1
|
Wu SS, Katabi L, DeSimone R, Borsting E, Ascha M. A Cross-Sectional Evaluation of Publication Bias in the Plastic Surgery Literature. Plast Reconstr Surg 2024; 153:1032e-1045e. [PMID: 37467390 DOI: 10.1097/prs.0000000000010931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Publication bias (PB) is the preferential publishing of studies with statistically significant results. PB can skew findings of systematic reviews (SRs) and meta-analyses (MAs), with potential consequences for patient care and health policy. This study aims to determine the extent to which SRs and MAs in the plastic surgery literature evaluate and report PB. METHODS This cross-sectional study assessed PB reporting and analysis from plastic surgery studies published between January 1, 2015, and June 19, 2020. Full texts of SRs and MAs were assessed by two reviewers for PB assessment methodology and analysis. Post hoc assessment of studies that did not originally analyze PB was performed using Egger regression, Duval, Tweedie trim-and-fill, and Copas selection models. RESULTS There were 549 studies evaluated, of which 531 full texts were included. PB was discussed by 183 studies (34.5%), and formally assessed by 97 studies (18.3%). Among SRs and MAs that formally assessed PB, PB was present in 24 studies (10.7%), not present in 52 (23.1%), and inconclusive in eight (3.6%); 141 studies (62.7%) did not report the results of their PB assessment. Funnel plots were the most common assessment method [ n = 88 (39.1%)], and 60 studies (68.2%) published funnel plots. The post hoc assessment revealed PB in 17 of 20 studies (85.0%). CONCLUSIONS PB is inadequately reported and analyzed among studies in the plastic surgery literature. Most studies that assessed PB found PB, as did post hoc analysis of nonreporting studies. Increased assessment and reporting of PB among SRs and MAs would improve the quality of evidence in plastic surgery.
Collapse
Affiliation(s)
- Shannon S Wu
- From the Cleveland Clinic Lerner College of Medicine
| | - Leila Katabi
- Department of Anesthesia, University of Michigan School of Medicine
| | - Robert DeSimone
- Department of Plastic Surgery, University of California, Irvine
| | - Emily Borsting
- Department of Plastic Surgery, University of California, Irvine
| | - Mona Ascha
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Virk SK, Gumber TK, Dhawan A, Bhullar RS, Kapila S. Comparative Evaluation of Masticatory Bite Force in Mandible Fractures Treated with Three-Dimensional Curved Locking Strut Plate Versus Straight Locking Miniplate. J Maxillofac Oral Surg 2023; 22:1006-1021. [PMID: 38105849 PMCID: PMC10719182 DOI: 10.1007/s12663-023-01996-3] [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: 04/07/2023] [Accepted: 08/05/2023] [Indexed: 12/19/2023] Open
Abstract
Aims and Objectives To compare the efficacy of titanium 2.0-mm curved locking strut plate and 2.0-mm straight locking miniplate with regard to their intraoperative use and the stability of fixation achieved both, clinically and radiographically. Materials and Methods Forty patients with 62 sites of mandibular fractures requiring open reduction and internal fixation were included in the study. The sample was divided into two groups of twenty patients each depending upon whether patient received three-dimensional 2.0-mm locking curved strut plate (group A) or 2.0-mm straight locking miniplates (group B). Mouth opening, teeth in the fracture line, degree of displacement, time taken, neurosensory and bite force evaluation were done preoperatively, 1st, 7th day, 2nd week, 4th week, 6th week and 12th week postoperatively. Results Positive correlation was found between preoperative and postoperative bite force values at subsequent follow-up weeks. At 3rd month evaluation, the change in bite force from the previous follow-up visit was significantly greater in group A (locking strut plate) than group B (locking miniplate) in the incisor, left molar and right molar region. Statistically significant difference was observed between the two groups regarding time taken (P < 0.016) depicting less time taken for placement of three-dimensional 2.0-mm locking curved strut plate(group A) 20.30 ± 4.85 min as compared to 27.30 ± 6.82 min for fixation with 2.0 mm straight locking miniplates in group B. Conclusion The findings were suggestive that the both systems had better adaptation during fixation, comparable radiographic reduction and increased stability in postoperative period. However, 3D locking strut plate took relatively lesser operative time, offered good rigidity and better stabilization of fractured segments in three dimensions along with significant improvement in the masticatory bite force postoperatively.
