1
|
Tatsumi H, Matsuda Y, Okui T, Karino M, Koike T, Okuma S, Toda E, Ishizuka S, Sonoyama-Osako R, Morioka R, Kotani T, Shimamura Y, Kanno T. Impact of COVID-19 pandemic on the dynamic of patients with oral and maxillofacial trauma: interrupted time-series analysis. Sci Rep 2024; 14:13202. [PMID: 38851787 PMCID: PMC11162448 DOI: 10.1038/s41598-024-63890-3] [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: 02/08/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024] Open
Abstract
Oral and maxillofacial trauma is influenced by various factors, including regional characteristics and social background. Due to the coronavirus disease 2019 (COVID-19) pandemic, a state of emergency was declared in Japan in March 2020. In this study, we aimed to examine the dynamics of patients with oral and maxillofacial trauma over a 12-years period using interrupted time-series (ITS) analysis. Patients were examined at the Shimane University Hospital, Maxillofacial Trauma Center from April 2012 to April 2023. In addition to general patient characteristics, data regarding the type of trauma and its treatment were obtained from 1203 patients (770 men and 433 women). Group comparisons showed significant differences in age, trauma status, method of treatment, referral source, route, and injury occasion. ITS analysis indicated significant changes in combined nasal fractures, non-invasive reduction, and sports injuries (P < 0.05), suggesting COVID-19 significantly impacted oral and maxillofacial trauma dynamics. A pandemic of an infectious disease may decrease the number of minor trauma cases but increase the number of injuries from outdoor activities, resulting in no overall change in the dynamics of the number of trauma patients. Medical systems for oral and maxillofacial trauma should be in place at all times, independent of infectious disease pandemics.
Collapse
Affiliation(s)
- Hiroto Tatsumi
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
- Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Yuhei Matsuda
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Tatsuo Okui
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
- Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Masaaki Karino
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
- Department of Oral and Maxillofacial Surgery, Shimane Prefectural Central Hospital, Izumo, Shimane, Japan
| | - Takashi Koike
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
- Department of Oral and Maxillofacial Surgery, Unnan City Hospital, Unnan, Shimane, Japan
| | - Satoe Okuma
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
- Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Erina Toda
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
- Department of Oral and Maxillofacial Surgery, National Hospital Organization Hamada Medical Center, Hamada, Shimane, Japan
| | - Shinji Ishizuka
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
- Division of Oral and Maxillofacial Surgery, Oki Hospital, Oki, Shimane, Japan
| | - Rie Sonoyama-Osako
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
- Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Reon Morioka
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
- Department of Oral and Maxillofacial Surgery, Masuda Red Cross Hospital, Masuda, Shimane, Japan
| | - Tatsuhito Kotani
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
- Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Yukiho Shimamura
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
- Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
- Maxillofacial Trauma Center, Shimane University Hospital, Izumo, Shimane, Japan.
