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Jung HY, Cho JY, Jung S, Park HJ, Oh HK, Ryu J. Can Fracture Reduction be Attempted Through a 3D-Printed Guide Template Without Maxillomandibular Fixation? J Oral Maxillofac Surg 2023:S0278-2391(23)00399-3. [PMID: 37220868 DOI: 10.1016/j.joms.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Computer-aided design and manufacturing is widely used in clinical practice. This technology may change existing methods for mandibular fracture management. PURPOSE The purpose of this in-vitro study was to determine if the reduction for mandibular symphysis fracture is performed without maxillomandibular fixation (MMF) using 3-dimensional (3D)-printed template. STUDY DESIGN, SETTING, AND SAMPLE This was an in-vitro study and had the character of a proof-of-concept study. The study was planned using the existing 20 pairs of intraoral scan and computed tomography data. The mandibular model STL file was created by merging the STL file obtained for the bimaxillary dentitions with the computed tomography DICOM file, and this was set as the original model. In the original model, STL file of fracture model of mandibular symphysis was created using computer-aided design. A template similar to a wafer or an implant guide was manufactured from restoring the own occlusion, and the mandibular fracture model was reduced and fixed using the 3D-printed template and wire, and this was set as the experimental group. The 3D coordinate system error was measured at 6 landmarks and statistically compared using scan data between models of the groups. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLES Reduction techniques with MMF or without MMF using guide template for mandibular fracture model. MAIN OUTCOME VARIABLE(S) The 3D coordinate system error (mm). COVARIATES The position of landmarks. ANALYSES The Mann-Whitney U test, student's t-test, and the Kruskal-Wallis test were used to analyze the coordinate errors between the landmarks. A P value of < .05 was considered statistically significant. RESULTS The 3D error value of the control and experimental group were 1.06 ± 0.63 mm (range: 0.11 to 2.92 mm) and 0.96 ± 0.48 mm (range: 0.2 to 2.95 mm), respectively. There was no statistical difference between the control and experimental group. There was a statistically significant difference in the lower 2 and lower 3 landmarks compared to the upper 1 (P = .001 and .000, respectively) before and after the reduction in the experimental group. CONCLUSION AND RELEVANCE This study demonstrates that the reduction using a 3D-printed guide template for the mandibular symphysis fracture could be possible even without the MMF.
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Affiliation(s)
- Hee-Yeoung Jung
- Department of Oral & Maxillofacial Surgery, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Oral & Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Jin-Yong Cho
- Department of Oral & Maxillofacial Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Seunggon Jung
- Department of Oral & Maxillofacial Surgery, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Oral & Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Hong-Ju Park
- Department of Oral & Maxillofacial Surgery, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Oral & Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Hee-Kyun Oh
- Department of Oral & Maxillofacial Surgery, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Oral & Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea
| | - Jaeyoung Ryu
- Department of Oral & Maxillofacial Surgery, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Oral & Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Republic of Korea.
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Khattak YR, Sardar T, Iqbal A, Khan MH, Khan A, Ullah U, Ahmad I. Treatment of pediatric bilateral condylar fractures: A comprehensive analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101339. [PMID: 36403929 DOI: 10.1016/j.jormas.2022.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
Abstract
Pediatric bilateral condylar fractures (PBCF) is a rare clinical pathology, where the management is carried out with both conservative and surgical approaches. The purpose of this study was to analyze and compare these two treatment approaches and their associated long term complications in PBCF. An extensive literature review- through the search of online databases- was conducted to survey, collect, analyze and compare the reported outcomes of different treatment modalities for PBCF. The number of studies presenting PBCF case reports was 16, while the number of such retrospective studies included here was 19. Analyses of these studies revealed that the conservative treatment is preferred in PBCF patients younger than 12 years of age. Moreover, a composite approach where the open reduction and internal fixation (ORIF) is carried out for one side while the intermaxillary fixation (IMF) for the contralateral side is frequently reported for the management of PBCF cases; this approach appears effective in improving daily functioning of temporomandibular joint and reducing long term complications. Performing ORIF for one side while IMF for the contralateral side seems the most common treatment approach in PBCF. This study may help in rapid decision making for treatment selection of PBCF patients while minimizing the risk for late complications.
