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1.
Ned Tijdschr Tandheelkd ; 127(5): 287-291, 2020 May.
Artigo em Holandês | MEDLINE | ID: mdl-32609099

RESUMO

A 15-year-old girl was brought to the emergency department of a hospital by ambulance with extensive facial trauma following a horse's kick. The considerable impact resulted in a combination of injuries to the bone, teeth and soft tissue. Following the transfer from the ambulance, the AE physician immediately consulted an oral and maxillofacial surgeon. Consequently, the patient could be brought to the operating theatre almost straight after stabilisation. There, the oral and maxillofacial surgeon first repositioned her teeth in anatomical position, followed by repositioning and fixation of the mandibular fracture. Next, the teeth in the upper front were stabilised with an acid-etch composite splint and the lip was reconstructed.


Assuntos
Traumatismos Faciais , Fraturas Mandibulares , Adolescente , Animais , Feminino , Cavalos , Humanos
2.
J Contemp Dent Pract ; 21(4): 400-403, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32584276

RESUMO

AIMS: The aim of this study was to compare 2D plates with 3D miniplate system in the management of mandibular angle fractures. MATERIALS AND METHODS: The study was conducted on 146 patients with mandibular angle fracture, who were equally divided into two groups of 73. Patients in group I were treated with 3D plating and in group II with 2D plating. In all cases, 2.0 mm titanium miniplates were used. The etiology of fracture, amount of mouth opening, and pain and sensory deficit were recorded. Clinical and radiographic assessment was done at 1, 3, and 6 months. RESULTS: The etiology of mandibular angle fracture is roadside accident (RSA) seen in 110 (75.3%) cases, fall in 24 (16.4%), and assault in 12 (2.6%) cases. There was significant (p < 0.05) mouth opening in group I at 1 month postoperatively (32.4 mm) as compared to group II (27.5 mm), at 3 months in group I (33.6 mm) as compared to group II (30.2 mm), and at 6 months in group I (36.4 mm) as compared to group II (31.6 mm). After 1 month, sensory deficit was present in six patients in group I and 10 patients in group II. After 3 months, group I had no patients and three patients in group II. Right angle fracture was found in 71 patients (group I-36, group II-35). Mandibular right angle fracture in 58 patients (group I-28, group II-30). CONCLUSION: The authors found that the 3D miniplate system is more useful in the management of cases of mandibular angle fracture as compared to 2D miniplates. CLINICAL SIGNIFICANCE: There has been increase in mandibular fractures in the last few years. Appropriate management with 3D miniplates may be useful in providing better treatment outcomes.


Assuntos
Fraturas Mandibulares , Placas Ósseas , Fixação Interna de Fraturas , Humanos , Estudos Prospectivos , Titânio
3.
J Contemp Dent Pract ; 21(4): 445-452, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32584284

RESUMO

AIM: The aim of the present study was to assess the prevalence, common age, gender, causes, types, treatment modality, and complication of the maxillofacial fractures for the patients admitted to King Fahad Central Hospital in Gizan City, Saudi Arabia. MATERIALS AND METHODS: The medical records of all cases admitted to the Department of Oral and Maxillofacial Surgery (OMFS) ward at King Fahad Central Hospital (KFCH) in Gizan City, Saudi Arabia, were reviewed for presence of maxillofacial fractures. The statistical analysis was done using IBM SPSS version 20. RESULTS: A total of 166 patients with maxillofacial fractures were included in this study. There were 140 males and 26 females. The most affected age-group was 21-30 with a mean age of (30.69 ± 14.65 standard deviation, SD) and the male-female ratio was 5.4:1. Road traffic accidents (RTAs) were found to be the most common cause of maxillofacial fractures (52.4%). The mandibular body was fractured more than any other maxillofacial bones (15.7%) followed by mandibular angle (13.3%) and zygomaticomaxillary complex (ZMC) (12.0%). Nine cases (5.4%) of the associated injuries were diagnosed as head injuries. Open reduction with internal fixation (ORIF) was the most common treatment methods (72.3%) utilized in this study. CONCLUSION: Maxillofacial fractures most commonly affected young individuals in the 21-30-year-old age-group, often as a result of RTA, and body of the mandible was the most frequent site of fracture. CLINICAL SIGNIFICANCE: The prevalence, common age, gender, causes, types, treatment modality, and complication of the maxillofacial fractures for the patients admitted can be assessed from the present study.


