-
Indian Journal of Dental Research :... 2020The aim of this study was to determine the etiology, dissemination of mandibular fractures among different age, gender, and to determine the frequency of anatomic...
AIM
The aim of this study was to determine the etiology, dissemination of mandibular fractures among different age, gender, and to determine the frequency of anatomic distribution in patients who reported to our institution from February 2015 to September 2015.
MATERIALS AND METHODS
All patients who fulfilled the selection criteria and had mandible fracture were selected for the study. The values were subjected to Z and Chi-square tests.
RESULTS
Out of 50 patients, 44 were male patients (88%) and 6 were female patients (12%). We found a peak occurrence of fractures in young adults, with mean age of 36 years. In case of etiology of fracture, road traffic accident was the most common (72%) and parasymphysis was most frequently involved site (n = 13.26%).
CONCLUSION
In this study, the prevalence of mandibular fracture was more prevalent in male patients, especially during the third decade of life. The most common cause was road traffic accident and the more frequently affected region was parasymphysis of the mandible.
Topics: Accidents, Traffic; Adult; Female; Humans; Male; Mandible; Mandibular Fractures; Prevalence; Retrospective Studies; Young Adult
PubMed: 33753671
DOI: 10.4103/ijdr.IJDR_286_18 -
The Journal of Clinical Pediatric... Jan 2024To investigate the role of a fully digital process in the surgical treatment of mandibular fractures in children. We analyzed a complete dataset from 22 children with...
To investigate the role of a fully digital process in the surgical treatment of mandibular fractures in children. We analyzed a complete dataset from 22 children with mandibular fractures treated with digital surgical assistance. The patient's treatment process included preoperative thin layer CT (Computed Tomography) scanning, computer-aided design (3D reconstruction, virtual reduction, and internal fixation device determination and shaping), and 3D printing (jaw model, bite plate). We used occlusal and shaping plates during surgery to assist in fracture reduction and fixation. During the follow-up, we observed the occurrence of fracture healing, occlusal relationships, opening degrees, and complications in pediatric patients after surgery. Next, we used the 3D overlay function of MIMICS software to compare the preoperative surgical design with postoperative jaw imaging data to evaluate the overall surgical effect. The postoperative imaging data showed good fracture healing, normal occlusion during follow-up, and significant improvement in opening degrees. The mean preoperative opening degree was 23.59 ± 2.89 mm, and the mean postoperative opening degree was 29.82 ± 1.79 mm; there was a significant difference between these two parameters ( < 0.05). There were no complications such as tooth germ injury, nerve injury or fracture block displacement. The postoperative mandibular imaging data was imported into MIMICS software for 3D overlay visualization, and the postoperative mandibular morphology recovery was well-matched with the preoperative design. We measured the average upper deviation (0.65 ± 0.09) mm and the average lower deviation (-0.57 ± 0.14) mm. The fully digital process has a precise, minimally invasive, and safe effect in the surgical treatment of mandibular fractures in children, and the clinical effect is satisfactory.
Topics: Humans; Child; Mandibular Fractures; Fracture Fixation, Internal; Fracture Healing; Printing, Three-Dimensional; Computer-Aided Design
PubMed: 38239165
DOI: 10.22514/jocpd.2024.014 -
Oral and Maxillofacial Surgery Mar 2022Dental injuries (DIs) are associated with facial fractures, particularly mandibular fractures. As paediatric mandibular fractures have special features, we sought to...
PURPOSE
Dental injuries (DIs) are associated with facial fractures, particularly mandibular fractures. As paediatric mandibular fractures have special features, we sought to clarify the occurrence and types of DIs among this patient group. We assessed how age, injury type, and fracture location affects the occurrence of DIs and thereby defined which patients are most susceptible.
METHODS
This retrospective study included patients < 18 years with a recent mandibular fracture. Predictor variables were gender, age group, mechanism of injury, type of mandibular fracture, and other associated facial fracture(s). Types and locations of DIs and tooth loss due to injury were also reported.
