Incidencia de consultas por fracturas maxilofaciales en un servicio de urgencias odontológicas del Área Metropolitana de Buenos Aires / Incidence of consultations for maxillofacial fractures in a dental emergency department in the Metropolitan Area of Buenos Aires

Objetivo: Describir la incidencia, la causa, el patrón y el tratamiento de fracturas maxilofaciales en sujetos que solici- taron atención en un Servicio de Urgencias Odontológicas del Área Metropolitana de Buenos Aires. Materiales y métodos: Se analizaron las historias clíni- cas de los individuos que concurrieron al Servicio de Urgencias y Orientación de Pacientes de la Facultad de Odontología de la Universidad de Buenos Aires (SUyOP) en el período compren- dido entre marzo de 2018 y diciembre de 2019. Se registró la fre- cuencia de consultas vinculadas con diagnóstico de algún tipo de fractura del esqueleto maxilofacial y en el caso de estos pacien- tes, se registraron sexo, edad, etiología, ubicación y tratamiento. Resultados: Durante el periodo evaluado asistieron al SUyOP un total de 13.919 pacientes por algún tipo de urgen- cia odontológica, entre los cuales 47 (0,33%) se presentaron con traumatismos en la región bucomaxilofacial; 39 fueron del sexo masculino (83%). En total fueron diagnosticadas 66 frac- turas. La edad media se extendió entre los 30 y los 51 años. Las fracturas se encontraron con mayor frecuencia en la mandíbu- la (95,45%). La agresión interpersonal fue la principal causa (53,19%). El tratamiento realizado con mayor frecuencia fue el bloqueo intermaxilar en el 57,44% de los pacientes. Conclusión: Las fracturas de maxilar inferior fueron las que se registraron con mayor frecuencia. Si bien estas fracturas no ponen en riesgo la vida del paciente, la falla en el diagnóstico y el tratamiento apropiados puede derivar en la pérdida de fun- ciones del sistema estomatognático, y desarrollar deformidades secundarias que requieren de un tratamiento más complejo (AU)

Aim: To describe the incidence, etiology, pattern and treat- ment of maxillofacial fractures in a dental emergency department of the Buenos Aires Metropolitan Area. Materials and methods: A study was conducted, re- cording sex, age, etiology, location and treatment of maxillofa- cial fractures in patients who visited the Emergency and Patient Orientation Service of the School of Dentistry of the University of Buenos Aires (SUyOP) from March 2018 to December 2019. Data were obtained from dental medical records. Results: During the evaluated period, a total 13,919 pa- tients visited the SUyOP for dental emergencies, of whom 47 (0.33%) presented with trauma in the oral-maxillofacial region, and 39 were male (83%). Age range was 30 to 51 years. Over- all, 66 fractures were diagnosed. Fractures were most frequent in the mandible (95.45%). Interpersonal aggression was the most prevalent cause (53.19%). The most frequent treatment was inter- maxillary fixation, which was performed in 57.44% of the cases. Conclusion: Fractures of the lower jaw were the most fre- quently reported. Although these fractures are not life-threaten- ing, failure to diagnose and treat them properly can lead to loss of function of the stomatognathic system and development of sec- ondary deformities requiring more complex treatment (AU)

Multicenter epidemiological study of maxillofacial trauma: a one-year retrospective- descriptive assessment of 1356 cases in a colombian metropolitan region / Estudio epidemiológico multicéntrico de trauma maxilofacial: evaluación retrospectiva-descriptiva de un año, de 1356 casos en una región metropolitana de Colombia

