-
Journal of Oral Rehabilitation Jun 2022Botulinum toxin type A (BoNTA) injection into the masticatory muscles has been widely used to treat a number of painful and nonpainful conditions; however, no systematic... (Review)
Review
BACKGROUND
Botulinum toxin type A (BoNTA) injection into the masticatory muscles has been widely used to treat a number of painful and nonpainful conditions; however, no systematic reviews have been performed on the long-term effect to the mandibular bone.
OBJECTIVE
Our systematic review aimed to evaluate the impact of botulinum toxin injection into the masticatory muscles on mandibular bone based.
METHODS
PubMed, Embase, Ovid, CINAHL and Web of Science were searched for human studies assessing mandibular bone after injection of BoNTA using computed tomography (CT) and cone beam CT (CBCT).
RESULTS
Seven studies were eligible for review; five reported significant bony changes to one or more areas of the mandible. Most frequently affected were the condylar head, coronoid process and ramus. The most frequent changes were decreased bone volume, cortical thickness and cortical and trabecular density.
CONCLUSIONS
This is the first systematic review to examine an association between BoNTA injection into the masticatory muscles and mandibular bone quality. Data were analysed from a limited number of studies with a small sample size, and the quality of the included studies was very low. While the majority of available evidence suggests BoNTA injection results in bony change, further study is required to confirm a dose-dependence effect and the impact of gender and age. High-quality trials should utilise a combination of software analysis and radiologist review, with longer-term follow-up to monitor for persistence of bony effect and clinical significance.
Topics: Botulinum Toxins, Type A; Cone-Beam Computed Tomography; Humans; Mandible; Mandibular Condyle; Masticatory Muscles; Tomography, X-Ray Computed
PubMed: 35348239
DOI: 10.1111/joor.13326 -
The British Journal of Oral &... Feb 2024This study aims to review surgical treatment in paediatric condylar fractures and describe different types of techniques performed, along with the results obtained from... (Review)
Review
This study aims to review surgical treatment in paediatric condylar fractures and describe different types of techniques performed, along with the results obtained from them. A retrospective review was conducted from records of paediatric patients (from one to 17 years old) who sustained fractures of the mandibular condyle and underwent surgical treatment from 2003 to 2023. The number of patients, age, location, and type of fracture, clinical and imaging examinations, treatment methods, intraoperative/postoperative complications, removal of osteosynthesis material, follow up and outcomes were recorded and analysed. A total of 68 patients with 79 fractures were identified. The most common fracture pattern was condylar neck fracture (61.1%). Of the 68 patients who underwent surgical treatment, one had a complication of minimal temporal paraesthesia and another patient had near-complete resorption of the condyle. A total of 55 patients (81%) reported normal dental occlusion, mouth opening (>35 mm), lateral excursions (7-8 mm), TMJ function, no pain, no deviation of the midline or the jaw, and no ankylosis. Thirteen patients (19%) developed an unsatisfactory result, nine patients (13%) had a jaw deviation on mouth opening, four patients (6%) had mandibular retrusion, and seven patients (10%) had signs of TMJ dysfunction. A total of 59 patients (87%) reported bone completely healed with no signs of bone abnormality; seven patients (10%) had shortening of the condylar neck and/or ramus. Surgical treatment can lead to good or excellent results for severely dislocated and displaced condylar fractures in children and can reduce the unsatisfactory results resulting from closed treatment.