RESULTS
DIs were detected in 34.7% (n = 41) out of 118 patients. Patients with tooth injury had on average 3.5 injured teeth. A total of 16.2% of injured teeth were lost, typically at the time of the injury. Loss of at least one tooth was seen in approximately 10% of patients. Avulsion was the most common cause of tooth loss (52.2%). Non-complicated crown fracture (50.7%) was the most common DI type. Statistically significant associations between studied variables and DIs were not detected.
CONCLUSION
DIs are common and often multiple in paediatric mandibular fracture patients regardless of background factors. DIs often lead to tooth loss. Prompt replantation of an avulsed tooth, early detection of DIs, and prevention of tooth loss whenever possible are important to avoid permanent tooth defects.
Topics: Child; Humans; Mandibular Fractures; Retrospective Studies; Tooth Avulsion; Tooth Crown; Tooth Fractures; Tooth Injuries
PubMed: 33913044
DOI: 10.1007/s10006-021-00966-8 -
Maxillofacial Plastic and... Nov 2022As society becomes more complex, the incidence of mandibular fractures is increasing. This study aimed to analyze the incidence and type and identify etiological factors...
BACKGROUND
As society becomes more complex, the incidence of mandibular fractures is increasing. This study aimed to analyze the incidence and type and identify etiological factors of mandibular fractures to use them in future treatments.
MATERIAL AND METHODS
Data were collected from 224 patients who visited the department of oral and maxillofacial surgery at the Kyung Hee Medical Center dental hospital during a 6-year period (2016 to 2021). A logistic regression model was used for data analysis.
RESULTS
In a total of 224 patients, 362 fractures were appeared. The average age of the patients was 34.1 years, with the highest incidence in the 20s. And the ratio between male and female was 4.09:1. Symphysis fractures were the most prevalent of all patients (52.7%), followed by unilateral condyle (37.1%), angle (36.2%), bilateral condyle (9.4%), body (8%), and coronoid (2.2%). The most common cause of fracture was daily-life activity (57.6%), followed by violence (30.4%), traffic accidents (8.5%), and syncope (3.6%). Patients with symphysis fracture were at low risk (OR < 1) of angle, body, and unilateral condyle fractures. Similarly, patients with unilateral fracture were at low risk (OR < 1) of symphysis, angle, body, and others site fractures. In contrast, patient with bilateral condyle fracture were at high risk (OR > 1) of coronoid fractures. And younger patients were high risk of mandibular angle fractures.
CONCLUSION
Through this study, it was confirmed that etiological factors of mandibular fractures were like those of previous studies.
PubMed: 36322224
DOI: 10.1186/s40902-022-00365-3 -
Acta Stomatologica Croatica Sep 2022Diagnosing child abuse still poses a challenge for healthcare professionals. We will present a case in which a physically and emotionally abused four-year-old boy had an...
Diagnosing child abuse still poses a challenge for healthcare professionals. We will present a case in which a physically and emotionally abused four-year-old boy had an undiagnosed lower jaw fracture for almost eight months. The child first presented with a peri-mandibular swelling and was treated with antibiotics prescribed by his doctor of dental medicine. After not having responded to antibiotic treatment, the boy was referred to the Department of Oral and Maxillofacial Surgery, accompanied by his birth mother. The deciduous mandibular molars with deep cavities were extracted since we thought that they were the reason for swelling. After several visits with his foster mother, the child was finally diagnosed with a lower jaw fracture and a psychosomatic disorder. Physical abuse by his birth parents was later on confirmed, and the consequences were insufficient growth, non-perception of pain and reduced speech development. After having been with his foster mother for almost a year, the child learned to complain when he was in pain. This report emphasizes the importance of taking a detailed medical history along with a thorough clinical examination.
PubMed: 36382211
DOI: 10.15644/asc56/3/9 -
Medicines (Basel, Switzerland) Dec 2022This study aimed at identifying errors encountered in orthopantomography (OPG) in post-traumatic patients caused by limitations in performing a correct technique. A...
