The profile of patients with maxillofacial trauma due to interpersonal violence treated in a hospital emergency room.

AIM: This study evaluated records of patients with maxillofacial trauma due to interpersonal violence (IPV) being treated in the emergency room of a level I trauma center hospital in São Paulo, Brazil. MATERIAL AND METHODS: Data of patients with maxillofacial trauma due to IPV recorded between January 2019 and December 2019 were retrospectively examined. Personal data, days on which they experienced IPV, and the type of maxillofacial trauma sustained were extracted and statistically analyzed (p < .050). RESULTS: During the analysis, 1034 patients with maxillofacial trauma were identified; of these patients, 292 (28.2%) who experienced trauma due to IPV were included in this study. There was a mean age of 32.6 years and the most common type of trauma was soft tissue injuries (38.7%). Mandible and nose fractures were more prevalent in males and females, respectively. Our data, when compared with other studies on maxillofacial trauma due to IPV, showed a lower prevalence and male-to-female ratio, and a higher presence of dentoalveolar trauma. Additionally, our data when compared with studies on maxillofacial trauma due to other causes showed lower mean age and male-to-female ratios, and a higher occurrence of nose fractures differing from the predominance of mandibular fractures. CONCLUSION: Oral and maxillofacial surgeons must be able to suspect and identify cases due to IPV among their patients with trauma. With our results, although each case has its individuality, we can suggest that cases of maxillofacial trauma in young, female, and nasal fracture patients may be suspicious for IPV.

Characteristics and management of teeth in the line of mandibular fractures treated with internal fixation.

BACKGROUND/AIMS: The ideal management of teeth in the line of mandibular fractures is unclear and controversial. The aim of this study was to analyze the characteristics and management of teeth in the line of mandibular fractures treated with open reduction and internal fixation. MATERIAL AND METHODS: Medical records of patients with mandibular fractures in the symphysis, body and angle regions seen between July 2019 and January 2021 were evaluated. Personal data, etiology, location of fractures, characteristics of the teeth involved in the fracture lines and management were collected. The relationship between the fracture lines and the periodontium was classified according to Kamboozia & Punnia-Moorthy. Fractures were divided into two groups according to the management of the tooth in the fracture line: removal and retention. The likelihood ratio test was used (p < .050). RESULTS: During the study period, 52 patients with mandibular fractures were seen, of which 42 patients (83.3% men) with a mean age of 29.6 years and 54 fractures were included. The most frequent location was the angle of the mandible (41.3%) (p < .001). The removal group represented 35.2% of the fractures, and the retention group represented 64.8%. The most frequently removed tooth was the third molar (p < .001), and the most frequent classification of dental involvement in the fracture line was type II (p = .047). There was no correlation between age, gender, or etiology and the management of the teeth involved. CONCLUSION: The retention of teeth in the fracture line predominated, and the third molar in angle fractures was the most often removed tooth when the fracture line followed the root surface but did not cross the apical region, probably due to the greater frequency of this type of relationship between the fractures and the periodontium.

Effects of light-emitting diode (LED) therapy on sensory changes in the inferior alveolar nerve after surgical treatment of mandibular fractures: a randomized controlled trial.

PURPOSE: A randomized controlled trial was performed to evaluate the effects of light-emitting diode (LED) therapy on sensory changes in the inferior alveolar nerve after surgical treatment of mandibular fractures. METHODS: Patients admitted with surgically treated mandibular fractures between January 2018 and December 2019 were evaluated. Personal data, fracture location, fracture type, and dislocation degree were obtained. The cases were randomly allocated into two groups: LED therapy (LEDT) (57 points of 660 nm and 74 points of 850 nm, 6.4 mV/cm2, and 7.64 J) with the use of a prototype device and control (CTRL). For 6 months, tactile and thermal tests were used in the mental region. Data were analyzed using the Mann─Whitney U test and likelihood ratio test (p ≤ 0.050). RESULTS: The study included 42 patients, 25 of whom had bilateral fractures and 17 had unilateral fractures, totaling 67 fractures. The mean values of the tactile and thermal sensitivity tests were lower in the LEDT group in all evaluation periods. There was a significant difference between the groups in the parasymphysis location, displacement < 5 mm, and intraoral access. Sensory changes were observed in 68.7% of all fractures upon admission, with 91.2% in the LEDT group and 78.8% in the CTRL group demonstrating complete remission during the final period of the study. CONCLUSION: LED photobiomodulation accelerated the process of sensory change remission. There was an influence of the fracture location, degree of displacement, and surgical access, with a better response in the LEDT group.