Assuntos
Fraturas Ósseas , Fraturas Mandibulares , Acidentes de Trânsito , Adulto , Feminino , Humanos , Masculino , Prevalência , Estudos Retrospectivos , Arábia Saudita , Adulto Jovem
4.
Int. j. morphol ; 38(2): 309-315, abr. 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1056440

RESUMO

Stability is necessary to ensuring proper bone repair after osteotomies and fractures. The aim of this research was to analyze how the repair of pseudoarthrosis sites was affected by different conditions in related to soft tissue. An experimental study was designed with 18 New Zealand rabbits. Six study groups were formed. An osteotomy was performed on the mandibular body of each animal and muscle was installed at the osteotomy site to model pseudoarthrosis. Fixation by surgery was then carried out, using plates and screws. The animals were submitted to euthanasia after 21, 42 and 63 days to make a descriptive comparison of the histological results. No animal was lost during the experiment. In all the samples, bone formation was observed with different degrees of progress. Defects treated with or without removal of the tissue involved in pseudoarthrosis presented comparable bone repair, showing that stability of the bone segments allows the repair of adjacent tissue. In some samples cartilaginous tissue was associated with greater bone formation. Stabilization of the fracture is the key in bone repair; repair occurs whether or not the pseudoarthrosis tissue is removed.


La estabilidad de las osteotomías y de las fracturas son fundamentales para asegurar la adecuada reparación ósea; el objetivo de esta investigación fue analizar la reparación presente en sitios de pseudoartrosis realizando la limpieza de la zona previo a la fijación o manteniendo el tejido de la nounión en el mismo lugar durante la osteosíntesis. Se diseñó un estudio experimental incluyendo 18 conejos de raza Neozelandesa. Se formaron 6 grupos de estudios a quienes se relizó una osteotomía en el cuerpo mandibular y posterior instalación de músculo en el lugar de la osteotomía para fabricar un modelo de pseudoartrosis. En cirugía posterior se fijó con placa y tornillos. Se realizaron eutanasias a los 42 y 63 días para comparar los resultados de forma descriptiva mediante estudio histológico. No fue perdido ningún animal durante el experimento. En todas las muestras evaluadas se observó formación ósea en diferentes niveles de avance; defectos tratados con o sin el retiro del tejido involucrado en la pseudoartrosis presentaron una condición de reparación ósea comparables, determinando que la estabilidad de los segmentos óseos permite la reparación del tejido adyacente. El tejido cartilaginoso se presentó en algunas muestras asociadas a sectores con mayor presencia de formación ósea. La estabilización de la fractura es clave en la reparación ósea; la reparación se produce manteniendo o retirando el tejido presente en la pseudoartrosis.


Assuntos
Animais , Coelhos , Consolidação da Fratura , Fraturas Mal-Unidas/terapia , Fraturas Mandibulares/terapia , Osteotomia/efeitos adversos , Fraturas Mandibulares/cirurgia
5.
Indian J Dent Res ; 31(1): 134-137, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32246696

