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Brucoli M, Boffano P, Romeo I, Corio C, Benech A, Ruslin M, Forouzanfar T, Rodríguez-Santamarta T, Vicente JCD, Tarle M, Dediol E, Pechalova P, Pavlov N, Daskalov H, Doykova I, Kelemith K, Tamme T, Kopchak A, Shumynskyi I, Corre P, Bertin H, Bourry M, Guyonvarc'h P, Dovšak T, Vozlič D, Birk A, Aničić B, Konstantinovic VS, Starch-Jensen T. Surgical management of unilateral body fractures of the edentulous atrophic mandible. Oral Maxillofac Surg 2019; 24:65-71. [PMID: 31848774 DOI: 10.1007/s10006-019-00824-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 12/06/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Management of body fractures in patients with edentulous atrophic mandibles represents a challenging task due to patient's age, medical comorbidities, poor bone quality, and vascularity, as well as reduced contact area between the fracture ends. The aim of the study was to assess the demographic and clinical variables, the surgical technique, and outcomes of unilateral body fractures of the edentulous atrophic mandible managed at several European departments of oral and maxillofacial surgery. METHODS This study is based on a systematic computer-assisted database that allowed the recording of data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between 2008 and 2017. The following data were recorded for each patient: gender, age, comorbidities, etiology, synchronous body injuries, degree of atrophy of the mandible according to Luhr classification, type of surgical approach and fixation, length of hospitalization, and presence and type of complications. RESULTS A total of 43 patients were included in the study: 17 patients' mandibles were classified as class I according to Luhr, 15 as class II, and 11 as class III. All patients underwent open reduction and internal fixation by extraoral approach in 25 patients, intraoral in 15 patients, and mixed in 3 patients. A single 2.0 miniplate was used in 16 patients, followed by a single 2.4 reconstruction plate in 13 patients, by two 2.0 miniplates, and three 2.0 miniplates. Outcome was considered to be satisfying in 30 patients, with no complications. Complications were observed in 13 cases. CONCLUSIONS Treatment of unilateral body fractures of the edentulous mandible must still be based on the type of fracture, degree of atrophy, experience of the surgeon, and patients' preference. An adequate stability can be obtained by different plating techniques that have to be appropriately tailored to every single specific patient.
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Affiliation(s)
- Matteo Brucoli
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Paolo Boffano
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy.
| | - Irene Romeo
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Chiara Corio
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Arnaldo Benech
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Muhammad Ruslin
- Department of Oral and Maxillofacial Surgery, Hasanuddin University, Makassar, Indonesia
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | | | - Juan Carlos de Vicente
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Marko Tarle
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Petia Pechalova
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Nikolai Pavlov
- Private practice of oral surgery, University of Eastern Piedmont, Plovdiv, Bulgaria
| | - Hristo Daskalov
- Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Iva Doykova
- Department of maxillofacial surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Kadri Kelemith
- Department of maxillo-facial surgery, North Estonia Medical Centre Foundation, Tallinn, Estonia
| | - Tiia Tamme
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Andrey Kopchak
- Bogomolets National Medical University, Stomatological medical center, Kyiv, Ukraine
| | - Ievgen Shumynskyi
- Bogomolets National Medical, University, Kyiv City Clinical Emergency Hospital, Kyiv, Ukraine
| | - Pierre Corre
- Division of Maxillofacial Surgery, Chu de Nantes, Nantes, France
| | - Helios Bertin
- Division of Maxillofacial Surgery, Chu de Nantes, Nantes, France
| | - Maeva Bourry
- Division of Maxillofacial Surgery, Chu de Nantes, Nantes, France
| | | | - Tadej Dovšak
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - David Vozlič
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Boban Aničić
- Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Vitomir S Konstantinovic
- Department of Maxillofacial surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