This study aimed at identifying errors encountered in orthopantomography (OPG) in post-traumatic patients caused by limitations in performing a correct technique. A retrospective observational study was performed. Diagnosis, exposure/processing mistakes, positioning-related errors, and bimaxillary immobilization were evaluated. Thirty panoramic radiographs with mandible fractures were examined. Twelve error types were encountered: errors in exposure or processing, air radiolucency in the palatoglossal space, errors in the alignment of the Frankfort horizontal plane: head in flexion, with a joyful expression or head extended, with a somber appearance, errors towards the mid-sagittal plane (lateral head inclination, deviation, or rotation), errors caused by the non-use of the bite-block or inappropriate position on the device, errors caused by positioning outside the focal plane, artifacts/shadow images produced by post-operative metal plates, and bimaxillary immobilization errors. The number of errors per radiograph ranged from two to a maximum of five. The most dominant ones were inappropriate alignment in the focal plane and lateral rotation of the head in over 70% of cases. Lateral deviation and palatoglossal air were present in more than 50% of images. In trauma cases, technical difficulties in obtaining a proper OPG image are common and often insurmountable, limiting the diagnosis.
PubMed: 36547996
DOI: 10.3390/medicines9120063 -
Journal of Orthopaedic Research :... Aug 2021The majority of fracture research has been conducted using long bone fracture models, with significantly less research into the mechanisms driving craniofacial repair....
The majority of fracture research has been conducted using long bone fracture models, with significantly less research into the mechanisms driving craniofacial repair. However, craniofacial bones differ from long bones in both their developmental mechanism and embryonic origin. Thus, it is possible that their healing mechanisms could differ. In this study we utilize stabilized and unstabilized mandible fracture models to investigate the pathways regulating repair. Whereas fully stable trephine defects in the ramus form bone directly, mechanical motion within a transverse fracture across the same anatomical location promoted robust cartilage formation before boney remodeling. Literature investigating long bone fractures show chondrocytes are a direct precursor of osteoblasts during endochondral repair. Lineage tracing with Aggrecan-Cre ::Ai9 tdTomato mice demonstrated that mandibular callus chondrocytes also directly contribute to the formation of new bone. Furthermore, immunohistochemistry revealed that chondrocytes located at the chondro-osseous junction expressed Sox2, suggesting that plasticity of these chondrocytes may facilitate this chondrocyte-to-osteoblast transformation. Based on the direct role chondrocytes play in bone repair, we tested the efficacy of cartilage grafts in healing critical-sized mandibular defects. Whereas empty defects remained unbridged and filled with fibrous tissue, cartilage engraftment produced bony-bridging and robust marrow cavity formation, indicating healthy vascularization of the newly formed bone. Engrafted cartilage directly contributed to new bone formation since a significant portion of the newly formed bone was graft/donor-derived. Taken together these data demonstrate the important role of chondrocyte-to-osteoblast transformation during mandibular endochondral repair and the therapeutic promise of using cartilage as a tissue graft to heal craniofacial defects.
Topics: Animals; Bony Callus; Chondrocytes; Fracture Healing; Mandibular Fractures; Mice; Osteoblasts; Osteogenesis
PubMed: 33140859
DOI: 10.1002/jor.24904 -
Cirugia Y Cirujanos 2023Fractures of the atrophic mandible have been historically treated in various ways, from intermaxillary fixation to internal fixation, some cases require bone grafts....
BACKGROUND
Fractures of the atrophic mandible have been historically treated in various ways, from intermaxillary fixation to internal fixation, some cases require bone grafts. Besides, the Luhr classification serves as a guide to select the type of treatment.
OBJECTIVE
To show the treatment of fractures in atrophic mandible with plates and screws, and the potential indications of bone graft in this type of fractures.
METHOD
We presented a serie of 17 patients with atrophic mandible treated with plates and screws, some of them no blocked system and other with locked screws. For patients in luhr classes II and III cancellous bone grafts were used, looking for best osteogenic response, harvesting for the proximal third of the tibia.
