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1.
Introduction
Arch bars are regularly used in the management of dentoalveolar and minimally displaced fractures of the maxilla or mandible and luxation or avulsion of teeth by maxillofacial surgeons. The procedure for arch bar placement has remained unchanged over the period of years, and this coupled with the difficulty in maintenance of oral hygiene is a problem that begs attention.Technique
We have devised a technique to overcome these hurdles and achieve adequate intramaxillary splinting. The technique uses an arch wire and ligature wire assembly instead of the conventional arch bar.Conclusion
This technique is easy to learn and can thus be used as a rapid yet robust alternative to the conventional arch bar for dentoalveolar and minimally displaced fractures.2.
Yashmeet Kaur Sandhu Sarfaraz Padda Tejinder Kaur Amit Dhawan Sarika Kapila Jasmine Kaur 《Journal of maxillofacial and oral surgery》2018,17(2):211-217
Introduction
Maxillomandibular fixation is required in nearly all cases of facial fractures which can be achieved by conventional dental wiring techniques or newer methods using transalveolar screws.Material and Methods
A prospective randomized clinical study divided into two groups with thirty adult patients each with mandibular fractures was undertaken comparing the Maxillomandibular fixation technique using transalveolar screws and Erichs arch bar. Total time taken, rate of glove perforation, intraoperative and postoperative complications were noted in both the groups.Results
The time taken for maxillomandibular fixation in minutes and rate of glove perforation was found to be statistically significantly less for transalveolar group compared to arch bar group (p < 0.05). However, there was no significant difference found in the oral hygiene and gingival status using the Glass index and Gingival index. The rate of screw breakage (04.67%), wire breakage (05.12%), non-vitality due to iatrogenic dental damage (01.66%), soft tissue injury and tooth loss were some of the noted complications during the study.Conclusion
We found that transalveolar group offered advantages like less time taken with a definite decreased risk of percutaneous injury, while the iatrogenic complications like dental damage can be reduced by taking adequate precautions.3.
Osasuyi Anslem Okoturo Eyituoyo Ogunbanjo V. Olabode Olaitan A. Ademola Ayodele O Adesina 《Oral and maxillofacial surgery》2017,21(2):233-240
Background
The main goal of treatment of mandibular fractures is to restore normal dental occlusion and promote appropriate bone healing and a normal mouth opening. Recently, there has been a resurgent interest in the use of screws for intermaxillary fixation of mandibular fractures. This study was therefore designed to determine how the clinical outcomes of the use of screws for intermaxillary fixation compare with the use of miniplates in the treatment of mandibular fractures in Nigeria.Objectives
The objectives of this study are as follows:
- 1.To compare the clinical outcomes of the use of 2.0 mm × 9.0 mm screws for intermaxillary fixation with 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures in Lagos, Nigeria
- 2.To determine the clinical outcomes in the use of 2.0 mm × 9.0 mm screws for intermaxillary fixation (IMF) and 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures
- 3.To compare the complications associated with the use of 2.0 mm × 9.0 mm screws for IMF and 2.0 mm noncompression miniplates in the treatment of mandibular fractures
Methodology
This randomized controlled clinical study was carried out at the Department of Oral and Maxillofacial Surgery of the study institution. Subjects with simple unilateral mandibular fractures who met the inclusion criteria were randomly allocated into the study (intermaxillary fixation screw) and control (miniplate) groups through balloting. Factors assessed and compared during and after the procedures included intraoperative pain, postoperative nerve impairment, postoperative occlusion, limitation of mouth opening, incidence of hardware failure, incidence of infection and non-union. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 20.Results
A total of 56 subjects participated in the study, with 28 subjects in each group. Majority (91%) of the subjects were male. Road traffic crash was the highest aetiological factor while sport was the least (3.6%). A higher proportion (25.0%) of subjects in the miniplate group had major complications compared with 14.3% in the IMF screw group. There was no statistically significant association between site of mandibular fracture, time elapsed before treatment and complications (p < 0.05). All cases of mandibular fractures healed successfully at 6 weeks.Conclusion
The use of screws for IMF is as effective as 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures.4.