Collapse
Affiliation(s)
- Sukhpreet Kaur Virk
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, India
| | - Tejinder Kaur Gumber
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, India
| | - Amit Dhawan
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, India
| | - Ramandeep Singh Bhullar
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, India
| | - Sarika Kapila
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, India
| |
Collapse
|
4
|
Kostares E, Kostare G, Kostares M, Kantzanou M. Prevalence of surgical site infections after open reduction and internal fixation for mandibular fractures: a systematic review and meta-analysis. Sci Rep 2023; 13:11174. [PMID: 37430033 DOI: 10.1038/s41598-023-37652-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/25/2023] [Indexed: 07/12/2023] Open
Abstract
Our study aims to estimate the prevalence of surgical site infections (SSI) following open reduction and internal fixation (ORIF) for mandibular fractures and to determine the effect of potential moderators on it. A systematic literature search (Medline and Scopus databases) was conducted independently by two reviewers. The pooled prevalence with 95% confidence intervals was estimated. Quality assessment as well as outlier and influential analysis were performed. Additionally, subgroup and meta-regression analysis were conducted in order the effect of categorical and continuous variables on the estimated prevalence to be investigated. In total, seventy-five eligible studies (comprising a sum of 5825 participants) were included in this meta-analysis. The overall prevalence of SSI following ORIF for mandibular fractures was estimated as high as 4.2% (95% CI 3.0-5.6%) with significant heterogeneity between studies. One study was identified to be critically influential. In the subgroup analysis, the prevalence was 4.2% (95% CI 2.2-6.6%) among studies conducted in Europe, 4.3% (95% CI 3.1-5.6%) among studies conducted in Asia and higher among those conducted in America (7.3%) (95% CI 4.7-10.3%). It is important for healthcare professionals to be aware of the etiology of these infections, despite the relatively low rate of SSI in these procedures. However, further, well-designed prospective and retrospective studies need to be conducted in order this issue to be fully clarified.
Collapse
Affiliation(s)
- Evangelos Kostares
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece.
| | - Georgia Kostare
- National and Kapodistrian University of Athens Faculty of Medicine: Ethniko kai Kapodistriako Panepistemio Athenon Iatrike Schole, 115 27, Athens, Greece
| | - Michael Kostares
- National and Kapodistrian University of Athens Faculty of Medicine: Ethniko kai Kapodistriako Panepistemio Athenon Iatrike Schole, 115 27, Athens, Greece
| | - Maria Kantzanou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece
| |
Collapse
|
5
|
Sahoo NK, Dubey P, Vaswani H, Pandey S. Incidence and Management of Tooth Root Fracture in Mandibular Fracture Line - A Retrospective Study. Ann Maxillofac Surg 2023; 13:216-219. [PMID: 38405552 PMCID: PMC10883222 DOI: 10.4103/ams.ams_136_23] [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: 07/25/2023] [Revised: 09/25/2023] [Accepted: 11/02/2023] [Indexed: 02/27/2024] Open
Abstract
Introduction In cases of trauma, the most common fractures of the facial region are the nasal bone fractures followed by mandibular fractures. About 60% of mandible fractures are associated with teeth in the fracture line; however conversely, the dentulous mandible has a higher susceptibility of fracture in any impact. Whenever a tooth is involved in the fracture line, it is not unlikely that the tooth root fracture will be associated with it. The prognosis and treatment of such a tooth persistent in a fracture line depends upon the level of tooth root fracture. Materials and Methods This retrospective study was conducted in the Department of Oral and Maxillofacial Surgery in a Meerut hospital. The eligibility criteria were based on the cases involving fracture line passing through the teeth bearing area of mandible. Total of 56 cases of mandibular fracture treated from January 2021 till December 2022 by open reduction and fixation were included in the study. Results A total of 56 patients (66 fracture lines) with mandibular fractures were selected, out of which 18 (32%) patients had fracture of the root of the tooth in the fracture line. Third molar root fracture were present in 12 cases (66.6%), first premolars in 4 cases (22.2%), and first molars in 2 cases (11.1%). There were 14 multi rooted teeth (77.7%) and 4 single rooted teeth (22.2%) involvement. All the multi rooted teeth fracture were treated by extraction during open reduction and fracture fixation. The single rooted teeth were successfully treated by endodontic treatment postoperatively. Discussion The fracture line passing through the dentate segment may fracture the tooth crown and/or root or propagate through the socket without any injury to the root. Root fracture at cervical and middle third is constantly exposed to oral fluids. The affected tooth may be mobile and lose vitality. Teeth in the line of fracture must be removed when they preclude the correct reduction of the segments or if they represent a risk for infection. If the tooth or root does not cause any hindrance during reduction or it is not infected, the tooth can be salvaged by endodontic therapy. The incidence of root fracture was seen in 32% of cases. Fracture of the third molar roots was the single largest group (66.6%). No root fracture was observed in the anterior segment.
