affiliation(s)
- Vyoma Desai
- Former Senior Resident, Department of Oral and Maxillofacial Surgery, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, India
| | - Manoj Kumar Jain
- Former Associate Professor, Department of Oral and Maxillofacial Surgery, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, India.
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Khiabani K, Keyhan SO, Razmdideh R, Chaleh Chaleh Z, Amirzade-Iranaq MH. Effect of different miniplate osteosynthesis in different mandibular angle fracture patterns on bite force: A 3D finite element analysis. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2018. [DOI: 10.1016/j.ajoms.2018.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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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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Rastogi S, Paul S, Kukreja S, Aggarwal K, Choudhury R, Bhugra A, Indra B NP, Jawaid M. Treatment of Mandibular Angle Fractures with Single Three-Dimensional Locking Miniplates without Maxillomandibular Fixation: How Much Fixation Is Required? Craniomaxillofac Trauma Reconstr 2017; 10:188-196. [PMID: 28751942 DOI: 10.1055/s-0037-1600904] [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: 08/12/2016] [Accepted: 11/27/2016] [Indexed: 10/19/2022] Open
Abstract
The aim of this simple nonrandomized and observational study was to evaluate the efficacy of single three-dimensional (3D) plate for the treatment of mandibular angle fractures without maxillomandibular fixation. A total of 30 patients with noncomminuted fractures of mandibular angle requiring open reduction and internal fixation were included in the study. All the patients were treated by open reduction and internal fixation using single 3D titanium locking miniplate placed with the help of transbuccal trocar or Synthes 90-degree hand piece and screw driver. 3D locking titanium miniplates used in our study was four-holed, box-shaped plate, and screws with 2 mm diameter and 8 mm length. The following clinical parameters were assessed for each patient at each follow-up visit: pain (visual analog scale: 0-5), swelling (visual analog scale: 0-5), mouth opening, infection, paresthesia, hardware failure (plate fracture), occlusal discrepancies, and mobility between fracture fragments. A significant decrease in pain level was seen during the follow-up visits. No statistically significant changes were seen in swelling, but mouth opening increased in the subsequent visits. Also better results were seen in terms of fracture stability and occlusion in the postoperative period. Two cases of infection and two cases of hardware failure were noted in sixth postoperative week. 3D plating system is an easy to use alternative to conventional miniplates to treat mandibular angle fractures that uses lesser foreign material, thus reducing the operative time and overall cost of the treatment. Better fracture stability and occlusion was also achieved using the 3D plating system.
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Affiliation(s)
- Sanjay Rastogi
- Department of Oral and Maxillofacial Surgery and Oral Implantology, TMDCRC, Moradabad, Uttar Pradesh, India
| | - Sam Paul
- Department Orthodontics and Dentofacial Orthopaedics, Educare Institute of Dental Sciences, Chattiparamba, Malappuram, Kerala, India
| | - Sumedha Kukreja
- Department of Oral and Maxillofacial Surgery, Lady Hardinge Medical College, New Delhi, India
| | - Karun Aggarwal
- Department of Oral and Maxillofacial Surgery, Jodhpur Dental College and Research Center, Jodhpur, Rajasthan, India
| | - Rupshikha Choudhury
- Department of Oral and Maxillofacial Surgery, Regional Dental College, Guwahati, Assam, India
| | - Amit Bhugra
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Niranjana Prasad Indra B
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Moazzam Jawaid
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
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KILINÇ A, ERTAŞ Ü, YALÇIN E, SARUHAN N. Mandibula Kırıklarının Retrospektif Analizi. CUMHURIYET DENTAL JOURNAL 2017. [DOI: 10.7126/cumudj.306117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
Mandible fractures have a special place within the injuries of the other bones of the maxillofacial system. In their management, cosmetic issues and functional aspects such as chewing, speaking, and swallowing become very important.In this study, a retrospective analysis of 419 mandible fractures in 283 patients was performed in relation to epidemiologic factors, treatment strategies, and complications. The average age was 32.14 years (4-69 years). The male/female ratio was 4/1. The most frequent etiologic factor was interpersonal violence (104 patients, 36.7%). The parasymphysis region was the mostly affected site (28.4%). A total of 157 patients (55.5%) were presented with single fracture and the rest with 2, 3, or 4 fracture lines on the mandible. The most common fracture combination was angulus-parasymphysis fracture combination (24.6%). Open reduction and fixation with mini plates and screws was the most preferred treatment strategy (48.2%). Transient short arch bars were not used intraoperatively for any of the patients. There was not any difference in terms of complications between the patients treated with plating systems and plating systems plus intermaxillary fixation.In conclusion, proper treatment of mandible fractures is critical. Except certain fracture types, the usage of intermaxillary fixation as an adjunct to fixation with plating systems is not necessary.
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Yadav S, Mittal HC, Dhupar V, Akkara F, Sachdeva A. Transoral approach alone in single miniplate osteosynthesis of angle fracture - our experience. Natl J Maxillofac Surg 2017; 7:71-75. [PMID: 28163483 PMCID: PMC5242079 DOI: 10.4103/0975-5950.196136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aim: The aim of this study was to determine the outcome of transoral approach alone to treat the mandibular angle fracture using single 2.0 mm miniplate. Materials and Methods: In this study, 28 patients were included and treated with 2.0 mm single miniplate osteosynthesis at upper border along Champy's line of osteosynthesis using transoral approach alone. Results: All the cases were treated successfully with 2.0 mm single miniplate with common complications such as infection (two cases) and plate exposure (one case) in a total of two cases. Conclusion: Use of single miniplates by transoral approach alone for superior border osteosynthesis is effective and simple approach without need of extra armamentarium.
