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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 -
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 -
Animals : An Open Access Journal From... Aug 2022Skeletal Class II malocclusion is the most common skeletal anomaly in orthodontics. Growth in the body of the deficient mandible is induced by periosteal apposition and... (Review)
Review
Skeletal Class II malocclusion is the most common skeletal anomaly in orthodontics. Growth in the body of the deficient mandible is induced by periosteal apposition and endochondral ossification in the condyle. Functional appliances have been used in the correction of Class II malocclusions by inducing mandibular growth. Despite their utilization though, their effect still remains controversial. The aim of the present study is to review the existing literature regarding the effects of mandibular protrusion in mandibular growth of growing rats. A protocol was followed according to the guidelines of the . Databases were searched using a specific algorithm. From the ten studies finally analyzed, we conclude that the use of a functional appliance in growing rats induces cell proliferation and bone formation in their condyles, resulting in mandibular growth.
PubMed: 36009649
DOI: 10.3390/ani12162059 -
International Journal of Oral and... Jun 2017The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars in mandibular condyle fractures. An electronic... (Meta-Analysis)
Meta-Analysis Review
The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars in mandibular condyle fractures. An electronic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and VHL, through January 2016. The eligibility criteria included observational studies. The search strategy resulted in 704 articles. Following the selection process, 13 studies were included in the systematic review and 11 in the meta-analysis. In terms of the risk of bias analysis, six studies presented ≤6 stars in the Newcastle-Ottawa scale assessment. The presence of a mandibular third molar decreased the probability of condylar fracture (cross-sectional and case-control studies: odds ratio (OR) 0.26, 95% confidence interval (CI) 0.17-0.40, I=87.8%; case-control studies: OR 0.30, 95% CI 0.16-0.58, I=91.6%). The third molar positions most favourable to condylar fracture according to the Pell and Gregory classification are class A (OR 1.32, 95% CI 1.09-1.61, I=0%) and class I (OR 1.37, 95% CI 1.05-1.77, I=32.8%). Class B (OR 0.69, 95% CI 0.49-0.97, I=56.0%) and class II (OR 0.71, 95% CI 0.57-0.87, I=0%) act as protective factors for condylar fracture. The results suggest that the presence of a mandibular third molar decreases the chance of condylar fracture and that the positions of the third molar most favourable for condylar fracture are classes A and I, with classes B and II acting as protective factors.
Topics: Humans; Mandibular Condyle; Mandibular Fractures; Molar, Third; Risk Factors; Tooth, Impacted
PubMed: 28259600
DOI: 10.1016/j.ijom.2017.02.1265 -
Clinical Oral Investigations Aug 2021To identify the preferred surgical approach (intra- or extra-oral) to remove an ectopic third mandibular molar (ETMM) according on its location and presence of an... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To identify the preferred surgical approach (intra- or extra-oral) to remove an ectopic third mandibular molar (ETMM) according on its location and presence of an associated cyst or cutaneous fistula, and to determine the indications for a graft or osteosynthesis.
MATERIALS AND METHODS
A surgical practice questionnaire was distributed to oral and maxillo-facial surgeons attending a National Congress of the French Society of Stomatology, Maxillo-facial and Oral Surgery. A systematic review of the literature and meta-analysis was carried on Pubmed, Cochrane, Embase and ScienceDirect databases using the MeSH terms: "Ectopic teeth", "Third molar", "Mandibular". One hundred and forty-three surgeons answered the questionnaire and the meta-analysis included 66 articles.
RESULTS
From the questionnaire, the preferred surgical approach was intra-oral except when the ETMM was in the condyle, when it was extra-oral (69.5%; p < 0.001). In the meta-analysis, an extra-oral approach was only indicated when a cutaneous fistula was present (90% vs. 35.9%; p = 0.002), irrespective of ETMM location. In the questionnaire and meta-analysis, the presence of a cyst did not change the approach (p < 0.05). The indications for a graft or osteosynthesis were a condylar location (p < 0.001), while a cutaneous fistula decreased the indication (p = 0.04) and a cyst (p = 0.009) was only associated with a graft.
CONCLUSIONS
The preferential approach was intra-oral, except when the ETMM was condylar or a cutaneous fistula was present when an extra-oral approach was preferred. Osteosynthesis or a graft were more likely when the ETMM was in the condyle.
CLINICAL RELEVANCE
This study will help to orientate surgeons vis-à-vis ETMM treatment.