| |
Collapse
|
2
|
Sakkas A, Weiß C, Pietzka S, Wilde F, Thiele OC, Mischkowski RA. Evaluation of Different Patterns of Zygomaticoorbital Complex Fractures. Craniomaxillofac Trauma Reconstr 2024; 17:92-103. [PMID: 38779395 PMCID: PMC11107820 DOI: 10.1177/19433875231161906] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Study Design Very few studies exist regarding the fracture pattern variability of the zygomaticoorbital (ZMO) complex. The retrospective evaluation of a large series of surgically treated unilateral ZMO fractures would in certain circumstances help intraoperative predictability and define sensitive indicators for open reduction and internal fixation. Objective The aim of this study was to investigate the different fracture patterns after ZMO complex injury regarding the 5 anatomic sutures of the zygoma as well as the concomitance of the paranasal buttress and maxillary sinus wall fracture. Methods The medical records of all patients with unilateral ZMO fractures who underwent surgical intervention in a single trauma center department between April 2015 and June 2020 were retrospectively reviewed. Demographic and anamnesis data, radiologic findings, and surgical reports were evaluated. According to the preoperative radiologic evaluation, ZMO fractures were classified as unisutural, bisutural, trisutural, tetrasutural, and complete based on the number of zygomatic sutures. The prevalence of various fracture patterns was analyzed. The impact of patient's age and trauma etiology on the fracture pattern was evaluated using descriptive statistical analysis. Results The study included 492 patients with unilateral ZMO fractures, with a mean age of 49.93 years (SD = 20.66) and a male:female ratio of 2.23:1. The most affected age group was 19-44 years (41.67%) and tripping falls were the most common etiology (27.24%). Trisutural (57.32%) and unisutural fractures (23.17%) were the most common, followed by tetrasutural (8.94%), bisutural (8.54%), and complete fractures (2.03%). A trisutural fracture involving the zygomaticomaxillary suture, the infraorbital rim, and the zygomaticosphenoidal suture was the most common fracture pattern (52.03%). Most fractures were observed in the zygomaticosphenoidal suture (86.99%), followed by the infraorbital rim (74.59%) and the zygomaticomaxillary suture (68.29%). Fractures of the maxillary sinus wall and the paranasal buttress co-existed in 9.55% and 31.30% of all cases, respectively. No correlation was detected between age and fracture pattern (P = .4111). Tripping falls and bicycle accidents significantly influenced the fracture pattern (P < .0001). Conclusions According to the results, knowledge of the fracture pattern variability of the ZMO complex could in certain circumstances designate CT or CBCT as mandatory before operating on ZMO fractures. Consequently, unnecessary incisions could be avoided. The high concomitance of paranasal buttress fracture also suggests its intraoperative surgical exploration. Further studies should correlate the clinical findings with indication for surgery and postoperative outcome for the different fracture patterns described.
Collapse
Affiliation(s)
- Andreas Sakkas
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, University Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | - Christel Weiß
- Medical Statistics and Biomathematics, University Medical Centre Mannheim, Heidelberg University, Germany
| | - Sebastian Pietzka
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, University Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | - Frank Wilde
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, University Hospital Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Germany
| | | | | |
Collapse
|
3
|
Gokharman FD, Kadirhan O, Celik Aydin O, Yalcin AG, Kosar P, Aydin S. A Comprehensive Look at Maxillofacial Traumas: On the Basis of Orbital Involvement. Diagnostics (Basel) 2023; 13:3429. [PMID: 37998566 PMCID: PMC10670346 DOI: 10.3390/diagnostics13223429] [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: 09/17/2023] [Revised: 10/28/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION Orbital wall fractures that may develop in maxillofacial traumas (MFTs) may cause ophthalmic complications (OCs). The aim of this study is to determine the frequency of orbital fractures (OFs) accompanying MFTs and findings suspicious for orbital traumatic involvement. MATERIALS AND METHODS Computed tomography (CT) images of 887 patients who presented to the emergency department within a 1-year period with a history of MFT were retrospectively scanned. During the examination, patients with orbital wall fractures, craniofacial bone fractures, and posttraumatic soft tissue changes were recorded. RESULTS OF was observed in 47 (5.3%) of the patients admitted for MFT. In cases with OFs, accompanying nasal (25.5%), ethmoid (2.1%), frontal (19.1%), maxillary (38%), and zygomatic bone fracture (10.6%), sphenoid (4.3%), and soft tissue damage (55.3%) were observed. It was observed that the pathologies mentioned at these levels were significantly higher than in patients without orbital involvement (p < 0.05). In our study, mild (48.9%) and moderate-severe (2.12-4.25%) OCs accompanying OFs were observed after MFT. CONCLUSIONS The frequency of MFT varies depending on various factors, and such studies are needed to take preventive measures. Knowing the risk and frequency of orbital damage accompanying MFTs may help reduce complications by allowing rapid and accurate diagnosis.