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Affiliation(s)
- Sunil Yadav
- Department of Dentistry, BPS Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
| | - Hitesh Chander Mittal
- Department of Dentistry, BPS Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
| | - Vikas Dhupar
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Francis Akkara
- Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Akash Sachdeva
- Department of Oral and Maxillofacial Surgery, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
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Singh RK, Pal US, Singh P, Singh G. Role of fixation in posttraumatic nerve injury recovery in displaced mandibular angle fracture. Natl J Maxillofac Surg 2017; 7:29-32. [PMID: 28163475 PMCID: PMC5242070 DOI: 10.4103/0975-5950.196132] [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] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The objective of this study was to assess the effectiveness of different types of fixation in the enhancement of posttraumatic inferior alveolar nerve (IAN) recovery in displaced mandibular angle fracture and to establish. PATIENTS AND METHODS Thirty patients of displaced mandibular angle fracture were treated with preangulated plate and three-dimensional (3D) matrix plate in two groups and were observed during follow-up at 04,06 and 12 weeks along with other parameters. RESULTS Fifteen patients were treated with preangulated plate and 15 patients with 3D matrix miniplate. There was early nerve recovery in Group A than Group B, with residual paresthesia 20% in Group A and 26.6% in Group B at the end of 12-week follow-up. CONCLUSION The displaced mandibular angle fracture with posttraumatic IAN paresthesia treated with preangulated plate has shown evidence of early nerve recovery than those fractures were treated with matrix miniplate. The fracture fragments displaced more than 9 mm have shown poor nerve recovery in both groups.
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Affiliation(s)
- R K Singh
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - U S Pal
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Pranshu Singh
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Geeta Singh
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
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Yamaguchi S, Anchieta RB, Guastaldi FPS, Tovar N, Tawara D, Imazato S, Coelho PG. In Silico Analysis of the Biomechanical Stability of Commercially Pure Ti and Ti-15Mo Plates for the Treatment of Mandibular Angle Fracture. J Oral Maxillofac Surg 2017; 75:1004.e1-1004.e9. [PMID: 28137635 DOI: 10.1016/j.joms.2016.12.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 12/28/2016] [Accepted: 12/28/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the influence of different materials and fixation methods on maximum principal stress (MPS) and displacement in reconstruction plates using in silico 3-dimensional finite element analysis (3D-FEA). MATERIALS AND METHODS Computer-assisted designed (CAD) models of the mandible and teeth were constructed. Champy and AO/ASIF plates and fixation screws were designed with CAD software. 3D-FEA was performed by image-based CAE software. Maximum and minimum values of biomechanical stability, MPS, and displacement distribution were compared in Champy and AO/ASIF plates made from commercially pure titanium grade 2 (cp-Ti) and a titanium-and-molybdenum (14.47% wt) alloy (Ti-15Mo). RESULTS For plates fixed on a model of a fractured left angle of the mandible, the maximum and minimum values of MPS in the cp-Ti-constructed Champy plate, upper AO/ASIF plate, and lower AO/ASIF plate were 19.5 and 20.3%, 15.2 and 25.3%, and 21.4 and 4.6% lower, respectively, than those for plates made from Ti-15Mo. In the same model, the maximum and minimum values of displacement in the cp-Ti-constructed Champy plate, upper AO/ASIF plate, and lower AO/ASIF plate were 1.6 and 3.8%, 3.1 and 2.7%, and 5.4 and 10.4% higher, respectively, than those for plates made from Ti-15Mo. CONCLUSIONS This in silico 3D-FEA shows that Ti-15Mo plates have greater load-bearing capability.
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Affiliation(s)
- Satoshi Yamaguchi
- Associate Professor, Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Osaka, Japan.
| | - Rodolfo B Anchieta
- Assistant Professor, Centro Universotário do Norte Paulista (UNORP), São José do Rio Preto, SP, Brazil
| | - Fernando P S Guastaldi
- Postdoctoral Research Fellow, Faculdade de Odontologia de Araraquara, UNESP - Universidate Estadual Paulista, Araraquara, SP, Brazil
| | - Nick Tovar
- Assistant Professor, Department of Biomaterials and Biomimetics, New York University, New York, NY
| | - Daisuke Tawara
- Assistant Professor, Department of Mechanical and Systems Engineering, Ryukoku University, Shiga, Japan
| | - Satoshi Imazato
- Professor, Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Paulo G Coelho
- Associate Professor, Department of Biomaterials and Biomimetics, New York University, New York, NY
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Vashistha A, Singh M, Chaudhary M, Agarwal N, Kaur G. Comparison of 2 mm single locking miniplates versus 2 mm two non-locking miniplates in symphysis and parasymphysis fracture of mandible. J Oral Biol Craniofac Res 2017; 7:42-48. [PMID: 28316921 PMCID: PMC5343153 DOI: 10.1016/j.jobcr.2016.01.001] [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: 09/14/2015] [Accepted: 01/09/2016] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION The purpose of this study is to compare the efficacy of single 2 mm locking miniplates versus two 2 mm non-locking (conventional) miniplates in symphysis and parasymphysis fracture of mandible. METHOD This present study included 40 patients of maxillofacial trauma having mandibular symphysis/parasymphysis fractures in which open reduction and internal fixation is indicated. Patients were selected according to the inclusion criteria and divided into two groups, i.e. Group 1: consisted of 20 patients, requiring open reduction and internal fixation with 2 mm two non-locking titanium plate and Group 2: consisted of 20 patients, requiring open reduction and internal fixation with 2.0 mm single ultra-locking titanium plate. Fracture was then stabilized and postoperative clinical examination was carried out on 3rd day, 1st, 2nd, 4th, and 8th week. RESULT Results of this study suggested that the use of single 2.0 mm locking miniplate could be a viable option instead of using two miniplates in anterior mandibular fracture as advocated by Champy, as it provides equally good outcome along with placement of lesser implant material. DISCUSSION Single locking miniplates give the advantage of equally good stability and early restoration of function with almost similar results as seen in osteosynthesis with two miniplates. It was also found that less precision was required in plate adaptation when using single locking miniplate. This study suggests that there is not much difference in surgical outcome with the use of either single locking miniplate or two conventional miniplates in anterior mandibular region.