Topics: Humans; Mandible; Mandibular Condyle; Molar; Molar, Third; Tooth Extraction; Tooth, Supernumerary
PubMed: 34137925
DOI: 10.1007/s00784-021-04018-z -
Journal of Oral Rehabilitation Aug 2021Mandibular collum fractures among growing patients can lead to abnormal growth, function, esthetics and ultimately quality of life. Among the proposed treatment... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Mandibular collum fractures among growing patients can lead to abnormal growth, function, esthetics and ultimately quality of life. Among the proposed treatment alternatives, orthopaedic treatment with functional appliances has been suggested, with encouraging results. Aim of the present systematic review was to critically appraise existing evidence on the outcome of functional appliance treatment among growing patients with mandibular collum fractures.
MATERIALS AND METHODS
Eight databases were searched up to October 2020 for randomised and non-randomised clinical studies assessing functional appliance treatment outcome for children with mandibular fractures. After duplicate study selection, data extraction and risk of bias assessment, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE.
RESULTS
A total of 8 unique studies (one prospective and nine retrospective non-randomised) with 223 children could be identified. Functional appliance treatment was associated with greater anteroposterior condyle dimensions of the injured condyle compared with the contralateral healthy condyle (3 studies; MD = 0.87 mm; 95% CI = 0.30 to 1.45 mm; p = .003). No difference was found in the mesiodistal condyle size between the injured and the contralateral healthy joint (3 studies; MD = -0.05 mm; 95% CI = -1.05 to 0.95 mm; p = .92), but collum length was smaller at the injured side compared with the contralateral one (1 study; MD = -2.89 mm; 95% CI = -5.29 to -0.49 mm; p = .02). Treatment outcome might be influenced by patient age, patient sex and severity/localisation of the fracture, but the quality of evidence for all analyses was very low due to methodological limitations leading to bias.
CONCLUSIONS
While some evidence exists that functional appliances might lead to good clinical rehabilitation of fractured mandibular condyles, including considerable bone remodelling, available studies are small and have methodological weaknesses.
Topics: Child; Esthetics, Dental; Humans; Mandibular Fractures; Prospective Studies; Quality of Life; Retrospective Studies
PubMed: 33963591
DOI: 10.1111/joor.13178 -
Archives of Oral Biology Oct 2018The aim of this systematic review was to provide a comprehensive synthesis of available evidence evaluating the effect of dietary loading on temporomandibular... (Meta-Analysis)
Meta-Analysis Review
The impact of dietary consistency on structural craniofacial components: Temporomandibular joint/condyle, condylar cartilage, alveolar bone and periodontal ligament. A systematic review and meta-analysis in experimental in vivo research.
OBJECTIVE
The aim of this systematic review was to provide a comprehensive synthesis of available evidence evaluating the effect of dietary loading on temporomandibular joint/condyle, condylar cartilage, alveolar bone of the mandible and the periodontal ligament in healthy mice and rats.
DESIGN
Medline via PubMed, EMBASE and Open Grey databases were searched for published and unpublished literature. Search terms included "mandiblular condyle", "alveolar bone", "temporomandibular joint", "condylar cartilage", "periodontal ligament", "rat", "mice". After data extraction, risk of bias (SYRCLE) and reporting quality (ARRIVE) were assessed. Random effects meta-analyses were performed for the outcomes of interest where applicable.
RESULTS
A total of 33 relevant articles were considered in the systematic review, while only 6 studies were included in the quantitative synthesis. Risk of Bias in all studies was judged to be unclear to high overall, while reporting quality was suboptimal. Comparing soft to hard diet animals, significantly reduced anteroposterior condylar length (4 studies, weighted mean difference: -0.40 mm; 95% CI: -0.47, -0.32; p < 0.001) and width (4 studies, weighted mean difference: -0.043 mm; 95% CI: -0.51, -0.36; p < 0.001) were found in rats. Decreased anteroposterior condylar dimensions were detected for mice as well (2 studies, weighted mean difference: -0.049; 95% CI: -0.56, -0.43; p < 0.001).
CONCLUSIONS
Overall, there was strong evidence to suggest a significant effect of soft diet on reduced condylar dimensions in rodents; however, there is need for further high quality experimental studies to inform current knowledge on condylar cartilage, alveolar bone and periodontal ligament related outcomes.
Topics: Animal Feed; Animals; Cartilage, Articular; Databases, Factual; Diet; Mandible; Mandibular Condyle; Mice; Periodontal Ligament; Rats; Temporomandibular Joint
PubMed: 29957455
DOI: 10.1016/j.archoralbio.2018.06.016 -
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 -
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