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Frontiers in Veterinary Science 2015Repairing mandibular body fractures presents unique challenges not encountered when repairing long bones. Large tooth roots and the presence of the inferior alveolar...
Repairing mandibular body fractures presents unique challenges not encountered when repairing long bones. Large tooth roots and the presence of the inferior alveolar neurovascular bundle limit safe placement for many types of orthopedic implants. Use of non-invasive fracture repair methods have increasingly become popular and have proven safe and effective at achieving bone healing. Non-invasive fixation constructs have not been tested in dogs using cantilevered bending. Furthermore, non-invasive fracture repair constructs have not been tested at the location of a common fracture location - the mandibular first molar tooth (M1). The objectives of this study were to test the strength and stiffness of three non-invasive mandibular fracture repair constructs and to characterize the impact that tooth crown preservation has on fixation strength for fractures occurring at the M1 location. Specimens were assigned to three treatment groups: (1) composite only, (2) interdental wiring and composite (IWC), and (3) transmucosal fixation screw and composite. For each pair of mandibles, one mandible received crown amputation at the alveolar margin to simulate the effect of crown loss on fixation strength and stiffness. Regardless of the status of crown presence, IWC demonstrated the greatest bending stiffness and load to failure. With the crown removed, IWC was significantly stronger compared to other treatments. All fixation constructs were stiffer when the tooth crown was preserved. In fractures at this location, retaining the tooth crown of M1 significantly increases stiffness of interdental wiring with composite and transmucosal screw with composite constructs. If the crown of M1 was removed, IWC was significantly stronger than the other two forms of fixation.
PubMed: 26664947
DOI: 10.3389/fvets.2015.00018 -
Dental Traumatology : Official... Jun 2022Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric...
BACKGROUND/AIMS
Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1-year period.
METHODS
The following data were collected: age (preschool [0-6 years], school age [7-12 years], and adolescent [13-18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software.
RESULTS
Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0-18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001).
CONCLUSION
The main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0-6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.
Topics: Accidents, Traffic; Adolescent; Adult; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Mandibular Fractures; Maxillofacial Injuries; Prospective Studies; Retrospective Studies; Skull Fractures
PubMed: 35146900
DOI: 10.1111/edt.12735 -
International Journal of Oral and... Jan 2022This study clarified the injury characteristics and occurrence of associated injuries in patients with assault-related facial fractures. Data from 840 assault-related...
This study clarified the injury characteristics and occurrence of associated injuries in patients with assault-related facial fractures. Data from 840 assault-related facial fracture patients were included; demographic factors, facial fracture type, associated injuries, alcohol use, and injury mechanisms were recorded. Assault mechanisms most often included combinations of different mechanisms (57.5%) and resulted in the victim falling (50.1%). The perpetrator was most commonly a stranger (52.5%) and acted alone (57.7%). A total of 123 patients (14.6%) had associated injuries, with the most common being traumatic brain injury. Associated injuries occurred most frequently in patients with combined fractures of the facial thirds (24.2%) and upper third fractures (42.9%). The most significant differentiating factors for associated injuries were the number of perpetrators, falling, the use of an offensive weapon, and if the events of the assault remained unknown. In adjusted logistic regression analyses, statistically significant associations with associated injuries were found for age (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.03-1.07; P < 0.001), falling due to the assault (OR 2.87, 95% CI 1.49-5.50; P = 0.002), and upper third facial fractures (OR 6.93, 95% CI 2.06-23.33; P = 0.002). A single punch also caused severe injuries and should therefore not be overlooked, as this can be as dangerous as other assault mechanisms.
Topics: Accidental Falls; Alcohol Drinking; Facial Bones; Facial Injuries; Humans; Retrospective Studies; Skull Fractures
PubMed: 34175177
DOI: 10.1016/j.ijom.2021.06.001 -
International Journal of Environmental... Jul 2017This study aimed to determine the patterns associated with adult mandibular fractures from a Level-I trauma center in southern Taiwan. The data of adult trauma...