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Affiliation(s)
- Arpit Vashistha
- Resident, Department of Oral & Maxillofacial Surgery, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh 244001, India
| | - Manpreet Singh
- Reader, Department of Oral & Maxillofacial Surgery, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh 244001, India
| | - Manoj Chaudhary
- Head, Department of Oral & Maxillofacial Surgery, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh 244001, India
| | - Nimish Agarwal
- Senior Lecturer, Department of Oral & Maxillofacial Surgery, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh 244001, India
| | - Gagandeep Kaur
- Reader, Department of Conservative Dentistry & Endodontics, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh 244001, India
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Yadav S, Mittal HC, Malik S, Dhupar V, Sachdeva A, Malhotra V, Singh G. Post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve in mandibular fracture: a prospective study. J Korean Assoc Oral Maxillofac Surg 2016; 42:259-264. [PMID: 27847733 PMCID: PMC5104867 DOI: 10.5125/jkaoms.2016.42.5.259] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/06/2016] [Accepted: 08/26/2016] [Indexed: 11/23/2022] Open
Abstract
Objectives We evaluated and recorded post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve (IAN) in mandibular fracture in order to identify associated risk factors. Materials and Methods This was a prospective cohort study composed of 60 patients treated for mandibular fracture. The primary study variable was the change between the post-traumatic IAN neurosensory examination score and the score after fracture reduction. Risk factors were categorized as demographic, anatomic, fracture displacement, and treatment. Appropriate descriptive and bivariate statistics were computed. Results Sixty patients with unilateral mandibular fracture reported within 24 hours of injury were evaluated over a one-year period. A post-traumatic neurosensory deficit was observed in 52 patients (86.7%), the percentage of which was reduced to 23.3% over the follow-up period. Abnormal postoperative neurosensory scores were significantly higher in angle fracture cases (33.3%) compared to body fracture cases (11.1%). When recovered and non-recovered neurosensory scores were compared by fracture location, 88.9% of body fracture cases showed significant recovery compared to 66.7% of mandibular angle fracture cases. Cases with less than 5 mm fracture displacement showed statistically significantly higher neurosensory recovery scores (90.6%) compared to those with more than 5 mm fracture displacement (60.7%). Conclusion Use of a miniplate with mono-cortical screws does not play a role in increasing IAN post-traumatic neurosensory deficit. Early management can reduce the chances of permanent neurosensory deficit. Mandibular fracture displacement of 5 mm or more and fracture location were found to be associated with an increased risk of post-traumatic IAN neurosensory score worsening.
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Affiliation(s)
- Sunil Yadav
- Department of Dental Surgery, BPS Government Medical College for Women, Sonepat, India
| | - Hitesh Chander Mittal
- Department of Dental Surgery, BPS Government Medical College for Women, Sonepat, India
| | - Sunita Malik
- Department of Dental Surgery, BPS Government Medical College for Women, Sonepat, India
| | - Vikas Dhupar
- Department of Maxillofacial Surgery, Goa Dental College, Bambolim, India
| | - Akash Sachdeva
- Department of Maxillofacial Surgery, Inderprastha Dental College & Hospital, Ghaziabad, India
| | | | - Gurdarshan Singh
- Department of Dental Surgery, BPS Government Medical College for Women, Sonepat, India
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In vitro evaluation of the resistance of three types of fixation to treat fractures of the mandibular angle. Br J Oral Maxillofac Surg 2016; 55:136-140. [PMID: 27776924 DOI: 10.1016/j.bjoms.2016.09.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 09/20/2016] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to compare the mechanical resistance of three different plates used to treat fractures of the mandibular angle: a regular 4-hole plate, a longer 4-hole plate (both positioned using the Champy technique), and a 3-dimensional plate positioned over the oblique line. Three equal groups of replicas of human dentate mandibles made out of polyurethane resin were used (n=21 in each group). The force was applied perpendicular to the occlusal plane at a rate of 2mm/minute at three different points: the first molar on the sectioned side; the first molar on the contralateral side; and between the central incisors. This was followed by a resistance-to-load test. The two varying factors (type of plate and site-of-load application) were tested by analysis of variance, and probabilities of less than 0.05 were accepted as significant. There were no significant differences between the subgroups, or between the mean values of the different types of plates (p=0.925). The three types of plates showed similar mechanical behaviour, which showed that the 3-dimensional plates positioned over the oblique line can produce mechanical scores similar to those of conventional plates.
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Rizzi CJ, Ortlip T, Greywoode JD, Vakharia KT, Vakharia KT. A novel computer algorithm for modeling and treating mandibular fractures: A pilot study. Laryngoscope 2016; 127:331-336. [PMID: 27761894 DOI: 10.1002/lary.26086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/03/2016] [Accepted: 04/26/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS To describe a novel computer algorithm that can model mandibular fracture repair. To evaluate the algorithm as a tool to model mandibular fracture reduction and hardware selection. STUDY DESIGN Retrospective pilot study combined with cross-sectional survey. METHODS A computer algorithm utilizing Aquarius Net (TeraRecon, Inc, Foster City, CA) and Adobe Photoshop CS6 (Adobe Systems, Inc, San Jose, CA) was developed to model mandibular fracture repair. Ten different fracture patterns were selected from nine patients who had already undergone mandibular fracture repair. The preoperative computed tomography (CT) images were processed with the computer algorithm to create virtual images that matched the actual postoperative three-dimensional CT images. A survey comparing the true postoperative image with the virtual postoperative images was created and administered to otolaryngology resident and attending physicians. They were asked to rate on a scale from 0 to 10 (0 = completely different; 10 = identical) the similarity between the two images in terms of the fracture reduction and fixation hardware. RESULTS Ten mandible fracture cases were analyzed and processed. There were 15 survey respondents. The mean score for overall similarity between the images was 8.41 ± 0.91; the mean score for similarity of fracture reduction was 8.61 ± 0.98; and the mean score for hardware appearance was 8.27 ± 0.97. There were no significant differences between attending and resident responses. There were no significant differences based on fracture location. CONCLUSION This computer algorithm can accurately model mandibular fracture repair. Images created by the algorithm are highly similar to true postoperative images. The algorithm can potentially assist a surgeon planning mandibular fracture repair. LEVEL OF EVIDENCE 4. Laryngoscope, 2016 127:331-336, 2017.