Background: This retrospective study was conducted to identify the epidemiological profile and treatment modalities linked to the maxillofacial trauma (MFT) managed in the Maxillofacial Surgery Departments of seven hospital centers in Antioquia, Colombia. Material and Methods: Clinical records with specific attention to sociodemographic characteristics, mechanisms of injury, type of MFT, location of injuries, and treatment modalities of MFT were collected from January to December 2017. Descriptive analyses using Pearson's chi-square tests were performed. Results: A total of 1356 records were retrieved. Males were significantly more affected, with a male-to-female ratio of 3.85:1. The most susceptible age group involved was young adults (18 to 40 years). A low percentage of alcohol (9.3%) and drugs consumption (2.5%) was recorded. Most common causes of MFT were road traffic accidents (RTA), falls, and interpersonal violence (IPV). Most injuries involved both soft and hard tissues followed by hard tissues and isolated open soft tissue injuries. Among fractures, the middle third was the most commonly affected site and the utmost method of treatment was open reduction and internal fixation. Conclusion: Within the limitations of the evidence available, this study has demonstrated that the gender, age stratum, and etiological factors, such as RTA, falls, and IPV, but no alcohol and/or psychoactive substances consumption, may have a significant influence on the prevalence, patterns, and treatment modalities of MFT in this sample population.

Antecedentes: Este estudio retrospectivo se realizó para identificar el perfil epidemiológico y las modalidades de tratamiento vinculados al Trauma Maxilofacial (TMF) atendido en los Servicios de Cirugía Maxilofacial de siete centros hospitalarios de Antioquia, Colombia. Material y Métodos: Se recopilaron historias clínicas con atención específica a las características sociodemográficas, mecanismos de lesión, tipo de TMF, ubicación de las lesiones y modalidades de tratamiento de TMF de enero a diciembre de 2017. Análisis descriptivos utilizando el chi-cuadrado de Pearson fueron realizados. Resultados: Se recuperaron un total de 1356 registros. Los hombres se vieron significativamente más afectados, con una relación hombre-mujer de 3,85:1. El grupo de edad más susceptible involucrado fue el de los adultos jóvenes (18 a 40 años). Se registró un bajo porcentaje de consumo de alcohol (9,3%) y drogas (2,5%). Las causas más comunes de TMF fueron los accidentes de tránsito (ADT), las caídas y la violencia interpersonal (VIP). La mayoría de las lesiones involucraron tejidos blandos y duros, seguidas de tejidos duros y lesiones abiertas aisladas de tejidos blandos. Entre las fracturas, el tercio medio fue el sitio afectado con mayor frecuencia y el método de tratamiento más utilizado fue la reducción abierta y la fijación interna. Conclusion: Dentro de las limitaciones de la evidencia disponible, este estudio ha demostrado que el género, el estrato etario y los factores etiológicos, como ADT, caídas y VIP , pero no el consumo de alcohol y/o sustancias psicoactivas, pueden tener una influencia significativa en la la prevalencia, los patrones y las modalidades de tratamiento de TMF en esta poblaión muestral.

Epidemiologia do trauma maxilofacial: uma análise retrospectiva de 1230 casos / Epidemiology of maxillofacial trauma: a retrospective analysis of 1230 cases

Introdução: O trauma representa um considerável problema de saúde pública devido ao elevado índice de morbidade, incidência e prevalência, além de representar um alto custo em assistência hospitalar. Deve-se levar em consideração as variações geográficas, culturais e próprias da amostra a ser coletada ao estudar o tema. Este trabalho tem por objetivo realizar um levantamento epidemiológico, dos pacientes com fraturas faciais atendidos em um hospital terciàrio. Métodos: Foram revisados retrospectivamente os dados dos prontuários eletrônicos de pacientes, atendidos entre maio de 2013 e abril de 2018 no Hospital Cristo Redentor de Porto Alegre/RS. Resultados: Foram incluídos 1230 pacientes com um total de 2241 fraturas faciais, sendo a mandíbula o sítio mais acometido (45,65%), seguido pelo complexo orbitozigomáticomaxilar (31,28%). O fator etiológico mais observado foram os acidentes automobilísticos (32,2%), e o método de tratamento utilizado com maior frequência foi a redução aberta com fixação interna (RAFI), sendo aplicada em 377 pacientes (30,65%). Conclusões: Os resultados desta análise associados à divulgação contínua de dados atualizados que reflitam as realidades locais são determinantes na melhor compreensão desses eventos e na orientação de políticas de saúde públicas focadas em controle, prevenção e recuperação destes pacientes

Perfil Epidemiológico dos Pacientes com Fraturas / Epidemiological Profile of Patients with Fracture

