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Hesham A, Geiger J, Alshamrani Y, Sawatari Y. Can the Mechanism of Injury Impact the Location of a Mandibular Fracture? A Systematic Review. J Maxillofac Oral Surg 2024; 23:363-370. [PMID: 38601229 PMCID: PMC11001800 DOI: 10.1007/s12663-022-01750-1] [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: 10/23/2021] [Accepted: 06/05/2022] [Indexed: 10/16/2022] Open
Abstract
Purpose Mandible fractures are the second most common fractures of the facial skeleton because of the prominent position of the lower jaw. The purpose of this study was to calculate the prevalence of mandibular fractures based on their causes and locations. Materials and Method A systematic search of 3 electronic databases from January 2010 and January 2020 was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. There were 359 articles identified for screening against selection criteria. The search identified 39 articles to be included in our analysis. Results A total of 20,135 patients with 31,468 mandible fractures in this review. There was a 76% male predominance. The third decade was the most common age group (21-30). Motor vehicle accidents (39.89%) were the leading cause of mandible fractures, followed by falls (27.72%) and violence (25.35%). Condylar fractures are the most common cause of MVA and fall (33.11%, 50% respectively). Mandible body fractures are the second most common type of MVA injury (17.06%). When it came to violence, the angle of the mandible was the most common site (31.73%). Conclusions The prevalence of mandible fractures was higher in male patients in the current study, particularly in the second and third decades of life. Road traffic accidents were the most common cause, and the condylar process of the mandible was the most frequently affected region. Demographic data such as age, gender, and mechanism of injury can help surgeons predict and identify specific areas of mandibular fracture.
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Affiliation(s)
- Abdulrahman Hesham
- Department of Oral and Maxillofacial Surgery, University of Miami and Jackson Memorial Hospital, Miami, FL USA
| | - Joseph Geiger
- Department of Oral and Maxillofacial Surgery, University of Miami and Jackson Memorial Hospital, Miami, FL USA
| | - Yousef Alshamrani
- Department of Oral and Maxillofacial Surgery, University of Miami and Jackson Memorial Hospital, Miami, FL USA
| | - Yoh Sawatari
- Department of Oral and Maxillofacial Surgery, University of Miami and Jackson Memorial Hospital, Miami, FL USA
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Vishnani R, Pattanshetti C, Gilani R, Sankeshwari B. New design titanium miniplate versus conventional miniplate in treatment of mandibular angle fractures: A comparative study. Natl J Maxillofac Surg 2023; 14:420-425. [PMID: 38273910 PMCID: PMC10806310 DOI: 10.4103/njms.njms_451_21] [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: 08/11/2021] [Revised: 03/13/2022] [Accepted: 06/08/2022] [Indexed: 01/27/2024] Open
Abstract
Introduction Mandibular angle fracture (MAF) is the second most common site of all fractures of the mandible with the highest complication rate. Management of MAF has evolved in the past four decades. The purpose of the prospective study was to compare the efficacy of new design titanium miniplate (NDM) with conventional titanium miniplate (CTM) in the treatment of MAF. Objectives Mouth opening, occlusion, bite force measurement, and radiographs compared preoperatively and first week, first month and third month postoperatively. Materials and Method Fourteen patients diagnosed with MAF were randomly divided into two groups: Group A (seven patients) was treated with NDM and Group B (seven patients) with CTM. Patients were assessed preoperatively and postoperatively at an interval of one week, one month and three months. Results Repeated measures ANOVA and Post hoc Tukey test showed a significant increase in bite force and mouth opening for both groups in first and third postoperative months. Unpaired t-test showed slightly better mouth opening in Group B and slightly higher bite force in Group A. Discussion Both miniplates fulfilled all the study objectives and equally satisfactory healing was seen at the end of third month. NDM offers better stability, rigidity, and anatomic reduction of the fracture with a drawback of difficulty in adaptation and increased operative timing compared to CTM. Hence, we would like to conclude that both miniplates are equally efficient in the treatment of non-comminuted angle fractures with the NDM having upper hand in stability.