RESUMO

Introduction: Mandibular angle fracture is common in road traffic accidents. This study was conducted to compare 3D miniplate system with 2D plates for treatment of mandibular angle fractures. Materials and Methods: The study was conducted on 120 patients with mandibular angle fracture of both genders. After selecting patients, patients were divided into 2 groups of 60 each. In group I, patients were treated with 3D, 2.0-mm titanium plates, and in group II, patients were treated with 2D, 2.0-mm titanium miniplate in mandibular angle fracture. Patients were evaluated regularly after 1, 3, and 6 months for outcome of treatment. Results: In group I, males were 22 and females were 38. In group II, males were 40 and females were 20. Right angle fracture was seen in 32 patients in group I and 26 in group II. Left angle fracture was seen in 24 in group I and 28 in group II. Right angle and left parasymphysis fracture was seen in 3 in group I and 4 in group II. Left angle and right parasymphysis fracture was seen in 1 in group I and 2 in group II. [Table 3], [Graph 1] shows that in group I, after 1 month sensory deficit was present in 5 patients and in group II in 12 patients. After 3 months, there were no patients with sensory deficit in group I and 2 in group II. Preoperatively in group I, mouth opening was 24 mm and in group II patients was 25.80 mm, which increased to 31.20 mm in group I and 28.20 mm in group II at 1 month, 32 mm in group I and 30 mm in group II at 3 months, and 37.20 and 32.12 mm in groups I and II, respectively, at 6 months. The difference was significant (P < 0.05). Conclusion: 3D miniplate system is reliable and effective treatment modality for mandibular angle fractures as compared with traditional 2D miniplates.[INLINE:1].


Assuntos
Fixação Interna de Fraturas , Fraturas Mandibulares , Placas Ósseas , Feminino , Humanos , Masculino , Estudos Prospectivos , Titânio
6.
Quintessence Int ; 51(3): 230-237, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32020133

RESUMO

OBJECTIVES: Severe atrophied edentulous posterior mandible with inadequate bone height superior to the inferior alveolar canal may require transposition of the inferior alveolar nerve in order to insert dental implants. Mandibular fractures are considered a rare complication of this procedure. Implant-related spontaneous fractures of the mandible represent 0.2% of patients with inserted implants in an edentulous mandible. This report presents two cases of mandibular fractures that occurred 3 to 4 weeks after inferior alveolar nerve transposition, and were managed successfully by conservative nonsurgical treatments. METHOD AND MATERIALS: Overall, 132 procedures of inferior alveolar nerve transposition in 98 patients were performed over a period of 10 years with 379 dental implants inserted in one stage with the procedure. Patients were examined every 2 weeks. The inferior alveolar nerve function was evaluated with various sensory tests. Panoramic radiographs were obtained immediately, at 3 months, and at 1 year after the surgery. The patients received implant-supported fixed prostheses after 3 to 5 months. RESULTS: The healing process was uneventful in 96 patients; however, in two patients (1.5%) spontaneous fracture of the treated site was observed 3 and 4 weeks postoperatively. The fractures lines occurred at a failed implant site. Both cases were treated conservatively. CONCLUSIONS: Spontaneous fractures following inferior alveolar nerve transposition are an important but rare complication. Conservative treatment modalities might be useful and indicated in some of those cases.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Fraturas Espontâneas , Fraturas Mandibulares , Tratamento Conservador , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Humanos , Mandíbula , Nervo Mandibular
7.
J Korean Med Sci ; 35(7): e57, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32080989

RESUMO

BACKGROUND: The big data provided by Health Insurance Review and Assessment (HIRA) contains data from nearly all Korean populations enrolled in the National Health Insurance Service. We aimed to identify the incidence of facial fractures and its trends in Korea using this big data from HIRA. METHODS: We used the Korean Standard Classification of Disease and Cause of Death 6, 7 for diagnosis codes. A total of 582,318 patients were included in the final analysis. All statistical analyses were performed using SAS software and SPSS software. RESULTS: The incidence of facial fractures consistently declined, from 107,695 cases in 2011 to 87,306 cases in 2016. The incidence of facial fractures was the highest in June 2011 (n = 26,423) and lowest in January 2014 (n = 10,282). Nasal bone fractures were the most common, followed by orbit and frontal sinus fractures. The percentage of nasal bone fractures declined, whereas those of orbital fractures increased from 2011 to 2016 (P < 0.001). Among orbital fractures, inferior wall fractures were the most common, followed by medial wall fractures. Among mandibular fractures, angle fractures were the most common, followed by condylar process and symphysis fractures. Although it was difficult to predict the most common type of zygomatic and maxilla fractures, their incidence consistently declined since 2011. CONCLUSION: We observed trends in facial fractures in Korea using big data including information for nearly all nations in Korea. Therefore, it is possible to predict the incidence of facial fractures. This study is meaningful in that it is the first study that investigated the incidence of facial fractures by specific type.