Introdução: Os acidentes motociclísticos estão entre as causas mais frequentes de traumatismos faciais. O fato de a motocicleta ser um veículo leve e de fácil condução e o descumprimento à legislação atual contribuem para o aumento da incidência e da gravidade dessas fraturas. Metodologia: Foram entrevistados 123 pacientes, momento em que foram colhidas as seguintes variáveis: Dependentes: Faixa etária, gênero, local de procedência, uso de capacete, se havia ingerido bebida alcoólica antes do acidente, se possuia habilitação para motocicleta, ossos faciais fraturados e lesões em outras áreas do corpo. As fraturas faciais bem como as fraturas em outras áreas do corpo foram diagnosticadas após exame clínico e imaginológico. Resultados: Houve uma predominância de indivíduos do gênero masculino (85,4%) e de pacientes provenientes de cidades do interior do estado do Ceará (61,8%). Fraturas múltiplas da face ocorreram em 49,6% dos pacientes pesquisados. A maioria dos pacientes não utilizavam capacetes ou não possuíam habilitação (75,6% e 73,2%, respectivamente.), e 38,2% haviam ingerido bebida alcoólica antes do acidente. Foi observado ainda que 20.3% dos pacientes apresentavam fraturas em outros ossos do corpo que não a face. Conclusão: Observa-se que os acidentes motociclísticos correspondem a uma grande parcela das fraturas faciais e que a maior parte desses acidentes estão associados ao descumprimento da legislação... (AU)

Introduction: motorcycle accidents are among the most common causes of facial trauma. The fact that the motorcycle be a light vehicle and within easy driving and breach the current legislation contribute to the increased incidence and severity of these fractures. Methodology: We interviewed 123 patients, at which the following variables were collected: Dependents: age range, gender, place of origin, helmet use, if had been drinking before the accident, it has qualified for motorcycle, fractured facial bones and lesions in other areas of the body. Facial fractures and fractures in other areas of the body were diagnosed after clinical examination and imaginologic. Results: There was a predominance of male (85.4%) and patients from cities in the state of Ceará (61.8%). Multiple facial fractures occurred in 49.6% of patients surveyed. Most patients did not use helmets or had no qualifications (75.6% and 73.2% respectively.) And 38.2% had been drinking before the accident. It was also observed that 20.3% of patients had fractures in other bones of the body other than the face. Conclusion: It is observed that motorcycle accidents account for a large portion of facial fractures and that most of these accidents are associated with the breach of the legislation... (AU)

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.

Soccer-Related Facial Trauma: A Nationwide Perspective.

PURPOSE: Soccer participation continues to increase among all ages in the US. Our objective was to analyze trends in soccer-related facial injury epidemiology, demographics, and mechanisms of injury. MATERIALS AND METHODS: The National Electronic Injury Surveillance System was evaluated for soccer-related facial injuries from 2010 through 2014. Results for product code "soccer" were filtered for injures to the face. Number of injuries was extrapolated, and data were analyzed for age, sex, specific injury diagnoses, locations, and mechanisms. RESULTS: In all, 2054 soccer-related facial trauma entries were analyzed. During this time, the number of injures remained relatively stable. Lacerations were the most common diagnosis (44.2%), followed by contusions and fractures. The most common sites of fracture were the nose (75.1%). Of fractures with a reported mechanism of injury, the most common was head-to-head collisions (39.0%). Patients <19 years accounted for 66.9% of injuries, and athletes over 18 years old had a higher risk of fractures. CONCLUSIONS: The incidence of soccer-related facial trauma has remained stable, but the severity of such injuries remain a danger. Facial protection in soccer is virtually absent, and our findings reinforce the need to educate athletes, families, and physicians on injury awareness and prevention.

Traumatic dental injury.