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Affiliation(s)
- Rozina Vishnani
- Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College, Sawangi, Wardha Maharashtra, India
| | - Channaveer Pattanshetti
- Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Deemed to be University, Sangli, Maharashtra, India
| | - Rizwan Gilani
- Department of Orthodontics and Dentofacial Orthopaedics, Sharad Pawar Dental College, Sawangi, Wardha Maharashtra, India
| | - Banashree Sankeshwari
- Department of Prosthodontics, Bharati Vidyapeeth Deemed to be University, Sangli, Maharashtra, India
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Kozakiewicz M, Walczyk A. Current Frequency of Mandibular Condylar Process Fractures. J Clin Med 2023; 12:1394. [PMID: 36835931 PMCID: PMC9962693 DOI: 10.3390/jcm12041394] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
There are significant discrepancies in the reported prevalence of condylar process fractures among all mandibular fractures (16.5-56%) in the available literature. In addition, it seems that the actual number of difficult-to-treat fractures of the mandibular head is unknown. The purpose of this study is to present the current incidence of the different types of mandibular process fractures with a special focus on mandibular head fractures. The medical records of 386 patients with single or multiple mandibular fractures were reviewed. Of the fractures found, 58% were body fractures, 32% were angle fractures, 7% were ramus fractures, 2% were coronoid process fractures, and 45% were condylar process fractures. The most common fracture of the condylar process was a basal fracture (54% of condylar fractures), and the second most common fracture was a fracture of the mandibular head (34% of condylar process fractures). Further, 16% of patients had low-neck fractures, and 16% had high-neck fractures. Of the patients with head fractures, 8% had a type A fracture, 34% had a type B fracture, and 73% had a type C fracture. A total of 89.6% of the patients were surgically treated with ORIF. Mandibular head fractures are not as rare as previously thought. Head fractures occur twice as often in the pediatric population than in adults. A mandibular fracture is most likely related to a mandible head fracture. Such evidence can guide the diagnostic procedure in the future.
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Affiliation(s)
- Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 90–549 Lodz, Poland
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Correlation of radiomorphometric indices of the mandible and mandibular angle fractures. Heliyon 2022; 8:e10549. [PMID: 36132178 PMCID: PMC9483591 DOI: 10.1016/j.heliyon.2022.e10549] [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: 05/08/2022] [Revised: 06/29/2022] [Accepted: 09/01/2022] [Indexed: 11/22/2022] Open
Abstract
This study assessed the correlation of radiomorphometric indices of the mandible and mandibular angle fractures (MAFs) in an Iranian population. This retrospective study was conducted on 3D computed tomography (CT) scans of 118 patients between 18 to 60 years. The images were divided into two groups with MAFs and other types of mandibular fractures (non-MAF). The gonial angle, ramus height, condylar neck width, minimum ramus width, and mandibular length were all measured using MARCO PACS software. Age, gender, and presence and eruption status of third molar at the fracture side were all recorded. The correlation between these parameters and MAF was analyzed using R software (alpha = 0.05). Of all patients, 41 samples had MAF. The two groups were not significantly different regarding the mean age and gender (P > 0.05). The mean size of gonial angle and ramus height in the MAF group were significantly larger, and smaller than the corresponding values in the non-MAF group, respectively (P < 0.001). The median minimum ramus width in the MAF group was significantly smaller than that in the non-MAF group (P = 0.001). Patients with a large gonial angle had 6.6 times higher odds of MAF compared with other fracture types (P = 0.046). Condylar neck width, mandibular length, and erupted third molars had no significant correlation with type of fracture. Presence of impacted third molar increased the odds of MAF by 5.55 times. Patients with a large gonial angle, short ramus height, minimum ramus width, and impacted third molar are more susceptible to MAF. Surgeons can use these indices to predict the risk of MAF in trauma patients with such facial characteristics, and make a diagnosis by radiographic modalities.
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Bicsák Á, Abel D, Berbuesse A, Hassfeld S, Bonitz L. Evaluation of Mandibular Fractures in a German Nationwide Trauma Center Between 2015 and 2017. J Maxillofac Oral Surg 2022; 21:904-910. [PMID: 36274900 PMCID: PMC9474798 DOI: 10.1007/s12663-021-01513-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022] Open
Abstract
Introduction This study analyses the treatment of isolated mandibular fractures between 1.1.2015 and 21.31.2017 at Dortmund General Hospital. Materials and Methods Patient documentation and radiological images have been assessed, and a descriptive statistical analysis has been performed. Results Three hundred and twenty-eight patients were identified with isolated mandibular fractures (259 male, 69 female). The male-to-female ratio is 3.75: 1. A total of 541 fracture sites have been identified (1.65 fractures/patient). Forty of these were observed in the dentoalveolar region (fracture of the alveolar process, dental injuries), and the other 501 injuries were distributed in the remaining parts of the lower jaw.A detailed analysis of the osteosynthesis implants is provided. A total of 20 serious complications were observed (6% in all primary cases, 4.5% without osseointegrated implants). Discussion The demographic data and the anatomical distribution of the fracture sites are comparable with international literature. Dentoalveolar injuries mostly occur in younger patients. The complication rate in this study (4.5%) is below the international data; however, we found a considerably higher rate than in the midfacial region (central midface: 0%, lateral midface: 1.43%). Despite this complication rate, the procedure can be considered safe. Supplementary information The online version of this article (10.1007/s12663-021-01513-4).
