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The Journal of International Medical... Jul 2020To analyse the epidemiology of mandibular fractures and the correlation between combined fractures during a 10-year period in central Taiwan.
OBJECTIVE
To analyse the epidemiology of mandibular fractures and the correlation between combined fractures during a 10-year period in central Taiwan.
METHODS
This retrospective study analysed data collected from the medical records of patients that had mandibular fractures between January 2007 and October 2017. Data on age, sex, cause of injury, anatomical site of fracture, treatment and complications were obtained and analysed.
RESULTS
A total of 265 patients who received treatment were included in the study. The mean ± SD age was 30.08 ± 13.47 years (range, 6-70 years) and the 21-30 years age group showed the highest incidence of mandibular fractures. The male-to-female ratio was 1.25:1. Road traffic accidents were the most common cause of fracture (206 of 265; 77.74%). The symphysis and parasymphysis area was the most common fracture site (169 of 420; 39.29%). Single-site fracture represented slightly more than 50% of the total 420 fractures. The most frequent combination of two fractures was an angle fracture combined with a symphysis and parasymphysis fracture (29 of 106 double fracture patients [27.36%]). There was a weak positive association between several combinations of fractures.
CONCLUSIONS
A better understanding of the influence of age and sex on the mechanism of injury is of great clinical importance in the assessment and diagnosis of fractures.
Topics: Adolescent; Adult; Aged; Child; Female; Humans; Incidence; Male; Mandibular Fractures; Middle Aged; Retrospective Studies; Taiwan; Young Adult
PubMed: 32705932
DOI: 10.1177/0300060520915059 -
Dental and Medical Problems 2021The objective of rehabilitation after the treatment of a mandibular condyle fracture is to retrieve the effortless, symmetrical opening of the jaws with the preservation...
BACKGROUND
The objective of rehabilitation after the treatment of a mandibular condyle fracture is to retrieve the effortless, symmetrical opening of the jaws with the preservation of appropriate movements to the sides, and appropriate occlusion without a sense of tension in the mastication muscles or pain sensations.
OBJECTIVES
The aim of the article was to establish the conditions of the rehabilitation of temporomandibular joint (TMJ) after the surgical treatment of a fractured condyle.
MATERIAL AND METHODS
The research featured 46 of patients treated surgically between January 2, 2017 and December 30, 2017. The open reduction and rigid internal fixation (ORIF) was the method mainly applied. Rehabilitation with the use of the Delphi technique was implemented in each patient. The assessment of the mastication organ was mostly performed at 3 and 6 weeks since the beginning of rehabilitation. In every patient, the interincisal distance was measured; in chosen cases, the range and trajectory of the condyle movements, and the trajectory of the secant point during jaw opening were defined with the use of the Zebris® JMA device.
RESULTS
In 45 patients, a full reposition and immobilization of 52 bone fragments of fractured mandibular condyles was obtained. The displacement of the midline of the mandible in occlusion or an incorrect occlusion contact determined the decision on the application of intermaxillary fixation in 8 patients for a period of 2 weeks. The minimal jaw opening of 40 mm was achieved in 41 patients after 6 weeks of rehabilitation. In 5 of the rest of the patients, rehabilitation had to be continued. The reassessment of the X-ray images and additional computed tomography (CT) diagnosis in three-dimensional (3D) reconstruction in those patients revealed the possible causes of difficulties in the restoration of the stomatognathic system functions – the injuries of the muscles or ligaments connected with the joint.
CONCLUSIONS
The extension of radiological diagnostics with a CT examination may improve the assessment of the restored TMJ function after the surgical treatment of a fractured mandibular condyle.
Topics: Fracture Fixation, Internal; Humans; Mandible; Mandibular Condyle; Mandibular Fractures; Treatment Outcome
PubMed: 33847468
DOI: 10.17219/dmp/128092 -
The Journal of Craniofacial Surgery Oct 2022The aim of this study is to follow-up and evaluate the treatment result of mandibular subcondylar (MSC) fractures by osteosynthesis via endoscopy-assisted intraoral...