Auday M. AL-Anee Ahmed Fadhel Al-Quisi Hassanien A. Al-jumaily 《Oral and maxillofacial surgery》2018,22(3):303-307
Purpose
Is to compare the patterns, severity, and management of the high- and low-velocity mandibular war injuries managed at Al Shaheed Gazi Al-Hariri Hospital in Baghdad Medical City, Iraq, during a 2-year period.Methods
Forty-one patients with a history of mandibular war injuries treated by our maxillofacial team were reviewed during a period of 2 years (2015–2017). All patients were treated in the Maxillofacial Unit of the Hospital of Specialized Surgeries in Baghdad Medical City.Results
A 2-year retrospective study evaluated 41 patients with mandibular war injuries with a total of 94 fractures (comminution represents 79.06% of the bullet injuries, while it is only 62.74% with IED injuries). Management of these injuries was varied according to the severity of the injuries and resources available. Close reduction was used in 72.72% of the linear fracture cases, whereas open technique was used in 56.6% of the comminuted fractures.Conclusions
Bullet injuries were associated with a higher number of mandibular comminuted fractures, in addition to more extensive bone loss. While shell injuries of IED (improvised explosive devices), on the other hand, were associated with higher infection rate and more postoperative complication.5.
Satishkumar G. Patil Bindu S. Patil Udupikrishna Joshi B. M. Rudagi Aafreen Aftab 《Journal of maxillofacial and oral surgery》2017,16(2):212-218
Background and Purpose
The dislocation of mandibular condyle is a clinical condition in which the head of condyle has been displaced out of the glenoid fossa. Complete dislocation of the mandibular condyle can occur in anterior, posterior, lateral and superior direction. Among these dislocations, bilateral superolateral dislocation of mandibular condyles is quite rare and often misdiagnosed. Because of its rare occurrence and unusual clinical course, the best treatment is debatable.Patients and Method
We present the first case series of true bilateral superolateral dislocation of intact mandibular condyles (Type 2B) without fracturing the Zygomatic arch, associated with symphysis fracture.Conclusion
This article intends to provide information regarding the possible biomechanics and management of bilateral superolateral dislocation of mandibular condyles associated with symphysis fracture.6.
Lucas Borin Moura Guilherme dos Santos Trento Pedro Henrique de Azambuja Carvalho Mariana Granucci Júlio César Silva de Oliveira Valfrido Antonio Pereira-Filho 《Oral and maxillofacial surgery》2018,22(3):315-321
Purpose
Double and multiple mandibular fractures are associated to high morbidity and functional damage. This study aimed to evaluate the characteristics and outcomes of double unilateral, bilateral, and multiple mandibular fractures.Methods
A 7-year observational retrospective analysis was performed, and the injury-related data were collected from the medical records. Statistical analysis was performed using Fisher’s exact test (p?<?0.05).Results
In this period, 283 patients showed mandibular fractures. Of them, 83 (29.7%) had double or multiple mandibular fractures and were included in the study. Double bilateral fractures were more prevalent than multiple or double unilateral. Multiple fractures presented significant association with the combination of load-bearing and load-sharing fixation protocols. Most cases (94.0%) applied at least one type of internal fixation system. However, there was a positive association between condylar fractures and non-surgical treatment (p?<?0.01). Moreover, mandibular body fractures were associated with load-bearing fixation (p?<?0.01). In 56 cases, no complications were observed (67.5%). Complications were divided into treatment failure (10.8%) and transitory or minor complications (21.7%). There was no statistical association between complications and fracture pattern, fracture-tooth relation, and treatment modality.Conclusion
Double and multiple mandibular fractures represented almost one third of all mandibular fractures, and regardless to treatment protocol, there was no difference about complications. Moreover, although a considerable complication rate was found, most of them were minor or transitory.7.