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Affiliation(s)
- Ákos Bicsák
- Clinics of Oral- and Maxillofacial Surgery, Plastic Operations, General Hospital Dortmund, Department of the University of Witten-Herdecke, Dortmund, Germany
- Department of Oral- and Maxillofacial Surgery, General Hospital Dortmund, Muensterstrasse 240, 4145 Dortmund, Germany
| | - Dietmar Abel
- Clinics of Oral- and Maxillofacial Surgery, Plastic Operations, General Hospital Dortmund, Department of the University of Witten-Herdecke, Dortmund, Germany
| | - Anna Berbuesse
- Clinics of Oral- and Maxillofacial Surgery, Plastic Operations, General Hospital Dortmund, Department of the University of Witten-Herdecke, Dortmund, Germany
| | - Stefan Hassfeld
- Clinics of Oral- and Maxillofacial Surgery, Plastic Operations, General Hospital Dortmund, Department of the University of Witten-Herdecke, Dortmund, Germany
| | - Lars Bonitz
- Clinics of Oral- and Maxillofacial Surgery, Plastic Operations, General Hospital Dortmund, Department of the University of Witten-Herdecke, Dortmund, Germany
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Patterns of Mandibular Fractures in South Australia: Epidemiology, Treatment, and Clinical Outcomes. J Craniofac Surg 2021; 33:1018-1022. [PMID: 34560730 DOI: 10.1097/scs.0000000000008244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The mandible is one of the most common facial bones to be injured with great clinical variability across countries caused by assaults, road traffic accidents, and falls. METHODS A retrospective review was conducted for adult mandibular fractures from January 2012 to January 2017 at the Royal Adelaide Hospital, Adelaide. Our aim was to describe epidemiological trends of mandibular fractures, differences for sex and age, and clinical outcomes. RESULTS Five hundred sixty five adult patients presented with a mandibular fracture with a male predominance (4.5:1). The mean age was 34.2 years with men 11.9 years younger than females (32.0 versus 44.1 years, P < 0.001). Assaults represented 58.2% of cases. A quarter of the cohort reported alcohol use. Assaults commonly resulted in angle and symphyseal fractures, whereas almost all falls and road traffic accident resulted in condylar or coronoid fractures. Young men were 1.9 times more likely to have mandibular fractures compared to women, whereas elderly men were 11.8% less likely (P < 0.001). The most common fracture was the angle (33.6%) and the angle/symphyseal (14.2%). Men were 2.5 times more likely to have surgery. The complication rate was 10.8% and the re-operative rate was 5.0%. Women had a significantly longer admission of 1.6 days compared to men (4.4 versus 2.8 days, P = 0.003). CONCLUSIONS Young men are more likely to have mandibular fractures from assaults and have surgery. Young women and elderly females are more likely to have animal and fall-related injuries resulting including in condylar fractures with associated injuries and extended length of stay.
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Farzan R, Farzan A, Farzan A, Karimpour M, Tolouie M. A 6-Year Epidemiological Study of Mandibular Fractures in Traumatic Patients in North of Iran: Review of 463 Patients. World J Plast Surg 2021; 10:71-77. [PMID: 33833957 PMCID: PMC8016382 DOI: 10.29252/wjps.10.1.71] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Mandibular fracture is considered the second most common facial fracture worldwide. We aimed to evaluate the epidemiology of mandibular fractures in traumatic patients hospitalized at Velayat Teaching Hospital in Rasht, Iran for 6-year. METHODS In this retrospective study, all traumatic patients with mandibular fractures admitted to Velayat Teaching Hospital, Rasht, northern Iran for 6-year (2013-18) were enrolled. The data collection tool was a checklist consisting of two parts: demographic information, and injury data. All data were collected through the Hospital Information System (HIS), and analyzed using SPSS software and descriptive and analytical statistics tests. RESULTS Overall, 463 hospitalized patients were reviewed. Males had higher frequency than females. The most common accident place was rural roads. The most frequent mechanism of fractures was road accidents. The most common injuries occurred in motorcyclists, followed by car passengers, pedestrians, and cyclists. The highest and lowest frequency of injury occurred in September, and February, respectively. The most common site of fracture was condyle, followed by trunk. In concurrent fractures, the most frequently affected site was maxillary bone, followed by zygomatic bones, orbital, nasal, and frontal bones. CONCLUSION The majority of patients with mandibular fractures were young men of working age following motor vehicle accidents. Consequently, the most effective strategy for reducing accidents leading to mandibular fractures is considering all three components of human, environment, and vehicle.