INTRODUCTION
The aim of this study is to follow-up and evaluate the treatment result of mandibular subcondylar (MSC) fractures by osteosynthesis via endoscopy-assisted intraoral approach.
MATERIALS AND METHODS
This is a prospective study, in which 47 patients with 51 sites of MSC fractures treated osteosynthesis via endoscopic-assisted intraoral approach at the Department of Maxillofacial Surgery, National Hospital of Odonto-Stomatology HoChiMinh City-Vietnam were followed-up and evaluated clinically and radiographically up to 6 months postoperative.
RESULTS
Before surgery, all of the patients were malocclusion, 15% of patients were isolated MSC fractures, the rate of concomitant midface fractures were 30%, 92.2% of fracture sites with moderate displacement, 7.8% of fracture sites with severe displacement, 5.9% of fracture sites with dislocation. After surgery, all of the patients had preinjured centric occlusion; no patient had facial paralysis; 6% of patients had surgical site infection within 1 week; pain frequency were 56.9% at 1 month, 35.3% at 2 months, 7.8% at 3 months, and 2.0% at 6 months with Visual Analog Scale (VAS) means of pain were 1.74±1.85 at 1 month, 0.55±1.12 at 2 months, 0.08±0.27 at 3 months and 0.02±0.14 at 6 months; 90% of fracture sites had precise anatomy at 1 week and 96% at 6 months; 96% fracture sites had no displacement the of correlation between condyle and articular fossa at 1 week and 98% at 6 months; 1 fracture site had screw loosening at 2 months; 88% fracture sites had stage-4 radiographic bone healing at 6 months.
CONCLUSION
Endoscopic-assisted intraoral approach for osteosynthesis of MSC fractures have provided the esthetic and functional success and good bone healing.
Topics: Bone Plates; Endoscopy; Esthetics, Dental; Fracture Fixation, Internal; Humans; Mandibular Condyle; Mandibular Fractures; Pain; Prospective Studies; Treatment Outcome
PubMed: 36201692
DOI: 10.1097/SCS.0000000000008734 -
The Western Journal of Emergency... Jan 2015Numerous mandibular pathologies are diagnosed in the emergency department (ED). We present the case of a woman with severe right-sided mandibular pain who was found to...
Numerous mandibular pathologies are diagnosed in the emergency department (ED). We present the case of a woman with severe right-sided mandibular pain who was found to have a pathological fracture and osteonecrosis of the jaw (ONJ). The etiology of ONJ was found to be associated to previous use of zoledronic acid to treat osteoporosis. The aim of this case report is to discuss the etiology, diagnosis and treatment of ONJ secondary to the use of zoledronic acid and to outline a clinical condition rarely seen in the ED whose incidence might rise with the increasing use of bisphosphonates.
Topics: Aged; Bisphosphonate-Associated Osteonecrosis of the Jaw; Bone Density Conservation Agents; Diphosphonates; Female; Fractures, Spontaneous; Humans; Imidazoles; Mandibular Fractures; Zoledronic Acid
PubMed: 25671027
DOI: 10.5811/westjem.2014.10.23837 -
Journal of the Mechanical Behavior of... Mar 2022Titanium screws are commonly used for osteosynthesis of mandibular condylar head fractures. Evidence suggests that the insertion of three screws may result in better...
