Incidence of mandibular fractures in black sea region of Turkey

Patterns of Mandibular Fractures through Human Aggression: A 10-Year Cross-Sectional Cohort Retrospective Study

The World Health Organization considers the victims of interpersonal violence to be a medical priority. In order to provide services at the highest level, we aimed to evaluate the patterns of maxillofacial fractures caused by interpersonal violence, in order to treat, counsel and guide these patients. This retrospective study was conducted in 478 patients with mandibular fractures caused by interpersonal violence over 10 years in a university clinic. The most affected were male patients (95.19%), 20-29 years of age (46.86%), under the influence of alcohol (83.26%) and without education (43.9%). The majority of mandibular fractures were displaced (89.3%) and intraorally open (64.0%). The most frequent location was the mandibular angle (34.84%). The most frequent soft tissue lesions were hematomas (45.04%) and abrasions (34.71%), being associated frequently with closed (p = 0.945/p = 0.237), displaced (p = 0.001/p = 0.002), single angle fractures (p = 0.081/p = 0.222). Educating the population and fighting alcohol consumption would decrease the occurrence of mandibular fractures through aggression. Clinical diagnosis should be made, keeping in mind that the severity of associated soft tissue lesions is directly proportional to the pattern and number of underlying fracture lines.

Incidence and management of mandibular fractures in a low-resource health facility in Ghana

Objectives

The mandible and other parts of the maxillofacial region suffer significant morbid injuries following road traffic accidents. Our study gives epidemiological description of mandibular fractures in Ghana and also evaluates the relevance of closed reduction and indirect fixation for managing mandibular fractures in low-resource health facilities in low-income countries like Ghana.

Patients and Methods This is a retrospective study involving 268 patients who reported to the Department of Oral and Maxillofacial Surgery of the Sunyani Regional Hospital with mandibular fractures from January 2010 to December 2019. Patient medical records were assessed for information on age, sex, fracture etiology, anatomic location of fracture, time of day of road traffic accident, and other associated injuries.

Results

A total of 268 patients were included in this study (males, 216 [80.6%]; females, 52 [19.4%]). Motor vehicular accident (MVA) was the leading cause of mandibular fractures (202 injuries, 75.4%). Other etiologies included assault (39, 14.6%), gunshot (13, 4.9%), falls (12, 4.5%), and industrial accidents (2, 0.7%). Of the 161 male cases caused by MVA, 121 (75.2%) occurred at night and in the evening while the remaining 40 (24.8%) occurred in the morning and afternoon. Among all managed 222 patients, 212 (79.1%) were treated with closed reduction and indirect fixation technique while 10 (3.7%) were treated with open reduction and direct fixation.

Conclusion

Closed reduction with indirect fixation could successfully be used to manage mandibular fractures in low resourced health facilities, especially in low-income countries. The poor lightening system on roads in Ghana is a major contributory factor to motor vehicular accidents.

Virtual reconstruction of orbital floor defects using a statistical shape model

PURPOSE

The current standard in reconstructing defects of the orbital floor, by using the concept of mirroring, is time-consuming and ignores the natural asymmetry of the skull. By using a statistical shape model (SSM), the reconstruction can be automatized and improved in accuracy. The present study aims to show the possibilities of the virtual reconstruction of artificial defects of the orbital floor using an SSM and its potentials for clinical implementation.

METHODS

Based on 131 unaffected CT scans of the midface, an SSM was created which contained the shape variability of the orbital floor. Nineteen midface CT scans, that were not included in the SSM, were manually segmented to establish ground truth (control group). Then artificial defects of larger and smaller sizes were created and reconstructed using SSM (Group I) and the gold standard of mirroring (Group II). Eventually, a comparison to the surface of the manual segmentation (control group) was performed.

RESULTS

The proposed method of reconstruction using an SSM leads to more precise reconstruction results, compared with the conventional method of mirroring. Whereas mirroring led to the reconstruction errors of 0.7 mm for small defects and 0.73 mm for large defects, reconstruction using SSM led to deviations of 0.26 mm (small defect) and, respectively, 0.34 mm (large defect).

CONCLUSIONS

The presented approach is an effective and accurate method for reconstructing the orbital floor. In connection with modern computer-aided design and manufacturing, individual patient-specific implants could be produced according to SSM-based reconstructions and could replace current methods using manual bending techniques. By acknowledging the natural asymmetry of the human skull, the SSM-based approach achieves higher accuracy in reconstructing injured orbits.

Retrospective radiological evaluation to study the prevalence and pattern of maxillofacial fracture among Military personal at Prince Sultan Military Medical City [PSMMC], Riyadh: An institutional study

Purpose

The aim of the present study was to analyze the prevalence, causes, and patterns of maxillofacial fractures retrospectively in patients who were treated at Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Methods

Patients′ medical records were reviewed from 2005 to 2014. Patient′s age, gender, cause, and the pattern of maxillofacial fractures were studied. Associated body injuries were also recorded.