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Affiliation(s)
| | - Tariq Sardar
- Oral and Maxillofacial Surgery, KMU-Institute of Dental Sciences, Kohat, Pakistan.
| | | | | | - Ajmal Khan
- Oral and Maxillofacial Surgery, Saidu Medical College, Swat, Pakistan
| | - Umer Ullah
- Oral and Maxillofacial Surgery, Rehman College of Dentistry, Peshawar, Pakistan
| | - Iftikhar Ahmad
- Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan
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Pontell ME, Niklinska EB, Braun SA, Jaeger N, Kelly KJ, Golinko MS. Resorbable Versus Titanium Rigid Fixation for Pediatric Mandibular Fractures: A Systematic Review, Institutional Experience and Comparative Analysis. Craniomaxillofac Trauma Reconstr 2022; 15:189-200. [PMID: 36081676 PMCID: PMC9446277 DOI: 10.1177/19433875211022573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Study Design Pediatric mandible fractures mandate special consideration because of unerupted teeth, mixed dentition, facial growth and the inability to tolerate maxillomandibular fixation. No consensus exists as to whether resorbable or titanium plating systems are superior with regards to clinical outcomes. Objective This study aims to systematically review and compare the outcomes of both material types in the treatment of pediatric mandible fractures. Methods After PROSPERO registration, studies from 1990-2020 publishing on outcomes of ORIF of pediatric mandible fractures were systematically reviewed according to PRISMA guidelines. An additional retrospective review was conducted at a pediatric level 1 trauma center. Results 1,144 patients met inclusion criteria (30.5% resorbable vs. 69.5% titanium). Total complication rate was 13%, and 10% required a second, unplanned operation. Complication rates in the titanium and resorbable groups were not significantly different (14% vs. 10%; P = 0.07), and titanium hardware was more frequently removed on an elective basis (P < 0.001). Condylar/sub-condylar fractures were more often treated with resorbable hardware (P = 0.01); whereas angle fractures were more often treated with titanium hardware (P < 0.001). Within both cohorts, fracture type did not increase the risk of complications, and comparison between groups by anatomic level did not demonstrate any significant difference in complications. Conclusions Pediatric mandible fractures requiring ORIF are rare, and hardware-specific outcomes data is scarce. This study suggests that titanium and resorbable plating systems are equally safe, but titanium hardware often requires surgical removal. Surgical approach should be tailored by fracture anatomy, age-related concerns and surgeon preference.
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Affiliation(s)
- Matthew E. Pontell
- Department of Plastic Surgery,
Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Stephane A. Braun
- Department of Plastic Surgery,
Vanderbilt University Medical Center, Nashville, TN, USA
| | - Nolan Jaeger
- Division of Pediatric Plastic Surgery,
Division of Cleft and Craniofacial Surgery, Monroe Carell Jr. Children’s Hospital at
Vanderbilt, Nashville, TN, USA
| | - Kevin J. Kelly
- Division of Pediatric Plastic Surgery,
Division of Cleft and Craniofacial Surgery, Monroe Carell Jr. Children’s Hospital at
Vanderbilt, Nashville, TN, USA
| | - Michael S. Golinko
- Division of Pediatric Plastic Surgery,
Division of Cleft and Craniofacial Surgery, Monroe Carell Jr. Children’s Hospital at
Vanderbilt, Nashville, TN, USA
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Highland J, Dunya G, Teames C, Peacock J, Yamashiro D, Muntz H, Park A. Customizable interdental splinting for repair of pediatric mandibular fractures in children with mixed dentition: A novel technique. Int J Pediatr Otorhinolaryngol 2022; 157:111133. [PMID: 35462217 DOI: 10.1016/j.ijporl.2022.111133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/27/2022] [Accepted: 04/08/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Repair of pediatric mandibular fractures (PMFs) can be challenging due to the lack of permanent dentition for immobilization, and the presence of unerupted teeth and growth plates in the mandible limiting the space for fixation. Interdental splinting (IDS) has been advocated to provide temporary fixation without the need for mandibular plating; however, there is sparse description of the surgical methodology, and data on long term outcomes are even more limited. The aim of this study is to present our technique and outcomes using a novel technique for IDS repair of pediatric mandible fractures. STUDY DESIGN Observational retrospective