RESULTS
Postoperative progress was generally uneventful. Oral intake with purees was resumed 24 hours after surgery, as well as ambulation. Fracture healing at 6 months was seen in 17 patients. One patient died before the 6-month time point as the result of a stroke. Delayed union was diagnosed 3 months after surgery in another patient, who refused secondary treatment.
CONCLUSIONS
Treatment of fractures in atrophic mandibles with plates and screws is a reliable procedure. Luhr classification provide useful guidance regarding the use of bone grafts for best osteogenic response in the fracture. This treatment allows a quick restart of the feeding by mouth and movilization of the patients.
Topics: Humans; Mandibular Fractures; Jaw, Edentulous; Bone Plates; Mandible; Fracture Fixation, Internal
PubMed: 37084311
DOI: 10.24875/CIRU.21000281 -
Journal of Istanbul University Faculty... 2015Fractures in the jaw bones could present themselves differently according to the strength of the force and the bone's ability to absorb the impact. The location and type... (Review)
Review
Fractures in the jaw bones could present themselves differently according to the strength of the force and the bone's ability to absorb the impact. The location and type of the fracture is important as well as the cause of the fracture (traffic accidents, melee trauma, pathologic changes). Pre-existing pathologic lesions, position of the teeth and the way they are affected by the fracture have a great influence on the prognosis. Whether to extract the teeth in the line of a fracture has always been controversial among dentists. While some researchers advocate that such teeth should be extracted to avoid complications, others believe that retaining these teeth would benefit the patient more. Most clinicians prefer to treat their patients depending on their own previous experiences. This article aims to establish a guideline on assessing whether to retain or extract the teeth in the fracture line.
PubMed: 28955528
DOI: 10.17096/jiufd.98462 -
Frontiers in Veterinary Science 2022Treatment of craniomaxillofacial (CMF) trauma in dogs often requires a multidisciplinary approach and a thorough understanding of the CMF anatomical structures involved....
Treatment of craniomaxillofacial (CMF) trauma in dogs often requires a multidisciplinary approach and a thorough understanding of the CMF anatomical structures involved. This retrospective study aimed to utilize computed tomography (CT) studies of immature dogs evaluated for CMF trauma and to describe common fracture locations, treatment modalities, and complications, as well as the fracture healing outcomes. The medical records and CT studies of 94 dogs under 1 year of age over a 13-year period were evaluated. The skeletal location of CMF fractures, as well as the severity of displacement and fragmentation of each fracture, was recorded. Case demographic data and trauma etiology were also recorded. Animal bites accounted for the majority of trauma (71.0%). The most likely bone or region to be fractured was the maxillary bones, followed by the molar region of the mandibles. Up to 37 bones or specific regions were fractured in any given patient, with an average of 8.8 ± 3.1 fractured bones or regions per dog. Rostral mandibular trauma was associated with intra-articular fractures of the temporomandibular joint ( = 0.016). Patients sustained concomitant injuries in 32% of the cases. Muzzle therapy was the main treatment performed for most dogs (53.2%), followed by soft tissue closure (47.9%) and selective dental extractions (27.6%). Healing complications were recorded in 71.6% of the dogs, with malocclusion being the most reported complication (55.2%), and associated with dentate mandibular jaw fractures ( = 0.05). The average number of complications per dog was 2.4. No statistically significant association was found between treatment modality and healing outcome. There was a positive correlation between the severity of fracture fragmentation and displacement and a negative healing outcome (all rho >0.7). Further treatment was required in 55.6% of the dogs. Additional dental extractions were performed in 77.7% of patients. Healing complications were common in the immature CMF trauma case. Thus, the need for a comprehensive assessment of the entire CMF region during the initial visit, as well as follow-up, preferably using CT or cone beam CT, is underscored.
PubMed: 36090162
DOI: 10.3389/fvets.2022.932587