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Brucoli M, De Andreis M, Bonaso M, Boffano P, Benech A. Comparative assessment of dexamethasone administration routes for the management of postoperative symptoms following third molar surgery. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:529-533. [DOI: 10.1016/j.jormas.2019.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 01/31/2019] [Accepted: 03/07/2019] [Indexed: 11/26/2022]
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Brucoli M, Romeo I, Pezzana A, Boffano P, Benech A. The relationship between the status and position of third molars and the presence of mandibular angle and condylar fractures. Oral Maxillofac Surg 2019; 24:31-36. [PMID: 31728659 DOI: 10.1007/s10006-019-00811-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/09/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to assess the relationship between the status and position of third molars, and the presence of mandibular angle and/or condylar fractures, in a group of patients treated for mandibular fractures, thus hoping to contribute to the knowledge of potential predictors of these fractures. METHODS A retrospective study was designated to include all the patients who were diagnosed and treated with open reduction and internal fixation for isolated mandibular angle fractures or isolated mandibular condylar fractures between 1st of January 2012 and 31st of December 2018. The following data were collected for each included patient: gender, age, etiology, site and side of the fracture, and presence and eruption state of third molars in the fracture side. RESULTS Seventy patients were diagnosed with a condylar fracture, 48 with an angle fracture. No statistically significant difference was observed as for etiology and gender distribution between angle fracture and condyle fracture patients (p > 0.05). Angle fractures were statistically associated with the presence of third molars, whereas condylar fractures with the absence of third molars (p < 0.000005). The presence of completely erupted 3Ms was associated with condylar fractures (p < 0.05), and partially impacted 3Ms were associated with angle fractures (p < 0.0005). CONCLUSIONS Mandibular angle fractures and third molar presence are associated in patients who present with mandibular fractures, especially if the third molar is incompletely erupted. This information should be kept in consideration as for the diagnosis and management of patients with mandibular fractures.
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Affiliation(s)
- Matteo Brucoli
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Irene Romeo
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Andrea Pezzana
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
| | - Paolo Boffano
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy.
| | - Arnaldo Benech
- Division of Maxillofacial Surgery, University Hospital "Maggiore della Carità", University of Eastern Piedmont, Novara, Italy
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Franchi S, Brucoli M, Boffano P, Dosio C, Benech A. Medical students' knowledge of medication related osteonecrosis of the jaw. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 121:344-346. [PMID: 31672685 DOI: 10.1016/j.jormas.2019.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 09/21/2019] [Accepted: 10/14/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The objective of this study was to assess medical students' knowledge of "medication related osteonecrosis of the jaws" (MRONJ). METHODS A questionnaire survey was administered to all the medical students in the last two years of school of medicine at the University of Eastern Piedmont between January 2019 and March 2019. The questionnaire contained a first section regarding demographic and personal data of the student and a second section regarding the knowledge on MRONJ. RESULTS On the whole, 72 medical students agreed to participate to this study and filled in the questionnaire. As for indications for the use of bisphosphonates 45 students correctly answered "osteoporosis, osteogenesis imperfecta, multiple myeloma, or metastasis of some malignant tumors". Almost all students (71 out of 72) answered that a thorough examination of oral cavity and a dentist screening is needed and fundamental before starting bisphosphonate assumption. As for drugs responsible for MRONJ, only 12 students out of 72 correctly answered "bisphosphonates, denosumab, and antiangiogenic drugs". DISCUSSION A better level of knowledge and awareness by medical doctors and young physicians may lead, in future, to minimize incidence of MRONJ as well as to a better resolution of ONJ cases. Theoretical and practical initiatives could be promoted to improve and consolidate the knowledge of future physicians about this important issue.
