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Bertin E, Meyer C, Louvrier A, Weber E, Barrabé A, Pons M. Intraoperative Cone-Beam Computed Tomography for open reduction and internal fixation of condylar head fractures. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e593-e597. [PMID: 34906728 DOI: 10.1016/j.jormas.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/23/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Eugénie Bertin
- Chirurgie Maxillo-faciale, Stomatologie et Odontologie hospitalière, CHU-Besançon, F-25000 Besançon, France.
| | - Christophe Meyer
- Chirurgie Maxillo-faciale, Stomatologie et Odontologie hospitalière, CHU-Besançon, F-25000 Besançon, France; Nanomedicine lab, Imagery and Therapeutics, EA 4662, UFR Sciences et Techniques, University of Franche-Comté, route de Gray, 25030 Besançon cedex, France
| | - Aurélien Louvrier
- Chirurgie Maxillo-faciale, Stomatologie et Odontologie hospitalière, CHU-Besançon, F-25000 Besançon, France; University of Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Host-Graft Interactions/Cell and Gene Engineering, 25000 Besançon, France
| | - Elise Weber
- Chirurgie Maxillo-faciale, Stomatologie et Odontologie hospitalière, CHU-Besançon, F-25000 Besançon, France
| | - Aude Barrabé
- Chirurgie Maxillo-faciale, Stomatologie et Odontologie hospitalière, CHU-Besançon, F-25000 Besançon, France
| | - Mélanie Pons
- Chirurgie Maxillo-faciale, Stomatologie et Odontologie hospitalière, CHU-Besançon, F-25000 Besançon, France
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Bu L, Wei X, Zheng J, Qiu Y, Yang C. Evaluation of internal fixation techniques for extracapsular fracture: A finite element analysis and comparison. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 225:107072. [PMID: 36037603 DOI: 10.1016/j.cmpb.2022.107072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/30/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVES This study explored the optimal plates and screws fixation for extracapsular fracture by finite element analysis, and provided a biomechanical basis for clinical treatment. METHODS Four extracapsular fixation models were built and evaluated: A. One single straight four-hole plate with two bi-cortical screws on both sides and two mono-cortical screws in the middle; B. One single straight four-hole plate with four bi-cortical screws; C. Two straight four-hole plates, each with two bi-cortical screws on both sides and two mono-cortical screws in the middle; D. One L-shape four-hole plate in the back and one straight four-hole plate in the front, each with two bi-cortical screws on both sides and two mono-cortical screws in the middle. Displacements of fractured bone blocks and stress of plates, screws, cortical and cancellous bone and the deformation of plates were analyzed by finite element analysis to investigate their stability in clinical using. RESULTS Groups A and B showed larger displacements of the fractured bone block, greater deformation of plates and higher risk of the plate breakage during masticatory motion. Groups C and D exhibited the minimum displacements of the fractured bone block, the stress distribution within the safe range and less deformation of the plates. In addition, double plates fixation and bi-cortical screws exceeded single plate fixation and mono-cortical screws in stability, respectively, while an L-shape plate exhibited no significant differences in the stress dispersion and the displacement reduction. CONCLUSIONS Double plates fixation of the extracapsular condylar fracture was a safe and stable way and bi-cortical screws should be selected as far as possible.
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Affiliation(s)
- Lingtong Bu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639 Zhi Zao Ju Road, Shanghai 200011, China
| | - Xiang Wei
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639 Zhi Zao Ju Road, Shanghai 200011, China
| | - Jisi Zheng
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639 Zhi Zao Ju Road, Shanghai 200011, China.
| | - Yating Qiu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639 Zhi Zao Ju Road, Shanghai 200011, China.
| | - Chi Yang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639 Zhi Zao Ju Road, Shanghai 200011, China.