Sakshi Aggarwal Manpreet Singh Palash Modi Esha Walia Rachit Aggarwal 《Oral and maxillofacial surgery》2017,21(4):383-390
Introduction
This study was performed to evaluate the efficacy and post-operative complication of 3-dimensional (3D) titanium miniplate and locking plate in mandibular fractures (parasymphysis, symphysis, body, and angle).Materials and methods
Forty patients, with non-comminuted mandibular fractures treated with open reduction and internal fixation using 3D titanium miniplate system or locking plate system through an intra-oral approach, were included in this study. All patients were systematically monitored up to 2 months post-operatively. Parameters recorded were infection, occlusal discrepancies, hardware failure, wound dehiscence, sensory disturbance of the inferior alveolar nerve, and stability of fractured segments.Results
Forty patients with mandibular fracture were divided into two groups randomly without any bias. The fractures of all 40 patients were found to be adequately fixed when checked intra-operatively after fixation. One patient (2.5%) of the 3D plate group developed an infection on the first and second post-operative visit and was treated by antibiotic coverage. One patient in the locking plate group (2.5%) reported wound dehiscence after the first week follow-up.Conclusion
Both 3D titanium miniplates and locking plate are effective in the treatment of mandibular fractures, and overall complication rates are lesser. However, the 3D plating system uses less hardware in cases of parasymphysis and symphysis fractures and more hardware in cases of body and angle fractures.8.
Jamal Giri Prabhat Ranjan Pokharel Rajesh Gyawali Jigyasha Timsina Kashmira Pokhrel 《BMC oral health》2018,18(1):214
Background
Mixed dentition space analysis methods using regression equations, namely, Moyers’ analysis and Tanaka-Johnston analysis are commonly used around the world. However, the applicability of these analyses among different racial groups have been questioned. The primary objective of this study was to assess the applicability of the Moyers’ and Tanaka-Johnston analyses among Nepalese Mongoloids and to develop regression equations for the same population if needed.Methods
One hundred (50 males and 50 females) pre-treatment study models of the Nepalese Mongoloid patients undergoing orthodontic treatment were retrieved from the archives of the department of Orthodontics. The mesiodistal widths of mandibular incisors and widths of canines and premolars of all 4 quadrants were measured by a single investigator using a digital caliper to the nearest 0.01?mm. Predicted widths of canines and premolars were obtained using standard Moyers’ and Tanaka-Johnston analyses and then compared with the measured widths.Results
The measured widths of canines and premolars were significantly different from the predicted widths obtained from Moyers’ and Tanaka-Johnston analyses. Strong and positive correlations were found between the sum of mesiodistal widths of mandibular incisors and the sum of mesiodistal widths of canines and premolars in males (0.73 for maxillary arch and 0.68 for mandibular arch) and females (0.64 for maxillary arch and 0.79 for mandibular arch).Conclusions
The Moyers’ and Tanaka-Johnston analyses did not accurately predict the mesiodistal width of unerupted canines and premolars for Nepalese Mongoloid population. Hence, new regression equations have been developed for this population. However, validation studies should be conducted to confirm the applicability and accuracy of these equations.9.
Vinay V. Kumar P. C. Jacob Vikram Kekatpure Naveen Hedne Felix P. Koch Moni A. Kuriakose 《Journal of maxillofacial and oral surgery》2016,15(3):346-348
Aim
The aim of this clinical paper is to introduce a technique to plan for functional maxillofacial reconstructions.Materials and Methods
Preoperative dental casts were made of the patient and mock surgery performed on the casts. A fibula analogue was then placed in an ideal functional reconstruction position. New dentures were fabricated on the fibula analogue and drill holes for the placement of implants were placed through the denture. This denture formed as a guide to position the fibula transplant during surgery.Results
This technique was useful in producing functional and rehabilitative outcomes in cases of both maxillary and mandibular reconstructive surgeries.Conclusion
The Jugaad technique—denture based inverse planning—is a cost effective method for planning and executing maxillofacial reconstructions using mock surgery on casts and interim dentures.10.