This study aimed to determine the patterns associated with adult mandibular fractures from a Level-I trauma center in southern Taiwan. The data of adult trauma patients admitted between 1 January 2009 and 31 December 2014 were retrieved from the Trauma Registry System and retrospectively reviewed. Fracture site and cause of injury were categorized into groups for comparison, and corresponding odds ratios (ORs) and 95% confidence intervals (CIs) were obtained by multivariate logistic regression. Motorcycle accidents were the most common cause of mandibular fractures (76.3%), followed by falls (10.9%), motor vehicle accidents (4.8%), and being struck by/against objects (4.5%). Of the 503 cases of mandibular fractures, the condylar neck and head were the most common sites (32.0%), followed by the parasymphysis (21.7%), symphysis (19.5%), angle and ramus (17.5%), and body (9.3%). The location of mandibular fractures in patients who had motorcycle accidents was similar to that in all patients. Motor vehicle accidents resulted in a significantly higher number of body fractures (OR 3.3, 95% CI 1.24-8.76, = 0.017) and struck injury in a significantly higher number of angle and ramus fractures (OR 3.9, 95% CI 1.48-10.26, = 0.006) compared to motorcycle accidents. The helmet-wearing status and body weight were not associated with the location of mandibular fractures in motorcycle accidents. Our study revealed that the anatomic fracture sites of mandible were specifically related to different etiologies. In southern Taiwan, motorcycle accidents accounted for the major cause of mandibular fractures and were associated with the condylar neck and head as the most frequent fracture sites. In contrast, motor vehicle accidents and struck injuries tended to cause more body fracture as well as angle and ramus fracture compared to motorcycle accidents. Furthermore, the status of helmet-wearing and body weight were not associated with the location of mandible fractures caused by motorcycle accidents.
Topics: Accidental Falls; Accidents, Traffic; Adult; Cross-Sectional Studies; Female; Head Protective Devices; Humans; Logistic Models; Male; Mandibular Fractures; Middle Aged; Motorcycles; Registries; Retrospective Studies; Taiwan; Trauma Centers; Young Adult
PubMed: 28737727
DOI: 10.3390/ijerph14070821 -
Scientific Reports Nov 2022Mandibular fractures are among the most frequent facial traumas in oral and maxillofacial surgery, accounting for 57% of cases. An accurate diagnosis and appropriate...
Mandibular fractures are among the most frequent facial traumas in oral and maxillofacial surgery, accounting for 57% of cases. An accurate diagnosis and appropriate treatment plan are vital in achieving optimal re-establishment of occlusion, function and facial aesthetics. This study aims to detect mandibular fractures on panoramic radiographs (PR) automatically. 1624 PR with fractures were manually annotated and labelled as a reference. A deep learning approach based on Faster R-CNN and Swin-Transformer was trained and validated on 1640 PR with and without fractures. Subsequently, the trained algorithm was applied to a test set consisting of 149 PR with and 171 PR without fractures. The detection accuracy and the area-under-the-curve (AUC) were calculated. The proposed method achieved an F1 score of 0.947 and an AUC of 0.977. Deep learning-based assistance of clinicians may reduce the misdiagnosis and hence the severe complications.
Topics: Humans; Radiography, Panoramic; Deep Learning; Mandibular Fractures; Algorithms; Area Under Curve
PubMed: 36379971
DOI: 10.1038/s41598-022-23445-w -
Acta Medica (Hradec Kralove) 2021Iatrogenic mandible fracture is a rare complication of a tooth extraction with an incidence between 0.0033-0.0034%. This study retrospectively analyzes a total of 8...
Iatrogenic mandible fracture is a rare complication of a tooth extraction with an incidence between 0.0033-0.0034%. This study retrospectively analyzes a total of 8 patients who underwent lower molar extraction associated with mandible fracture during tooth removal in the period from April 2006 to March 2019. The assessed parameters were age and sex of patients, method of tooth extraction, side distribution of fracture, type of extracted tooth, the position of a lower third molar, presence of bone pathological lesion formed in connection with a tooth, displacement of bone fragments, and sensory impairment in the innervation area of the mental nerve. The position and impaction of the lower third molars were evaluated according to Pell and Gregory's classification and Winter's classification. One fracture was left-sided, and 7 fractures were right-sided. In 6 cases, Winter's extraction elevator was used. In 7 patients, the mandible fracture was treated surgically by performing stable osteosynthesis with the plates and screws. One patient was treated conservatively. This work analyzes the causes of iatrogenic mandible fractures and provides recommendations to reduce the risk of their occurrence.
Topics: Female; Humans; Iatrogenic Disease; Male; Mandibular Fractures; Molar, Third; Retrospective Studies; Tooth Extraction
PubMed: 34331430
DOI: 10.14712/18059694.2021.18 -
The British Journal of Oral &... Jul 2020
Topics: Bone Screws; Fracture Fixation, Internal; Humans; Jaw Fixation Techniques; Mandibular Fractures
PubMed: 32418762
DOI: 10.1016/j.bjoms.2020.04.040 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... May 2020To investigate the diagnosis and evaluation methods of nasal bone fractures after nasal trauma, and the guiding significance of three-dimensional CT imaging technology...