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Subcutaneous Emphysema Related to Dental Treatment: A Case Series. Healthcare (Basel) 2022; 10:healthcare10020290. [PMID: 35206904 PMCID: PMC8872011 DOI: 10.3390/healthcare10020290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/12/2022] [Accepted: 01/28/2022] [Indexed: 11/17/2022] Open
Abstract
Cervicofacial subcutaneous emphysema (SE) is primarily caused by dental treatment introducing gas into the subcutaneous tissue. Air rapidly dissects into the subcutaneous tissue with face and neck swelling, leading to respiratory distress, patient discomfort, and chest pain. Computed tomography (CT) can detect spreading SE patterns. However, the true volume of SE and the degree of air changes in the body over time remain unknown. We evaluated the healing process of SE and the temporal changes in the volume of emphysema in three cases detected using our hospital’s electronic health record systems based on inclusion and exclusion criteria over the past 10 years, with CT and three-dimensional (3D) images. The first case was a 46-year-old woman who presented with complaints of swelling from her right eyelid to the neck and clavicles, pain on swallowing, respiratory distress, and hoarseness. The second case was a 35-year-old man who presented with complaints of swelling over the face. The third case was a 36-year-old man who presented with complaints of swelling from the left cheek to the neck. CT revealed SE and pneumomediastinum in all cases. All the patients were administered an antibacterial drug. The CT and 3D images showed an improvement in emphysema 3 days after the onset, with more than half of the volume reduction in emphysema. This made it possible to evaluate the changes in the air content of SE. Observation with CT until the healing process of SE is completed is crucial, and 3D images also help evaluate changes over time.
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Kumar J, Kumar S, Kapoor S, Thakker R, Bhatnagar A, Singh M. Use of intraoperative C-arm fluoroscopy in open reduction and internal fixation of mandibular condyle fracture - A case report. Ann Maxillofac Surg 2022; 12:114-116. [PMID: 36199452 PMCID: PMC9527832 DOI: 10.4103/ams.ams_40_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/28/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
The Rationale: Condyle fractures are a common type of mandibular fracture that can result in malocclusion. Open reduction and internal fixation (ORIF) in condylar fracture is considered as the most acceptable treatment modality. Patient Concerns: The patient complained of pain and difficulty in the jaw while chewing. Diagnosis: An orthopantomogram and reverse Towne’s view can lead to diagnosis of the condylar fracture. Treatment: Open reduction and internal fixation using intraoperative real-time visualisation of subcondylar fracture reduction utilising the C-arm fluoroscopic approach were used to allow for adequate anatomical repositioning and fast restoration of function to meet the patient’s concerns. Outcomes: We were able to achieve correct reduction of the fracture fragments with restoration of function and occlusion. Take-away Lessons: When this procedure is used to treat condylar fractures, surgeons can get a better view of the fracture segments while eliminating the need for postoperative intermaxillary fixation and also reduces the complications from inappropriate reduction and fixation.
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Bonitz L, Wruck V, Peretti E, Abel D, Hassfeld S, Bicsák Á. Long-term evaluation of treatment protocols for isolated midfacial fractures in a German nation-wide craniomaxillofacial trauma center 2007-2017. Sci Rep 2021; 11:18291. [PMID: 34521960 PMCID: PMC8440643 DOI: 10.1038/s41598-021-97858-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/31/2021] [Indexed: 11/30/2022] Open
Abstract
An update on the trends in maxillofacial traumatology provides additional information on the actual and changing needs. This retrospective study aimed to review all patient records of patients treated for isolated midface fractures in the Department of Cranial- and Maxillofacial Surgery at the Dortmund General Hospital between 2007 and 2017. The patient radiographs and patient files were reviewed. The safety and efficacy of the applied methods were controlled by assessing complications based on the Clavien-Dindo classification system. The statistical analysis included descriptive methods including regression analysis and χ2-test. In eleven years, 3474 isolated midface fracture sites have been identified in 2868 patients. The yearly trend is slightly increasing, in elderly clearly worsening, in children and youth decreasing. The male-to-female ratio was 2.16:1 for the whole study population, in the age group 18-25 y.o. 6.95:1 while in elderly above 80 y.o. 1:2.51, the age group specific incidence reflects this result, too. The most common fractures were nasal bone fractures (1405), zygomatic fractures (832) and orbital floor fractures (700). The average hospital stay was 2.7 days, the most fractures were operated within 24 h. The complication rate was 2.02% (Clavien-Dindo class II-V). The incidence of midfacial fractures is increasing in the total population and especially in elderly, but decreasing in children. Development of injury prevention measures is needed in this population. The diagnostic and therapeutic procedures are appropriate, as there is a low complication rate and short inpatient stay observed.