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Affiliation(s)
- Christopher J Rizzi
- Department of Otolaryngology, University of Maryland School of Medicine, Baltimore, Maryland, U.S.A
| | - Timothy Ortlip
- Department of Otolaryngology, University of Maryland School of Medicine, Baltimore, Maryland, U.S.A
| | - Jewel D Greywoode
- Department of Otolaryngology, University of Maryland School of Medicine, Veterans Administration Medical Center at Baltimore, Baltimore, Maryland, U.S.A
| | - Kavita T Vakharia
- Division of Plastic Surgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, U.S.A
| | - Kalpesh T Vakharia
- Department of Otolaryngology, University of Maryland School of Medicine, Veterans Administration Medical Center at Baltimore, Baltimore, Maryland, U.S.A
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Lee JH, Kwon JS, Moon SK, Uhm SH, Choi BH, Joo UH, Kim KM, Kim KN. Titanium-Silver Alloy Miniplates for Mandibular Fixation: In Vitro and In Vivo Study. J Oral Maxillofac Surg 2016; 74:1622.e1-1622.e12. [DOI: 10.1016/j.joms.2016.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/06/2016] [Accepted: 04/06/2016] [Indexed: 10/21/2022]
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Kharmanda G, Kharma MY. Evaluating the Effect of Minimizing Screws on Stabilization of Symphysis Mandibular Fracture by 3D Finite Element Analysis. J Maxillofac Oral Surg 2016; 16:205-211. [PMID: 28439162 DOI: 10.1007/s12663-016-0903-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 03/21/2016] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The objective of this work is to integrate structural optimization and reliability concepts into mini-plate fixation strategy used in symphysis mandibular fractures. The structural reliability levels are next estimated when considering a single failure mode and multiple failure modes. PATIENTS AND METHODS A 3-dimensional finite element model is developed in order to evaluate the ability of reducing the negative effect due to the stabilization of the fracture. Topology optimization process is considered in the conceptual design stage to predict possible fixation layouts. In the detailed design stage, suitable mini-plates are selected taking into account the resulting topology and different anatomical considerations. Several muscle forces are considered in order to obtain realistic predictions. Since some muscles can be cut or harmed during the surgery and cannot operate at its maximum capacity, there is a strong motivation to introduce the loading uncertainties in order to obtain reliable designs. The structural reliability is carried out for a single failure mode and multiple failure modes. RESULTS The different results are validated with a clinical case of a male patient with symphysis fracture. In this case while use of the upper plate fixation with four holes, only two screws were applied to protect adjacent vital structure. This behavior does not affect the stability of the fracture. CONCLUSION The proposed strategy to optimize bone plates leads to fewer complications and second surgeries, less patient discomfort, and shorter time of healing.
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Affiliation(s)
| | - Mohamed-Yaser Kharma
- Department Oral Maxillofacial Surgery, Al-Farabi College for Dentistry, Jeddah, Kingdom of Saudi Arabia.,Department of Oral Maxillofacial Surgery, Dental School, Aleppo University, Aleppo, Syria
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Mittal Y, Varghese KG, Mohan S, Jayakumar N, Chhag S. A Comparative Study of 3-Dimensional Titanium Versus 2-Dimensional Titanium Miniplates for Open Reduction and Fixation of Mandibular Parasymphysis Fracture. J Maxillofac Oral Surg 2016; 15:93-8. [PMID: 26929559 DOI: 10.1007/s12663-015-0780-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 03/05/2015] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Three dimensional titanium plating system was developed by Farmand in 1995 to meet the requirements of semi rigid fixation with lesser complication. The purpose of this in vivo prospective study was to evaluate and compare the clinical effectiveness of three dimensional and two dimensional Titanium miniplates for open reduction and fixation of mandibular parasymphysis fracture. MATERIALS AND METHODS Thirty patients with non-comminuted mandibular parasymphysis fractures were divided randomly into two equal groups and were treated with 2 mm 3D and 2D miniplate system respectively. All patients were systematically monitored at 1st, 2nd, 3rd, 6th week, 3rd and 6th month postoperatively. The outcome parameters recorded were severity of pain, infection, mobility, occlusion derangement, paresthesia and implant failure. The data so collected was analyzed using independent t test and Chi square test (α = .05). RESULTS The results showed that one patient in each group had post-operative infection, occlusion derangement and mobility (p > .05). In Group A, one patient had paresthesia while in Group B, two patients had paresthesia (p > .05). None of the patients in both the groups had implant failure. There was no statistically significant difference between 3D and 2D miniplate system in all the recorded parameters at all the follow-ups (p > .05). CONCLUSION 3D miniplates were found to be better than 2D miniplates in terms of cost, ease of surgery and operative time. However, 3D miniplates were unfavorable for cases where fracture line was oblique and in close proximity to mental foramen, where they were difficult to adapt and more chances for tooth-root damage and inadvertent injury to the mental nerve due to traction.
