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International Journal of Oral and... Jan 2023The aim of this study was to perform a systematic review of the literature on the temporomandibular joint (TMJ) prosthesis as a treatment option after mandibular condyle... (Meta-Analysis)
Meta-Analysis Review
The aim of this study was to perform a systematic review of the literature on the temporomandibular joint (TMJ) prosthesis as a treatment option after mandibular condyle fracture. Three databases were searched (PubMed, Embase, Cochrane Library) and 2670 unique papers were identified. A total of 337 studies were included (121 case reports, 89 case series, and 127 cohort/clinical studies). In total 14,396 patients and 21,560 prostheses were described. Of the 127 cohort or clinical studies, 100 (79%) reported inclusion criteria, 54 (43%) reported exclusion criteria, and 96 (76%) reported the inclusion period. The base population from which patients were recruited was reported in 57 studies (45%). The reason for TMJ prosthesis implantation was reported for 4177 patients (29.0%). A history of condylar fracture was present in 83 patients (2.0%); a history of mandibular trauma was present in 580 patients (13.9%). The meta-analysis showed a pooled prevalence of condylar fracture of 1.6% (95% confidence interval 0.9-2.4%) and a pooled prevalence of trauma or condylar fracture of 11.3% (95% confidence interval 7.1-16.0%). Heterogeneity was highly significant (P < 0.001). The TMJ prosthesis appears to be reserved for patients with persistent pain, bony or fibrous ankylosis, or osteomyelitis after primary closed or open treatment of fractures of the mandibular condyle.
Topics: Humans; Mandibular Condyle; Temporomandibular Joint Disorders; Tooth Ankylosis; Mandibular Fractures; Temporomandibular Joint; Ankylosis
PubMed: 35752530
DOI: 10.1016/j.ijom.2022.05.014 -
Journal of Oral and Maxillofacial... Dec 2016The risk of developing concomitant medication-related osteonecrosis of the jaw (MRONJ) in patients who have sustained an atypical femoral fracture (AFF) in association... (Review)
Review
Patients Receiving Parenteral Bisphosphonates for Malignant Disease and Having Developed an Atypical Femoral Fracture Are at Risk of Concomitant Osteonecrosis of the Jaw: An Evidence-Based Review.
PURPOSE
The risk of developing concomitant medication-related osteonecrosis of the jaw (MRONJ) in patients who have sustained an atypical femoral fracture (AFF) in association with parental administration of a bisphosphonate osteoclastic inhibitor medication for malignant disease is unclear. Published data were searched to determine the prevalence of these concomitant adverse medication events, if any.
MATERIALS AND METHODS
A systematic review of published case series in the PubMed database was undertaken to ascertain the prevalence of patients having a concomitant history of AFF and MRONJ. The data were analyzed to provide prevalence rates of these events from the literature.
RESULTS
Two case series were identified that delineated the risk (25 and 33%, respectively) of concomitant development of MRONJ and AFF in recipients of parenteral bisphosphonate medication administered for malignant disease.
CONCLUSION
The published data suggest that approximately 30% of patients receiving parenteral bisphosphonates and having sustained an AFF could develop comorbid MRONJ.
Topics: Bisphosphonate-Associated Osteonecrosis of the Jaw; Bone Density Conservation Agents; Bone Neoplasms; Diphosphonates; Femoral Fractures; Fractures, Spontaneous; Humans; Injections, Intravenous; Prevalence; Risk Factors
PubMed: 27376180
DOI: 10.1016/j.joms.2016.06.003 -
Journal of Oral and Maxillofacial... Mar 2015The purposes of this study were to identify significant differences in clinical outcomes between open reduction and rigid internal fixation (ORIF) and closed treatment... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The purposes of this study were to identify significant differences in clinical outcomes between open reduction and rigid internal fixation (ORIF) and closed treatment (CT) for adult mandibular condylar fractures (MCFs) and to support or refute the superiority of one method over the other.
MATERIALS AND METHODS
To address our purpose, we designed and implemented a systematic review with meta-analysis. A comprehensive electronic search without date and language restrictions was performed in May 2014. The inclusion criteria were studies in humans, including randomized or quasi-randomized controlled trials, controlled clinical trials, and retrospective studies, that compared ORIF and CT regarding maximal interincisal opening, laterotrusive and protrusive movements, pain, malocclusion, chin deviation on mouth opening, and temporomandibular joint signs or symptoms for the management of unilateral or bilateral adult MCFs. Meta-analysis was conducted only if there were studies of similar comparisons reporting the same outcome measures. For binary outcomes, we calculated a standard estimation of the odds ratio by the random-effects model if heterogeneity was detected; otherwise, a fixed-effects model with a 95% confidence interval was performed. Weighted mean differences or standard mean differences were used to construct forest plots of continuous data.