Topics: Humans; Child; Infant; Child, Preschool; Adolescent; Mandibular Condyle; Tooth Ankylosis; Fractures, Bone; Intraoperative Complications; Postoperative Complications
PubMed: 38155068
DOI: 10.1016/j.bjoms.2023.10.015 -
National Journal of Maxillofacial... Aug 2022To review the literature on the effect of different surgical approaches on facial nerve injuries. The present systematic review addresses the following focus question:... (Review)
Review
To review the literature on the effect of different surgical approaches on facial nerve injuries. The present systematic review addresses the following focus question: Is the facial nerve at risk following surgical correction of mandibular condylar fracture? Electronic and manual literature searches were conducted on databases:PubMed, ScienceDirect and Google scholar,Cochrane and clinicaltrials.gov for studies published until July 2020 to collect information about the effect of different surgical approaches on facial nerve injuries. Systematic literature review was performed following the prisma guidelines to identify studies. Quantitative retrospective and prospective studies,controlled trials,controlled clinical trials were included;case reports and review articles were excluded from this systematic review. 1500 articles published till July 2020 was identified. 116 articles met inclusion criteria. After applying exclusion criteria seven articles were shortlisted. The level of heterogeneity was observed to be less than 50%, between all parameters for all studies making publication bias to be minimum. On comparing various studies statistically using Z-test for all parameters,it was observed that level of significance was significant for various findings like Displacement/Dislocation of fracture and transient facial nerve weakness was found to be statistically significant between all studies (p-value <0.05). Odd ratio, relative ratio and 95% CI was derived for all parameters recorded for various studies. Due to less number of subjective studies, and variability in study designs and lack of reporting on confounding factors,definitive conclusions on effect of various surgical approaches on facial nerve injury cannot be drawn Future well-designed long-term randomized controlled trials are necessary to reveal the necessary correlation between both the parameters.
PubMed: 36393942
DOI: 10.4103/njms.njms_481_21 -
Journal of Stomatology, Oral and... Oct 2022Maxillary impactions are seen as an orthognathic surgical movement that increases the number of complications. The aim of this paper is to research literature on this... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Maxillary impactions are seen as an orthognathic surgical movement that increases the number of complications. The aim of this paper is to research literature on this topic, with special attention to avoiding of complications.
METHODS
A systematic review was carried out according to the PRISMA guidelines. The PROSPERO registration has been performed. A risk of bias assessment was carried out with RevMan and graphics were created. A total of 20 articles were included in this systematic review.
RESULTS
Some interesting and conclusive facts about maxillary impactions. Relapses are not common due to the higher bone contact. Bleeding is a common complication due to the location of palatal artery. Aesthetic and functional complications can arise, especially in the nasal region. Bimaxillary orthognathic surgeries has a higher incidence of complications.
CONCLUSIONS
Today it is not possible to confirm that maxillary impactions alone are responsible for a higher incidence of complications due to the complexity of the three-dimensional movements. Some surgical steps could be safer and cause fewer complications.
Topics: Humans; Maxilla; Nose; Orthognathic Surgery; Orthognathic Surgical Procedures; Tooth, Impacted
PubMed: 34755611
DOI: 10.1016/j.jormas.2021.10.014 -
Oral Surgery, Oral Medicine, Oral... Sep 2022To address the factors that affect the quality of life (QoL) of individuals undergoing treatment for mandibular fractures. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To address the factors that affect the quality of life (QoL) of individuals undergoing treatment for mandibular fractures.
STUDY DESIGN
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the search strategy was constructed according to the Populations, Interventions, Comparison, Outcomes, and Study Design principle in the following databases: PubMed, Web of Science, Scopus, and EMBASE. Risk of bias assessment was performed with Risk Of Bias In Non-randomized Studies of Interventions and Cochrane Risk of Bias tool for randomized trials 2.
RESULTS
Nineteen studies were included: 15 observational and 4 clinical trials. Mean age ranged from 28 to 39 years, with a higher proportion of males. The condyle was the main fracture location and traffic accident was the fracture cause. Treatment approaches were mostly open reduction (89.4%) and maxillomandibular fixation (63%). QoL measurements varied considerably with the General Oral Health Assessment Index (31.5%) and Oral Health Impact Profile-14 (21%) as the main instruments. Meta-analysis showed that open reduction and maxillomandibular fixation did not present significant differences to QoL (P = .39), but significant differences were observed with time (P < .00001). Other factors affected QoL, such as mental health, pain, socializing, appearance, and eating difficulties.
CONCLUSIONS
Several factors, apart from the treatment approach, mentioned in this review seemed to affect the QoL of patients with mandibular trauma. Treatment choice should be based on well-stablished clinical criteria and on all other factors mentioned here.