Collapse
Affiliation(s)
- Fatma Dilek Gokharman
- Department of Radiology, SBU Ankara Education and Research Hospital, Ankara 06660, Turkey; (A.G.Y.); (P.K.)
| | - Ozlem Kadirhan
- Department of Radiology, Erzincan University, Erzincan 24100, Turkey; (O.K.); (S.A.)
| | - Ozlem Celik Aydin
- Department of Pharmacology, Erzincan University, Erzincan 24100, Turkey;
| | - Arzu Gulsah Yalcin
- Department of Radiology, SBU Ankara Education and Research Hospital, Ankara 06660, Turkey; (A.G.Y.); (P.K.)
| | - Pınar Kosar
- Department of Radiology, SBU Ankara Education and Research Hospital, Ankara 06660, Turkey; (A.G.Y.); (P.K.)
| | - Sonay Aydin
- Department of Radiology, Erzincan University, Erzincan 24100, Turkey; (O.K.); (S.A.)
| |
Collapse
|
4
|
Juncar M, Tent PA, Juncar RI, Harangus A, Mircea R. An epidemiological analysis of maxillofacial fractures: a 10-year cross-sectional cohort retrospective study of 1007 patients. BMC Oral Health 2021; 21:128. [PMID: 33731083 PMCID: PMC7968332 DOI: 10.1186/s12903-021-01503-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/04/2021] [Indexed: 12/03/2022] Open
Abstract
Background Epidemiological data is providing vital indicators for organizing the financial resources related to a particular type of trauma, estimating expenses and training of dental practioners and ambulatory medical staff for collaboration with a certain pattern of patients. Knowing the etiology and epidemiology of a certain pathology is significant for approaching its means of prevention.
Methods
A 10-year retrospective statistical analysis of 1007 patients with maxillofacial fractures treated in a University Clinic of Oral and Maxillofacial Surgery in Romania was performed. The data were extracted from patients’ medical records. Statistical analysis was performed. A value of p < 0.05 was considered statistically significant. Results The incidence of maxillofacial fractures was high among patients in the 20–29 age group (35.9%). Male patients (90.57%, M:F = 9.6:1), having a low level of education (46.60%) and living in urban areas (53.50%) were more affected. The main cause of maxillofacial fractures was interpersonal violence (59.37%), both in the mandibular and midface topographic regions (p = 0.001, p = 0.002). In urban areas, fractures caused by interpersonal violence and road traffic accidents were predominant, while in rural areas, most of the fractures were due to interpersonal violence, domestic accidents, work accidents and animal attacks (p = 0.001). Conclusions Interpersonal violence is the main cause of maxillofacial fractures having epidemic proportions. Male patients aged 20–29 years with a low level of education represent the major risk category. Considering the wide area of interpersonal aggression, both the medical staff in the hospital and in the dental offices must be educated in order to collaborate with possible violent patients. Dentists must be prepared to work on a post-traumatic dento-periodontal field. Taking all measures to prevent inter-human aggression is imperative and will lead to a major decrease in maxillofacial fractures and an overall increase of oral health in a population. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01503-5.
Collapse
Affiliation(s)
- Mihai Juncar
- Department of Oral and Maxillofacial Surgery, University of Oradea, Romania, Str. Piața 1 Decembrie, no.10, 410073, Oradea, Romania
| | - Paul Andrei Tent
- Department of Oral and Maxillofacial Surgery, University of Oradea, Romania, Str. Piața 1 Decembrie, no.10, 410073, Oradea, Romania.