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Affiliation(s)
- Ramyar Farzan
- Department of Plastic & Reconstructive Surgery, Guilan University of Medical Sciences, Rasht, Iran
| | - Avishan Farzan
- Department of Plastic & Reconstructive Surgery, Guilan University of Medical Sciences, Rasht, Iran
| | - Ava Farzan
- Department of Plastic & Reconstructive Surgery, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammadbagher Karimpour
- Department of Plastic & Reconstructive Surgery, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Tolouie
- Department of Plastic & Reconstructive Surgery, Guilan University of Medical Sciences, Rasht, Iran
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Chen YT, Chiu YW, Chang YC, Lin CW. Ten-year retrospective study on mandibular fractures in central Taiwan. J Int Med Res 2020; 48:300060520915059. [PMID: 32705932 PMCID: PMC7383631 DOI: 10.1177/0300060520915059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To analyse the epidemiology of mandibular fractures and the correlation between combined fractures during a 10-year period in central Taiwan. Methods This retrospective study analysed data collected from the medical records of patients that had mandibular fractures between January 2007 and October 2017. Data on age, sex, cause of injury, anatomical site of fracture, treatment and complications were obtained and analysed. Results A total of 265 patients who received treatment were included in the study. The mean ± SD age was 30.08 ± 13.47 years (range, 6–70 years) and the 21–30 years age group showed the highest incidence of mandibular fractures. The male-to-female ratio was 1.25:1. Road traffic accidents were the most common cause of fracture (206 of 265; 77.74%). The symphysis and parasymphysis area was the most common fracture site (169 of 420; 39.29%). Single-site fracture represented slightly more than 50% of the total 420 fractures. The most frequent combination of two fractures was an angle fracture combined with a symphysis and parasymphysis fracture (29 of 106 double fracture patients [27.36%]). There was a weak positive association between several combinations of fractures. Conclusions A better understanding of the influence of age and sex on the mechanism of injury is of great clinical importance in the assessment and diagnosis of fractures.
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Affiliation(s)
- Yi-Tzu Chen
- Department of Oral and Maxillofacial Surgery, Chung Shan Medical University Hospital, Taichung City.,School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung City
| | - Yu-Wei Chiu
- Department of Oral and Maxillofacial Surgery, Chung Shan Medical University Hospital, Taichung City.,School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung City
| | - Yu-Chao Chang
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung City.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung City
| | - Chiao-Wen Lin
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung City.,Graduate Institute of Oral Sciences, Chung Shan Medical University, Taichung City
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Nogami S, Yamauchi K, Bottini GB, Morishima H, Sai Y, Otake Y, Higuchi K, Kumagai M, Gaggl A, Takahashi T. Mandibular fractures and dental injuries sustained during baseball and softball over 14 years in a Japanese population: A retrospective multicentre study. Dent Traumatol 2019; 36:156-160. [DOI: 10.1111/edt.12512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/27/2019] [Accepted: 08/27/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Shinnosuke Nogami
- Division of Oral and Maxillofacial Surgery Department of Oral Medicine, and Surgery Tohoku University Graduate School of Dentistry Sendai Japan
| | - Kensuke Yamauchi
- Division of Oral and Maxillofacial Surgery Department of Oral Medicine, and Surgery Tohoku University Graduate School of Dentistry Sendai Japan
| | - Gian Battista Bottini
- Department of Oral and Maxillofacial Surgery Paracelsus Medical University Salzburg Austria
| | - Hiromitsu Morishima
- Division of Oral and Maxillofacial Surgery Department of Oral Medicine, and Surgery Tohoku University Graduate School of Dentistry Sendai Japan
| | - Yuko Sai
- Division of Oral and Maxillofacial Surgery Department of Oral Medicine, and Surgery Tohoku University Graduate School of Dentistry Sendai Japan
| | - Yoshio Otake
- Division of Oral and Maxillofacial Surgery Department of Oral Medicine, and Surgery Tohoku University Graduate School of Dentistry Sendai Japan
| | - Keisuke Higuchi
- Department of Oral and Maxillofacial Surgery Sendai City Hospital Sendai Japan
| | - Masahiro Kumagai
- Department of Oral and Maxillofacial Surgery KKR Tohoku Kosai Hospital Sendai Japan
| | - Alexander Gaggl
- Department of Oral and Maxillofacial Surgery Paracelsus Medical University Salzburg Austria
| | - Tetsu Takahashi
- Division of Oral and Maxillofacial Surgery Department of Oral Medicine, and Surgery Tohoku University Graduate School of Dentistry Sendai Japan
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Hassanein AG. Trends and Outcomes of Management of Mandibular Fractures. J Craniofac Surg 2019; 30:1245-1251. [DOI: 10.1097/scs.0000000000005469] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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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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