Topics: Adult; Humans; Jaw Fixation Techniques; Male; Mandibular Fractures; Quality of Life
PubMed: 35440426
DOI: 10.1016/j.oooo.2022.01.012 -
Otolaryngology--head and Neck Surgery :... May 2023The aim of this study is to review the current literature on treatment of subcondylar fractures using traditional open reduction internal fixation (ORIF), closed... (Review)
Review
OBJECTIVE
The aim of this study is to review the current literature on treatment of subcondylar fractures using traditional open reduction internal fixation (ORIF), closed reduction with maxillomandibular fixation (MMF), and endoscopic open approaches.
DATA SOURCES
PubMed, Embase, Cochrane CENTRAL, Clinicaltrials.gov, and WHO ICTRP.
REVIEW METHODS
A comprehensive database search was performed in accordance with PRISMA guidelines. All English-only texts published in the last 20 years with ≥10 patients were included. Studies that included patients <16 years old were excluded.
RESULTS
Thirty-two studies met the final inclusion criteria. Nine studies compared ORIF with closed reduction using MMF, 12 studies evaluated ORIF via different approaches, and 10 studies evaluated outcomes after endoscopic approaches. Five studies reported significant improvement in mouth opening with ORIF compared to closed reduction. In 1 study that recorded patient-reported outcomes measure (FACE-Q scale), quality of life scores and patient satisfaction were significantly higher in the ORIF group. Among the 10 studies that used the endoscopic approach, transient facial nerve injury ranged from 0% to 10%.
CONCLUSION
Several studies report better mouth opening, dental occlusion, and functional outcomes after ORIF compared to closed reduction, while some found no significant difference. Endoscopic approaches provide ease of access to the condyle with a low incidence of facial nerve injury. However, limitations include special equipment, longer operative times, and a steep learning curve using an endoscope. This review provides surgeons with an overview of the current literature on subcondylar fractures to allow for an individualized management approach for each patient.
Topics: Humans; Adolescent; Treatment Outcome; Fracture Fixation, Internal; Mandibular Fractures; Facial Nerve Injuries; Quality of Life; Mandibular Condyle
PubMed: 36939481
DOI: 10.1002/ohn.185 -
Journal of Oral Rehabilitation Sep 2023Fractures of the mandibular condyle are the most common jaw fractures. There are several treatment approaches. There is the non-surgical and surgical approach. The... (Review)
Review
Conservative treatment of temporomandibular joint condylar fractures: A systematic review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.
OBJECTIVE
Fractures of the mandibular condyle are the most common jaw fractures. There are several treatment approaches. There is the non-surgical and surgical approach. The purpose of this systematic literature review is to evaluate the indications and contraindications of either method to help the clinician make the best treatment choice.
METHODS
Pubmed, Web of Science and Lilacs were systematically searched until 20 May 2023. Clinical trials were selected to compare the two treatments for condyle fracture and evaluate indications and contraindications.
RESULTS
Out of 2515 papers, four studies were included. The surgical approach allows faster functional recovery and decreases patient discomfort. The study analyses under what circumstances a surgical procedure is more practical than a non-surgical one.
CONCLUSION
There is no evidence regarding the reliability of either method. Both have superimposable results. However, age, type of occlusion and other factors direct the clinician towards a surgical choice.
Topics: Humans; Treatment Outcome; Fracture Fixation, Internal; Conservative Treatment; Reproducibility of Results; Mandibular Fractures; Mandibular Condyle; Temporomandibular Joint Disorders; Temporomandibular Joint
PubMed: 37191365
DOI: 10.1111/joor.13497 -
Oral Surgery, Oral Medicine, Oral... May 2023The recent trend favors the open reduction and internal fixation of condylar fractures to prevent long-term consequences. Nonendoscopic intraoral approach is an option... (Review)
Review
OBJECTIVE
The recent trend favors the open reduction and internal fixation of condylar fractures to prevent long-term consequences. Nonendoscopic intraoral approach is an option for management without a visible scar. The purpose of this systematic review was to explore the evidence, armamentarium, methods of reduction and fixation, challenges, and complications.