Titanium screws are commonly used for osteosynthesis of mandibular condylar head fractures. Evidence suggests that the insertion of three screws may result in better fracture stability. Two screws only, on the other hand, could reduce adverse effects, mainly bone resorption. This study aimed to investigate the biomechanical differences in mandibular condylar head osteosynthesis with two versus three titanium screws using finite element analysis. A finite element model of the mandible with a right type P condylar head fracture fixed with two or three titanium screws was analyzed in ANSYS Mechanical. The geometry of the model assembly was constructed in ANSYS Spaceclaim. Biomechanical load boundary conditions were obtained from a validated musculoskeletal model in AnyBody Modeling System™. The preprocessing of the finite element model and mapping of the obtained boundary conditions was done in docq VIT. Fracture displacement, fragment deformation, von Mises stress distribution, and reaction forces within the screws were evaluated in ANSYS for three different loading scenarios. Finite element analysis showed similar results when comparing osteosynthesis with two versus three titanium screws for all three loading scenarios. Contralateral molar loading resulted in the highest stress on both the fracture and the screws with the maximum von Mises stress being found at the condylar neck. Stress concentration within the screws was found in the fracture gap and was higher in the lateral fragment. In all scenarios, maximum von Mises stress values were smaller when forces were distributed among three screws. However, stability was also adequate when two screws were used. Mandibular condylar head osteosynthesis with two titanium screws appears to provide sufficient fracture stability. Further clinical studies are needed to clarify the implications of these results.
Topics: Biomechanical Phenomena; Bone Plates; Bone Screws; Finite Element Analysis; Fracture Fixation, Internal; Humans; Mandibular Fractures; Stress, Mechanical
PubMed: 35033984
DOI: 10.1016/j.jmbbm.2022.105077 -
International Journal of Environmental... Oct 2021The aim of the retrospective analysis of the medical documentation of 101 patients was to assess the incidence, etiology, and type of craniofacial fractures in the...
The aim of the retrospective analysis of the medical documentation of 101 patients was to assess the incidence, etiology, and type of craniofacial fractures in the elderly population of southern Poland, who required specialist treatment at the Department of Cranio-Maxillo-Facial Surgery Jagiellonian University, Krakow, Poland, in the period 2010-2019. Patients were divided into 3 age groups: 65-74, 75-84, and 85 and older. The following was noted: age, sex, place of residence, education, cause and location of fracture, treatment, injuries and comorbidities, complications, alcohol and other drugs at the time of injury, and the period of hospitalization. The dominant group were patients aged 65-74 (72.28%), mainly males (56.44%). The main cause was fall (47.52%). The fractures involved mainly the mandible and the zygomaticomaxillary complex. Over half of patients (50.50%) lived in the countryside or small towns. Work tool-related accidents prevailed among geriatric patients living in small towns and rural areas. Craniofacial fractures were additionally accompanied by common complications regarding the organ of vision. Further studies analyzing factors leading to increased risk of craniofacial injuries in the elderly of the rural population will enable proper support programs, prophylaxis, and principles concerning agricultural activities.
Topics: Accidental Falls; Accidents, Traffic; Aged; Humans; Male; Mandible; Maxillary Fractures; Retrospective Studies; Skull Fractures
PubMed: 34769738
DOI: 10.3390/ijerph182111219 -
Journal of Oral Biology and... 2020Epidemiology of the lower jaw fractures varies between populations. This study explores the epidemiology of the lower jaw fractures at the Department of Surgical... (Review)
Review
BACKGROUND/AIM
Epidemiology of the lower jaw fractures varies between populations. This study explores the epidemiology of the lower jaw fractures at the Department of Surgical Dentistry and Maxillofacial Surgery of Childhood, Bogomolets National Medical University.
METHODS
This is a retrospective analysis of 210 case histories of children with traumatic fractures of the lower jaw, from the age of 6 months-18 years old, carried out at the Department of Surgical Dentistry and Maxillofacial Surgery of Childhood, Bogomolets National Medical University, from January 2014 to December 2018.