Collapse
Affiliation(s)
- Nanda Kishore Sahoo
- Department of Oral and Maxillofacial Surgery, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Prajesh Dubey
- Department of Oral and Maxillofacial Surgery, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Himani Vaswani
- Department of Oral and Maxillofacial Surgery, Subharti Dental College, Meerut, Uttar Pradesh, India
| | - Swati Pandey
- Department of Oral and Maxillofacial Surgery, Subharti Dental College, Meerut, Uttar Pradesh, India
| |
Collapse
|
6
|
Arcila VG, Correa CR, Castellar-Mendoza C. Tooth in the line of a mandibular fracture: Retain it or remove it? Clinical case report. Dent Traumatol 2023; 39:179-183. [PMID: 36263458 DOI: 10.1111/edt.12799] [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: 07/14/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/26/2022]
Abstract
Defining the prognosis and treatment plan for teeth in the line of a mandibular fracture is a challenge for the maxillofacial surgeon. The periodontal ligament may provide a communication with the oral cavity and become a pathway for infection. There is currently no consensus on the management of teeth in mandibular fracture lines. This report outlines a case where a tooth was successfully retained in the line of fracture as well as providing a review of the literature on the best-accepted treatments for this scenario.
Collapse
Affiliation(s)
- Verónica Gómez Arcila
- Hospital Universitario del Valle, Teacher of Oral y Maxilofacial Surgery, Universidad del Valle, Cali, Colombia
| | | | | |
Collapse
|
7
|
Kotha VS, de Ruiter BJ, Knudsen MG, Nicoleau M, Davidson EH. Should Degree of Third Molar Eruption Influence Operative Management of Mandibular Angle Fractures? A Systematic Review. Craniomaxillofac Trauma Reconstr 2022; 15:379-386. [PMID: 36387312 PMCID: PMC9647372 DOI: 10.1177/19433875211059330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
Study Design Systematic review. Objective There is a growing trend toward evidence-based management of third molars in the fracture line of mandibular angle fractures (MAFs). This study aimed to differentiate MAF fixation complications by degree of third molar eruption and by extraction strategy in patients undergoing Champy fixation. Methods PubMed, EMBASE, OVID, SCOPUS, the Cochrane Library, and clinicaltrials.gov were queried through May 2020 for English-language publications for MAFs with third molar involvement for this systematic review. Bias was assessed using author-defined criteria. Relative risk (RR) of post-operative complications associated with extracted unerupted and retained partially erupted third molars (Group I) was calculated against controls of retained unerupted and extracted partially erupted third molars (Group II). Results Ten studies reported complications by eruption or extraction; however, only one study stratified complications by both eruption and extraction to meet inclusion criteria. The risk of bias was medium as only cases meeting defined follow-up were included. 73 cases (N) were included: 34 qualified for Group I and 39 for Group II. Quantitative synthesis of individual case data demonstrated significantly higher complication rate in Group I compared to Group II (23.5% vs 5.1%) (RR 4.6, 95% CI 1.04-20.1). No significant differences were observed between groups for infectious complications, mechanical complications, nonunion, or dehiscence. Reoperation was required significantly more often for Group I (P = .043). Conclusions For MAFs involving the third molar, concomitant extraction of unerupted as well as retention of partially erupted third molars increases risk of complications with Champy fixation technique. For these patients, alternative strategies for fixation should be considered.