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Affiliation(s)
- Yogesh Mittal
- Department of Trauma and Emergency, All India Institute of Medical Sciences (AIIMS), Jodhpur, 342005 Rajasthan India
| | - K George Varghese
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, 686008 Kerala India
| | - S Mohan
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, 686008 Kerala India
| | - N Jayakumar
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, 686008 Kerala India
| | - Somil Chhag
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, 686008 Kerala India
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Rastogi S, Reddy MP, Swarup AG, Swarup D, Choudhury R. Assessment of Bite Force in Patients Treated with 2.0-mm Traditional Miniplates versus 2.0-mm Locking Plates for Mandibular Fracture. Craniomaxillofac Trauma Reconstr 2016; 9:62-8. [PMID: 26889350 DOI: 10.1055/s-0035-1563697] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 06/13/2015] [Indexed: 10/23/2022] Open
Abstract
The objective of this study is to analyze the difference in bite forces in patients treated for mandibular fractures with 2.0 mm conventional and locking titanium plating system. A randomized study was performed for the treatment of fractures of mandible. In this study, 20 adult patients with isolated mandibular fracture were included. The patients were randomly allocated into two groups, that is, Group I-2.0 mm nonlocking (traditional) and Group II-2.0 mm locking plates. Bite force was evaluated at 1st, 3rd, and 6th weeks. Comparison of all the assessed parameters between both the groups depicted no significant difference in terms of pain, swelling including the incidence of infection, paresthesia, and hardware failure. Although same was true in case of bite force between both the groups at various time intervals, there was statistically significant increase in the bite force within the group comprising patients in whom locking plates was used between 1st and 3rd weeks follow-up period and highly significant increase in bite force between 1st and 6th weeks of follow-up period. The rapid improvement of bite force values when locking plates were used implies that the locking plate can be used in preference to conventional plates to achieve early mobilization with assured stability in the treatment of mandibular fractures.
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Affiliation(s)
- Sanjay Rastogi
- Department of Oral and Maxillofacial Surgery and Oral Implantology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Mahendra Parvath Reddy
- Department of Oral and Maxillofacial Surgery, Jaipur Dental College, Jaipur, Rajasthan, India
| | | | | | - Rupshikha Choudhury
- Department of Oral and Maxillofacial Surgery, Private Practice, Guwahati, India
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Chuang J, Barnes C, Wong BJF. Overview of Facial Plastic Surgery and Current Developments. Surg J (N Y) 2016; 2:e17-e28. [PMID: 28824978 PMCID: PMC5553462 DOI: 10.1055/s-0036-1572360] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 01/05/2016] [Indexed: 11/01/2022] Open
Abstract
Facial plastic surgery is a multidisciplinary specialty largely driven by otolaryngology but includes oral maxillary surgery, dermatology, ophthalmology, and plastic surgery. It encompasses both reconstructive and cosmetic components. The scope of practice for facial plastic surgeons in the United States may include rhinoplasty, browlifts, blepharoplasty, facelifts, microvascular reconstruction of the head and neck, craniomaxillofacial trauma reconstruction, and correction of defects in the face after skin cancer resection. Facial plastic surgery also encompasses the use of injectable fillers, neural modulators (e.g., BOTOX Cosmetic, Allergan Pharmaceuticals, Westport, Ireland), lasers, and other devices aimed at rejuvenating skin. Facial plastic surgery is a constantly evolving field with continuing innovative advances in surgical techniques and cosmetic adjunctive technologies. This article aims to give an overview of the various procedures that encompass the field of facial plastic surgery and to highlight the recent advances and trends in procedures and surgical techniques.
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Affiliation(s)
- Jessica Chuang
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California
| | - Christian Barnes
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California.,Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Irvine, California
| | - Brian J F Wong
- Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, California.,Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Irvine, California
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Hernandez Rosa J, Villanueva NL, Sanati-Mehrizy P, Factor SH, Taub PJ. Review of Maxillofacial Hardware Complications and Indications for Salvage. Craniomaxillofac Trauma Reconstr 2015; 9:134-40. [PMID: 27162569 DOI: 10.1055/s-0035-1570074] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 07/25/2015] [Indexed: 10/22/2022] Open
Abstract
From 2002 to 2006, more than 117,000 facial fractures were recorded in the U.S. National Trauma Database. These fractures are commonly treated with open reduction and internal fixation. While in place, the hardware facilitates successful bony union. However, when postoperative complications occur, the plates may require removal before bony union. Indications for salvage versus removal of the maxillofacial hardware are not well defined. A literature review was performed to identify instances when hardware may be salvaged. Articles considered for inclusion were found in the PubMed and Web of Science databases in August 2014 with the keywords maxillofacial trauma AND hardware complications OR indications for hardware removal. Included studies looked at human patients with only facial trauma and miniplate fixation, and presented data on complications and/or hardware removal. Fifteen articles were included. None were clinical trials. Complication data were presented by patient, fractures, and/or plate without consistency. The data described 1,075 fractures, 2,961 patients, and 2,592 plates, nonexclusive. Complication rates varied from 6 to 8% by fracture and 6 to 13% by patient. When their data were combined, 50% of complications were treated with plate removal; this was consistent across the mandible, midface, and upper face. All complications caused by loosening, nonunion, broken hardware, and severe/prolonged pain were treated with removal. Some complications caused by exposures, deformities, and infections were treated with salvage. Exposed plates were treated with flaps, plates with deformities were treated with secondary procedures including hardware revision, and hardware infections were treated with antibiotics alone or in conjunction with soft-tissue debridement and/or tooth extraction. Well-designed clinical trials evaluating hardware removal versus salvage are lacking. Some postoperative complications caused by exposure, deformity, and/or infection may be successfully treated with plate salvage. We propose an algorithm using this review and clinical expertise. We also propose that a national databank be created where surgeons can uniformly compile their patient information and examine it in a standardized format to further our understanding of clinical management.
