Evaluation of Efficacy of Low Intensity Pulsed Ultrasound in Facilitating Mandibular Fracture Healing-A Blinded Randomized Controlled Clinical Trial.

PURPOSE: The aim of the study was to evaluate the role of low intensity pulsed ultrasound (LIPUS) in improving fracture healing in American Society of Anesthesiologists Class II patients with mandibular fractures. MATERIALS AND METHODS: A randomized controlled clinical trial of 40 patients with mandibular fractures was conducted. The patients were randomly allocated to the study and control groups, with 20 members each. A standardized surgical protocol was followed to manage the fractures by open reduction and internal fixation. After fixation, the study group received LIPUS stimulation (1.5 MHz, 30 mW/cm2) on postoperative days 4, 8, 14, and 20 for 20 minutes daily; the control group received no LIPUS stimulation. The outcome parameters assessed were postoperative pain, wound healing, teeth mobility, and radiographic and ultrasound fracture healing. RESULTS: The study variables were analyzed using the independent samples t test or Mann-Whitney U test. The pain score was reduced in the study group on all postoperative days (P < .001). The mean amount of wound healing was better in the study group than in the control group on days 5 and 9 (P < .004 and P < .019, respectively). The mean score for the ultrasound assessment of fracture healing was greater in the study group, with a statistically significant difference. CONCLUSIONS: LIPUS application reduced postoperative pain and facilitated fracture healing in patients with compromised healing potential.

Comparison of two incisions for open reduction and internal fixation of mandibular body fractures: A randomised controlled clinical trial evaluating the surgical outcome.

PURPOSE: The purpose of the study is to compare the surgical access and post-operative outcome of two intra-oral incisions used for approaching a mandibular body fracture. METHODS: This clinical trial involved 60 patients with mandibular body fractures who were randomly allocated to control and study groups. The fractures were approached using the routine vestibular incision in the control group and crevicular incision with vertical release in the study group. The effects of incision design on the post-surgical outcome variables like swelling, trismus, paresthesia, wound healing and gingival recession were statistically analysed with non-parametric tests by using SPSS 22.0 software. Comparison of continuous variables between the groups and time points was done using Mann Whitney test and Friedman test respectively. Chi-square test was used to compare proportions between groups. Dunn's test with Bonferroni correction was used for pair wise comparisons. RESULTS: The study group demonstrated favourable surgical outcome in the immediate postoperative phase as compared to the control group. The difference in mouth opening, swelling and neurosensory impairment between the two groups was found to be statistically significant (p < 0.05). CONCLUSION: Crevicular incision was found to be an ideal alternative to vestibular incision in achieving surgical access and fixation of mandibular body fractures with reduction in postoperative patient discomfort and better surgical outcome.

Knotless Suture for Wound Closure in Intraoral Surgery-A Report of 2 Cases.

Suturing is the most commonly used method of wound closure in intraoral surgery, whose objectives include anatomic reapproximation of tissues, hemostasis, and prevention of wound contamination by providing an adequate tissue seal. Conventional suturing in the oral cavity is difficult because of the restricted space for instrumentation. Further, knots act as a nidus to food entrapment and microbial colonization. The knotless (barbed) suture could be considered an ideal alternative to eliminate these limitations. This report describes the effectiveness of the intraoral use of the knotless suture after open reduction and internal fixation of maxillofacial fractures.