chart review. SETTING Tertiary care pediatric hospital. SUBJECTS AND METHODS Pediatric patients requiring operative repair for mandibular fracture at our tertiary care institution between 2004 and 2021 were included. Patients over 18 years of age, those who died due to associated injuries, or those who underwent non-IDS repairs were excluded. Subjects with at least 3 months of follow-up were assessed for efficacy of surgical repair and short-term adverse outcomes, and at least 1 year for long-term adverse events. Descriptive statistics were obtained. RESULTS Twenty-three children were included in the study with an average age of 7.4 years (range 2-17 years). Fifty-two percent (52.2%) were female. The most common fracture site was the condyle, occurring in 16 children (70%). The indication for operative repair in all cases was malocclusion. The average duration of maxillomandibular fixation (MMF) with the novel IDS was 21 days (range 12-42 days). The average length of follow up was 1.6 years (range 3 months-11 years). All children had restored, functional occlusion at follow up with none requiring further orthodontic or dental intervention. Three children of the total cohort (13.0%) had prolonged hospitalization beyond 48 h for poor oral intake. Five children (21.7%) experienced minor long-term complications including persistent temporomandibular joint pain (n = 1, 4.3%), infection (n = 2, 8.7%), hypertrophic scar (n = 1, 4.3%) and exposure of hardware (n = 1, 4.3%). CONCLUSION PMFs resulting in malocclusion are safely and effectively managed with operative repair utilizing a customizable IDS, with few observed short- and long-term complications.
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Affiliation(s)
- Julie Highland
- Division of Otolaryngology, University of Utah Health, 50N Medical Drive, SOM 3C120, Salt Lake City, UT, 84132, United States.
| | - Gabriel Dunya
- Division of Otolaryngology, University of Utah Health, 50N Medical Drive, SOM 3C120, Salt Lake City, UT, 84132, United States
| | - Charles Teames
- University of Utah School of Medicine, Eccles Health and Sciences Building, Suite 5900, 26 South 2000 East, Salt Lake City, UT, 84112, United States
| | - Jordan Peacock
- University of Utah School of Medicine, Eccles Health and Sciences Building, Suite 5900, 26 South 2000 East, Salt Lake City, UT, 84112, United States
| | - Duane Yamashiro
- Division of Plastic Surgery, University of Utah Health, 30N 1900 E, 3B400, Salt Lake City, UT, 84132, United States
| | - Harlan Muntz
- Division of Otolaryngology, University of Utah Health, 50N Medical Drive, SOM 3C120, Salt Lake City, UT, 84132, United States
| | - Albert Park
- Division of Otolaryngology, University of Utah Health, 50N Medical Drive, SOM 3C120, Salt Lake City, UT, 84132, United States
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Fukumoto Y, Miyama T. Alleviation of masticatory disturbance with an occlusal splint in a Duchenne muscular dystrophy patient. SPECIAL CARE IN DENTISTRY 2021; 41:572-578. [PMID: 33826161 PMCID: PMC8518792 DOI: 10.1111/scd.12594] [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: 11/12/2020] [Revised: 03/11/2021] [Accepted: 03/23/2021] [Indexed: 12/03/2022]
Abstract
Aim To present an occlusal splint effective for alleviating masticatory disturbance in Duchenne muscular dystrophy (DMD). Case report A 13‐year‐old male DMD patient with masticatory disturbance presented with an open bite, with occlusal contact only between the first and second molars bilaterally and reduced masticatory performance. We applied an occlusal splint that achieved occlusal contact for all teeth and monitored its effects on masticatory function over 6 years. The occlusal splint increased occlusal contact points from 11 to 60. Although occlusal force remained at 13.9‒16 kg, masticatory performance increased, and the number of mastication strokes increased from 124 to 169. Masseter muscle activity decreased from 76.8% to 33.4% maximum voluntary contraction (MVC) and digastric muscle activity increased from 8.7% to 18.0% MVC. Time from start of peanut mastication to swallowing decreased, and the vertical mastication cycle diameter and its width on the habitual side increased. Conclusions Masticatory disturbance in a DMD patient was alleviated using an occlusal splint. The number of mastication strokes and the digastric to masseter muscle activity ratio were increased. Furthermore, the mastication cycle was enlarged, which increased masticatory movement. As masseter muscle activity during mastication decreased, the occlusal splint likely reduced muscle fatigue during masticatory movement.
