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Cremona G, Paione S, Roccia F, Samieirad S, Lazíc M, Konstantinovic VS, Rae E, Laverick S, Vesnaver A, Birk A, de Oliveira Gorla LF, Pereira-Filho VA, Dediol E, Kos B, Pechalova P, Sapundzhiev A, Dubron K, Politis C, Zavattero E, Bottini GB, Goetzinger M, Sivrić A, Kordić M, Rahman SA, Rahman T, Sohal KS, Aladelusi T, Sobrero F. Policy of fourteen maxillofacial divisions towards titanium plates removal after internal fixation of paediatric maxillofacial fractures: A World Oral Maxillofacial Trauma (WORMAT) project. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101986. [PMID: 39067638 DOI: 10.1016/j.jormas.2024.101986] [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: 05/18/2024] [Revised: 07/08/2024] [Accepted: 07/25/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION The aim of this 11-year retrospective multicentric study is to evaluate the policy of 14 maxillofacial surgery divisions in terms of titanium plate removal from paediatric patients who had undergone open reduction and internal fixation (ORIF) to treat maxillofacial fractures. MATERIAL AND METHODS Patients ≤ 16 years undergoing surgical treatment for fractures of middle and lower third of the face between January 2011 and December 2022, with a minimum follow-up of 6 months, were included. Age (group A: ≤ 6 years, B: 7-12 years, C: 13-16 years), sex, fracture location and type, surgical approach, number, and location of positioned and removed plates, timing and indications for removal were recorded. RESULTS 191/383 (50 %) patients (median age, 10 years; M:F ratio 2.1:1) underwent removal of 319/708 (45 %) plates. Maxillary dentoalveolar process (91 %), angle/ramus (63 %) and mandibular body (61 %) had a significantly higher removal rate than other fracture sites (p < 0.001). A significant decreasing trend in removal with increasing age was observed, from 83 % in Group A to 24 % in Group C (p < 0.001). On the total of positioned plates, 11 % were removed for symptomatic reasons (5 % infections, 6 % discomfort/pain) and 34 % for other reasons (28 % scheduled removal). DISCUSSION This multicentric study showed that plate removal was not performed routinely in the paediatric population. The incidence and causes of symptomatic plates removal were consistent with the literature, while the plate removal rate from asymptomatic patients was lower. A correlation was found between increasing age and a reduction in the frequency of plate removal procedures.
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Affiliation(s)
- Giulia Cremona
- Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Serena Paione
- Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy.
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Sahand Samieirad
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marko Lazíc
- Clinic of Maxillofacial Surgery, School of dentistry, University of Belgrade, Belgrade, Serbia
| | | | - Euan Rae
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, United Kingdom
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee, United Kingdom
| | - Aleš Vesnaver
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Luis Fernando de Oliveira Gorla
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, Araraquara, São Paulo, Brazil
| | - Valfrido Antonio Pereira-Filho
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, Araraquara, São Paulo, Brazil
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Boris Kos
- Department of Maxillofacial Surgery, University Hospital Dubrava, Zagreb, Croatia
| | - Petia Pechalova
- Department of Oral surgery, Faculty of Dental medicine, Medical University of Plovdiv, Bulgaria
| | - Angel Sapundzhiev
- Department of Oral surgery, Faculty of Dental medicine, Medical University of Plovdiv, Bulgaria
| | - Kathia Dubron
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Emanuele Zavattero
- Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Gian Battista Bottini
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Maximilian Goetzinger
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Anamaria Sivrić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Mario Kordić
- Clinic for ENT and OMS, University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | - Sajjad Abdur Rahman
- Department of Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Tabishur Rahman
- Department of Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Karpal Singh Sohal
- Department of Oral and Maxillofacial Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Timothy Aladelusi
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Federica Sobrero
- Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