Assuntos
Big Data , Ossos Faciais , Traumatismos Faciais , Fraturas Mandibulares , Fraturas Orbitárias , Interpretação Estatística de Dados , Ossos Faciais/lesões , Traumatismos Faciais/epidemiologia , Humanos , Fraturas Mandibulares/epidemiologia , Fraturas Orbitárias/epidemiologia , República da Coreia/epidemiologia , Estudos Retrospectivos
8.
Oral Maxillofac Surg ; 24(1): 31-36, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31728659

RESUMO

INTRODUCTION: The aim of this study was to assess the relationship between the status and position of third molars, and the presence of mandibular angle and/or condylar fractures, in a group of patients treated for mandibular fractures, thus hoping to contribute to the knowledge of potential predictors of these fractures. METHODS: A retrospective study was designated to include all the patients who were diagnosed and treated with open reduction and internal fixation for isolated mandibular angle fractures or isolated mandibular condylar fractures between 1st of January 2012 and 31st of December 2018. The following data were collected for each included patient: gender, age, etiology, site and side of the fracture, and presence and eruption state of third molars in the fracture side. RESULTS: Seventy patients were diagnosed with a condylar fracture, 48 with an angle fracture. No statistically significant difference was observed as for etiology and gender distribution between angle fracture and condyle fracture patients (p > 0.05). Angle fractures were statistically associated with the presence of third molars, whereas condylar fractures with the absence of third molars (p < 0.000005). The presence of completely erupted 3Ms was associated with condylar fractures (p < 0.05), and partially impacted 3Ms were associated with angle fractures (p < 0.0005). CONCLUSIONS: Mandibular angle fractures and third molar presence are associated in patients who present with mandibular fractures, especially if the third molar is incompletely erupted. This information should be kept in consideration as for the diagnosis and management of patients with mandibular fractures.


Assuntos
Fraturas Mandibulares , Dente Impactado , Humanos , Côndilo Mandibular , Dente Serotino , Estudos Retrospectivos
9.
Oral Maxillofac Surg ; 24(1): 19-24, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31713697

RESUMO

PURPOSE: This study was to assess the efficiency of using a combination of one microplate and one miniplate for management of patients with parasymphyseal mandibular fractures versus two miniplates through measurement of the biting force. PATIENTS AND METHODS: The study sample consisted of sixteen patients with an isolated mandibular fracture and randomly divided into two groups; group I was managed using two miniplates, while group II was managed using a combination of one microplate at subapical region and one miniplate at the inferior border of the mandible. The biting force was measured at 1 week, 1 month, and 3 months follow-up visits. A control group consisted of 40 healthy adult volunteers was selected to measure the normal biting force. RESULTS: The mean of the normal biting force of the control group was 435 N ± 219, 103.2 N ± 4.8, and 390.6 N ± 195.4 at right molar, incisor, and left molar regions respectively. There was a statistically non-significant difference regarding the bite force of both study groups, with a progressive increase through the different follow-up visits and a period of 3 months is sufficient for recovery of patients to regain their normal biting force. CONCLUSION: Consequently a combination of one microplate and one miniplate is efficient for the management of isolated parasymphyseal mandibular fracture in the same way as two miniplates.