BACKGROUND: The aim of this study was to retrospectively evaluate the incidence of traumatic dental injury and consequential dental impairment following road traffic accidents and to examine the factors that can affect the monetary value of compensation for bodily injury payable pursuant to current insurance regulations. METHODS: From 2004 to 2014, 7233 persons involved in road traffic accidents in the province of Messina, eastern Sicily, were examined by insurance physicians to assess bodily injury damage. Data were collected from cases of traumatic dental injury causing malocclusion and temporomandibular joint dysfunction, either alone or concomitant with injuries to other parts of the body. Injury characteristics and consequential bodily injury damage were classified and the incidence calculated using Microsoft Excel software. RESULTS: The incidence of traumatic dental injuries was 3% of the total population (195 subjects - 127 males and 68 females); the majority of cases (56%) involved riders of two-wheeled vehicles. A high percentage of riders received injury to one or more teeth, i.e. fractures and dislocations, more frequently to the anterior teeth (68%) than the posterior teeth because of their position in the dental arch. Temporomandibular joint injuries were far fewer (8%) and resulted from either direct or indirect trauma associated with severe head and/or neck injury. The incidence of permanent bodily damage consequential to these injuries was fairly low. CONCLUSIONS: Although the incidence of dental trauma following road traffic accidents is low, the monetary compensation for consequential dental impairment based on current insurance regulatory law is far from negligible.

Fraturas maxilomandibulares no hospital de ensino: perfil epidemiológico e percepção dos usuários / Maxillomandibular fractures teaching hospital: epidemiological profile and perception of users

Investigar o perfil epidemiológico dos pacientes com fraturas no complexo maxilomandibular e compreender a percepção desses usuários quanto ao evento trauma maxilomandibular. Método: Adotou-se o método misto, mediante uma abordagem quanti-qualitativa. A coleta de dados foi realizada nos meses de julho a novembro de 2014, nos retornos dos usuários juanto ao serviço odontológico. Utilizou-se uma entrevista semi-estruturada, com informações sociodemográficas dos usuários e três perguntas norteadoras. O referencial metodológico utilizado foi a análise de conteúdo de Bardin e a Teoria Geral da Enfermagem de Orem. Resultados: Predominaram indivíduos do sexo masculino, jovens, vítimas de acidentes com veículos mootorizados, com fraturas na mandíbula. Conclusões: Os resultados encontrados neste estudo permitem considerar que os indivíduos, vítimas de trauma de face e bloqueio intermaxilar, apresentam déficit no autocuidado, sobretudo nos aspectos da higienização bucal e alimentação, além de comunicação verbal prejudicada, que pode comprometer ainda mais suas necessidades...

Maxillofacial injuries in infants and preschools: a 2.5-year study.

PURPOSE: This study aims to evaluate the epidemiology of maxillofacial injuries in infants and preschools. PATIENTS AND METHODS: The data from 110 infants and preschools with maxillofacial injuries from October 2010 to March 2013 were analyzed retrospectively. RESULTS: The male-to-female ratio was 1.89:1. The peak age was 1 to 3 years (53.64%). Accident falls (76.36%) were the major cause. A total of 166 soft-tissue injuries were found in 103 patients, 102 dental traumas in 36 patients, and 53 maxillofacial fractures in 33 patients. The most common sites of soft-tissue injuries included the gingiva (17.47%), lower lip (13.86%), upper lip (13.25%), and chin (12.05%), and the majority were lacerations (77.71%). Dental traumas occurred mainly in incisors (81.37%) and the lower arch (60.78%). Of the 53 fractures, the most common sites were the condyle (45.28%), symphysis (22.64%), and mandibular body (16.98%); 28 (52.83%) were treated by operation and 25 (47.17%) by conservative treatment. CONCLUSIONS: Maxillofacial injuries in infants and preschools exhibit specific epidemiological features. These are related to anatomic, physiologic, and psychologic development in infants and preschools.

Etiology, distribution, treatment modalities and complications of maxillofacial fractures