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Affiliation(s)
- S Franchi
- Division of Maxillofacial Surgery, University of Eastern Piedmont, Novara, Italy
| | - M Brucoli
- Division of Maxillofacial Surgery, University of Eastern Piedmont, Novara, Italy
| | - P Boffano
- Division of Maxillofacial Surgery, University of Eastern Piedmont, Novara, Italy.
| | - C Dosio
- Division of Maxillofacial Surgery, University of Eastern Piedmont, Novara, Italy
| | - A Benech
- Division of Maxillofacial Surgery, University of Eastern Piedmont, Novara, Italy
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Brucoli M, Boffano P, Pezzana A, Benech A, Corre P, Bertin H, Pechalova P, Pavlov N, Petrov P, Tamme T, Kopchak A, Romanova A, Shuminsky E, Dediol E, Tarle M, Konstantinovic VS, Jelovac D, Karagozoglu KH, Forouzanfar T. The “European Mandibular Angle” research project: the analysis of complications after unilateral angle fractures. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:14-17. [DOI: 10.1016/j.oooo.2019.02.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/25/2019] [Indexed: 11/16/2022]
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Brucoli M, Boffano P, Bonaso M, Benech A. The management of a Y-shaped fracture of the mandibular ramus. ACTA ACUST UNITED AC 2019. [DOI: 10.23736/s0392-6621.18.02196-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Psychological profiles in patients undergoing orthognathic surgery or rhinoplasty: a preoperative and preliminary comparison. Oral Maxillofac Surg 2019; 23:179-186. [PMID: 31016403 DOI: 10.1007/s10006-019-00758-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 04/12/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this study was to assess, identify, and compare the personality traits and psychosocial status of two groups of patients undergoing orthognathic surgery and rhinoseptoplasty respectively. STUDY DESIGN This prospective study recruited patients referred for orthognathic surgery and for rhinoseptoplasty. The research protocol included the administrations of questionnaires to the patients during their last visit before surgery, including the Minnesota Multiphasic Personality Inventory (MMPI-2), the Myers-Briggs Type Indicator (MBTI), the tree drawing test (or Baum test), and the BC Scale. RESULTS As for MMPI-2, the highest (pathological) percentages were encountered in Hypochondriasis and Psychasthenia scales within the Orthognathic Surgery Group, whereas in the rhinoseptoplasty group, the highest scores were obtained in the Hypochondriasis, Psychasthenia, Psychopathic Deviate, and Schizophrenia scales. CONCLUSIONS It would be important to assess some characteristics of the patients' mental health and emotional state prior to surgery, including depression, anxiety, panic, and aggression. The overview of these factors may give an insight into the psychological and emotional capacity of the patients undergoing orthognathic and rhinoseptoplasty surgery.
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The “European Mandibular Angle” Research Project: The Epidemiologic Results From a Multicenter European Collaboration. J Oral Maxillofac Surg 2019; 77:791.e1-791.e7. [DOI: 10.1016/j.joms.2018.12.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 12/14/2018] [Indexed: 11/22/2022]
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Brucoli M, Boffano P, Broccardo E, Benech A, Corre P, Bertin H, Pechalova P, Pavlov N, Petrov P, Tamme T, Kopchak A, Hresko A, Shuminsky E, Dediol E, Tarle M, Konstantinovic VS, Petrovic M, Holmes S, Karagozoglu KH, Forouzanfar T. The "European zygomatic fracture" research project: The epidemiological results from a multicenter European collaboration. J Craniomaxillofac Surg 2019; 47:616-621. [PMID: 30765246 DOI: 10.1016/j.jcms.2019.01.026] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 01/23/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Fractures of the zygomaticomaxillary complex (ZMC) are common injuries that may lead to loss of an aesthetically pleasing appearance and functional impairment. The aim of this study was to analyze the demographics, causes, characteristics, and outcomes of zygomatic fractures managed at several European departments of oral and maxillofacial surgery. MATERIALS AND METHODS This study is based on a multicenter systematic database that allowed the recording of all patients with ZMC fractures between 1 January 2013 and 31 December 2017. The following data were recorded: gender, age, personal medical history, etiology, side of zygomatic fracture, classification of ZMC fracture, associated maxillofacial fractures, symptoms at diagnosis, type of performed treatment, and sequelae/complications. RESULTS A total of 1406 patients (1172 males, 234 females) were included in the study. Statistically significant correlations were found between assault-related ZMC fractures and the A3 class (p < .0000005) and between Infraorbital Nerve (ION) anesthesia and B class (p < .00000005). CONCLUSION The most frequent cause of ZMC fractures was assault, followed by falls. The most frequently involved decade of age was between 20 and 29 years. The decision and type of surgical treatment of ZMC fractures depends on several issues that need to be considered on a case by case basis.
