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Otolaryngologic Clinics of North America Dec 2023Mandible fracture management has evolved dramatically. Therefore, the variety of surgical complications associated with mandibular fractures, and their incidences, have... (Review)
Review
Mandible fracture management has evolved dramatically. Therefore, the variety of surgical complications associated with mandibular fractures, and their incidences, have continued to change as well. This article aims to assess the most common and most concerning complications that can occur secondary to management of mandibular fractures by examining categories of complication types. This article also explores factors and techniques associated with reduced rates of complications as well as the management of complications.
Topics: Humans; Mandibular Fractures; Mandibular Condyle; Temporomandibular Joint Disorders; Ankylosis
PubMed: 37353369
DOI: 10.1016/j.otc.2023.05.008 -
Journal of Feline Medicine and Surgery Feb 2023Feline head trauma injuries are common in general practice, often resulting in mandibular fracture. An understanding of the recent advances in the field of mandibular... (Review)
Review
PRACTICAL RELEVANCE
Feline head trauma injuries are common in general practice, often resulting in mandibular fracture. An understanding of the recent advances in the field of mandibular fracture repair will facilitate evidence-based decision-making in clinical practice.
CLINICAL CHALLENGES
Feline maxillofacial and oral anatomy brings unique challenges in comparison with dogs. It has been commonplace to adapt techniques and equipment that are better suited to other body regions or are species-inappropriate for use in feline maxillofacial surgery, and this has traditionally resulted in high morbidity.
AIMS
This review presents an overview of the diagnosis of, and decison-making for, maxillofacial trauma in cats, specifically with reference to the feline mandible. The challenges associated with the management of these injuries are presented. Techniques for repair that can be employed in general practice, as well as more advanced surgical options, are discussed, as well as the indications for invasive vs non-invasive management. Underutilised methods involving composite dental materials and their versatility for the repair of mandibular fractures in cats, and miniplates for caudal mandibular fractures in cats, are specifically covered, as well as other recent advances in the field, including three-dimensional printing and custom-printed implants.
EVIDENCE BASE
Management of feline facial fractures is an often neglected topic, with very few published studies choosing to focus on head trauma outcomes in cats. Where available, however, this review draws on the published literature, as well as the authors' own clinical experience.
Topics: Animals; Cats; Humans; Craniocerebral Trauma; Dentists; Mandibular Fractures
PubMed: 36744847
DOI: 10.1177/1098612X231152521 -
International Journal of Oral and... Nov 2020The purpose of this study was to clarify the frequency of missed mandibular fractures and to identify possible predictive factors for missed diagnosis. This was a...
The purpose of this study was to clarify the frequency of missed mandibular fractures and to identify possible predictive factors for missed diagnosis. This was a retrospective study that included patients <20 years of age with a recent mandibular fracture. The outcome variable was missed mandibular fracture, which was determined when a fracture was not suspected or diagnosed during the patient's first assessment in primary healthcare. The primary predictor variable was age group (i.e. children <13 years or teenagers/adolescents aged 13-19 years). The explanatory variables were sex, mechanism of injury, and type of facial facture. Other variables were clinical symptoms and findings. Mandibular fracture was missed at first contact in 27 of 182 patients (14.8%). Fracture was missed significantly more often in patients <13 years than in older patients (33.3% vs. 8.8%, P<0.001). The only significant symptom or clinical finding that was associated with missed fractures was skin wound of the jaw (P=0.009). There was no association between missed fracture and sex or mechanism of injury. Mandibular fractures in children are often missed at the first healthcare contact. Careful examination is necessary in paediatric mandibular injuries, particularly in the youngest age groups. Consultation should be smooth between paediatric trauma units and maxillofacial surgeons.
Topics: Adolescent; Adult; Aged; Child; Humans; Mandibular Fractures; Retrospective Studies; Young Adult
PubMed: 32680807
DOI: 10.1016/j.ijom.2020.06.008 -
Stomatologija 2022To clarify antibiotic use by oral and maxillofacial surgeons in mandibular fracture patients and evaluate practices based on scientific evidence. (Review)
Review
OBJECTIVE
To clarify antibiotic use by oral and maxillofacial surgeons in mandibular fracture patients and evaluate practices based on scientific evidence.
MATERIAL AND METHODS
We assessed antibiotic use in simple symphysis and angle mandibular fractures among oral and maxillofacial surgeons in the Nordic countries through an e-survey. In addition, we performed a literature review of antibiotic administration in mandibular fracture surgery.