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Affiliation(s)
- Jonatan Hernandez Rosa
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nathaniel L Villanueva
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Paymon Sanati-Mehrizy
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Stephanie H Factor
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Peter J Taub
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
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Strasz M, Wolschner R, Schopper C, Pöschl WP, Perisanidis C, Wick F, Seemann R. Miniplate osteosynthesis for mandibular angle fractures--A retrospective comparative study of 3 concepts in a temporal cohort. J Craniomaxillofac Surg 2015; 44:56-61. [PMID: 26646637 DOI: 10.1016/j.jcms.2015.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 09/21/2015] [Accepted: 10/07/2015] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Purpose of this retrospective study was to compare fixation of mandibular angle fractures by three different miniplating-concepts (single miniplate, double miniplate, TriLock mandibular angle plate) regarding osteosynthesis failure and hardware removal. METHODS In this retrospective study a temporal cohort of 184 patients with 194 simple mandibular angle fractures, which had been treated by open reduction and internal fixation via miniplates at the University Clinic of Cranio-, Maxillofacial and Oral Surgery (General Hospital Vienna) in the period of 2005-2011, were included. Patients with pathologic fractures (e.g. tumour or osteonecrosis related) or comminuted fractures were not considered. RESULTS 9 of 194 (4.6%) fractures showed osteosynthesis failures. The osteosynthesis failure rates were 2.9% in the single miniplate group, 3.4% in the TriLock plate group, and 11.1% in the double miniplate group. In the double miniplate group 33.3% of the patients had undergone hardware removal, 21.4% in the single miniplate group, and 11.4% in the TriLock plate group. CONCLUSION A single 4-hole locking plate with a thickness of 1.25-1.3 mm guarantees for low osteosynthesis failure rates without postoperative maxillo-mandibular fixation and requires less hardware removal in simple mandibular angle fractures. Two miniplates, longer plates with more holes and thicker plates are prone to hardware removal.
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Affiliation(s)
- Martin Strasz
- University Clinic of Cranio-Maxillofacial and Oral Surgery, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Rainer Wolschner
- Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria
| | - Christian Schopper
- University Clinic of Cranio-Maxillofacial and Oral Surgery, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Wolfgang Paul Pöschl
- University Clinic of Cranio-Maxillofacial and Oral Surgery, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Christos Perisanidis
- University Clinic of Cranio-Maxillofacial and Oral Surgery, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Felix Wick
- University Clinic of Cranio-Maxillofacial and Oral Surgery, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Rudolf Seemann
- University Clinic of Cranio-Maxillofacial and Oral Surgery, Waehringer Guertel 18-20, 1090 Vienna, Austria
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Giri KY, Sahu P, Rastogi S, Dandriyal R, Mall S, Singh AP, Indra B NP, Pratap Singh H. Bite Force Evaluation of Conventional Plating System Versus Locking Plating System for Mandibular Fracture. J Maxillofac Oral Surg 2015; 14:972-8. [PMID: 26604472 PMCID: PMC4648785 DOI: 10.1007/s12663-015-0764-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 02/13/2015] [Indexed: 10/23/2022] Open
Abstract
AIMS AND OBJECTIVES To compare and evaluate the variation in recorded bite forces in patients with mandibular fractures undergoing open reduction and rigid internal fixation using standard 2.0 versus 2.0 mm locking miniplates. MATERIALS AND METHODS A prospective randomized study was conducted for the treatment of mandibular fractures. Twenty adult patients with 31 mandibular fractures requiring an open reduction and internal fixation were included in the study. The sample was divided into two groups depending upon whether the patients received 2.0 mm non-locking (standard) or 2.0 mm locking miniplates for rigid fixation respectively. Bite force was evaluated at 1st, 3rd and 6th week after the open reduction and rigid fixation using miniplates. RESULTS A statistically significant difference was not found in the clinical parameters such as pain, swelling, infection, paresthesia, hardware failure, and mobility between the fracture segments. The results showed that amongst locking vs non-locking miniplates, the former showed a greater bite force enhancement when compared to baseline values(post-trauma).A comparison between 2nd day post-operative vs 6th week post-operative values showed a significant increase in bite force in Group 1 (non-locking) (p < 0.05) whereas the values Were highly significant (p < 0.001) in Group 2 (locking Plate). CONCLUSION The findings were suggestive that the efficacy of locking miniplates plate in mandibular fracture was superior in terms of bearing the masticatory loads during osteosynthesis of the fracture. However, the clinical results were almost similar to those seen with non-locking miniplate osteosynthesis.
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Affiliation(s)
- Kolli Yada Giri
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, U.P. India
| | - Puneet Sahu
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, U.P. India
| | - Sanjay Rastogi
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, U.P. India
| | - Ramakant Dandriyal
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, U.P. India
| | - Sunil Mall
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, U.P. India
| | - Aishwarya Pratap Singh
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, U.P. India
| | - Niranjana Prasad Indra B
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, U.P. India
| | - Himanshu Pratap Singh
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bareilly, U.P. India
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Samieirad S, Tohidi E, Shahidi-Payam A, Hashemipour MA, Abedini A. Retrospective study maxillofacial fractures epidemiology and treatment plans in Southeast of Iran. Med Oral Patol Oral Cir Bucal 2015; 20:e729-36. [PMID: 26116845 PMCID: PMC4670254 DOI: 10.4317/medoral.20652] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 04/01/2015] [Indexed: 11/19/2022] Open
Abstract
Background The epidemiology of facial injuries varies in different countries and geographic zones. Population concentration, lifestyle, cultural background, and socioeconomic status can affect the prevalence of maxillofacial injuries. Therefore, in this study, we evaluated the maxillofacial fractures epidemiology and treatment plans in hospitalized patients (2012-2014) which would be useful for better policy making strategies. Material and Methods In this retrospective study, the medical records of 386 hospitalized patients were evaluated from the department of maxillofacial surgery at Bahonar Hospital of Kerman, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. For data analysis, ANOVA, t-test, Chi-square, and Fisher’s exact test were performed, using SPSS version 21. Results The majority of patients were male (76.5%). Most subjects were within the age range of 20-30 years. Fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the mandible (parasymphysis). There was a significant association between the type of treatment and age. In fact, the age group of 16-59 years under went open reduction internal fixation (ORIF) more than other age groups (P=0.02). Also, a significant association was observed between gender and the occurrence of fractures (P=0.01). Conclusions Considering the geographic and cultural indices of the evaluated population, it can be concluded that patients age and gender and trauma causes significantly affect the prevalence of maxillofacial traumas and fracture kinds and treatment plans. Key words:Epidemiology, treatment, facial injuries, face fractures, maxillofacial trauma, trauma.