Assuntos
Placas Ósseas , Fixação Interna de Fraturas , Fraturas Mandibulares , Adulto , Força de Mordida , Humanos , Mandíbula
10.
Int J Oral Maxillofac Surg ; 49(4): 471-482, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31653555

RESUMO

The aim of this systematic review was to verify whether the presence of a lower third molar in the mandibular angle fracture line is associated with postoperative complications. An electronic survey was conducted in five databases. Eligibility criteria included observational and experimental studies that evaluated the association between the presence of the lower third molar in the fracture line of mandibular angle fractures and possible postoperative complications, including infection, paresthesia, necessity of plate removal, temporomandibular joint disorders, malocclusion, dehiscence, and non-union. Thirty-four papers were included in the qualitative analysis and 26 of those in the meta-analysis. The risk of bias of observational studies was assessed by Newcastle-Ottawa scale and of the clinical trials by Cochrane Collaboration risk-of-bias tool. Absence of the third molar was associated with a lower chance of postoperative infection in angle fractures compared to presence of the tooth (odds ratio 0.55, 95% confidence interval 0.34-0.88). No statistically significant difference between the groups was found for the other outcomes evaluated. The findings of this systematic review suggest that the absence of the third molar in the mandibular angle fracture line is associated with a lower postoperative infection rate when compared to angle fractures with a third molar present.


Assuntos
Fraturas Mandibulares , Dente Impactado , Gerenciamento de Dados , Humanos , Mandíbula , Dente Serotino , Complicações Pós-Operatórias , Estudos Retrospectivos
11.
Int J Oral Maxillofac Surg ; 49(4): 491-495, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31570287

RESUMO

Intermaxillary fixation (IMF) screws are commonly used for maxillomandibular immobilization in the management of mandible fractures as definitive closed reduction treatment or in adjunct intraoperatively. In this report, we present three cases of isolated unilateral mandible fractures, in which IMF screws were used and resulted in propagation of a second fracture on the contralateral side, at the site where IMF screws were placed during the surgery. The use of IMF screws has many advantages with an overall low risk of morbidity, however, there are potential complications that must be recognized.


Assuntos
Fraturas Mandibulares , Traumatismos Maxilofaciais , Parafusos Ósseos , Fixação de Fratura , Fixação Interna de Fraturas , Humanos , Técnicas de Fixação da Arcada Osseodentária , Resultado do Tratamento
12.
J Oral Rehabil ; 47(4): 460-466, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31785007

RESUMO

OBJECTIVE: This study assessed the test-retest reproducibility of the Utrecht mixing ability test (MAT) and the construct validity of the MAT in relation to the Mandibular Function Impairment Questionnaire (MFIQ) in patients with mandibular condylar fractures. MATERIAL AND METHODS: Twenty-six patients treated for a mandibular condylar fracture participated in this clinimetric study; all patients performed the MAT twice. Simultaneously the MFIQ was conducted. Test-retest reliability and construct validity were assessed using the intra-class correlation coefficient (ICC) and Spearman correlation, respectively. RESULTS: The ICC of the MAT was 0.906 (95% CI: 0.801-0.957), which indicates an excellent reliability. A weak correlation of 0.386 (P = .052) between the first MAT and the overall outcome of the MFIQ was found. A significant moderate correlation of 0.401 (P = .042) was found between the retest of the MAT and the overall outcome of the MFIQ. One question on the MFIQ (about yawning) showed a moderate positive correlation of 0.569 (P = .002) and 0.416 (P = .034) for the MAT test and retest, respectively. CONCLUSION: The MAT is an easy test to use in follow-up of patients. The test-retest reliability of this test is excellent in condylar trauma patients. As the validity of the MAT and the MFIQ could not be confirmed, the MFIQ may be an addition to patient's feedback about the rehabilitation process of their mandibular functioning.


