Impact of the COVID-19 on the epidemiology of maxillofacial fractures surgically treated in a Cuban university hospital / Impacto del COVID-19 en la epidemiología de las fracturas maxilofaciales tratadas quirúrgicamente en un hospital universitario cubano

Introduction: COVID-19 pandemic has had a significant impact on people's behavior. Aim: To evaluate the impact of the COVID-19 on the epidemiology of maxillofacial fractures surgically treated in a Cuban university hospital. Methods: This research involved a 4-year descriptive, comparative, retrospective and cross-sectional study. Patients surgically treated between March 1 and December 31, 2020 (COVID-19 period) were compared with those who had undergone surgery between the same date in the years 2017-2019 (non-pandemic period). Age, sex, residence, year, month, alcohol consumption at the time of trauma, etiology, fractures types, and number of fractures per patient were recorded. Results: A decline in patients with maxillofacial fractures in 2020 (n=25) was observed when compared to equivalent periods in the three previous years (2017: n=37; 2018: n=31; 2019: n=41), respectively, with an annual average reduction of 31.19 percent. Interpersonal violence was found to be the paramount etiological factor for maxillofacial fractures during the comparison periods (2017-2019); however, road traffic accident prevailed in the 2020 (n=12; 48 percent). There was a small increase in the number of alcohol-related fractures (56 percent in 2020 vs 46.34 percent, 41.94 percent, and 51.35 percent in 2019, 2018, and 2017, respectively). Conclusion: COVID-19 impacted on the epidemiology maxillofacial fractures surgically treated in this Cuban university hospital (AU)

Introducción: La pandemia de la COVID-19 ha tenido un impacto significativo en el comportamiento de la población. Objetivo: Evaluar el impacto de la COVID-19 en la epidemiología de las fracturas maxilofaciales tratadas quirúrgicamente en un hospital universitario cubano. Métodos: Esta investigación consistió en un estudio descriptivo, comparativo, retrospectivo y transversal de 4 años de duración. Se compararon los pacientes intervenidos quirúrgicamente entre el 1 de marzo y el 31 de diciembre de 2020 (periodo COVID-19) con los intervenidos entre la misma fecha en los años 2017-2019 (periodo no pandémico). Se registraron edad, sexo, residencia, año, mes, consumo de alcohol en el momento del traumatismo, etiología, tipos de fracturas y número de fracturas por paciente. Resultados: Se observó un descenso de pacientes con fracturas maxilofaciales en 2020 (n=25) en comparación con periodos equivalentes de los tres años anteriores (2017: n=37; 2018: n=31; 2019: n=41), respectivamente, con una reducción media anual del 31,19 poe ciento. Se observó que la violencia interpersonal fue el factor etiológico primordial de las fracturas maxilofaciales durante los periodos de comparación (2017-2019); sin embargo, el accidente de tráfico prevaleció en el 2020 (n=12; 48 por ciento). Hubo un pequeño aumento en el número de fracturas relacionadas con el alcohol (56 por ciento en 2020 frente a 46,34 por ciento, 41,94 por ciento y 51,35 por ciento en 2019, 2018 y 2017, respectivamente). Conclusiones: La COVID-19 impactó en la epidemiología de fracturas maxilofaciales atendidas quirúrgicamente en este hospital universitario cubano (AU)

Functional recovery time after facial fractures: characteristics and associated factors in a sample of patients from southern Brazil / Tempo de recuperação funcional após fraturas faciais: perfil e fatores associados em amostra de pacientes do sul do Brasil

ABSTRACT Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.

RESUMO O entendimento da causa, da gravidade e do tempo decorrido para o restabelecimento das funções de lesões maxilofaciais pode contribuir para o estabelecimento de prioridades clínicas objetivando o efetivo tratamento e prevenção dos traumatismos de face. Assim, o objetivo deste estudo foi compreender quais os fatores associados ao restabelecimento das funções mastigatórias, oculares e nasais em vítimas de trauma de face, estimando o tempo para recuperação das funções, após o tratamento cirúrgico. Foram analisados 114 prontuários de pacientes atendidos no Hospital de Montenegro que compareceram às consultas de acompanhamento por até 180 dias. Para a análise do tempo para a recuperação, foi realizada a análise de sobrevida, seguida da análise de COX. Observou-se que metade dos pacientes recuperaram as funções em até 20 dias, sendo que o tempo médio para recuperação dos traumas no complexo zigomático-orbitário-malar-nasal foi de 11 dias e do complexo maxilo - mandibular de 21 dias (HR: 1,5 (0,99 - 2,3) p=0,055). Embora o restabelecimento das funções tenha atingido taxas elevadas após abordagem cirúrgicas, faz-se necessária a análise dos casos de insucessos bem como os impactos econômicos e as estratégias de prevenção associados aos traumas de face a fim de qualificar o serviço prestado à população.