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Affiliation(s)
- Sahand Samieirad
- Department of Oral Medicine, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran,
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Effect of surgical treatment of mandibular fracture: electromyographic analysis, bite force, and mandibular mobility. J Craniofac Surg 2015; 25:1714-20. [PMID: 25203573 DOI: 10.1097/scs.0000000000000968] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aimed to examine individuals undergoing surgery for the treatment of the fractured mandibular angle, using bite force, mandibular mobility, and electromyographic (EMG) analysis in many different clinical conditions, after 2 months postoperatively. Bite force was recorded with a digital dynamometer, model IDDK. The EMG activity (Myosystem-Br1) included the analysis of the masseter and temporal muscles. Mandibular mobility was measured using a digital pachymeter. The subjects were divided into 3 groups: G1, mandibular angle fracture (n = 7); G2, condylar process fracture (n = 5); and G3, control (n = 12). Data were tabulated and submitted to statistical analysis using the repeated-measure test carried out over time and the Student's t-test (P < 0.05), using the Statistical Package for the Social Sciences software, version 19 (SPSS Inc, Chicago, IL). G1 and G2 had an increase in bite force. In G1, there was a regular decrease in the EMG activity in the second postoperative month. G2 presented an irregular pattern in EMG data during the period tested. Regarding the mandibular mobility, both groups obtained amplitude of all mandibular movements with a high percentage, when compared with control. A good functional recovery was achieved by the individuals who had a mandible angle fracture or condylar process fracture, after 2 postoperative months.
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Bereket C, Şener İ, Şenel E, Özkan N, Yilmaz N. Incidence of mandibular fractures in black sea region of Turkey. J Clin Exp Dent 2015; 7:e410-3. [PMID: 26330940 PMCID: PMC4554243 DOI: 10.4317/jced.52169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 11/27/2014] [Indexed: 11/16/2022] Open
Abstract
Background The aim of this study is to review the incidence of mandibular fractures in the Black Sea Region of Turkey and to present our treatment protocol. Material and Methods Data were collected regarding age, sex, etiology, time distribution, site of the fracture and the associated injuries and evaluated. These patients were treated at Ondokuz Mayıs University Department of Oral and Maxillofacial Surgery between 2003 and 2010. Data were collected from patient files in the archive and were analyzed using SPSS version 20.0 software. Results A total of 82 patients with 133 mandibular fractures were included in this study. After the follow up period of the patients, the results were achieved from 58 (70.7%) males and 24 (29.3%) females, whose ages ranged from 5 to 72 years and the mean age was 29. Fractures were most seen in 2008 and the busiest month was August. Falls (40.2%) were the major causes of mandibular fractures followed by traffic accidents and violence. The mandibular anatomical sites of higher fracture incidence were: condyle (34.6%), body and symphysis. The number of the fractures and injuries which were seen in other places such as zygomatic arch, alveolar process, tongue, upper and lower lips, orbita, arms was 14. 53 (64.6%) patients were treated by closed reduction, whereas 13 (15.8%) patients were treated by open reduction. Conclusions We concluded that our results were widely similar with the studies in developing countries. Socio-economic factors, cultures, geographic conditions and education could affect the etiology of the mandibular fractures and cause different results between the studies conducted in different countries. Key words:Mandibular fractures, etiology, trauma, treatment, complication.
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Affiliation(s)
- Cihan Bereket
- DDS, PhD, Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun- Turkey
| | - İsmail Şener
- DDS, PhD, Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun- Turkey
| | - Erman Şenel
- DDS, PhD, Research Assistant, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun- Turkey
| | - Nilüfer Özkan
- DDS, PhD, Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun- Turkey
| | - Nergiz Yilmaz
- DDS, PhD, Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun- Turkey
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Tay ABG, Lai JB, Lye KW, Wong WY, Nadkarni NV, Li W, Bautista D. Inferior Alveolar Nerve Injury in Trauma-Induced Mandible Fractures. J Oral Maxillofac Surg 2015; 73:1328-40. [DOI: 10.1016/j.joms.2015.02.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/04/2015] [Accepted: 02/04/2015] [Indexed: 10/23/2022]
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Histologic and Histometric Analysis of Bone Repair at the Site of Mandibular Body Osteotomy and at the Bone-Screw Interface After Using a Biodegradable 2.0-mm Internal Fixation System. J Craniofac Surg 2015; 26:1214-9. [PMID: 26080160 DOI: 10.1097/scs.0000000000001723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of the study was to evaluate histologically and histometrically the bone repair at the mandibular body osteotomy and at the bone-screw interface after using a biodegradable 2.0-mm internal fixation system. Six dogs were subjected to an osteotomy in the mandibular body, which was stabilized by applying a fixation device manufactured with poly-L-DL-lactic acid (70:30). The dogs were euthanized at 2 and 18 weeks. Each screw was sectioned along its long axis, and the osteotomy sites were divided into 3 parts: the upper part was labeled the tension third (TT); the lower part, compression third (CT); and the part between the TT and CT, intermediary third (IT). Histologic analysis showed areas of direct contact between the screw surface and the parent lamellar bone at 2 weeks. At 18 weeks, 3 microscopically distinct layers at the bone-screw interface were noted. At the osteotomy sites, union between the bone fragments was observed at 18 weeks. Statistically significant differences in the newly formed bone among TT, IT, and CT (P = 0.019) were observed. In conclusion, the biomechanical environment created by the biodegradable IF system used in this study facilitated bone repair at the osteotomy site.