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Affiliation(s)
- Yutaka Fukumoto
- Department of Dentistry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Takeshi Miyama
- Department of Surgery, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
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Nezam S, Kumar A, Shukla JN, Khan SA. Management of mandibular fracture in pediatric patient. Natl J Maxillofac Surg 2018; 9:106-109. [PMID: 29937672 PMCID: PMC5996639 DOI: 10.4103/njms.njms_54_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A pediatric mandibular fracture can cause a child severe pain and the parent or caregiver extreme worry. While the pattern of fractures in children is similar to adults, however, due to a number of factors, including the anatomical complexity of the developing mandible, management of such fractures differs from that of adults and can greatly challenge the pediatric dentist. Various treatment modalities of managing mandibular fracture are available, such as closed/open cap splint with circummandibular wiring, arch-bar fixation, and cementation of the cap splint.
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Affiliation(s)
- Sumaiya Nezam
- Department of Pedodontics and Preventive Dentistry, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Arvind Kumar
- Department of Pedodontics and Preventive Dentistry, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Jeevendra Nath Shukla
- Department of Pedodontics and Preventive Dentistry, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Shabab Ahmed Khan
- Department of Prosthodontics and Crown and Bridge, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
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Bobrowski A, Torriani M, Sonego C, Carvalho PD, Post L, Chagas Júnior O. Complications associated with the treatment of fractures of the dentate portion of the mandible in paediatric patients: a systematic review. Int J Oral Maxillofac Surg 2017; 46:465-472. [DOI: 10.1016/j.ijom.2016.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/03/2016] [Accepted: 12/19/2016] [Indexed: 10/20/2022]
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Xu Y, Gong SG, Zhu F, Li M, Biao X. Conservative orthodontic fixed appliance management of pediatric mandibular bilateral condylar fracture. Am J Orthod Dentofacial Orthop 2017; 150:181-7. [PMID: 27364219 DOI: 10.1016/j.ajodo.2016.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 02/01/2015] [Accepted: 02/01/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Management of mandibular condylar fractures is difficult in children with their inherently dynamic and unstable deciduous and mixed dentitions. We present a variation of the conservative fixed orthodontic approach that was used as an adjunct to aid in the reduction of a bilateral condylar fracture in a pediatric patient. METHODS A boy, aged 10 years 9 months, came with clinical signs and symptoms of mandibular fracture after being involved in a motor vehicle accident. A computed tomography scan showed a vertical fracture on the left condylar head, a displaced fracture of the right condylar neck, and a mandibular symphysis fracture. The patient was treated with an orthodontic fixed appliance instead of an arch bar splint, followed by elastic traction to achieve a proper occlusion and condylar remodeling. Follow-up appointments were made 2 weeks and 1, 2, 20, 37, and 49 months after treatment. RESULTS Clinical recovery was observed 2 months after treatment. At the follow-up appointments at 20, 37, and 49 months, jaw function and occlusal relationship remained stable, and no ankylosis was observed. The computed tomography scans showed that the right condyle had remodeled, and the left condyle exhibited a slight curve in the head at 49 months posttreatment. The patient's satisfaction with these treatment results was high. CONCLUSIONS Conservative treatment of a mandibular fracture by fixed orthodontic means is a viable treatment option that is relatively straightforward and cost-effective and has a high level of patient acceptance and comfort.
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Affiliation(s)
- Yanhua Xu
- Professor, Department of Orthodontics, School of Stomatology, Kunming Medical University, Kunming, China
| | - Siew-Ging Gong
- Associate professor, Department of Orthodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Fangyong Zhu
- Assistant professor, Department of Stomatology, Third Hospital of Wuxi, Wuxi, China
| | - Ming Li
- Professor, Department of Oral and Maxillofacial Surgery, School of Stomatology, Kunming Medical University, Kunming, China
| | - Xu Biao
- Professor and dean, Department of Oral and Maxillofacial Surgery, School of Stomatology, Kunming Medical University, Kunming, China.