STUDY DESIGN
We have systematically reviewed published articles on the intraoral approach for condylar fracture management following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane library database, to find relevant articles from January 1980 to March 2022. Descriptive statistics were applied to obtain the results.
RESULTS
Finally, 23 studies were included. The incision described for the intraoral approach was similar to sagittal split osteotomy in all studies. A wide array of specialized instruments, methods, and challenges has been outlined for visualization, reduction, and fixation. The incidence of complications in the entire review was 23% (72/306).
CONCLUSION
The challenges encountered in the nonendoscopic intraoral approach for condylar fracture management can be negated with the use of specialized instruments and with experience. However, further research is warranted for a specialized set of miniature instruments to ease the procedure, make it time-efficient and optimize hardware selection.
Topics: Humans; Mandibular Condyle; Mandibular Fractures; Fracture Fixation, Internal; Osteotomy
PubMed: 36257907
DOI: 10.1016/j.oooo.2022.09.003 -
Dento Maxillo Facial Radiology Jul 2020To critically synthesize the literature surrounding segmentation of the mandibular condyle using three-dimensional imaging modalities. Specifically, analyzing the...
OBJECTIVE
To critically synthesize the literature surrounding segmentation of the mandibular condyle using three-dimensional imaging modalities. Specifically, analyzing the reliability and accuracy of methods used for three-dimensional condyle segmentation.
METHODS
Three electronic databases were searched for studies reporting the reliability and accuracy of various methods used to segment mandibular condyles from three-dimensional imaging modalities. Two authors independently reviewed articles for eligibility and data extraction.
RESULTS
Nine studies fulfilled the inclusion criteria. Eight studies assessed the condylar segmentation from CBCT images and limited studies were available on non-CBCT three-dimensional imaging modalities. Threshold-based volume segmentation, manual segmentation, and semi-automatic segmentation techniques were presented. Threshold-based volume segmentation reported higher accuracy when completed by an experienced technician compared to clinicians. Adequate reliability and accuracy were observed in manual segmentation. Although adequate reliability was reported in semi-automatic segmentation, data on its accuracy were lacking.
CONCLUSION
A definitive conclusion with regards to which current technique is most reliable and accurate to efficiently segment the mandibular condyle cannot be made with the currently available evidence. This is especially true in terms of non-CBCT imaging modalities with very limited literature available.
Topics: Cone-Beam Computed Tomography; Imaging, Three-Dimensional; Mandibular Condyle; Reproducibility of Results
PubMed: 31778321
DOI: 10.1259/dmfr.20190150 -
The British Journal of Oral &... Dec 2023The choices for managing a condylar head fracture (CHF) of the mandible are either open surgical or closed functional treatments (CFT) and the decision depends on... (Meta-Analysis)
Meta-Analysis Review
The choices for managing a condylar head fracture (CHF) of the mandible are either open surgical or closed functional treatments (CFT) and the decision depends on various factors. The purpose of this systematic review was to ascertain from the available literature whether the open method or CFT yields better outcomes in managing CHF. We have systematically reviewed published articles according to the PRISMA statement. The search was conducted in PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library database for comparative studies about both open and closed treatments from inception until April 2023. The outcomes of interest were mouth opening (MO), protrusion, laterotrusion, postoperative pain, and malocclusion. Eight studies met the inclusion criteria. The review comprised of 326 cases, among which 177 were managed by open methods and 149 were treated by CFT. The incidence of postoperative malocclusion and pain were significantly less in the open group. MO was better in the open treatment group although this was not statistically significant. Protrusion and laterotrusion occurred slightly more in CFT, although these were also statistically not significant. Overall, meta-analysis favoured open methods of managing CHF. Although enough evidence exists for the use of open methods for selected condylar head fractures, CFT still demonstrated favourable outcomes in undisplaced fractures. The selection of a particular treatment method should be individualised on the basis of each particular case considering the risk/benefits. Further high quality randomised trials are needed to establish a therapeutic guideline.
Topics: Humans; Mandibular Condyle; Mandibular Fractures; Fracture Fixation, Internal; Treatment Outcome; Malocclusion
PubMed: 37996317
DOI: 10.1016/j.bjoms.2023.10.010