RESULTS
A total of 41 oral and maxillofacial surgeons who treat mandibular fractures responded to the questionnaire. Timing and duration of antibiotic use varied. The duration of postoperative antibiotic treatment ranged from 1 to 7 days (mean 5.6 days). Respondents' practices were not in concordance with scientific evidence. According to previous studies, restricting antibiotic exposure to a maximum of 24 hours postoperatively was not related to a higher risk of surgical site infections. No articles described a benefit of prolonged postoperative antibiotic therapy.
CONCLUSIONS
Antibiotic use in connection with mandibular fracture treatment varied in the Nordic countries and antibiotic practices are not in concordance with the current literature. Restricting antibiotic exposure to a maximum of 24 hours postoperatively should be considered. Clear guidelines for antibiotic prophylaxis as part of the surgical management of mandibular fractures are required.
Topics: Humans; Anti-Bacterial Agents; Mandibular Fractures; Antibiotic Prophylaxis; Surgical Wound Infection; Surveys and Questionnaires
PubMed: 37140236
DOI: No ID Found -
Journal of Cranio-maxillo-facial... Aug 2017Intermaxillary fixation (IMF) techniques are commonly used in mandibular fracture treatment to reduce bone fragments and re-establish normal occlusion. However, non-IMF... (Review)
Review
BACKGROUND
Intermaxillary fixation (IMF) techniques are commonly used in mandibular fracture treatment to reduce bone fragments and re-establish normal occlusion. However, non-IMF reduction techniques such as repositioning forceps may be preferable due to their quick yet adequate reduction. The purpose of this paper is to assess which non-IMF reduction techniques and reduction forceps are available for fracture reduction in the mandible.
METHODS
A systematic search was performed in the databases of Pubmed and EMBASE. The search was updated until February 2016 and no initial date and language preference was set.
RESULTS
14 articles were selected for this review, among them ten articles related to reduction forceps and four articles describing other techniques. Thus, modification and design of reduction forceps and other reduction techniques are qualitatively described.
CONCLUSION
Few designs of repositioning forceps have been proposed in the literature. Quick and adequate reduction of fractures seems possible with non-IMF techniques resulting in anatomic repositioning and shorter operation time, especially in cases with good interfragmentary stability. Further development and clinical testing of reduction forceps is necessary to establish their future role in maxillofacial fracture treatment.
Topics: Fracture Fixation; Humans; Mandibular Fractures
PubMed: 28624238
DOI: 10.1016/j.jcms.2017.05.017 -
International Journal of Oral and... Jan 2017Factors associated with the diagnosis, aetiology, and treatment of mandibular fractures occurring during the postoperative period following the removal of a lower third... (Review)
Review
Factors associated with the diagnosis, aetiology, and treatment of mandibular fractures occurring during the postoperative period following the removal of a lower third molar are discussed. The following databases were searched using specific key words: PubMed/MEDLINE, LILACS, Embase, and Scopus. The search yielded 124 cases. Sex, age, side, tooth position and angulation, bone impaction, relationship between the tooth and the inferior alveolar nerve, local pathological conditions, aetiology of the fracture, symptomatology, and time between surgery and fracture, as well as any displacement of the fracture and the treatment of the fracture, were evaluated. Data were tabulated and the χ statistical test was applied (P<0.05). Male patients aged >35 years, with teeth in positions II/III and B/C, complete bony impaction, and local bone-like alterations, were found to have a higher frequency of fracture and pericoronitis (P<0.05). Late fractures generally occurred between the second and fourth postoperative weeks (P<0.05). They were generally not displaced and the typical treatment was the non-surgical approach (P<0.05). It is concluded that the risk of mandibular fracture after extraction is associated with excessive ostectomy and/or local alterations. At-risk patients should be thoroughly briefed on the importance of a proper postoperative diet.
Topics: Fracture Fixation; Humans; Mandibular Fractures; Molar, Third; Postoperative Complications; Risk Factors; Tooth Extraction; Tooth, Impacted
PubMed: 27688170
DOI: 10.1016/j.ijom.2016.09.003 -
The Journal of Craniofacial Surgery 2019The mandibular fracture takes the second position among facial bones fractures, with significant increase of cases in the last years. The aim of this paper is to report...
The mandibular fracture takes the second position among facial bones fractures, with significant increase of cases in the last years. The aim of this paper is to report a clinical case of a patient with facial trauma due to an automotive accident, resulting in an atypical fracture in a unilateral mandibular angle. In the image examinations an atypical favorable fracture in the right mandibular angle region involving the apex of the erupted 48 tooth was found. The fracture line started in the posterior region of mandibular ramus, below mandibular condyle, and spread out until inferior border of the mandible in premolar region. Despite the atypical design of the mandibular angle fracture described in this paper, the treatment showed satisfactory results, without any aesthetic or functional changes for the patient.