RESULTS
Twenty-three publications were included: 5 randomized controlled trials, 16 controlled clinical trials, and 2 retrospective studies. Five studies showed a low risk of bias, whereas 18 showed a moderate risk of bias. There were statistically significant differences between ORIF and CT regarding maximal interincisal opening, laterotrusive movement, protrusive movement, malocclusion, pain, and chin deviation on mouth opening (P = .001, P = .001, P = .001, P = .001, P = .001, and P = .05, respectively).
CONCLUSIONS
The result of the meta-analysis confirmed that ORIF provides superior functional clinical outcomes (subjective and objective) compared with CT in the management of adult MCFs.
Topics: Controlled Clinical Trials as Topic; Fracture Fixation, Internal; Humans; Mandibular Condyle; Mandibular Fractures; Randomized Controlled Trials as Topic; Range of Motion, Articular; Retrospective Studies; Treatment Outcome
PubMed: 25577459
DOI: 10.1016/j.joms.2014.09.027 -
Journal of Oral and Maxillofacial... Dec 2014The aims of this study were to 1) determine which fixation method has the fewest complications in the treatment of anterior mandibular fractures (AMFs) and 2) provide... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The aims of this study were to 1) determine which fixation method has the fewest complications in the treatment of anterior mandibular fractures (AMFs) and 2) provide scientific data to enable surgeons to make evidence-based decisions regarding the best technique.
MATERIALS AND METHODS
A comprehensive electronic search without date and language restrictions was performed in March 2014. Studies in humans, including randomized or quasi-randomized controlled trials, controlled clinical trials, and retrospective studies, were included with the aim of comparing fixation techniques (lag screws, 3-dimensional plates, 1 plate, and 2 miniplates) in the management of AMFs. The incidence of postoperative complications was evaluated.
RESULTS
Thirteen publications were included: 8 randomized controlled trials, 3 controlled clinical trials, and 2 retrospective studies. Seven studies showed a low risk for bias, 3 studies showed a moderate risk for bias, and 3 studies showed a high risk for bias. There were statistically significant advantages for lag screws and 1 plate plus an arch bar. There was no statistically significant difference between 3-dimensional plates and 2 miniplates. The cumulative odds ratio was 0.29, meaning that the use of lag screws in the fixation of AMFs decreases the risk for postoperative complications by 71% over the use of 2 miniplates. The cumulative odds ratio for 1 plate plus an arch bar was 0.28, showing that the use of 1 plate plus an arch bar in the fixation of AMFs decreases the risk for postoperative complications by 72% over the use of 2 plates.
CONCLUSIONS
The results of this meta-analysis revealed that the use of both lag screws and 1 plate plus an arch bar were superior to 2 miniplates in reducing the incidence of postoperative complications in the management of AMFs. Also, there were significantly shorter operating times with lag screws and 3-dimensional miniplates over 2 miniplates in the fixation of AMFs.
Topics: Humans; Mandibular Fractures; Orthognathic Surgical Procedures
PubMed: 25315317
DOI: 10.1016/j.joms.2014.07.042 -
International Journal of Oral and... Mar 2018The treatment of mandibular fractures by open reduction and internal fixation is very variable. Thus, there are many controversies about the best fixation system in... (Review)
Review
The treatment of mandibular fractures by open reduction and internal fixation is very variable. Thus, there are many controversies about the best fixation system in terms of stability, functional recovery, and postoperative complications. This systematic review sought scientific evidence regarding the best indication for the use of three-dimensional (3D) plates in the treatment of mandibular fractures. A systematic search of the PubMed/MEDLINE, Elsevier/Scopus, and Cochrane Library databases was conducted to include articles published up until November 2016. Following the application of the inclusion criteria, 25 scientific articles were selected for detailed analysis. These studies included a total of 1036 patients (mean age 29 years), with a higher prevalence of males. The anatomical location most involved was the mandibular angle. The success rate of 3D plates was high at this location compared to other methods of fixation. In conclusion, the use of 3D plates for the treatment of mandibular fractures is recommended, since they result in little or no displacement between bone fragments.
