Treatment of condylar fractures with an intraoral approach using an angulated screwdriver: results of a multicentre study.

BACKGROUND: This multicentre study aimed to investigate long-term radiographic and functional results following the treatment of condylar fractures using an angulated screwdriver system and open rigid internal fixation with an intraoral surgical approach. METHODS: Twenty-nine patients with a total of 32 condylar fractures were evaluated. The patients were investigated prospectively based on the following variables: age, sex, aetiology, side, location and classification of the fracture, degree of displacement, associated fractures, surgical approach, oral health status, type of osteosynthesis plate, duration of surgery, mouth-opening, complications, and duration of follow-up. RESULTS: The fractures were classified as subcondylar (n = 25) or condylar neck (n = 7). Mean patient age was 36.38 ± 16.60 years. The median duration of postoperative follow-up was 24.39 ± 13.94 months. No joint noise, weakness of the facial nerve, joint pain, or muscle pain was observed. An additional retromandibular approach was necessary to enable the treatment of one subcondylar fracture with medial displacement. CONCLUSION: Subcondylar or condylar neck fractures with medial or lateral displacement can be treated using an intraoral approach with satisfactory results with the advantages of the absence of visible scarring, the avoidance of facial nerve injury, and the ability to obtain rapid access to the fracture.

Treatment of zygomatic arch fracture with lag screws.

Zygomatic arch fractures often occur as part of a zygoma fracture or Le Fort type III fractures of the maxillary. Isolated fractures of the zygomatic arch comprise around 10% of all zygoma fractures. The main etiologic factors are traffic accidents, falls, assaults, and sport accidents. Treatment may involve minimally invasive surgical procedures for slightly dislocated fractures or surgery with more extensive access for large dislocations of bone segments. This article reports the case of a 41-year-old male victim of physical aggression to the face with a steel sickle with an exposed, unstable fracture of the zygomatic arch. The patient underwent general anesthesia, and after the reduction of the fractures, the bone segments were fixed with 2.0-mm screws.

Correlation of the radiographic and morphological features of the dental follicle of third molars with incomplete root formation.

The objective of this study was to determine the correlation of the radiographic and morphological features of the dental follicle of unerupted third molars with incomplete root formation. A cross-sectional study was carried out with 56 patients (105 teeth) aged 13 to 24 years. Panoramic radiography was used to determine the stage of root formation to locate and measure pericoronal radiolucency. The width of the dental follicle ranged from 0.0 to 4.0 mm, the distal face being the one most frequently involved, and stage 7 of root formation showing the highest incidence. An inactive enamel reduced epithelium and inactive epithelium remnant also showed a high incidence. Dense connective tissue showed a high incidence, chronic inflammation was infrequent and calcification was a common finding. There was a significant association between the progression of the rhizogenesis and the transformation of the enamel reduced epithelium into a stratified squamous epithelium. No significant association was found between rhizogenesis and the other morphological findings or between the latter and the width of the pericoronal space. It was concluded that there was no clinically significant correlation between the radiographic and morphological features. Every asymptomatic unerupted third molar should be followed up and the follicular tissue analyzed.

Fracture of the coronoid and pterygoid processes by firearms: case report.

A rare case of fracture of the coronoid and the pterygoid process caused by firearms is described. A 28-year-old male was hit by a bullet in the face, resulting in restricted mouth opening, difficulty in chewing and pain when opening the mouth. Clinical examination revealed a perforating wound in the right parotid region and a similar wound on the left side of the same region. A CT scan showed comminuted fracture of the left coronoid process and bilateral comminuted fracture of the pterygoid processes. Treatment was conservative, speech therapy was conducted and it was successful. Details of the clinical signs, radiology (3D-CT scan), treatment and follow-up are presented.