To investigate the diagnosis and evaluation methods of nasal bone fractures after nasal trauma, and the guiding significance of three-dimensional CT imaging technology for its treatment. A total of 255 patients with nasal bone fractures were randomly selected from our hospital. All patients underwent CT scan of the nasal bones and reconstructed on a computer system. The reconstructed CT images were observed, measured and evaluated. Analyze the morphological characteristics of nasal bone fractures and evaluate the involvement of other facial structures. Among 255 patients with nasal trauma, there were traumatic nasal bone fractures, including 71 cases(27.8%) with simple nasal bone fractures, 143 cases(56.1%) with traumatic nasal septum deviation, and 41 cases(16.1%) with other fractures. External nasal fracture classification: type Ⅰ(unilateral nasal bone or maxillary frontal fracture) 91 cases(35.7%), type Ⅱ(bilateral nasal bone or fracture) 21 cases(8.2%),type Ⅲ(with trauma Nasal septum deviation) 143 cases(56.1%). A total of 214 patients(83.9%) underwent surgical treatment, and underwent nasal endoscopic reduction of nasal bone fractures under local anesthesia, and 77 patients(30.2%) underwent nasal septum surgery. CT three-dimensional imaging technology can clearly display the location of the nasal bone fracture, the shape of the fracture line, the number of fragments formed by the fracture, and quantitative analysis of the deformity caused by it, which plays an important role in its diagnosis and treatment.
Topics: Facial Bones; Humans; Maxillary Fractures; Nasal Bone; Skull Fractures; Tomography, X-Ray Computed
PubMed: 32791619
DOI: 10.13201/j.issn.2096-7993.2020.05.016 -
Journal of Clinical Medicine Sep 2020Three-dimensional (3D) mini plate systems are used in the treatment of mandibular fractures. The system is advantageous in comparison to conventional plates due to the...
Three-dimensional (3D) mini plate systems are used in the treatment of mandibular fractures. The system is advantageous in comparison to conventional plates due to the stabilization of tension and compression areas, improved initial stability, and biomechanical behavior. The aim of this retrospective study was to evaluate the use of a 3D miniplate system for the treatment of patients with mandibular fractures. Patients with mandibular fractures treated with a 3D plate system at the Department of Oral and Maxillofacial Surgery, University Hospital Münster, during a period of 5 years, were included in this study. Mandibular fracture conditions and minor and major post-operative complications were reported. In total, 336 patients and 391 mandibular fractures were assessed. The most common fracture site was anterior mandible, and 155 cases involved a tooth-bearing area. Minor complications were seen in 8.03% of cases, whereas only 1.49% of patients suffered from major complications. The treatment of mandible fractures using 3D miniplates resulted in fracture reduction with a low complication rate.
PubMed: 32927782
DOI: 10.3390/jcm9092922 -
Indian Journal of Dental Research :... 2011The aim of this prospective study was to compare the postoperative results of mandibular angle fracture cases treated by open reduction and internal fixation wherein the... (Comparative Study)
Comparative Study
AIMS AND OBJECTIVE
The aim of this prospective study was to compare the postoperative results of mandibular angle fracture cases treated by open reduction and internal fixation wherein the third molar in the line of fracture was preserved in one group while it was extracted in the second group.
MATERIALS AND METHODS
Group I consisted of 30 patients in which the mandibular third molar in the line of fracture was preserved and group II consisted of 24 patients in which it was extracted following specific criteria. Various parameters like postoperative healing, infection, occlusion, tooth vitality, and mobility were graded numerically. Statistical analysis using a t-test was done. Data were expressed as mean±SD and a probability (P) value of <0.05 was considered significant.
RESULTS
The presence of infection with pain and tenderness was higher in group I. Osteogenesis was higher in group I till the end of the third week but the difference was not significant later. Discrepancy in occlusion was more in group II. Mobility of tooth decreased and status of periodontal tissue improved significantly with time. In the tooth involved, the return of vitality and decrease in pain/tenderness was significant after 1 week and continued till 24 weeks to normalcy. Two teeth showed mild root resorbtion and none showed ankylosis.
CONCLUSION
Postoperative occlusal discrepancy is less but infection is higher when the tooth in the line of fracture is preserved as compared to when it is removed. More than half of the teeth in the fracture line show complete recovery within a period of 6 months to 1 year. Despite the risk of an increase in the rate of complications, the tooth in the line of fracture should be preserved for its merits.
Topics: Adult; Female; Follow-Up Studies; Fracture Fixation, Internal; Humans; Male; Mandibular Fractures; Molar, Third; Tooth Extraction; Tooth Loss; Treatment Outcome
PubMed: 22048601
DOI: 10.4103/0970-9290.87083