-
Journal of Oral and Maxillofacial... Aug 2019The management of mandibular angle fractures is controversial. The present study proposed to determine the superiority between the 1 miniplate and 2 miniplate fixation... (Meta-Analysis)
Meta-Analysis
PURPOSE
The management of mandibular angle fractures is controversial. The present study proposed to determine the superiority between the 1 miniplate and 2 miniplate fixation system and evaluated the best option for patients.
PATIENTS AND METHODS
A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, examining Medline-Ovid, Embase, and PubMed databases for relevant reports in English without date restrictions in October 2018. The inclusion criteria were studies of humans, including randomized controlled trials, controlled clinical trials, and retrospective studies, with the aim of comparing the 2 techniques. The incidence of postoperative complications and operative times were evaluated, and the relative risk and corresponding 95% confidence intervals were assessed to measure the effect size. Subgroup analyses of the different fracture regions and different miniplate sizes were performed. Publication bias was measured using a funnel plot.
RESULTS
Thirteen reports were enrolled for analysis. The results showed that the 1 miniplate fixation system reduced the overall complication rate compared with the 2 miniplate fixation system (P = .02). The incidence of wound dehiscence, hardware failure, scarring, and paresthesia showed statistically significant differences in favor of the 1 miniplate system (P < .05). The subgroup analyses indicated that 1 miniplate with isolated fractures caused a lower incidence rate of wound dehiscence, scarring, and hardware failure compared with the 2 miniplate fixation technique (P < .05).
CONCLUSION
The results of the present study suggest that the 1 miniplate system is superior to 2 miniplates with a reduction in postoperative complication rates for the management of mandibular angle fractures.
Topics: Bone Plates; Fracture Fixation, Internal; Humans; Mandibular Fractures; Postoperative Complications; Retrospective Studies
PubMed: 31077670
DOI: 10.1016/j.joms.2019.04.006 -
Journal of Oral and Maxillofacial... Aug 2019The present study reviewed the clinical, imaging, and therapeutic aspects of genial tubercle fracture (GTF). (Meta-Analysis)
Meta-Analysis
PURPOSE
The present study reviewed the clinical, imaging, and therapeutic aspects of genial tubercle fracture (GTF).
MATERIALS AND METHODS
A 2-phase systematic search of the literature was performed. Search strategies were developed for specific databases (PubMed, Scopus, Web of Science, Cochrane, and LILACS), including the gray literature (Open Grey and Google Scholar). The descriptors "genial tubercle," "fractures, bone," "mentalis," "spinae," and "mandible" were searched without restriction to year of publication. The CARE guideline was applied to evaluate methodologic aspects, and the Meta-Analysis of Assessment and Review Instrument was used to assess the risk of bias. The adopted level of significance was .05.
RESULTS
Of 1,970 articles, 1,948 were excluded after applying the eligibility criteria. Furthermore, 2 studies were added through a manual search of the reference lists, totaling 24 articles. Occurrence of GTF was most common in women older than 61 years and men younger than 60 years (difference in age at occurrence was statistically significant; P = .019). The main clinical findings were edentulism, sublingual edema, and pain (P < .001). Previous trauma was commonly absent in women and present in men (P = .018). A cracking sound was mainly reported by women (P = .009). Isolated panoramic and occlusal radiographs were the most commonly performed examinations (P < .001). Diagnosis of sialolithiasis occurred in 37.5% of cases, and conservative treatment was performed in 76.6% of cases.
CONCLUSION
GTF was mainly observed in older women, edentulous patients, and those without previous trauma. Conventional radiography and nonsurgical treatment were frequently reported.
Topics: Aged; Bias; Conservative Treatment; Female; Humans; Male; Mandible; Mandibular Fractures
PubMed: 31028733
DOI: 10.1016/j.joms.2019.03.030 -
International Journal of Oral and... Aug 2019The purpose of this study was to systematically review all published cases of Gorham-Stout disease (GSD) involving the jaws and to identify the clinico-radiological and...
The purpose of this study was to systematically review all published cases of Gorham-Stout disease (GSD) involving the jaws and to identify the clinico-radiological and histopathological features associated with persistence of the lesions, as well as the best treatment options available. An electronic search was undertaken in November 2018. Eligibility criteria included publications with sufficient information to confirm the diagnosis. Eighty-six publications reporting 89 cases were included. Features observed included symptomatic disease (51.1%), swelling (34.1%), pathological fracture (31.8%), history of previous trauma (32.1%), high alkaline phosphatase levels (24.3%), and predominance of vascular tissue (72.4%). Nearly a quarter of the patients were only followed up, with no treatment implemented. Most treatments consisted of some type of surgery with/without additional therapies (42.0%), drugs (20.5%), and radiotherapy (14.8%). Half of the cases were found to persist after some treatment modality, and five patients died. Among the variables investigated, only a lesion crossing the midline showed an association with persistence of the disease. There remains much to understand about GSD, a rare condition with no clear consensus on the aetiopathology, an unpredictable clinical course, and no standard treatment. The high rate of persistence after treatment was found to be associated only with the lesion crossing the midline.
Topics: Humans; Jaw; Osteolysis, Essential; Radiography
PubMed: 30898430
DOI: 10.1016/j.ijom.2019.03.002 -
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