Topics: Bone Plates; Fracture Fixation, Internal; Humans; Mandibular Fractures; Postoperative Complications; Prosthesis Design
PubMed: 28928010
DOI: 10.1016/j.ijom.2017.08.009 -
Osteoporosis International : a Journal... Jan 2015This systematic review aimed to examine the evidence for teriparatide in Asia for osteoporosis with a high fracture risk and for exploratory (unapproved) bone-related... (Review)
Review
This systematic review aimed to examine the evidence for teriparatide in Asia for osteoporosis with a high fracture risk and for exploratory (unapproved) bone-related indications. MEDLINE (1946+), EMBASE (1966+), and ClinicalTrials.gov (2008+) were searched (16 August 2013); all studies of daily subcutaneous teriparatide 20 μg for bone-related conditions from China, Hong Kong, Japan, Republic of Korea, Philippines, Singapore, and Taiwan were included. Evidence on efficacy/safety was retrieved primarily from randomized controlled trials (10 publications) of postmenopausal women from Japan and China. In these studies, teriparatide was well tolerated; subjects had significantly greater increases in lumbar spine bone mineral density (BMD) from baseline compared with placebo, antiresorptive agents, or elcatonin/calcitonin; bone turnover markers increased from baseline and were sustained at elevated levels during teriparatide treatment. Few studies reported fracture risk, pain, or quality of life; one study showed a lower incidence of new-onset vertebral fracture with teriparatide versus antiresorptive agents. Nonrandomized studies (nine publications, one unpublished trial) conducted mainly in Taiwan, Japan, and the Republic of Korea provided supporting data for efficacy. The exploratory (unapproved) use of teriparatide (17 publications) for fracture healing and osteonecrosis of the jaw was described primarily in case reports. The clinical effectiveness of teriparatide for treatment of postmenopausal women with osteoporosis who are at high risk of fracture in Asia is focused primarily on improvements in BMD and tolerability. Recommended additional studies may include assessment of fracture risk and the effect of teriparatide on pain, quality of life, and mortality in Asia.
Topics: Asia; Asian People; Bone Density; Bone Density Conservation Agents; Drug Administration Schedule; Female; Humans; Injections, Subcutaneous; Male; Osteoporosis; Osteoporosis, Postmenopausal; Osteoporotic Fractures; Teriparatide
PubMed: 25138261
DOI: 10.1007/s00198-014-2838-7 -
PloS One 2023The aim of this META-analysis was to evaluate the efficacy of photobiomodulation (PBM) therapy in the treatment of inferior alveolar nerve (IAN) injury due to... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aim of this META-analysis was to evaluate the efficacy of photobiomodulation (PBM) therapy in the treatment of inferior alveolar nerve (IAN) injury due to orthognathic surgeries, extraction of impacted third molars and mandibular fractures.
METHODS AND MATERIALS
A electric search was conducted by a combination of manual search and four electric databases including Pubmed, Embase, Cochrane library and Web of Science, with no limitation on language and publication date. Gray literature was searched in ClinicalTrials.gov and googlescholar. All retrieved articles were imported into ENDNOTE software (version X9) and screened by two independent reviewers. All analysis was performed using the REVMAN software (version 5.3).
RESULTS
Finally, 15 randomized controlled trials met the inclusion criteria for qualitative analysis and 14 for META-analysis from 219 articles. The results showed that PBM therapy had no effect on nerve injury in a short period of time (0-48h, 14 days), but had significant effect over 30 days. However, the effect of photobiomodulation therapy on thermal discrimination was still controversial, most authors supported no significant improvement. By calculating the effective rate of PBM, it was found that there was no significant difference in the onset time of treatment, whether within or over 6 months.
CONCLUSIONS
The results of this META-analysis show that PBM therapy is effective in the treatment of IAN injures no matter it begins early or later. However, due to the limited number of well-designed RCTs and small number of patients in each study, it would be necessary to conduct randomized controlled trials with large sample size, long follow-up time and more standardized treatment and evaluation methods in the future to provide more accurate and clinically meaningful results.
Topics: Humans; Low-Level Light Therapy; Tooth Extraction; Mandibular Nerve; Mandibular Fractures
PubMed: 37561792
DOI: 10.1371/journal.pone.0287833 -
Annals of Plastic Surgery Sep 2015Little debate exists regarding the use of preoperative and perioperative antibiotic prophylaxis in the setting of mandibular fracture management; however, employing... (Review)
Review
INTRODUCTION
Little debate exists regarding the use of preoperative and perioperative antibiotic prophylaxis in the setting of mandibular fracture management; however, employing postoperative prophylactic antibiotics remains an inexact science based on experience rather than evidence. In this systematic review, the authors evaluate scientific literature and report results of an international survey that provide information regarding current practices of the plastic surgery community.