Collapse
Affiliation(s)
- Vikas S. Kotha
- Division of Plastic and Reconstructive
Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, USA
- Case Western Reserve University School of
Medicine, Cleveland, OH, USA
| | - Brandon J. de Ruiter
- Division of Plastic and Reconstructive
Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, USA
- Case Western Reserve University School of
Medicine, Cleveland, OH, USA
| | - M. Grace Knudsen
- Division of Plastic and Reconstructive
Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, USA
| | - Marvin Nicoleau
- Case Western Reserve University School of
Medicine, Cleveland, OH, USA
| | - Edward H. Davidson
- Division of Plastic and Reconstructive
Surgery, University Hospitals Cleveland Medical
Center, Cleveland, OH, USA
- Case Western Reserve University School of
Medicine, Cleveland, OH, USA
| |
Collapse
|
8
|
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
| |
Collapse
|
9
|
Panesar K, Susarla SM. Mandibular Fractures: Diagnosis and Management. Semin Plast Surg 2021; 35:238-249. [PMID: 34819805 DOI: 10.1055/s-0041-1735818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Accurate evaluation, diagnosis, and management of mandibular fractures is essential to effectively restore an individual's facial esthetics and function. Understanding of surgical anatomy, fracture fixation principles, and the nuances of specific fractures with respect to various patient populations can aid in adequately avoiding complications such as malocclusion, non-union, paresthesia, and revision procedures. This article reviews comprehensive mandibular fracture assessment, mandibular surgical anatomy, fracture fixation principles, management considerations, and commonly encountered complications. In addition, this article reviews emerging literature examining 3-dimensional printing and intraoperative imaging.
Collapse
Affiliation(s)
- Kanvar Panesar
- Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, Washington
| | - Srinivas M Susarla
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, Washington.,Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, Washington.,Divisions of Plastic and Craniofacial Surgery and Oral-Maxillofacial Surgery, Craniofacial Center, Seattle Children's Hospital, Seattle, Washington
| |
Collapse
|
10
|
Fang D, Li D, Li C, Yang W, Xiao F, Long Z. Efficacy and Safety of Concentrated Growth Factor Fibrin on the Extraction of Mandibular Third Molars: A Prospective, Randomized, Double-Blind Controlled Clinical Study. J Oral Maxillofac Surg 2021; 80:700-708. [PMID: 34801470 DOI: 10.1016/j.joms.2021.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate the efficacy and safety of concentrated growth factor fibrin (CGF) for the extraction of mandibular third molars. PATIENTS AND METHODS This was a randomized, double-blind, and controlled clinical study. Patients who underwent mandibular impacted tooth extraction were randomly divided into 2 groups. In the CGF group, the tooth extraction fossa was utilized to place CGF gel. In the control group, the fossa was filled with serum. The visual analogue scale (VAS), reductions in swelling and trismus, incidence of postoperative dry socket, distal periodontal depth and bone regeneration of the second molar, and bone density (BMD) of the extraction fossa at 24 weeks were evaluated. RESULTS One hundred eighteen patients were enrolled in this study. There was no significant difference in baseline clinical characteristics between the 2 groups. The pain score of the CGF group was significantly lower than that of the control group at 2, 24, and 48 hours after operation. There was no significant difference in the reduction in swelling or trismus between the 2 groups. There were no cases of dry socket in the CGF group and 3 cases of dry socket in the control group. The periodontal probing depth and bone regeneration of the second molar when the socket was implanted with CGF were better than those that healed naturally (P < .05). The bone mineral density of each group was significantly increased at 24 weeks but was significantly different between groups (P < .05). CONCLUSION CGF can effectively reduce reactive tooth extraction pain and help avoid dry sockets. It can promote periodontal tissue and bone healing in distal and extracted sockets.