PURPOSE: This study evaluated the trends and factors associated with maxillofacial fractures treated from 1997 to 2007 in the Oral and Maxillofacial Surgery Department of the Clermont-Ferrand University Hospital. MATERIAL AND METHODS: This study included 364 patients of which 82% were men and 45%, 20-29-years old. The etiology, anatomical distribution, treatment modality and complications of maxillofacial fractures were examined. RESULTS: Overall, interpersonal violence, traffic accidents and falls were the most common mechanisms of injury. There was a decreasing trend in traffic accidents and increasing one in falls as a cause of fracture over the 11-years period of this study. Young male patients were preferentially victim of interpersonal violence and traffic accidents, while middle-aged ones were of falls and work-related accidents. Middle-aged female patients were preferentially victim of traffic accidents and interpersonal violence, while older ones were of falls. And the number of fractures per patient varied according to the mechanism of injury: low after work-related accidents and high after traffic accidents. About two-third of fractures involved the mandible. Most of these mandibular fractures were treated by osteosynthesis with or without intermaxillary fixation, with the proportion of the latter increasing over time. There were very few postoperative infections and only in mandible. CONCLUSIONS: Maxillofacial fractures predominantly occur in young men, due to interpersonal violence. There is nevertheless an increasing trend in falls as a cause of fracture, especially in female patients, consistent with the increasing trend in presentation of older people. Most maxillofacial fractures involve the mandible and there is an increasing trend in treating these fractures by osteosynthesis without intermaxillary fixation. Antibiotic prophy-laxis associated with dental hygiene care can be indicated to prevent postoperative infections

Nonfatal sport-related craniofacial fractures: characteristics, mechanisms, and demographic data in the pediatric population.

BACKGROUND: Few reports exist on sport-related craniofacial fracture injuries in the pediatric population. Most patients with craniofacial injuries are adults, and most studies on pediatric sport injuries do not focus specifically on craniofacial fractures. The authors' goal was to provide a retrospective, descriptive review of the common mechanisms of sport-related craniofacial injuries in the pediatric population, identifying the characteristics of these injuries and providing a description of the demographics of this population. METHODS: The study population included children between the ages of 0 and 18 years who were seen in the emergency department at Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center between 2000 and 2005. Of the 1508 patients identified, 167 had injuries caused by sport-related trauma (10.6 percent). RESULTS: After evaluation in the emergency department, 45.5 percent were hospitalized, and 15.0 percent of these were admitted to the intensive care unit. The peak incidence of sport-related injuries occurred between the ages of 13 and 15 years (40.7 percent). Nasal (35.9 percent), orbital (33.5 percent), and skull fractures (30.5 percent) were most common, whereas fractures of the maxilla (12.6 percent), mandible (7.2 percent), zygomaticomaxillary complex (4.2 percent), and naso-orbitoethmoid complex (1.2 percent) were observed less frequently. Baseball and softball were most frequently associated with the craniofacial injuries (44.3 percent), whereas basketball (7.2 percent) and football (3.0 percent) were associated with fewer injuries. The most common mechanisms of injury were throwing, catching, or hitting a ball (34.1 percent) and collision with other players (24.5 percent). CONCLUSION: These data may allow targeted or sport-specific craniofacial fracture injury prevention strategies.

Dental trauma in patients with maxillofacial fractures.

PURPOSE: The purpose of this study was to analyze and evaluate the correlation between dental injuries and the pattern of maxillofacial fractures. The correlation with age, gender, trauma mechanism and type of maxillofacial fracture was also investigated. MATERIALS AND METHODS: From January 2000 to December 2009, 1131 patients with facial fractures were registered. Of these, 473 presented with associated dental trauma. The information and data collected and analyzed included: age, gender, mechanism of injury, type of facial fracture, type of dental injury, and the relationship between dental injury and facial fracture. RESULTS: Dental injury was sustained by 473 patients (41.8%), with a total of 2215 injured teeth. Of the 2215 injured teeth, 1191 (53.8%) were in the maxilla and 1024 (46.2%) in the mandible. Fall from a height had the highest risk of dental injuries (OR = 4.145, P = 0.002). The central incisor was the most injured tooth for both the maxilla (388, 36.2%) and mandible (284, 27.7%). The most common type of dental injury was avulsion (1070, 47.4%). More anterior teeth in the maxilla were of crown fracture, avulsion, and intrusion than that in the mandible, whereas more anterior teeth in the mandible were of subluxation and concussion than that in the maxilla. Dental injuries were more prone to occur in patients who sustained only symphysis fractures (OR = 2.817, P < 0.001), only 0.236-fold risk in patients who sustained only mandible angle fracture (P < 0.001). CONCLUSIONS: The occurrence of dental trauma is significantly related to the pattern and position of the maxillofacial fractures.