Results

Out of 263 patients, 207 (78.7%) were male and 56 (21.3%) were female. The age range was from 3 to 67 yr with a mean age of 26.21 yr. Road traffic accidents 236 (89.8%) were the most commonly reported cause of maxillofacial fractures, followed by falls 14 (5.3%), assaults 4 (1.5%), gunshot 3 (1.1%), and sport accidents 2 (0.8%). Most of the cases of maxillary fracture were Le Fort II 27 (36.5%), followed by LeFort I 23 (31.1%), LeFort III 20 (27.0%) and palatal fractures 4 (5.4%). Of the mandibular fractures, parasymphysis fractures constituted 61 (27.4%), body 50 (22.4%), condyle 45 (20.2%), angle 40 (17.9%), symphysis 16 (7.2%), ramus 7 (3.1%) and coronoid 4 (1.8%). Zygomatic complex fractures 110 (94.8%) were the most commonly reported fractures in the mid and upper facial region. Other facial fractures included orbital floor 61 (97.0%), naso-orbito-ethmoidal 18 (19.8%), and frontal 12 (13.2%).

Conclusion

Road traffic accidents were the most common cause of maxillofacial fractures. Spreading awareness among young drivers regarding road safety regulations is highly recommended.

Patterns of Mandibular Fractures and Associated Comorbidities in Peshawar, Khyber Pakhtunkhwa

Objectives

The objective of this study was to assess patterns of mandibular fractures and associated comorbidities in Peshawar, Pakistan.

Methodology

This multicenter, descriptive, cross-sectional study analyzed patients aged >15 years who had been clinically or radiographically diagnosed with mandibular fractures from January to December, 2015. Patients with pathological fractures or bomb-blast injuries were excluded. Data were analyzed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY).

Results

The 138 patients diagnosed with mandibular fractures in 2015 included 108 men (78.3%) and 30 women (21.7%), with a male preponderance of 3.6:1. Most patients (56%) were aged 15-25 years, followed by those aged 26-35 years (26%). The most frequent cause of fractures was road traffic accidents (RTAs; 59.42%), followed by falls (18.8%). RTAs were predominant in men (89%); whereas, falls were predominant in women (80%). Fractures due to firearm injuries and interpersonal violence were more frequent in men (p <0.001). In patients with unilateral fractures, the most common fracture site was the parasymphysis (24.6%) followed by the symphysis (10.1%). In patients with bilateral fractures, the most common fracture sites were the parasymphysis and condyle (11.6%), followed by the parasymphysis and angle (8.0%).

Conclusions

RTA was the most frequent cause of mandibular fracture and trauma. Mandibular fractures were more common in men than women, with most patients aged 15-25 years. The most common fracture site was the parasymphysis.

Incidence and Pattern of Mandible Fractures in the Madinah Region: A Retrospective Study

Objectives

The objective of the study is to study the incidence and pattern of mandible fractures in the holy city of Madinah in the Kingdom of Saudi Arabia over a retrospective period of 3 years from 2013 (1434H) to 2016 (1436H) and to compare the results with those from other regions of Saudi Arabia and elsewhere.

Materials and Methods

Relevant data of patients admitted to the King Fahad Hospital, Madinah with a fracture of the mandible during the study were collected from their medical records and radiographs. The age, gender, etiology, role of the patient, site, and number of fractures in the patients were evaluated. The data were analyzed by standard statistical methods.

Results

A total of 197 patients with fracture of the mandible were admitted in the period of the study by the Oral Maxillofacial Surgery Department, King Fahad Hospital, Madinah. There were 165 male and 32 female patients. The ages ranged from 3 to 86 years with a mean of 24 years. A total of 260 fractures of Mandible were documented. The largest number (113) of patients was found in the age group between 16 and 30 years. Trauma caused by motor vehicle road traffic accidents (RTAs) was the main etiology of the fractures followed by falls and assault. The majority of the patients were in the role of vehicle drivers. The condylar anatomical site of mandible was most frequently affected and constituted the largest number (103) of fractures followed by the angle (51), parasymphysis (45), and then by the body (23) of the mandible. Dentoalveolar fractures were present in 22 cases. Very less number of coronoid fractures (7), followed by those of the ramus (5), and least number at the symphysis (4) of the mandible were found.

Conclusion

RTA was the most common etiology for trauma and fracture of the mandible. The males outnumbered the female patients, the largest number of patients with trauma and mandible fracture was found in the age group between 16 and 30 years and frequency of condylar fractures was higher.