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Abstract
Maxillofacial trauma is rare in children younger than the age of 5 years (range 0.6%-1.2%), and they can require different clinical treatment strategies compared with fractures in the adult population because of concerns regarding mandibular growth and development of dentition. A 5-year-old girl with a history of falling from a bicycle 7 hours earlier was referred to the department of oral and maxillofacial surgery. Multislice computed tomographic examination demonstrated a bilateral fracture of the mandibular condyle neck associated with minimal fracture of the alveolar ridge of the maxilla. The multislice computed tomographic scan also demonstrated dislocation on the right condyle neck and, on the left side, a medial inclination of approximately 45 degrees associated with greenstick fracture of the right parasymphysis region. In this particular case, orthodontic rubber elastics in combination with fixed orthodontic brackets provided good results in the treatment of bilateral condyle neck fractures associated with greenstick fracture of parasymphysis.
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Li Z, David O, Li ZB. The use of resorbable plates in association with dental arch stabilization in the treatment of mandibular fractures in children. J Craniomaxillofac Surg 2014; 42:548-51. [DOI: 10.1016/j.jcms.2013.07.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 04/20/2013] [Accepted: 07/17/2013] [Indexed: 10/26/2022] Open
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Gupta L, Aparna IN, Dhanasekar B, Kamath AT, Lingeshwar D, Agarwal P. Fabrication of a surgical splint in an emergency situation: a clinical report. J Prosthodont 2012; 22:223-5. [PMID: 23107385 DOI: 10.1111/j.1532-849x.2012.00939.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Fractures involving pediatric jaws most often require a splint to prevent the fragments from being displaced; however, impression making presents a challenge. This article describes the fabrication of a surgical splint over an ideal cast, which is subsequently refitted with a tissue conditioner onto the patient's jaw. The highlight of this technique is the elimination of an impression procedure, thereby reducing clinical and laboratory time and easing pain in the child.
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Affiliation(s)
- Lokendra Gupta
- Department of Prosthodontics and Crown & Bridge, Manipal College of Dental Sciences, Manipal, Karnataka, India.
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John B, John RR, Stalin A, Elango I. Management of mandibular body fractures in pediatric patients: a case report with review of literature. Contemp Clin Dent 2011; 1:291-6. [PMID: 22114443 PMCID: PMC3220159 DOI: 10.4103/0976-237x.76406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Mandibular fractures are relatively less frequent in children when compared to adults, which may be due to the child's protected anatomic features and infrequent exposure of children to alcohol related traffic accidents. Treatment principles of mandibular fractures differ from that of adults due to concerns regarding mandibular growth and development of dentition. A case of a 4.5-year-old boy with fractured body of mandible managed by closed reduction using open occlusal acrylic splint and circum mandibular wiring is presented. This article also provides a review of literature regarding the management of mandibular body fracture in young children.
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Affiliation(s)
- Baby John
- Department of Pediatric and Preventive Dentistry, KSR College of Dental Sciences and Research Institute, Trichengode, India.
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Aizenbud D, Hazan‐Molina H, Emodi O, Rachmiel A. The management of mandibular body fractures in young children. Dent Traumatol 2009; 25:565-570. [DOI: 10.1111/j.1600-9657.2009.00815.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Abstract – This article reviews the management of mandibular body fractures in young children. Treatment principles of this fracture type differ from that of adults due to concerns regarding mandibular growth processes and dentition development. The goal of this fracture treatment is to restore the underlying bony architecture to its preinjury position in a stable fashion as non‐invasively as possible and with minimal residual esthetic and functional impairment. The management of mandibular body fractures in children depends on the fracture type and the stage of skeletal and dental development; treatment modalities range from conservative non‐invasive, through closed reduction and immobilization methods to open reduction with internal fixation. Disruption of the periosteal envelope of the mandibular body may have an unpredictable effect on growth. Thus, if intervention is required closed reduction is favored.
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2008; 16:569-72. [PMID: 19005328 DOI: 10.1097/moo.0b013e32831cf1a7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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