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Affiliation(s)
- Lars Bonitz
- Clinic for Cranial- and Maxillofacial Surgery, Regional Plastic Surgery, Dortmund General Hospital, Chair of the University of Witten-Herdecke, Muensterstrasse 240, 44145, Dortmund, Germany
- Health Faculty, University of Witten/Herdecke, Alfred-Herrhausen-Strasse 45, 58453, Witten, Germany
| | - Vivienne Wruck
- Health Faculty, University of Witten/Herdecke, Alfred-Herrhausen-Strasse 45, 58453, Witten, Germany
| | - Elena Peretti
- Health Faculty, University of Witten/Herdecke, Alfred-Herrhausen-Strasse 45, 58453, Witten, Germany
| | - Dietmar Abel
- Clinic for Cranial- and Maxillofacial Surgery, Regional Plastic Surgery, Dortmund General Hospital, Chair of the University of Witten-Herdecke, Muensterstrasse 240, 44145, Dortmund, Germany
- Health Faculty, University of Witten/Herdecke, Alfred-Herrhausen-Strasse 45, 58453, Witten, Germany
| | - Stefan Hassfeld
- Clinic for Cranial- and Maxillofacial Surgery, Regional Plastic Surgery, Dortmund General Hospital, Chair of the University of Witten-Herdecke, Muensterstrasse 240, 44145, Dortmund, Germany
- Health Faculty, University of Witten/Herdecke, Alfred-Herrhausen-Strasse 45, 58453, Witten, Germany
| | - Ákos Bicsák
- Clinic for Cranial- and Maxillofacial Surgery, Regional Plastic Surgery, Dortmund General Hospital, Chair of the University of Witten-Herdecke, Muensterstrasse 240, 44145, Dortmund, Germany.
- Health Faculty, University of Witten/Herdecke, Alfred-Herrhausen-Strasse 45, 58453, Witten, Germany.
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ORHAN K, ÖZEMRE M, KÖSEOĞLU SEÇGİN C, KARSLIOĞLU H, KAMBUROGLU K, GÜR GG, VURAL S. Comparison of Panoramic, Lateral Skull Projection and CBCT Images in Detection of Mandibular Condyle Fractures. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.881763] [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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Change of body composition, physical strength, and nutritional status of patients with mandibular fractures. J Craniomaxillofac Surg 2021; 49:292-297. [PMID: 33589334 DOI: 10.1016/j.jcms.2021.01.023] [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: 04/08/2020] [Revised: 10/27/2020] [Accepted: 01/31/2021] [Indexed: 11/20/2022] Open
Abstract
The aim was to determine changes in various parameters indicating physical conditions and nutritional status of patients during surgical and conservative treatment of mandibular fractures. A round by a nutrition support team was done once postoperatively for the surgical treatment group. For the conservative treatment group, three rounds were performed during the period of intermaxillary fixation. Data obtained from the rounds were compared between the groups. There were 29 patients surgically and 30 patients conservatively treated. A significant weight loss was observed in both groups postoperatively. The mean weight loss of the surgical treatment group measured at the postoperative round was 1.73 kg (SD ± 1.78) (P < 0.001) and that of the conservative treatment group at the third round was 2.74 kg (SD ± 2.35) (P < 0.001). During the entire treatment period, weight loss, body fat percentage, skeletal muscle percentage, grip strength and parameters indicating body composition and nutritional status of the conservative treatment group did not substantially differ from those of the surgical group. The influence of the conservative procedure on the nutritional condition of the patients seems to be limited and reversible at the end of the treatment. The weight loss observed here suggests that systematic nutrition support is necessary during both surgical and conservative treatment.
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