RESULTS
The most common cause of the mandibular fractures was falling 142 (67%). Mostly, qualified help was sought on the first day of injury (n = 103-49%). X-ray diagnostics was performed for all patients, but in different forms: orthopantomography was performed in 57 cases (27%), panoramic radiographs of the lower jaw in a direct projection - 17 (8%), and CT studies - in 136 (65%) children. The immobilization of fractured fragments of the lower jaw is mainly carried out using the double jaw splinting according to Tigerstedt 153 (73%), in combination with osteosynthesis - 29 (14%) cases.
CONCLUSION
Fractures of the lower jaw occurred more commonly between the ages of 7 and 17 years, the cause of which in most cases was a fall. The most common location of the mandibular fractures was-the condylar process. The most common method of fixing fragments of the lower jaw was double jaw splinting.
PubMed: 32025479
DOI: 10.1016/j.jobcr.2020.01.004 -
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 -
Pharmaceuticals (Basel, Switzerland) Dec 2021Fractures occur when bones become fragile and are subjected to external forces as occurring during falls. The use of drugs that increase bone fragility or fall risk...
Fractures occur when bones become fragile and are subjected to external forces as occurring during falls. The use of drugs that increase bone fragility or fall risk increases the risk of fracture. This study investigates drug-induced fractures reported in the Japanese Adverse Drug Event Report (JADER) database in patients using 4892 drugs. Atypical femur fracture was the most frequently reported fracture, and 58 other fractures were also reported. Using Volcano plots and multiple logistic regression analysis, we identified the risk factors for drug-induced fractures as being female, of older age, higher body mass index, and using one of 90 drugs. The drug groups significantly associated with drug-induced fractures included bone resorption inhibitors, antiviral drugs, dopaminergic drugs, corticosteroids, and sleep sedatives. Principal component analysis was used to examine the relationship between the use of specific drugs and the site of drug-induced fracture. Bone resorption inhibitors and corticosteroids were associated with atypical femur fractures, jaw fractures, and ulna fractures through an osteoclast-mediated process. Other drugs were found to increase fracture risk via non-osteoclast-mediated mechanisms. These findings suggest that many drugs can result in drug-induced fractures through a variety of mechanisms.
PubMed: 34959699
DOI: 10.3390/ph14121299 -
Dental Traumatology : Official... Oct 2022Pediatric oral and maxillofacial surgeons have faced severe challenges in ward management due to their high risk of exposure during the COVID-19 epidemic. The aim of...
BACKGROUND/AIMS
Pediatric oral and maxillofacial surgeons have faced severe challenges in ward management due to their high risk of exposure during the COVID-19 epidemic. The aim of this study was to analyze and summarize the treatment methods and infection prevention and control measures applied in emergency cases in the Department of Pediatric Oral and Maxillofacial Surgery, Children's Hospital of Chongqing Medical University, during the COVID-19 epidemic.
METHODS
In this retrospective study, information was collected from 256 pediatric emergency patients who were treated from January 23, 2020 to August 9, 2021. The patients' data were statistically analyzed according to age, gender, disease and pathogenesis, operation time, and the main treatment applied in pediatric oral and maxillofacial emergency cases during the COVID-19 epidemic.
RESULTS
During the epidemic period, 256 pediatric emergency patients were successfully treated. Among them, there were 170 boys and 86 girls. In all, 182 patients were diagnosed with oral or facial lacerations; 43 had jaw fractures; 26 had maxillofacial infections; and five had dento-alveolar fractures. A total of 246 patients underwent surgery under negative pressure with level 3 protection standards. No doctors or patients infected with COVID-19 were found throughout the stury period.
CONCLUSIONS
Pediatric oral and maxillofacial emergency in-patients mainly experienced maxillofacial trauma during the COVID-19 epidemic, followed by infection. Effective diagnosis and treatment, and avoidance of COVID-19 infection can be achieved by strictly following epidemic prevention and treatment procedures.
Topics: COVID-19; Child; Disease Outbreaks; Female; Humans; Male; Maxillofacial Injuries; Retrospective Studies; Skull Fractures
PubMed: 35605156
DOI: 10.1111/edt.12759