Levantamento de lesões na região bucomaxilofacial em vítimas de violência periciadas no Instituto Médico Legal (IML) de Feira de Santana-BA, entre 2007 e 2009 / Survey of oral and maxillofacial injuries in victims of violence who were subjected forensic dental expertise at Feira de Santana's Forensic Medicine Institute, Bahia, between 2007 and 2009

Objetivo: Analisar o perfil das vítimas e agressores, segundo as variáveis sociodemográficas e manifestações clínicas orofaciais em Feira de Santana-Bahia, no período de 2007-2009. Materiais e Métodos: Estudo epidemiológico do tipo descritivo utilizando dados secundários coletados no Instituto Médico Legalde Feira de Santana, nos anos de 2007 a 2009. Foram consultadas as características sócio-demográficas davítima; vínculo da mesma com o agressor; caracterização do instrumento; descrição das lesões quanto ao tipo e localização; avaliação do dano causado. Após a tabulação dos dados, realizou-se a análise estatísticados mesmos através do programa SPSS, versão 15.0. Resultados: A maioria das vítimas pertenceu ao sexomasculino, eram solteiras, faiodermas e apresentaram idade entre 18 e 35 anos. Quanto ao tipo de lesão,houve destaque para o edema (14,8%), a fratura dentária (14,8%) e a luxação dentária (11,2%). As estruturas intra-orais mais afetadas foram os dentes e a mucosa labial, com 54,6% e 30,9%, respectivamente. No exame extra-oral as regiões bucal (39%) e malar (10,3%) apresentaram um comprometimento maior. O emprego do instrumento contundente foi mais comum, na maioria das agressões. Conclusão: Houve um maior número de vítimas do sexo masculino, solteiro, estudante, faioderma e com idade entre 18 e 35 anos. Na maioria dos laudos não havia informações sobre o agressor. O instrumento contudente foi o mais utilizado no momento da agressão. O edema e a fratura dentária foram os principais tipos de lesões resultantes da violência. Os resultados desta pesquisa denotam a necessidade de implementação de programas preventivos da violência nasáreas de saúde e de segurança pública.

Trends in the pattern of facial fractures in different countries of the world / Tendencias en el patrón de fracturas faciales en diferentes países del mundo

The aim of the present study was to examine the changes in the pattern of maxillofacial fractures between developed and developing countries over two time periods; (1987-1999) and (2000-2007). A comprehensive search of the literature using PubMed was conducted for publications on maxillofacial injuries published during the last 20 years. Only 45 articles met the inclusion criteria and the full-texts of these articles were thoroughly examined. For each of the included studies, different parameters were recorded. Calculated "weighed" percentages of each parameter across the total number of all patients were performed. The mandible was the most frequently fractured facial bone (57 percent). In the total period, the mean age of patients with facial fractures was 24.4 years and the incidence of facial fractures was higher in males (81.3 percent) than in females. The male to female ratio of patients with facial fractures was greater in developing countries (5.1:1.0) than that in developed countries (3.7:1.0) in the total period. Road traffic accident-related injuries had significantly decreased in developed countries and increased in developing countries over the two periods. However, assault-related facial injuries had significantly increased in developed countries and decreased in developing countries over the two periods. The body of the mandible was the most common mandibular fracture site (27.2 percent). It was concluded that mandibular fractures are more common than middle third injuries of the facial skeleton. Most patients affected by facial fractures in different countries were young adult males.

El objetivo del estudio fue examinar los cambios en el patrón de las fracturas maxilofaciales entre los países desarrollados y en vías de desarrollo en dos períodos de tiempo (1987-1999) y (2000-2007). Una búsqueda exhaustiva de la literatura en PubMed se llevó a cabo entre las publicaciones de lesiones maxilofaciales publicados durante los últimos 20 años. Sólo 45 artículos cumplieron con los criterios de inclusión, y los textos completos de estos artículos fueron examinados a fondo. En cada uno de los estudios incluidos se registraron diferentes parámetros. Se calculó el porcentaje de "peso" de cada parámetro a través del número total de pacientes. La mandíbula fue el hueso facial más fracturado (57 por ciento). En todo el periodo evaluado, la media de edad de los pacientes con fracturas faciales fue de 24,4 años y la incidencia de las fracturas faciales fue mayor en hombres (81,3 por ciento) que en mujeres. La razón hombre-mujer de los pacientes con fracturas faciales fue mayor en los países en vías de desarrollo (5,1:1,0) que en los países desarrollados (3,7:1,0) en todo el período. Las lesiones relacionadas con accidentes de tránsito disminuyeron considerablemente en los países desarrollados, mientras que aumentó en los países en vías de desarrollo durante los dos períodos. Sin embargo, las lesiones faciales relacionadas con asaltos aumentaron considerablemente en los países desarrollados y disminuyó en los países en vías de desarrollo durante los dos períodos. El cuerpo de la mandíbula fue el sitio de fractura más común (27,2 por ciento). Se concluyó que las fracturas mandibulares son las lesiones más comunes en el tercio medio del esqueleto facial. La mayoría de los pacientes afectados por fracturas faciales en los diferentes países fueron hombres jóvenes.

