ABSTRACT
Oral and maxillofacial trauma is influenced by various factors, including regional characteristics and social background. Due to the coronavirus disease 2019 (COVID-19) pandemic, a state of emergency was declared in Japan in March 2020. In this study, we aimed to examine the dynamics of patients with oral and maxillofacial trauma over a 12-years period using interrupted time-series (ITS) analysis. Patients were examined at the Shimane University Hospital, Maxillofacial Trauma Center from April 2012 to April 2023. In addition to general patient characteristics, data regarding the type of trauma and its treatment were obtained from 1203 patients (770 men and 433 women). Group comparisons showed significant differences in age, trauma status, method of treatment, referral source, route, and injury occasion. ITS analysis indicated significant changes in combined nasal fractures, non-invasive reduction, and sports injuries (P < 0.05), suggesting COVID-19 significantly impacted oral and maxillofacial trauma dynamics. A pandemic of an infectious disease may decrease the number of minor trauma cases but increase the number of injuries from outdoor activities, resulting in no overall change in the dynamics of the number of trauma patients. Medical systems for oral and maxillofacial trauma should be in place at all times, independent of infectious disease pandemics.
Subject(s)
COVID-19 , Interrupted Time Series Analysis , Maxillofacial Injuries , Humans , COVID-19/epidemiology , Female , Male , Maxillofacial Injuries/epidemiology , Adult , Middle Aged , Aged , Japan/epidemiology , Pandemics , Young Adult , Adolescent , SARS-CoV-2/isolation & purification , Trauma Centers/statistics & numerical data , Child , Aged, 80 and overABSTRACT
Bone stabilization using osteosynthesis devices is essential in maxillofacial surgery. Owing to numerous disadvantages, bioresorbable materials are preferred over titanium for osteofixation in certain procedures. The biomaterials used for osteosynthesis in maxillofacial surgery have been subdivided into four generations. No study has compared the tissue responses generated by four generations of biomaterials and the feasibility of using these biomaterials in different maxillofacial surgeries. We conducted an in vivo animal study to evaluate host tissue response to four generations of implanted biomaterial sheets, namely, PLLA, PLLA/PGA, u-HA/PLLA, and u-HA/PLLA/PGA. New bone volume and pertinent biomarkers for bone regeneration, such as Runx2, osteocalcin (OCN), and the inflammatory marker CD68, were analyzed, and the expression of each biomarker was correlated with soft tissues outside the biomaterial and toward the host bone at the end of week 2 and week 10. The use of first-generation biomaterials for maxillofacial osteosynthesis is not advantageous over the use of other updated biomaterials. Second-generation biomaterials degrade faster and can be potentially used in non-stress regions, such as the midface. Third and fourth-generation biomaterials possess bioactive/osteoconductivity improved strength. Application of third-generation biomaterials can be considered panfacially. Fourth-generation biomaterials can be worth considering applying at midface due to the shorter degradation period.
ABSTRACT
Maxillofacial bone defects are treated by autografting or filling with synthetic materials in various forms and shapes. Electrospun nanobiomaterials are becoming popular due to their easy placement and handling; combining ideal biomaterials extrapolates better outcomes. We used a novel electrospun cotton-like fiber made from two time-tested bioresorbable materials, ß-TCP and PLLA/PGA, to check the feasibility of its application to maxillofacial bone defects through an in vivo rat mandibular bone defect model. Novel ß-TCP/PLLA/PGA and pure ß-TCP blocks were evaluated for new bone regeneration through assessment of bone volume, inner defect diameter reduction, and bone mineral density. Bioactive/osteoconductivity was checked by scoring the levels of Runt-related transcription factor x, Leptin Receptor, Osteocalcin, and Periostin biomarkers. Bone regeneration in both ß-TCP/PLLA/PGA and ß-TCP was comparable at initial timepoints. Osteogenic cell accumulation was greater in ß-TCP/PLLA/PGA than in ß-TCP at initial as well as late phases. Periostin expression was more marked in ß-TCP/PLLA/PGA. This study demonstrated comparable results between ß-TCP/PLLA/PGA and ß-TCP in terms of bone regeneration and bioactivity, even with a small material volume of ß-TCP/PLLA/PGA and a decreased percentage of ß-TCP. Electrospun ß-TCP/PLLA/PGA is an ideal nanobiomaterial for inducing bone regeneration through osteoconductivity and bioresorbability in bony defects of the maxillofacial region.