Collapse
Affiliation(s)
- Dongdong Fang
- Associate Chief of Doctor, Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Dan Li
- Attending Doctor, Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Chengjing Li
- Attending Doctor, Department of Oral and maxillofacial surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wenyu Yang
- Attending Doctor, Department of Oral and maxillofacial surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Feng Xiao
- Attending Doctor, Department of Oral and maxillofacial surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhangbiao Long
- Associate Professor, Department of Hematology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
| |
Collapse
|
11
|
Beret M, Nicot R, Roland-Billecart T, Ramdane N, Ferri J, Schlund M. Impacted lower third molar relationship with mandibular angle fracture complications. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:149-154. [PMID: 34000436 DOI: 10.1016/j.jormas.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Mandibular angle fractures are very common and are associated with the highest risk of complications. The aim of this study is to evaluate the correlation between impacted lower third molar and mandibular angle fracture complications. MATERIAL AND METHODS All patients presenting with a mandibular angle fracture and at least 2 months follow up were retrospectively included. The following complications were recorded: post-traumatic malocclusion, mouth opening limitation, inferior alveolar nerve hypoesthesia, infection, delayed union, hardware loosening. The patients were divided in two groups: impacted lower third molar or erupted/absent lower third molar. RESULTS A total of 68 patients were included, lower third molar was impacted in 36 cases and erupted/absent in 32 cases. 40 complications were recorded in 27 patients at 2 months. No statistically significant difference could be found about malocclusion, mouth opening limitation and inferior alveolar nerve hypoesthesia. A lower rate of persistent inferior alveolar nerve hypoesthesia (p = 0.0557) in patients with impacted lower third molar (19.4%) was observed compared to patients without impacted lower third molar (40.6%). There was no occurrence of delayed union and hardware loosening in impacted lower third molar group, whereas 5 delayed unions and 4 hardware loosening were recorded in erupted/absent lower third molar group. Finally, the rate of patients with at least one of the 6 complications is significantly higher in the erupted/absent lower third molar group (17/32, 53.1%) than in the impacted lower third molar group (10/36, 27.8%), p = 0.033. DISCUSSION The risk of overall complication is decreased when lower third molar is impacted in mandibular angle fracture. This supports the idea of a role of the impacted lower third molar in fracture reduction and stability.
Collapse
Affiliation(s)
- Marie Beret
- Univ. Lille, CHU Lille, Service de Chirurgie Maxillo-Faciale et Stomatologie, F-59000 Lille, France.
| | - Romain Nicot
- Univ. Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterial, F-59000 Lille, France
| | | | - Nassima Ramdane
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - Joël Ferri
- Univ. Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterial, F-59000 Lille, France
| | - Matthias Schlund
- Univ. Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterial, F-59000 Lille, France
| |
Collapse
|
12
|
Petsos H, Fleige J, Korte J, Eickholz P, Hoffmann T, Borchard R. Five-Years Periodontal Outcomes of Early Removal of Unerupted Third Molars Referred for Orthodontic Purposes. J Oral Maxillofac Surg 2020; 79:520-531. [PMID: 33338418 DOI: 10.1016/j.joms.2020.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE The removal of third molars (M3) is one of the most common oral-maxillofacial surgical procedures affecting periodontal tissues of neighboring second molars (M2). The aim of this study was to evaluate the periodontal status of lower M2 following the removal of unerupted lower M3 up to 5 years after removal. PATIENTS AND METHODS Primary predictor variable in this prospective cohort-study was time [baseline (BL; preoperatively), 6 and 60 months postoperatively]. The primary outcome variable was probing pocket depth (PPD). Clinical attachment level (CAL) was defined as a secondary outcome variable. Plaque index (PlI) and gingival index (GI) were assessed descriptively. All variables were compared using nonparametric tests. M3 were classified as either completely bony or partially bony unerupted. Risk factors (removed M3, type of impaction, mean BL PPD≥4 mm, gender, age) were analyzed (repeated measures ANCOVA). The significance level was set at 0.05. RESULTS From originally 91 subjects enrolled in this study, 39 subjects (22 females; mean age: 21.6 ± 2.5 years) contributing 39 M3 completed the study after 5 years. Average BL PPD significantly decreased at 6 (-0.50 ± 0.61 mm, P = .001), 60 months (-0.81 ± 0.56, P < .0001), as well as between 6 and 60 months (-0.31 ± 0.51 mm, P = .030). Corresponding CAL values decreased accordingly (BL-6 months: -0.37 ± 0.59 mm, P = .004; BL-60 months: -0.67 ± 0.55 mm, P < .0001; 6 to 60 months: -0.34 ± 0.48 mm, P = .004). The was confirmed as risk factor for PPD (P = .026) and CAL (P = .042) changes. CONCLUSIONS Average PPD and CAL of mandibular M2 in young subjects improved 5 years after early removal of unerupted M3 in favor of an initial partially bony unerupted type of impaction.