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Bottini GB, Hitzl W, Götzinger M, Politis C, Dubron K, Kordić M, Sivrić A, Pechalova P, Sapundzhiev A, Pereira-Filho VA, de Oliveira Gorla LF, Dediol E, Kos B, Rahman T, Rahman SA, Samieirad S, Aladelusi T, Konstantinovic VS, Lazić M, Vesnaver A, Birk A, Sohal KS, Laverick S, Rae E, Rossi MB, Roccia F, Sobrero F. Management of Mandibular Condyle Fractures in Pediatric Patients: A Multicentric Retrospective Study with 180 Children and Adolescents. J Clin Med 2024; 13:5455. [PMID: 39336942 PMCID: PMC11431969 DOI: 10.3390/jcm13185455] [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: 07/29/2024] [Revised: 08/21/2024] [Accepted: 09/04/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Mandibular condyle fractures in pediatric patients can lead to crippling sequelae such as ankylosis, pain and facial deformity if not managed properly. However, there is no consensus on the best approach for treating these fractures in children. Objective: This study aimed to describe the management of mandibular condyle fractures in growing patients across 14 maxillofacial departments worldwide. Methods: A retrospective multicenter study was conducted on children and adolescents aged 0 to 16 who had at least one mandibular condyle fracture. This study included patients who underwent expectant, closed, or open management and were treated over an 11-year period. Results: 180 patients had at least one mandibular condyle fracture, and 37 had a second condylar fracture. One hundred sixteen patients (65%) were males, and 64 (35%) were females (ratio 1.8:1). An expectant strategy was chosen in 51 (28%) patients, a closed treatment-stand-alone maxillomandibular fixation (MMF)-in 47 (26%), and open reduction and internal fixation (ORIF) was performed in 82 (46%) patients. The management varied significantly between the different departments (p < 0.0001). Significant differences were also identified between the fracture type (non-displaced, displaced or comminuted) and the management of the 180 patients with a single condylar fracture. Out of 50 non-displaced fractures, only 3 (6%) had ORIF, 25 (50%) had expectant management, and 22 (44%) had MMF. Out of 129 displaced fractures, 79 (62%) had ORIF, 25 (19%) had a soft diet, and 25 (19%) had MMF. Conclusions: Expectative management, MMF, and ORIF were all effective in treating pediatric mandibular condyle fractures, with a low incidence of complications and asymmetry.
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Affiliation(s)
- Gian Battista Bottini
- Department of Oral and Maxillofacial Surgery and Center for Reconstructive Surgery, University Hospital of the Private Medical University Paracelsus, 5020 Salzburg, Austria
| | - Wolfgang Hitzl
- Research and Innovation Management, Biostatistics, Department of Ophthalmology and Optometry, Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Maximilian Götzinger
- Department of Oral and Maxillofacial Surgery and Center for Reconstructive Surgery, University Hospital of the Private Medical University Paracelsus, 5020 Salzburg, Austria
| | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Lueven, Belgium
| | - Kathia Dubron
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7, 3000 Lueven, Belgium
| | - Mario Kordić
- Clinic for ENT and OMS, University Clinical Hospital, 88000 Mostar, Bosnia and Herzegovina
| | - Anamaria Sivrić
- Clinic for ENT and OMS, University Clinical Hospital, 88000 Mostar, Bosnia and Herzegovina
| | - Petia Pechalova
- Department of Oral Surgery, Faculty of Dental medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Angel Sapundzhiev
- Department of Oral Surgery, Faculty of Dental medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Valfrido Antonio Pereira-Filho
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, Araraquara 14801903, SP, Brazil
| | - Luis Fernando de Oliveira Gorla
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, Araraquara 14801903, SP, Brazil
| | - Emil Dediol
- Department of Maxillofacial Surgery, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Boris Kos
- Department of Maxillofacial Surgery, University Hospital Dubrava, 10000 Zagreb, Croatia
| | - Tabishur Rahman
- Department of Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh 202002, India
| | - Sajjad Abdur Rahman
- Department of Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh 202002, India
| | - Sahand Samieirad
- Oral & Maxillofacial Surgery Department, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad 91779-48564, Iran
| | - Timothy Aladelusi
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan 200005, Nigeria
| | - Vitomir S Konstantinovic
- Clinic of Maxillofacial Surgery, School of Dentistry, University of Belgrade, 11000 Belgrade, Serbia
| | - Marko Lazić
- Clinic of Maxillofacial Surgery, School of Dentistry, University of Belgrade, 11000 Belgrade, Serbia
| | - Aleš Vesnaver
- Department of Maxillofacial and Oral Surgery, University Medical Centre, 1000 Ljubljana, Slovenia
| | - Anže Birk
- Department of Maxillofacial and Oral Surgery, University Medical Centre, 1000 Ljubljana, Slovenia
| | - Karpal Singh Sohal
- Department of Oral and Maxillofacial Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam 65001, Tanzania
| | - Sean Laverick
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee DD1 4HR, UK
| | - Euan Rae
- Department of Oral and Maxillofacial Surgery, University of Dundee, Dundee DD1 4HR, UK
| | - Maria Beatrice Rossi
- Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy
| | - Federica Sobrero
- Division of Maxillofacial Surgery, Città della Salute e della Scienza Hospital, University of Turin, 10126 Turin, Italy
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Bressler S, Morris L. Pediatric Head and Neck Trauma. Otolaryngol Clin North Am 2023; 56:1169-1182. [PMID: 37460373 DOI: 10.1016/j.otc.2023.05.012] [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] [Indexed: 08/26/2023]
Abstract
The pediatric patient population has unique anatomic characteristics that bring challenges and increased risk to management. The purpose of this article is to guide the head and neck trauma surgeon in decision making for the treatment of pediatric head and neck trauma with an emphasis on facial fracture management.