Assuntos
Fraturas Mandibulares , Humanos , Mandíbula , Côndilo Mandibular , Reprodutibilidade dos Testes , Inquéritos e Questionários
13.
Int J Oral Maxillofac Surg ; 49(1): 82-89, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31076199

RESUMO

The aim of this study was to evaluate the outcomes of temporomandibular joint (TMJ) anterior disc displacement and condylar remodelling for sagittal fracture of the mandibular condyle (SFMC) in children. Disc displacement was observed in 20 patients with 24 SFMCs (age 4-12 years) via magnetic resonance imaging. After 6 months of closed treatment (T1), the joints were categorized based on the displaced disc status as complete reduction (DCR) or incomplete reduction (DICR). Moreover, condylar remodelling was compared between the groups using cone beam computed tomography images of the TMJ obtained at T1 and at the 1-year follow-up (T2; 15 patients with 18 displaced SFMCs). At T1, 17 of 24 joints with SFMC were assigned to the DCR group and six to the DICR group; one unilateral SFMC case developed ankylosis. Condylar depth and height differed significantly between the groups at T1, but not at T2. Intra-group comparison exhibited significant changes in the condylar depth and height over time in the DICR group. Thus, most of the anteriorly displaced discs (17/24, 70.8%) achieved reduction following closed treatment. Although sustained anterior disc displacement was associated with an increased depth and reduced height of the condyle, no clinical impairment was noted unless ankylosis developed.


Assuntos
Luxações Articulares , Fraturas Mandibulares , Anquilose Dental , Criança , Humanos , Imagem por Ressonância Magnética , Côndilo Mandibular , Disco da Articulação Temporomandibular
14.
Oral Maxillofac Surg ; 24(1): 65-71, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31848774

RESUMO

INTRODUCTION: Management of body fractures in patients with edentulous atrophic mandibles represents a challenging task due to patient's age, medical comorbidities, poor bone quality, and vascularity, as well as reduced contact area between the fracture ends. The aim of the study was to assess the demographic and clinical variables, the surgical technique, and outcomes of unilateral body fractures of the edentulous atrophic mandible managed at several European departments of oral and maxillofacial surgery. METHODS: This study is based on a systematic computer-assisted database that allowed the recording of data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between 2008 and 2017. The following data were recorded for each patient: gender, age, comorbidities, etiology, synchronous body injuries, degree of atrophy of the mandible according to Luhr classification, type of surgical approach and fixation, length of hospitalization, and presence and type of complications. RESULTS: A total of 43 patients were included in the study: 17 patients' mandibles were classified as class I according to Luhr, 15 as class II, and 11 as class III. All patients underwent open reduction and internal fixation by extraoral approach in 25 patients, intraoral in 15 patients, and mixed in 3 patients. A single 2.0 miniplate was used in 16 patients, followed by a single 2.4 reconstruction plate in 13 patients, by two 2.0 miniplates, and three 2.0 miniplates. Outcome was considered to be satisfying in 30 patients, with no complications. Complications were observed in 13 cases. CONCLUSIONS: Treatment of unilateral body fractures of the edentulous mandible must still be based on the type of fracture, degree of atrophy, experience of the surgeon, and patients' preference. An adequate stability can be obtained by different plating techniques that have to be appropriately tailored to every single specific patient.


Assuntos
Arcada Edêntula , Fraturas Mandibulares , Atrofia , Placas Ósseas , Europa (Continente) , Fixação Interna de Fraturas , Humanos , Mandíbula
16.
Acta Cir Bras ; 34(9): e201900906, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31826098

RESUMO

PURPOSE: To develop 3D anatomical models, and corresponding radiographs, of canine jaw fractures. METHODS: A base model was generated from a mandibular bone scan. With this model it was possible to perform fracture planning according to the anatomical location. RESULTS: The 3D base model of the canine mandible was similar in conformation to the natural bone, demonstrating structures such as canine tooth crowns, premolars and molars, mental foramina, body of the mandible, ramus of the mandible, masseteric fossa, the coronoid process, condylar process, and angular process. It was not possible to obtain detail of the crown of the incisor teeth, mandibular symphysis, and the medullary channel. Production of the 3D CJF model took 10.6 h, used 150.1 g of filament (ABS) and cost US$5.83. CONCLUSION: The 3D canine jaw fractures models, which reproduced natural canine jaw fractures, and their respective radiographic images, are a possible source of educational material for the teaching of veterinary medicine.