Marcio Bruno Figueiredo Amaral Sebastião Cristian Bueno Icaro Buchholz Abdala Roger Lanes da Silveira 《Oral and maxillofacial surgery》2017,21(3):357-361
Purpose
The present study aims to describe three cases of patients inflicted by rubber bullets with severe facial fractures.Methods
In addition, a review of English-language literature involving facial fractures by rubber bullets from 1975 to 2016 was performed.Results
This current study demonstrated that the use of the LLRBW is unsafety even when applied by police enforcements exclusively.Conclusions
Management of facial fractures caused by LLRBW is done in a usual manner with closed or open reduction associated with bone mini-plates or reconstruction plates when indicated. Special initial wound care should be done to avoid secondary infection and additional procedures.11.
Introduction
Management of condylar fractures in children is especially important. If not properly treated, these fractures may lead to serious problems, such as ankylosis of the temporomandibular joint. This article describes an extraordinarily favorable recovery after conservative treatment of a unilateral condylar fracture in a 4-year-old girl.Case presentation
A 4-year-old Japanese girl was referred to our institution with a right mandibular condylar fracture caused by a fall. In this article, we report the 2-year follow-up of this case by clinical and radiological evaluations after conservative treatment, highlighting the strategy used.Conclusions
The outcomes throughout the 2-year follow-up and the remodeling process of the condyle observed on panoramic radiographs and computed tomographic images proved the suitability of the conservative treatment.12.
Complication rate in mandibular angle fractures—one vs. two plates: a 12-year retrospective analysis
Raphael Ferrari M. Lanzer D. Wiedemeier M. Rücker M. Bredell 《Oral and maxillofacial surgery》2018,22(4):435-441
Purpose
Treatment of mandibular angle fractures using one or two osteosynthesis plates is still a controversial topic. Fracture, treatment, and patient-dependent influencing factors could affect the overall outcome. In the present retrospective study, complication rates of mandibular angle fractures treated by open reduction were assessed according to type of treatment.Materials and methods
We analyzed retrospective medical records using the search terms “mandibular angle fracture.” We included all patients presenting with a mandibular angle fracture treated by open reduction and internal fixation at our department between 2002 and 2012.Results
We included 186 patients treated with open reduction and miniplate fixation (84 one plate; 102 two plates). The early complication rate was significantly higher for the double-plate group (72.5% vs. 47.6%, respectively; p?=?0.001). Most common findings in the postoperative period were transient hypoesthesia and tissue swelling. In the two-plate group, a significantly increased operation time of 183 min versus 150 min in the one-plate group was found (p?<?0.001). Late complications did not differ significantly between both groups (21.4% single-plate group; 30.4% two-plate fixation group; p?=?0.32).Conclusion
We found a significantly increased early complication rate in the two-plate group. Long-term complications did not differ between both groups.13.
Darpan Bhargava Shaji Thomas Ankit Pandey 《Journal of maxillofacial and oral surgery》2018,17(1):71-74
Purpose
The aim of the study is to compare the post reduction squealae of transmucosal miniplate fixation technique for stabilization of palatal fractures with intra-arch wiring technique.Materials and Method
This study was prospectively undertaken on 16 patients, dividing them into two treatment arms based on random sampling methodology (Group A & B). For patients in Group A, intra-arch wire stabilization technique and in Group B trans-mucosal miniplate stabilization technique was used. The pre-operative and post-operative occlusion and time taken for stabilization in both the techniques was compared.Results
The mean time taken for reduction and stabilization of palatal fracture in group A was 10.9 ± 2.21 min and in group B was 14.2 ± 1.13 min. Four out of eight study patients in group A required post reduction interception to stabilize occlusion postoperatively, whereas none of the patients in group B needed any post operative intervention.Conclusion
The post operative occlusal stability was found better in study patients included in group B when compared to group A patients, although satisfactory post-operative occlusion was obtained even in group A with post-operative interception for occlusal stability.14.