Maxillofacial fractures in Hyderabad city: a 1-year study of 448 patients

This descriptive study assesses the cause, type, incidence and treatment modalities of maxillofacial fractures managed at our center during the 1-year of time period. Descriptive Study. This study was carried out at Department of Oral and Maxillofacial surgery Institute of Dentistry LUMHS, Jamshoro. A total 384 cases were studied. A detailed history, clinical examination was performed and finally diagnosis confirmed with the help of radiograph, at least two radiographs were taken. Records of patients enrolled who were either treated in the Emergency Room, Out-Patients Department or in the Ward. A numbers of parameters, including Age, gender, cause, type of injury and treatment provided were assessed. Out of 448 patients, 318 were male and 130 were female. Majority of patients belong to 3[rd] decade [21-30 years] of life. Road traffic accidents 56.91% accounted for the majority of cases of maxillofacial fractures followed by assault 10.49%, fall 19.86%, sports 4.68% Mandible was seen as the most commonly fractured bone 44% [287] followed by maxillary bone 23.92% [156], Zygomatic bone complex 18.40% [120] and majority of the bony maxillofacial injuries were treated by open reduction and internal fixation [ORIF]. Males of age group 21-30 years were more frequently involved in maxillofacial fractures. Road traffic accident was the most common cause of trauma in this part of the country, which requires proper implementation of traffic legislation use of helmet while riding the cycle or motor bike. Mandible was fractured in majority of cases; common treatment modality of maxillofacial fractures at our center was Maxillo-mandibular fixation with miniplates

Retrospective study of prevalence of face fractures in southern Brazil.

Context: Trauma has been an important public health problem worldwide. Facial injuries are among the most common types of trauma treated at emergency departments, associated or not with injuries in other anatomic sites. The patterns of facial fractures are usually affected by geography and socioeconomic conditions. Aim: To investigate the prevalence of facial fractures in Lages, state of Santa Catarina, southern Brazil, from September 2003 to August 2008. Settings and Design: Cross-sectional, retrospective, epidemiological study. Materials and Methods: Data on patients' gender, age, etiological agent, and facial region affected by fracture were collected from the charts of patients treated with facial fractures. Statistical Analysis Used: Qualitative variables were expressed as absolute and relative frequencies, and quantitative variables as means and standard deviation. The Chi-square test was used to evaluate the association between gender, traffic accidents and facial region affected. The association between etiological agents and facial region affected was assessed using the chi-square test and the adjusted residuals analysis. Results: 492 patients presented with oral and maxillofacial trauma, with 988 facial fractures; 80.9% of the patients were men, and the most frequent age group was 21-30 years (29.5%). The most frequent causes of fractures were: Traffic accidents in 27.9%, physical assault in 14.9%, and bicycle falls in 10.5%; several other causes scored below 10%. Conclusion: Regular publication of epidemiological data is extremely important for the implementation of prevention campaigns and for an increased awareness of the etiology of fractures affecting the face and other anatomic sites.

Complications of exodontia: A retrospective study.

Purpose: The purpose of this study was to analyze the incidence of various complications following routine exodontia performed using fixed protocols. Materials and Methods: A total of 22,330 extractions carried out in 14,975 patients, aged between 14 and 82 years, who reported to the Department of Oral and Maxillofacial Surgery at Padmashree Dr. D. Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, were evaluated for various complications. Results: The most common complications encountered were tooth fracture, trismus, fracture of cortical plates and dry socket. Wound dehiscence, postoperative pain and hemorrhage were encountered less frequently. Luxation of adjacent teeth, fracture of maxillary tuberosity, and displacement of tooth into adjacent tissue spaces were rare complications. Conclusion: The practice of exodontia inevitably results in complications from time to time. It is imperative for the clinician to recognize impending complications and manage them accordingly.

