[Experimental study on accelerated healing of jaw fracture using gelatin sponge compound growth factor].

OBJECTIVE: To explore the role and mechanism of drug delivery systems using growth factor combined with gelatin sponge on accelerating the healing of jaw fracture and to seek better treatment of accelerating the maxillofacial fracture. METHODS: About 100 µg recombinant human bone morphogenetic protein (BMP)-2 was completely dissolved in 1 mL recombinant bovine basic fibroblast growth factor (bFGF), and the solution (40 µL) was dropped in gelatin sponge (0.5 cm×0.5 cm×1.0 cm). Then, it was freeze dried and prepared into bFGF/BMP/gelatin sponge delivery systems. The mandibular fracture model on two sides were prepared in 12 New Zealand rabbits and randomly divided into two groups. The left side was the control group, which was only fixed with titanium plates. The right side was the experimental group, in which bFGF/BMP/gelatin sponge delivery systems were put under the titanium plates. General observation, X-ray, and histological examination were taken at 2, 4, and 12 weeks after surgery. RESULTS: After 2 weeks, more fibrous tissues were seen between the fracture ends in the experimental group than in the control group. After 4 weeks, fibrous fracture callus were seen in the fracture gap in the experimental group. The ingrowths of fibrous tissue and blood vessels were seen in the control group. The fracture healing of the experimental group was significantly faster than the control group at 2 and 4 weeks. After 12 weeks, the experimental and control groups all healed completely. CONCLUSIONS: bFGF/BMP/gelatin sponge can accelerate and improve fracture healing; thus, it has better clinical application prospect.

Dental Trauma in a Pediatric Emergency Department Referral Center.

OBJECTIVE: The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department. METHODS: We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition. RESULTS: We identified 108 children with dental and if present, associated oral injuries. The median age was 12.3 years, the most common tooth injured were the primary (25.9%) or permanent (62%) upper central incisors, and the majority of subjects presented in the afternoon (mean time was 3:50 PM, SD ±24 minutes). A large proportion of dental injuries occurred in patients with permanent dentation (62%) and half of all children had more than 1 tooth injury. The majority of children (75%) were evaluated by either pediatric dental, oral surgery, or otolaryngology services, whereas 3.7% of the cases required multiple services. Twenty-five percent of children had an associated jaw fracture. Eighty-three percent of children were discharged home, of those, 49.1% were prescribed opioids, and 38.3% oral antibiotics. CONCLUSIONS: Emergency departments are often relied upon to evaluate and treat simple and complex dental and oral injuries. The ability to use a multidisciplinary team to manage pediatric oral and dental trauma is essential for care.