Assuntos
Educação em Veterinária/métodos , Imageamento Tridimensional/veterinária , Fraturas Mandibulares/veterinária , Modelos Anatômicos , Impressão Tridimensional , Animais , Cães , Imageamento Tridimensional/métodos , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Fraturas Mandibulares/diagnóstico por imagem , Radiografia/veterinária , Reprodutibilidade dos Testes , Fatores de Tempo
17.
J Craniomaxillofac Surg ; 47(12): 1929-1934, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31810843

RESUMO

INTRODUCTION: The objective of the present study was to assess the demographic variables, causes, and patterns of edentulous atrophic fractures of the mandible managed at several European departments of oral and maxillofacial surgery. The results of this multicenter collaboration over a 10-year period are presented. METHODS: The data of all patients with fractures of the atrophic edentulous mandible from the involved maxillofacial surgical units across Europe between January 1, 2008, and December 31, 2017 were recorded: gender; age; voluptuary habits; comorbidities; etiology; fracture sites; synchronous body injuries; atrophy of the mandible according to Luhr classification; eventual type of treatment; timing of the eventual surgery; length of hospital stay. RESULTS: A total of 197 patients (86 male and 111 female patients) with 285 mandibular fractures were included in the study. Mean age of the study population was 75 years. Statistically significant associations were found between Luhr classes I - II and condylar fractures on one hand (p < .0005), and between Luhr class III and body and parasymphyseal fractures on the other hand (p < .05). Finally, 135 patients underwent open reduction and internal fixation, 56 patients did not undergo any intervention, and 6 patients underwent closed reduction. No statistically significant association was observed between treatment, timing of treatment, comorbidities, and concomitant injuries. CONCLUSIONS: The management of edentulous atrophic mandibular fractures remains challenging. Treatment decisions should continue to be based on the clinician's previous experience and on the degree of bone resorption in edentulous mandible in relation to fracture subsites.


Assuntos
Fixação Interna de Fraturas/métodos , Arcada Edêntula/cirurgia , Fraturas Mandibulares/cirurgia , Idoso , Atrofia , Europa (Continente)/epidemiologia , Feminino , Humanos , Arcada Edêntula/epidemiologia , Masculino , Fraturas Mandibulares/epidemiologia , Resultado do Tratamento
18.
Artigo em Inglês | MEDLINE | ID: mdl-31861285

RESUMO

Maxillofacial fractures (MFF) belong to the major modern medicine and public health concerns. The recovery from MFF is associated with a number of social problems. The patient's mood may be affected by the change in self-image and lack of satisfaction with life, in many cases leading to a deepening of mental health disorders, resulting in alcoholism, loss of job or conflicts in the area of family life. The aim of this study was to evaluate the quality of life of patients with MFF, with respect to demographic and medical variables. The mean age of the 227 patients was 36 years. The mandible was the most frequent MFF location (52.9%), followed by the zygomatic bone (30.8%) then the maxilla (16.3%). Bone fracture displacement occurred in 79.3% of patients. A comminuted fracture was found in 71% of patients. The quality of life of patients with MFF was significantly better in all analyzed domains 3 months after the end of hospitalization compared to the initial survey carried out shortly after implementation of the treatment. Among the demographic variables, older age had a statistically significant but weak positive association with the improvement of the quality of life of respondents in General health perception domain.


Assuntos
Fraturas Mandibulares/psicologia , Fraturas Maxilares/psicologia , Qualidade de Vida , Fraturas Zigomáticas/psicologia , Tratamento Conservador/métodos , Tratamento Conservador/psicologia , Feminino , Seguimentos , Fixação de Fratura/métodos , Fixação de Fratura/psicologia , Indicadores Básicos de Saúde , Hospitalização , Humanos , Masculino , Fraturas Mandibulares/terapia , Fraturas Maxilares/terapia , Fraturas Zigomáticas/terapia
19.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(11): 727-732, 2019 Nov 09.
Artigo em Chinês | MEDLINE | ID: mdl-31683378