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Davies JC, Ravichandiran M, Agur AM, Fattah A. Evaluation of clinically relevant landmarks of the marginal mandibular branch of the facial nerve: A three-dimensional study with application to avoiding facial nerve palsy. Clin Anat 2015; 29:151-6. [PMID: 26096443 DOI: 10.1002/ca.22570] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 05/14/2015] [Accepted: 05/15/2015] [Indexed: 11/05/2022]
Abstract
Injury to the marginal mandibular branch of the facial nerve (MMN) during surgery often results in poor functional and cosmetic outcomes. A line two finger breadths or 2 cm inferior to the border of the mandible is commonly used in planning neck incisions to avoid injury to the MMN. The purpose was to compare the two finger breadth/2 cm landmarks in predicting MMN course, and their accuracy/reliability. Thirty-one cadaveric specimens were scanned to obtain 3D surface topography (FARO® scanner). Four independent raters pinned the inferior border of the mandible and a two finger breadth line and 2cm line below. The location of each pin was digitized (Microscribe™). A preauricular flap was raised, and MMN branches were digitized and modelled (Geomagic®/Maya®) enabling quantification of the accuracy of these landmarks. The location of the two-finger breadth line was variable, spanning 25-51 mm below the inferior border of the mandible (ICC = 0.10). The most inferior MMN branch did not pass below the two-finger breadth line in any specimen, but a narrow clearance zone (≤5 mm) was found in two. In contrast, in 7/31 specimens, the most inferior MMN branch coursed below the 2 cm line and would be at risk of injury. It was concluded that an incision two finger breadths below the inferior border of the mandible could provide safer access than the 2 cm line. After an incision has been placed using the two finger-breadth landmark, caution must be exercised during dissection as branches of the MMN may lie only a few millimeters superior to the incision.
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Affiliation(s)
- Joel C Davies
- Division of Anatomy, Department of Surgery, University of Toronto, Ontario, M5S 1A8, Canada
| | | | - Anne M Agur
- Division of Anatomy, Department of Surgery, University of Toronto, Ontario, M5S 1A8, Canada
| | - Adel Fattah
- Facial Nerve Programme, Regional Paediatric Burns and Plastic Surgery service, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP, UK
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Muñante-Cardenas JL, Passeri LA. Biomechanical comparison of four mandibular angle fracture fixation techniques. Craniomaxillofac Trauma Reconstr 2015; 8:123-8. [PMID: 26000083 DOI: 10.1055/s-0034-1393737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 04/21/2014] [Indexed: 10/24/2022] Open
Abstract
The aim of this study was to make a comparison of the biomechanical behavior of four different internal fixation systems for mandibular angle fractures. A total of 40 polyurethane mandible replicas were employed with different fixation methods: group 1SP, one 2.0-mm four-hole miniplate; group 2PPL, two 2.0-mm four-hole parallel miniplates; group 3DP, one 3D 2.0-mm four-hole miniplate; and group 3DPP, one 3D 2.0-mm eight-hole miniplate. Each group was subjected to incisal or homolateral molar region loading. The load resistance values were measured at load application causing tip displacement of 1, 3, and 5 mm, and at the time at which the system achieves its maximum strength (MS). Means and standard deviations were compared among groups using analysis of variance and the Tukey test. Group 2PPL showed higher strength for all the displacements. For incisal loading, no statistically significant differences were found between groups 1SP, 3DP, and 3DPP. For molar loading, group 1SP and 3DPP showed statistically significant differences. For MS testing, group 1SP and 2PPL showed statistically significant differences in incisal loading; group 1SP and 3DP showed no statistically significant differences; and group 3DPP showed lower values of strength. Two parallel miniplates provide the most favorable mechanical behavior under the conditions tested.
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Affiliation(s)
| | - Luis Augusto Passeri
- Department of Surgery, School of Medical Sciences, State University of Campinas, Sao Paulo, Brazil
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Ykeda RBA, Ballin CR, Moraes RS, Ykeda RBA, Miksza AF. Epidemiological profile of 277 patients with facial fractures treated at the emergency room at the ENT Department of Hospital do Trabalhador in Curitiba/PR, in 2010. Int Arch Otorhinolaryngol 2015; 16:437-44. [PMID: 25991971 PMCID: PMC4432531 DOI: 10.7162/s1809-97772012000400003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Accepted: 06/07/2012] [Indexed: 11/30/2022] Open
Abstract
Introduction: Epidemiological studies that focus on facial injuries are of great interest for the knowledge of occurrence and severity of presentation. Aim: To study the epidemiological profile of 277 patients who suffered facial fractures at the Hospital do Trabalhador (HT), with an emphasis on variables such as sex, age, cause, and anatomical sites of fractures, comparing the clinical findings with other studies. Method: Retrospective nonrandomized chart review of 277 patients who were treated at HT by the ENT service during the full year 2010, victims of facial fractures. Results: Of 277 patients, 74.72% were male and 25.27% female (ratio 3:1). According to age, the fractures were distributed as follows: 0–9 years: 4.69%, 10–19 years: 17.32%, 20–29 years: 23.82%, 30–39 years: 20.21%, 40–49 years: 16.24%, 50–59 years: 10.83%, 60–69 years: 3.97%, and 60–79 years: 2.88%. The cause of trauma was most frequently interpersonal violence, 36.45%, followed by falls, 23.09%, and motor vehicle crashes with 17.32%. Regarding location, nasal fracture was the most common, with 44.75%, followed by the mandible, 14.32%, orbit, 12.78%, maxillary, 12.02%, zygomatic, 9.97%, 3.32% and front Le Fort 2.88%. Conclusion: The patients were mostly males, aged 21–30 years, victims of aggression with the most commonly fractured bone being the nose. The adoption of personal and public strategies and measures may prevent facial fractures.
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Affiliation(s)
| | - Carlos Roberto Ballin
- Master. Chief of the Skull Maxillofacial Surgery Service of Otorhinolaryngology UFPR
| | - Rafael Souza Moraes
- Postgraduate. Skull Maxillofacial Surgeon in the Department of Otorhinolaryngology, Hospital do Trabalhador-PR
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