| | - Raluca Iulia Juncar
- Department of Oral and Maxillofacial Surgery, University of Oradea, Romania, Str. Piața 1 Decembrie, no.10, 410073, Oradea, Romania
| | - Antonia Harangus
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu" University of Medicine and Pharmacy, 400337, Cluj-Napoca, Romania
| | - Rivis Mircea
- Discipline of Oral Surgery, 2nd Department of Dental Medicine, "Victor Babeş" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041, Timisoara, Romania
| |
Collapse
|
5
|
Ţent PA, Juncar RI, Juncar M. Epidemiological Analysis of Zygomatic Bone Fractures in North-Western Romanian Population: A 10-Year Retrospective Study. In Vivo 2020; 34:2049-2055. [PMID: 32606181 DOI: 10.21873/invivo.12006] [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: 04/05/2020] [Revised: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Midface fractures represent a challenge for medical practitioners due to the severe esthetic and functional consequences. This study aimed to determine the causes and to provide a demographic analysis of zygomatic bone fractures in our geographical area, with a view to implementing the necessary prevention methods, training the medical staff for a certain type of patients and decreasing the required costs. PATIENTS AND METHODS A retrospective statistical epidemiological analysis of 242 patients with zygomatic bone fractures over a 10-year period was performed. RESULTS The most affected age group was 20-29 years (27.27%). The most affected were men (n=211, 87.19%) from urban areas (n=140, 57.85%), and without education (n=122, 50.41%). The most frequent cause was interpersonal violence (54.04%), followed by falls (17.36%) and road traffic accidents (16.53%). CONCLUSIONS Interpersonal violence as a cause of zygomatic bone fractures is currently reaching epidemic proportions. Taking legal measures to prevent aggression is a public health emergency that would considerably decrease the incidence of these fractures in our population.
Collapse
Affiliation(s)
- Paul Andrei Ţent
- Department of Oral and Maxillofacial Surgery, University of Oradea, Oradea, Romania
| | - Raluca-Iulia Juncar
- Department of Oral and Maxillofacial Surgery, University of Oradea, Oradea, Romania
| | - Mihai Juncar
- Department of Oral and Maxillofacial Surgery, University of Oradea, Oradea, Romania
| |
Collapse
|
6
|
Al-Bokhamseen M, Salma R, Al-Bodbaij M. Patterns of maxillofacial fractures in Hofuf, Saudi Arabia: A 10-year retrospective case series. Saudi Dent J 2018; 31:129-136. [PMID: 30705576 PMCID: PMC6349956 DOI: 10.1016/j.sdentj.2018.10.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/30/2018] [Accepted: 10/04/2018] [Indexed: 10/28/2022] Open
Abstract
Objectives This retrospective study was performed to analyze the incidence, etiology, and types of maxillofacial fractures in a major city in Eastern Province, Saudi Arabia. Materials and methods The medical records of all patients treated in the operating rooms for maxillofacial fractures by the Oral and Maxillofacial Surgery Department at King Fahad Hospital, Hofuf, Al-Ahsa, Saudi Arabia, between January 1, 2007, and December 31, 2016, were reviewed. A total of 270 patients with complete records were included. The data extracted included the age, gender, nationality, causes of injury, and patterns of maxillofacial fractures involved. Results Among the 270 patients, 241 (89.3%) were males, and 29 (10.7%) were females. The young adult (19-44 years) age group was the most affected (65.6%). Road traffic accidents (63.3%) were found to be the most frequent causes of maxillofacial fractures; falls were the second most common (15.9%). The rate of mandibular (54.6%) fractures was higher than that of mid-facial (45.4%) fractures. Among the mandibular fractures, the most common type was the parasymphyseal fracture (24.6%). Zygomatic fractures were the most common (48.6%) of midface fractures. Conclusions Similar to reports of other studies in different regions of Saudi Arabia, Al-Ahsa showed that road traffic accidents were the most predominant etiology of maxillofacial fractures affecting most frequently males of young adult age group. These findings emphasize the need for better education of road safety and enforcement of traffic laws, especially for the most affected age group.
Collapse
Affiliation(s)
| | - Ra'ed Salma
- Maxillofacial Surgery, Riyadh Elm University, Riyadh, Saudi Arabia
| | | |
Collapse
|