Collapse
Affiliation(s)
- Hari Petsos
- Dentist, Private Practice, Soest, Germany; and Research Assistant, Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany.
| | | | - Jörg Korte
- Dentist, Maxillofacial Surgeon, Private Practice, Soest, Germany
| | - Peter Eickholz
- Professor, Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany
| | - Thomas Hoffmann
- Professor, Dresden International University, Dresden, Germany
| | | |
Collapse
|
13
|
Bohner L, Beiglboeck F, Schwipper S, Lustosa RM, Pieirna Marino Segura C, Kleinheinz J, Jung S. Treatment of Mandible Fractures Using a Miniplate System: A Retrospective Analysis. J Clin Med 2020; 9:jcm9092922. [PMID: 32927782 PMCID: PMC7565660 DOI: 10.3390/jcm9092922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 11/16/2022] Open
Abstract
Three-dimensional (3D) mini plate systems are used in the treatment of mandibular fractures. The system is advantageous in comparison to conventional plates due to the stabilization of tension and compression areas, improved initial stability, and biomechanical behavior. The aim of this retrospective study was to evaluate the use of a 3D miniplate system for the treatment of patients with mandibular fractures. Patients with mandibular fractures treated with a 3D plate system at the Department of Oral and Maxillofacial Surgery, University Hospital Münster, during a period of 5 years, were included in this study. Mandibular fracture conditions and minor and major post-operative complications were reported. In total, 336 patients and 391 mandibular fractures were assessed. The most common fracture site was anterior mandible, and 155 cases involved a tooth-bearing area. Minor complications were seen in 8.03% of cases, whereas only 1.49% of patients suffered from major complications. The treatment of mandible fractures using 3D miniplates resulted in fracture reduction with a low complication rate.
Collapse
Affiliation(s)
- Lauren Bohner
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149 Münster, Germany; (F.B); (S.S.); (J.K.); (S.J.)
- Correspondence: ; Tel.: +49-25183-47004
| | - Fabian Beiglboeck
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149 Münster, Germany; (F.B); (S.S.); (J.K.); (S.J.)
| | - Stephanie Schwipper
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149 Münster, Germany; (F.B); (S.S.); (J.K.); (S.J.)
| | | | | | - Johannes Kleinheinz
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149 Münster, Germany; (F.B); (S.S.); (J.K.); (S.J.)
| | - Susanne Jung
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149 Münster, Germany; (F.B); (S.S.); (J.K.); (S.J.)
| |
Collapse
|
14
|
Open Reduction, Internal Fixation of Isolated Mandible Angle Fractures in Growing Children. J Craniofac Surg 2020; 31:1946-1950. [PMID: 32804826 DOI: 10.1097/scs.0000000000006892] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Mandible angle fractures can result in significant, long-term morbidity in children. However, management of this particular mandibular fracture type is not well-characterized in the pediatric population. This study investigated isolated mandibular angle fractures in the pediatric patients. METHODS This was a 30-year retrospective, longitudinal cohort study of pediatric patients presenting to a single institution with mandibular angle fractures. Patient data were abstracted from electronic medical records. Subgroup analyses were completed by dentition stage. RESULTS Seventeen patients met inclusion criteria, of whom 6 (35.3%) had deciduous, 4 (23.5%) had mixed, and 7 (41.2%) had permanent dentition. Deciduous/mixed dentition patients with mobile, displaced fractures underwent ORIF, whereas those with nondisplaced fractures underwent treatment with soft diet. Among permanent dentition patients, most patients (71.4%) underwent ORIF regardless of fracture severity. The post-ORIF complication rate was 55.6%; no complications were reported after soft diet or closed treatment (Fischer exact: P = 0.05). The most common post-ORIF complication was alveolar nerve paresthesia (17.6%) and post-ORIF complication rates did not vary by age (deciduous: 16.7%, mixed: 25.0%, permanent: 42.9%, Fischer exact: P = 0.80). ORIF patients who received a single upper border miniplate had a lower complication rate (42.9%) than other plating methods (upper and lower miniplates-100%). Fracture severity was predictive of post-ORIF complications (odds ratio: 2.23, 95% confidence interval: 2.22-2.24, P < 0.0001). CONCLUSIONS Isolated mandible angle fractures were relatively rare in children, and treatment requirements varied by injury severity and dentition stage. Although isolated angle fractures had substantial associated morbidity, this fracture pattern did not result in notable growth limitations/deformity.
Collapse
|