Factors influencing the incidence of maxillofacial fractures.

PURPOSE: Maxillofacial injuries occur in a significant proportion of trauma patients. Trauma causes considerable economic expense due to procedural costs, the time a patient is off work, and the associated loss of income. For these reasons, it is an important health and economic issue. The aim of this study is to discuss the factors that may influence the incidence of maxillofacial fractures. As it is necessary to determine trends to help guide the development of new methods of injury prevention, preventative measures are also discussed. METHODS: An electronic search was undertaken in March 2011, including articles published between 1980 and 2011 with the terms "facial fractures" and "maxillofacial fractures" in the title. The texts of epidemiological studies were reviewed in order to identify factors that may influence the incidence of maxillofacial fractures. RESULTS: From the selected articles, ten factors were identified: age, gender, geographic region and cultural aspects, socioeconomic status, temporal and climatic influence, use of alcohol and drugs, compliance with road traffic legislation, domestic violence, osteoporosis, and etiology of the maxillofacial trauma. CONCLUSIONS: Care of injured patients should include not only management of the acute phase, but also combine preventive programs and interventional programs aimed at reducing the incidence of maxillofacial fractures. Therefore, there is a need to ensure strict compliance of traffic rules and regulations, implement improvement in automotive safety devices, organize prevention programs to minimize assaults, implement school education in alcohol abuse and handling potentially hostile situations (especially for men), improve protection during sporting activities, and legislate wearing of protective headgear in workers. Preventive strategies remain the cheapest way to reduce direct and indirect costs of the sequelae of trauma. Societal attitudes and behaviors must be modified before a significant reduction in the incidence of maxillofacial fractures will be seen.

Retrospective study on the occurrence of primary incisor trauma in preschool children of a low-income area in Brazil.

AIM: The objective of this study was to investigate the occurrence of trauma in primary incisors in a sample of preschool Brazilian children living in a low-income area of Rio de Janeiro, Brazil. METHODS: For the study 527 dental records of a Municipal Children's Hospital were evaluated, and the following related factors were recorded: gender age, tooth affected, type and cause of trauma. Data were tabulated and subjected to statistical analysis (chi-square test). RESULTS: There were no significant differences in the prevalence of injuries among boys and girls. Children 10 to 24 months-old were the most affected (p < 0.05). The maxillary central incisor was the most affected tooth (p < 0.05), with predominance of lateral luxation and concussions (p > 0.05). The most common cause of trauma was associated with child's own-height fall (p < 0.05). CONCLUSION: Based on the results, it was concluded that the high incidence of incisor trauma in deciduous teeth should be viewed with concern, requiring the implementation of health policies aimed primarily at the prevention of such accidents.

Maxillofacial injuries in Calabar south-south, Nigeria: a 5 year study of jawbone fractures.