Topics: Adult; Fracture Fixation, Internal; Humans; Male; Mandibular Condyle; Mandibular Fractures
PubMed: 30608380
DOI: 10.1097/SCS.0000000000005080 -
Journal of Cranio-maxillo-facial... Apr 2018The aim of this study was to investigate the risk of mandibular angle fracture associated with the presence of a mandibular third molar and its position when the... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The aim of this study was to investigate the risk of mandibular angle fracture associated with the presence of a mandibular third molar and its position when the mandibular fracture occurs.
METHODS
A systematic literary search was performed in Pubmed, Scopus, and the Cochrane Library for observational studies with at least 250 patients that included frequency of mandibular angle fracture, presence of third molar, and its position.
RESULTS
A total of seven studies were included in the review, from an initial search of 622 titles. The relative risk of mandibular angle fracture with third molar was 1.90 (95% CI = 1.47-2.46). The relative risk of mandibular angle fracture related to third molar position (according to the Pell and Gregory classification) was 1.18 (95% CI = 0.62-2.25), 1.98 (95% CI = 0.95-4.10), 2.72 (95% CI = 1.78-4.16), 1.31 (95% CI = 0.80-2.14), 2.21 (95% CI = 1.69-2.87) and 2.99 (95% CI = 2.12-4.22) for Class A, Class B, Class C, Class I, Class II, and Class III, respectively.
CONCLUSIONS
Our meta-analysis reported a two-fold increased risk of mandibular angle fracture with the presence of a third molar in patients who presented with mandibular fractures. Even the third molar position seemed to influence mandibular angle fracture, especially Class C, Class II, and Class III.
Topics: Humans; Mandible; Mandibular Fractures; Molar, Third
PubMed: 29459187
DOI: 10.1016/j.jcms.2017.12.011 -
Dental Traumatology : Official... Jun 2021Teeth in a jaw fracture line, because of the presence of the periodontal ligament, may communicate with the oral cavity. There are no guidelines for the management of...
BACKGROUND/AIMS
Teeth in a jaw fracture line, because of the presence of the periodontal ligament, may communicate with the oral cavity. There are no guidelines for the management of teeth in mandibular fracture lines. The aim of this study was to investigate the factors related to dental problems with teeth involved in mandibular fracture lines and to determine the best treatment option.
MATERIAL AND METHODS
This retrospective study was based on the medical and radiographic records of patients with mandibular fractures. The relationships among the patient's age, gender, smoking history, amount of bony displacement, surgery, trauma-surgery period, apical involvement, tooth mobility, and periodontal status were investigated. Group comparisons were performed using the chi-squared test, Fisher's exact test, and Mann-Whitney U-test.
RESULT
A total of 238 patients (247 fracture lines) with mandibular fractures including a tooth in the line of the fracture were examined. Post-operative dental complications occurred in 42 cases (17.0%). Extraction of related teeth occurred in 34 cases (80.9%) compared to eight cases (19.0%) related to root canal therapy. This study defined "dental problem" as "a case with a tooth extracted or endodontically treated after trauma." The variables associated with an increased risk of dental problems were the amount of bony displacement (p < .01), tooth mobility (p < .01), and pre-existing marginal alveolar bone loss (p = .027).
CONCLUSION
The prognosis of teeth in mandibular fracture lines was related to tooth mobility, periodontal state, and the amount of bony displacement.
Topics: Humans; Mandibular Fractures; Prognosis; Retrospective Studies; Tooth; Tooth Fractures; Tooth Mobility
PubMed: 33421357
DOI: 10.1111/edt.12647 -
Nederlands Tijdschrift Voor... Nov 1997This article describes the present status of diagnostic and therapeutic methods to treat mandibular fractures. In view of the needs of a functional rehabilitation as... (Review)
Review
This article describes the present status of diagnostic and therapeutic methods to treat mandibular fractures. In view of the needs of a functional rehabilitation as complete as possible, considerations about treatment procedures are presented. Fracture treatment of the mandible in this respect means anatomical reduction and stabilisation of the fracture fragments in order to achieve complete restoration of the bony continuity, preferable without intermaxillary fixation, and restoration of speech and chewing functions enhanced by normal dental hygiene. The role and development of fixation techniques are described and discussed. Finally the role of the general practitioner at the time of diagnostics and initial treatment as well as regarding postoperative treatment and interpretation of treatment modalities is discussed.
Topics: Fracture Fixation; Fracture Fixation, Internal; Humans; Mandibular Fractures; Patient Care Planning; Postoperative Care
PubMed: 11924438
DOI: No ID Found