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Affiliation(s)
- Sara Bressler
- Louisiana State University Health Sciences Center-New Orleans, 533 Bolivar Street Suite 566, New Orleans, LA 70112, USA
| | - Lisa Morris
- Louisiana State University Health Sciences Center-New Orleans, 533 Bolivar Street Suite 566, New Orleans, LA 70112, USA.
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Gibson AC, Merrill TB, Boyette JR. Complications of Mandibular Fracture Repair. Otolaryngol Clin North Am 2023; 56:1137-1150. [PMID: 37353369 DOI: 10.1016/j.otc.2023.05.008] [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] [Indexed: 06/25/2023]
Abstract
Mandible fracture management has evolved dramatically. Therefore, the variety of surgical complications associated with mandibular fractures, and their incidences, have continued to change as well. This article aims to assess the most common and most concerning complications that can occur secondary to management of mandibular fractures by examining categories of complication types. This article also explores factors and techniques associated with reduced rates of complications as well as the management of complications.
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Affiliation(s)
- Anna Celeste Gibson
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #543, Little Rock, AR 72205, USA.
| | - Tyler Branch Merrill
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #543, Little Rock, AR 72205, USA
| | - Jennings Russell Boyette
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #543, Little Rock, AR 72205, USA
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5
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Lee KC, Reynolds R, Recker MJ, Markiewicz MR. Rigid Fixation of the Pediatric Facial Skeleton. Oral Maxillofac Surg Clin North Am 2023; 35:529-541. [PMID: 37537081 DOI: 10.1016/j.coms.2023.04.003] [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: 08/05/2023]
Abstract
Pediatric facial fractures are uncommon, and fortunately, the majority can be managed with conservative measures. Rigid fixation of the pediatric facial skeleton can potentially be associated with delayed hardware issues and growth inhibition. When appropriate, resorbable fixation is most commonly used for this purpose. Titanium plates and screws are advantageous when rigid fixation is a priority because properly placed hardware that respects natural suture lines is not thought to significantly inhibit growth. Furthermore, titanium fixation may be removed following healing.
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Affiliation(s)
- Kevin C Lee
- Department of Oral and Maxillofacial Surgery, University at Buffalo, 3425 Main Street 112 Squire Hall, Buffalo, NY 14214, USA; Department of Head & Neck/Plastic & Reconstructive Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA
| | - Renée Reynolds
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, 818 Ellicott Street, Buffalo, NY 14203, USA
| | - Matthew J Recker
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, 818 Ellicott Street, Buffalo, NY 14203, USA
| | - Michael R Markiewicz
- Department of Oral and Maxillofacial Surgery, University at Buffalo, 3425 Main Street 112 Squire Hall, Buffalo, NY 14214, USA.
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Hajibandeh J, Peacock ZS. Pediatric Mandible Fractures. Oral Maxillofac Surg Clin North Am 2023; 35:555-562. [PMID: 37517978 DOI: 10.1016/j.coms.2023.05.001] [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: 08/01/2023]
Abstract
The management of pediatric facial fractures requires several considerations by the treating surgeon. Pediatric facial fractures occur less commonly than in adults. Among fracture patterns in children, studies have repeatedly demonstrated that mandible fractures are the most common facial fracture particularly the condyle. Most fractures in children are amenable to nonsurgical or closed treatment; however, certain indications exist for open treatment. The literature describing epidemiology, treatment trends, and long-term outcomes are limited in comparison with adult populations. The purpose of the article is to review the etiology, workup, and management of mandible fractures in children.
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Affiliation(s)
- Jeffrey Hajibandeh
- Massachusetts General Hospital, Division of Oral & Maxillofacial Surgery, Warren 1201, 55 Fruit Street, Boston, MA 02127, USA.