OBJECTIVES: The aim of this study is to highlight the overall uniqueness of the pattern of presentation of maxillofacial injuries seen at the Department of Oral and Maxillofacial Surgery of the University of Calabar Teaching Hospital, Calabar south-south Nigeria between January 2000 and December 2004 and to share our experience in terms of occurrence, seasonal fluctuations and the adequacy of treatment methods in our environment. MATERIALS AND METHODS: Case notes of all. the 200 maxillofacial trauma patients were retrieved, examined and analyzed with regards to age, gender and cause of injury, socio-demographic data, diagnosis, pattern of presentation, distribution and treatment. RESULTS: A male-to-female ratio of 3.65:1 was obtained. Out of the 200 patients the highest incidence of injury was in the 20-30 year age group 85 (n=85; 42.5%). The major causes of injuries were motorcycle (n=74; 37%), vehicle (n=62; 31.5%) and assault (n=40; 20%). Six (3%) river-related or boat accidents were recorded. Industrial and sports related accidents contributed the least (n=5; 2.5%). CONCLUSION: Road traffic accident had the highest proportion of the entire maxillofacial injuries with more males affected than females. Seasonal distribution showed a bimodal peak variation of May-June and September-January. This paper calls for the reinforcement of measures for the prevention of automobile accident and the establishment of more maxillofacial specialist centers with modern equipment for effective management of maxillofacial injuries.

Management of maxillofacial injuries in Iraq.

These clinical studies reflect the experience of the author in managing 673 patients treated during the last 8 years. All patients were treated in the Maxillofacial Unit, Surgical Specialties Hospital, Medical City, Baghdad, and in the author's private clinic. Included patients were 530 males and 143 females; patients' age ranged between 1 year and 75 years (mean, 38 y). Distribution of injuries was as follows: fracture of the mandible, 287 (42.64%); middle third injuries, 39 (5.79%); orbital injuries, 236 (35.07%; including 12 cases with cranioorbital injuries); injuries in children, 27 (4.0%); fracture of the zygoma, 52 (7.73%); and fracture of the nose, 40 (5.94%).Maxillofacial injuries in this study were classified as follows: (1) craniomaxillofacial with head injuries and cerebrospinal fluid leak; (2) fracture of the middle third including Le Fort I, II, and III and midline split in the face; (3) fracture of the mandible as an isolated injury or as part of a facial skeleton injury; and (4) isolated complex injuries of the zygoma, the orbital skeleton, and the nasoethmoidal region.The technique used for treating middle third injuries was external fixation either by halo frame (with vertical rods and cheek wires) or by box frame (using 4 external pins connected by rods) or internal fixation by suspending the middle third with internal wires (0.5 mm stainless steel) from the zygomatic process of the frontal bone beneath the zygomatic arch down the lower arch bar. Fractures of the mandible were treated by gunning splint with intermaxillary fixation (IMF) or with open reduction and fixation by stainless steel wire with IMF or by IMF screw or by an arch bar and IMF. Other fractures such as fracture of the orbit were treated by bone graft, sialastic, or lyophilized dura with open reduction. Fractures of the zygoma were treated by open reduction and fixation with stainless steel wire and bone graft or by reduction without fixation. Fractures of the nose were treated by reduction with straightening of the septum with a splint (lead splint or polythene) or by external splint with plaster of Paris. With the techniques used, results from managing these cases were satisfactory.

Eye injuries and orofacial traumas in floorball--a survey in Switzerland and Sweden.

The objective of this study was to investigate the occurrence of eye injuries and orofacial traumas in floorball. In addition, the athletes' habits of wearing protective goggles and mouthguards was surveyed, and an assessment was made of the general level of knowledge amongst athletes and coaches about preventive and first aid measures after a dental trauma and the resulting consequences. The study was conducted by the same interviewer in Switzerland and Sweden during the 2009/2010 season using a standardized questionnaire. A total of 608 individuals (565 athletes and 43 coaches) belonging to the amateur and semi-professional leagues in the two countries were individually interviewed. Although 72.7% of all athletes had observed and 27.7% of field players had sustained an injury to the eye or its vicinity, only 25 athletes (4.9%) wore protective eyewear. Similarly, despite 31.7% of all players having observed a dental or jaw injury and 11.3% of interviewed field players having suffered one, only one athlete wore a mouthguard on a regular basis. Participants from Switzerland were significantly better informed than participants from Sweden with regard to first aid measures. The results of this study show that floorball has an equally high risk for dental trauma as handball. Further investigations of dental injuries in floorball would be valuable in order to provide players, coaches, parents and sporting federations with the necessary information to make decisions regarding the use of mouthguards. It is strongly recommended that protective eyewear should be made mandatory.