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Affiliation(s)
- Matteo Brucoli
- Division of Maxillofacial Surgery at the University of Eastern Piedmont, Novara, Italy.
| | - Paolo Boffano
- Division of Maxillofacial Surgery at the University of Eastern Piedmont, Novara, Italy
| | - Emanuele Broccardo
- Division of Maxillofacial Surgery at the University of Eastern Piedmont, Novara, Italy
| | - Arnaldo Benech
- Division of Maxillofacial Surgery at the University of Eastern Piedmont, Novara, Italy
| | - Pierre Corre
- Service de Stomatologie et Chirurgie Maxillo-faciale at the Chu de Nantes, Nantes, France
| | - Helios Bertin
- Service de Stomatologie et Chirurgie Maxillo-faciale at the Chu de Nantes, Nantes, France
| | - Petia Pechalova
- Department of Oral Surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | | | - Petko Petrov
- Department of Maxillofacial Surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Tiia Tamme
- Department of Maxillofacial Surgery, Stomatology Clinic, Tartu University, Tartu, Estonia
| | - Andrey Kopchak
- Department for Oral and Maxillofacial Surgery at the Bogomolets National Medical University, Kiev, Ukraine
| | - Andrii Hresko
- Department for Oral and Maxillofacial Surgery at the Bogomolets National Medical University, Kiev, Ukraine
| | - Eugen Shuminsky
- Department for Oral and Maxillofacial Surgery at the Bogomolets National Medical University, Kiev, Ukraine
| | - Emil Dediol
- Department of Maxillofacial Surgery at the University Hospital Dubrava, Zagreb, Croatia
| | - Marko Tarle
- Department of Maxillofacial Surgery at the University Hospital Dubrava, Zagreb, Croatia
| | - Vitomir S Konstantinovic
- The Clinic of Maxillofacial Surgery of the School of Dentistry at the University of Belgrade, Belgrade, Serbia
| | - Milan Petrovic
- The Clinic of Maxillofacial Surgery of the School of Dentistry at the University of Belgrade, Belgrade, Serbia
| | - Simon Holmes
- Department of Oral and Maxillofacial Surgery, Royal London Hospital, Barts Health NHS, London, UK
| | - K Hakki Karagozoglu
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
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Brucoli M, Boffano P, Magnano M, Mistretta R, Benech R, Benech A. The management of a high-risk patient with edentulous mandibular fractures. ACTA ACUST UNITED AC 2019. [DOI: 10.23736/s0392-6621.18.02174-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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An underestimated "ghost" foreign body as an unusual cause of mandibular osseocutaneous fistula formation: impacted spike of a soccer cleat. J Craniofac Surg 2014; 25:666-7. [PMID: 24469364 DOI: 10.1097/scs.0000000000000389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In this article, the case of a patient with osteocutaneous fistula at the left malar region secondary to impacted spike of a soccer cleat to the mandible is presented. Both the clinical and radiologic diagnoses failed because of an obscure anamnesis of the patient and the unavailability of viewing the spike in orthopantomogram and computed tomography. Surgical extirpation was performed to the 41-year-old man who was injured in a football match 3 months before the presentation and had a swooning history after an accidental booting. There were no early or late complications after the surgery at the end of 9 months. This study shows the importance of both obtaining a definite history of patients and sequential radiologic imaging to make a differential diagnosis between the foreign bodies and cystic or noncystic tumors and inflammatory lesions of the mandible.
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