Analysis of 185 maxillofacial fractures in the state of Santa Catarina, Brazil

A retrospective study was performed to assess maxillofacial fractures in patients treated at a public hospital from 2002 to 2006. The data collected included age, gender, etiology, type of injury, treatment modalities and period of treatment. Causes were grouped into seven categories: road traffic collisions, sports accidents, occupational accidents, gunshot fractures, falls, violence and other causes. The analyses involved descriptive statistics, the Chi-squared Test and the Fisher Exact Test. Records from 132 patients sustaining 185 maxillofacial fractures were evaluated. The mandible (54.6 percent) was the most commonly fractured bone in the facial skeleton, followed by the zygoma (27.6 percent). The mean age of the patients was 37.7 years, and the male:female ratio was 4.3:1. Most fractures occurred in adults with ages ranging from 18 to 39 years. A significant statistical relation was found between the age and the etiology of the trauma (p < 0.05), and between the number of fractured sites and the age of the patient (p < 0.05). Considering the age groups, accidents were the most frequent cause of maxillofacial fractures in the age group between 18 to 39 years, and interpersonal violence was the most frequent cause of maxillofacial fractures in the age group between 40 to 59 years. Treatment was performed on the same day as the diagnosis in 44.7 percent of the patients. Open surgery with internal stable fixation was indicated for most of the patients. Facial fractures occurred primarily among men under 30 years of age, and the most common sites of fractures in the face were the mandible and the zygomatic complex. Traffic road collisions were the main etiologic factor associated with maxillofacial trauma.

Fracturas maxilofaciales y factores asociados en derechohabientes del IMSS Campeche, México: Análisis retrospectivo 1994-1999 / Maxilofacial Fractures and Associated Factors in Campeche Mexico, Instituto Mexicano del Seguro Social Medical Insurance Policyholders: Retropsective Analysis 1994-1999

Objetivo: determinar la prevalencia y distribución de fracturas maxilofaciales (FMs) en derechohabientes del Instituto Mexicano del Seguro Social (IMSS) Campeche. Material y métodos: estudio transversal con datos de pacientes atendidos en el departamento de Cirugía Oral y Maxilofacial (enero-1994 a diciembre-1999) del IMSS Campeche. Se utilizaron registros diarios, libretas de programación quirúrgica y expedientes de 1611 pacientes para determinar la presencia de FMs la edad, el sexo y la calidad del asegurado. FI análisis se realizó en STATA 7 utilizando X². Se calcularon razones de momios (RM) con intervalos de confianza al 95% (1C95%). Resultados: la prevalencia de FMs fue de 9.4%. la media de edad fue de 31.04 ± 15.49 años. El mayor porcentaje de FMs fueron las Dentó alveolares (26.3%), seguida de las del ángulo mandibular (20.4%) y de las del cuerpo mandibular (13.2%). El sexo masculino estuvo fuertemente asociado a la presencia de FMs (RM=6.1; 1C95% 4.08,9.12). los grupos de edad con mayor asociación a FMs fueron los de 41-50 (RM=3.30 1C95% 1.57, 6.96) y el de 31-40 (RM=2.871C95%1.53, 5.55). los trabajadores presentaron una asociación superior (RM=6.25 1C95% 3.21,13.56) a los otros grupos de asegurados. Conclusiones: las características epidemiológicas de FMs fueron similares a las reportadas en la literatura especializada. Se observó principalmente en hombres y en los grupos de edad intermedia. los patrones de fracturas en los pacientes estudiados fueron diferentes según el grupo de edad al que pertenecían.

Objective: To determine prevalence, distribution, and associated factors of maxillofacial fractures (MFs) among third-party insurance plan patients. Method: A cross-sectional and descriptive study with data of patients from Oral and Maxilofacial Surgery Department (January 1994 to December-1999) at the Instituto Mexicano del Seguro Social in Campeche, Mexico, was carried out. Daily registries, surgical programming lists' and charts off 611 patients were used to determine presence of MFs, age, sex, and status of the insured. Analysis was made in STATA 7 using X². Odds ratio (OR) with confidence intervals to 95% were calculated (1C9 5%). Results: The prevalence of MFs was 9.4%. The age average was 31.04 +15.49 years old. The major percentage of MFs were dentoalveolar fractures (26.3%), followed by mandibular angle (20.4%) and mandibular body (13.2%). Being a male was strongly associated with presence of MFs (OR=6. 1; 1C95% 4.08, 9.12). The groups of age with greater association to MFs were those of 41-50 (RM-3.30 1C 95% 1.57, 6.96) and those of 31-40 (RM=2.87 1C95% 1.53,5.55). The workers-category displayed a superior association (RM=6.251C 95% 3.21, 13.56) to the other groups of the insured category. Conclusions: The epidemiologic characteristics of MFs were similar to those reported in the specialized literature. Appearing mainly in men and intermediate age groups ages. The patterns of fractures in the studied patients were different according to the age group to which they belonged.