RESUMO

Objective: A retrospective research was made to summarize the clinical characteristics, treatment methods, results of the adult cases with sagittal fracture of mandibular condyle (SFMC). Methods: One hundred and fifty-one cases of hospitalized patients were enrolled. The age, sex, etiology, level of fracture, degree of displacement, associated facial fractures, treatment methods and results were retrospectively analyzed. Results: The patient's age ranged from 16 to 81 years old, with a median age of 38.5 years. The male to female ratio was 2.97∶1. The most involved age group was 20-29 years old [35.1% (53/151)]. Falls [53.6% (81/151)] were the most common cause. According to the classification of He (2009) and Duan (2011), the most common type of SFMC was type A [60.5% (130/215)] and the displacement type [80.9% (174/215)]. Eighty-six point zero percent (185/215) of SFMC were treated by surgery. The surgical rates of type A, B and M fractures were 91.5% (119/130), 79.6% (43/54) and 88.5% (23/26), with significant differences between the groups (P<0.05). The surgical rates of the displacement and dislocation type were 89.7% and 100%, with significant differences. The differences between the fixations of type A, type B and type M fractures were statistically significant. The follow-up results showed that, 78.7% (59/75) of patients treated with surgery had normal occlusion, no joint symptoms and no limited mandibular movement. Patients treated with conservative therapy had good occlusion and an average maximum mouth opening of 36.25 mm with malunion occurred in 5/6 of the condyles. Conclusions: Under appropriate surgical indications, surgical treatment of SFMCs could achieve significantly better outcomes than conservative treatment.


Assuntos
Luxações Articulares , Côndilo Mandibular , Fraturas Mandibulares , Transtornos da Articulação Temporomandibular , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Fixação Interna de Fraturas , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
20.
Plast Reconstr Surg ; 144(6): 1393-1402, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31764658

RESUMO

BACKGROUND: Mandibular angle fractures are common and frequently involve a tooth in the fracture line. Despite trends toward more conservative indications for tooth extraction during open repair, the literature remains heterogeneous. This review aims to ascertain the effect of tooth extraction/retention on patient outcomes following mandible open reduction and internal fixation and to evaluate the evidence surrounding indications for extraction. METHODS: PubMed, EMBASE, the Cochrane Library, Elsevier text mining tool database, and clinicaltrials.gov were queried through March of 2018 for English language publication on adults with traumatic mandibular fractures. The review protocol was not registered online. Quality of evidence was assigned using the Grading of Recommendations Assessment, Development and Evaluation methodology. Meta-analyses were performed when definitions of outcomes were deemed similar. RESULTS: Overall, 26 of 1212 identified studies met inclusion criteria. Indications for tooth extraction and rates of extraction varied considerably across studies. The quality of evidence was low or very low for all outcomes. Tooth retention was associated with lower overall complications (OR, 0.54; 95 percent CI, 0.37 to 0.79), major complications requiring readmission or reoperation (OR, 0.47; 95 percent CI, 0.24 to 0.92), and malocclusion (OR, 0.56; 95 percent CI, 0.32 to 0.97); there was no difference in wound issues or nonunion. Removal of asymptomatic teeth was associated with inferior alveolar nerve injury (39.4 percent versus 16.1 percent). CONCLUSIONS: The literature is limited by retrospective study deign and poor follow-up; however, when indicated, tooth extraction is not associated with an increased risk of infection or nonunion. Removal of asymptomatic teeth was associated with a risk of inferior alveolar nerve injury. Additional high-quality studies are needed to evaluate potentially expanded indications for tooth extraction.


Assuntos
Fixação Interna de Fraturas/métodos , Fraturas Mandibulares/cirurgia , Redução Aberta/métodos , Extração Dentária/métodos , Humanos , Mandíbula/cirurgia , Dente Serotino/cirurgia , Complicações Pós-Operatórias/etiologia , Reoperação/estatística & dados numéricos , Infecção da Ferida Cirúrgica/etiologia
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