METHODS
Systematic literature review was performed using Medline, Embase, PubMed, and Cochrane databases to identify studies evaluating use of antibiotics in patients suffering from mandible fractures. Level 1, 2, and large retrospective studies were included. Case reports were excluded. Additionally, an E-survey was distributed to all ASPS members and data were collected over a 5-month period through SurveyMonkey.
RESULTS
Four hundred twenty-seven articles published before December 2012 were identified. Seventy-one articles met inclusion criteria. Five articles remained when exclusion criteria were applied.ASPS member survey demonstrated 13% response rate (687 responses/5299 questionnaires). Of respondents, 75% placed patients (ORIF group) with open mandible fractures on prophylactic antibiotics for up to 3 days (44.1%), 1 week (54.8%), and more than 1 week (1.1%). Of respondents, 51% placed patients (ORIF group) with closed mandible fracture on prophylactic antibiotics for up to 3 days (50.5%), 1 week (48.6%), and more than 1 week (1%).
CONCLUSION
Critical literature review demonstrates a trend towards no postoperative antibiotic coverage (>24 hours) in patients undergoing mandibular ORIF. There is further need for prospective, randomized control trials with a standardized regimen. Our survey elucidates the variability of plastic surgeons' clinical practices.
Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Health Care Surveys; Humans; Mandibular Fractures; Postoperative Care; Practice Patterns, Physicians'; Surgical Wound Infection; Treatment Outcome
PubMed: 24691320
DOI: 10.1097/SAP.0000000000000135 -
International Journal of Oral and... Sep 2019This systematic review and meta-analysis was performed to critically assess the methodological quality of the existing systematic reviews, and to evaluate the... (Meta-Analysis)
Meta-Analysis
This systematic review and meta-analysis was performed to critically assess the methodological quality of the existing systematic reviews, and to evaluate the postoperative complications of the mandibular fractures treated with locking and non-locking plate systems. An electronic search was conducted in PubMed, Embase, Web of Science, Cochrane library's electronic databases and grey literate using a combination of Medical Subject Heading terms and key words, until September 2018. No restrictions were applied to the search strategy. In total, three relevant systematic reviews were included, and the quality of these studies was low. A total of 33 studies (20 randomized studies and 13 non-randomized studies) were included in this systematic review, and 16 of them were included in meta-analysis. Most of the included randomized studies had an unclear risk of bias (Cochrane Collaboration); the quality of non-randomized studies ranged between 6 and 17 (Methodological Index for Non-Randomized Studies - MINORS). Based on the results of our meta-analysis, we conclude that locking plates are superior only with respect to the need for mandibulomaxillary fixation (MMF) in the early postoperative period.
Topics: Bone Plates; Fracture Fixation, Internal; Humans; Mandibular Fractures; Postoperative Complications
PubMed: 30876794
DOI: 10.1016/j.ijom.2019.02.019 -
International Journal of Oral and... Nov 2021The aim of this review was to compare mandibular angle fracture fixation methods that were evaluated through randomized clinical trials considering postoperative... (Meta-Analysis)
Meta-Analysis Review
The aim of this review was to compare mandibular angle fracture fixation methods that were evaluated through randomized clinical trials considering postoperative complications. Additionally, different treatment methods were ranked based on their performance. A systematic review was performed based on the Cochrane and PRISMA guidelines. The quality of evidence and network meta-analysis were conducted using the GRADE tool and R software, respectively. Four databases were searched, and the papers were selected based on the PICOS strategy. A total of 3584 papers were found. After screening 15 papers were included. One plate placed on lateral border (tension zone) presented lower risk than one plate placed on superior border (tension zone) for infection [risk ratio (RR): 0.48, 95% confidence interval (CI): 0.33 to 0.71] and plate removal necessity (RR: 0.44, 95% CI: 0.28 to 0.69), with moderate quality of evidence. There were no significant differences among the mandibular angle fracture treatments for malocclusion and paraesthesia outcomes. In conclusion, one plate placed on the lateral border in the tension zone is the best choice regarding postoperative infection and plate removal necessity when fixing mandibular angle fractures. None of the tested fixation methods were associated with a significant risk of malocclusion and paraesthesia events.
Topics: Bone Plates; Fracture Fixation; Fracture Fixation, Internal; Humans; Mandibular Fractures; Network Meta-Analysis; Randomized Controlled Trials as Topic
PubMed: 33676800
DOI: 10.1016/j.ijom.2021.02.009