| | - Zachary S Peacock
- Massachusetts General Hospital, Division of Oral & Maxillofacial Surgery, Warren 1201, 55 Fruit Street, Boston, MA 02127, USA
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7
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Sarfraz S, Tamminen AM, Leikola J, Salmi S, Kaakinen M, Sorsa T, Suojanen J, Reunanen J. High Adherence of Oral Streptococcus to Polylactic Acid Might Explain Implant Infections Associated with PLA Mesh Implantation. Int J Mol Sci 2023; 24:9504. [PMID: 37298455 PMCID: PMC10253304 DOI: 10.3390/ijms24119504] [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: 04/18/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
The aim of this study was to evaluate and compare the biofilm formation properties of common pathogens associated with implant-related infections on two different implant material types. Bacterial strains tested in this study were Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis, and Escherichia coli. Implant materials tested and compared were PLA Resorb × polymer of Poly DL-lactide (PDLLA) comprising 50% poly-L-lactic acid and 50% poly-D-lactic acid) and Ti grade 2 (tooled with a Planmeca CAD-CAM milling device). Biofilm assays were done with and without saliva treatment to evaluate the effect of saliva on bacterial adhesion and to mimic the intraoral and extraoral surgical routes of implant placement, respectively. Five specimens of each implant type were tested for each bacterial strain. Autoclaved material specimens were first treated with 1:1 saliva-PBS solution for 30 min, followed by washing of specimens and the addition of bacterial suspension. Specimens with bacterial suspension were incubated for 24 h at 37 °C for biofilm formation. After 24 h, non-adhered bacteria were removed, and specimens were washed, followed by removal and calculation of adhered bacterial biofilm. S. aureus and E. faecalis showed more attachment to Ti grade 2, whereas S. mutans showed higher adherence to PLA in a statistically significant manner. The salivary coating of specimens enhanced the bacterial attachment by all the bacterial strains tested. In conclusion, both implant materials showed significant levels of bacterial adhesion, but saliva treatment played a vital role in bacterial attachment, therefore, saliva contamination of the implant materials should be minimized and considered when placing implant materials inside the body.
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Affiliation(s)
- Sonia Sarfraz
- Biocenter Oulu, Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (S.S.); (M.K.)
| | - Anni-Maria Tamminen
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland;
| | - Junnu Leikola
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, 00029 Helsinki, Finland;
| | - Sonja Salmi
- Biocenter Oulu, Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (S.S.); (M.K.)
| | - Mika Kaakinen
- Biocenter Oulu, Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (S.S.); (M.K.)
- Oulu Centre for Cell-Matrix Research, Faculty of Biochemistry and Molecular Medicine, University of Oulu, 90220 Oulu, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, 00014 Helsinki, Finland;
| | - Juho Suojanen
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland;
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, 00029 Helsinki, Finland;
- Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Justus Reunanen
- Biocenter Oulu, Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (S.S.); (M.K.)
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Pontell ME, O'Sick NR, Kalmar CL, Golinko MS. Pediatric Craniomaxillofacial Trauma. Pediatr Rev 2022; 43:665-675. [PMID: 36450635 DOI: 10.1542/pir.2021-005276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Matthew E Pontell
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Nicholas R O'Sick
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Christopher L Kalmar
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Michael S Golinko
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN.,Division of Pediatric Plastic Surgery, Cleft and Craniofacial Program, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN
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Balaji SM, Balaji P. Rigid versus resorbable plate fixation in fronto-orbital advancement in unicoronal stenosis - A retrospective study. Ann Maxillofac Surg 2022; 12:22-26. [PMID: 36199468 PMCID: PMC9527842 DOI: 10.4103/ams.ams_35_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: 02/06/2022] [Revised: 06/28/2022] [Accepted: 07/03/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction: Rigid plating fixation (RPF) and resorbable plating systems (RPS) advanced the field of reconstruction in craniomaxillofacial region. However, their performance in patients, particularly the effect on bone remodeling at site of hardware placement is not much documented. This manuscript aims to compare the performance of RPF and RPS in a cohort using a retrospective audit of case records. Methods: Archival records were searched for patients who had undergone cranial metal-RPF or RPS or combination for the correction of craniofacial deformities following inclusion-exclusion criteria. From records, data of the quality and quantity of bone formed along the site of plate fixation as compared with the adjacent site, accommodating or facilitating brain growth, and persistence of bone deformity at the site of hardware placement were collected at the end of the follow-up period. A total of 128 sites from 18 individuals (6 with exclusive metal-RPF and 12 with RPS) mean age of 7.45 ± 7.28 (Median 4; IQR of 8.88;2.6–11.5) who underwent cranial bone remodeling surgery formed the study group. Results: There was a statistically significant difference between the RPF and PRS system at the fronto-orbital suture (P = 0.002) and coronal suture (P = 0.036) with bone quality and quantity. Discussion: The RPF system was rigid but had a set of issues, while RPS has advantages and limitations. The qualitative difference in between the two systems is different. Due to inherent dissimilarity, the two systems cannot be interchanged and due diligence has to be exercised while deciding on the system. More prospective studies are needed to validate the findings.
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