Yuvaraj Vaithilingam T. S. Balaji Nithin Jude Joseph Varsha Murthy Suresh Kumar 《Journal of maxillofacial and oral surgery》2017,16(4):510-511
Introduction
Lingual nerve damage is one of the common complications following mandibular third molar surgery. On considering the impact of lingual nerve damage on the patient’s quality of life, it is necessary to exercise caution to minimize its occurrence.Material and methods
Although many lingual retractors are available, in this article we describe an indigenously designed lingual retractor for use in mandibular third molar surgery.Conclusion
The indigenous lingual retractor described in this article provides advantages like clear access and excellent retention unlike conventional retractors.15.
Batchu Pavan Kumar V. Venkatesh K. A. Jeevan Kumar B. Yashwanth Yadav S. Ram Mohan 《Journal of maxillofacial and oral surgery》2016,15(4):425-441
Introduction
Mandibular reconstruction has changed significantly over the years and continues to evolve with the introduction of newer technologies and techniques.Purpose
This article reviews the history of oromandibular reconstruction, biomechanics of mandible, summarizes the reconstruction options available for mandible with defect classification, goals in reconstruction, the various donor sites, current reconstructive options, dental rehabilitation and persistent associated problems.Summary
Oromandibular reconstruction, although a challenge for the head and neck reconstructive surgeon, is now reliable and highly successful with excellent long-term functional and aesthetic outcomes with the use of autogenous bone grafts and current reconstructive options. The ideal reconstruction would provide a solid arch to articulate with the upper jaw, restoring swallowing speech, mastication, and esthetics. Autogenous vascularized bone grafts in combination with microsurgical techniques have revolutionized mandibular reconstruction in oral cancer surgery. Current trends in mandibular reconstruction aim to achieve reestablishment of a viable mandible of proper form and maxillary mandibular relationship while decreasing the need for invasive autogenous graft procurement. However the optimal reconstruction of mandibular defects is still controversial in regards to reconstructive options which include the donor site selection, timing of surgery and method of reconstruction.16.
Yoshiko Ariji Akitoshi Katsumata Ryota Kubo Akira Taguchi Hiroshi Fujita Eiichiro Ariji 《Oral Radiology》2017,33(2):117-123
Objectives
To assess intra- and inter-observer agreement in the morphological evaluation of mandibular cortical bone on panoramic radiographs, to examine factors affecting the diagnosis, and to determine causes of diagnostic discrepancy.Methods
Three experienced observers evaluated mandibular cortical shape on panoramic radiographs of 228 females, and divided the images into three classes. The intra- and inter-observer agreements were calculated. The effect of mandibular cortical width on shape classification was examined. Causes of diagnostic discrepancy were investigated.Results
Overall intra- and inter-observer kappa values in diagnosing mandibular cortical shape were 0.58–0.76 and 0.62–0.69, respectively. The kappa values in diagnosing Class 2 were low. In radiographs diagnosed as Class 2 and Class 3, the ranges of mandibular cortical width overlapped. Discrepancies in diagnosis were caused by slight resorption at the endosteal margin of the cortical bone, endosteal cortical residues near the thinned smooth cortex, and superimposition of the hyoid bone over the mandible.Conclusions
Inter-observer agreement in evaluating mandibular cortical shape was moderate to substantial. Diagnostic discrepancies were mainly caused by differences in evaluation of the endosteum near the cortical bone.17.
Rubens Camino Junior Rogério Bonfante Moraes Constantin Landes João Gualberto C. Luz 《Oral and maxillofacial surgery》2017,21(3):327-334
Purpose
A comparative study of the use of the 2.0-mm locking fixation system with conventional systems in the treatment of mandibular fractures was performed.Methods
For this study, 87 consecutive patients with 112 mandibular fractures were randomized to receive either 2.0-mm locking plates (n = 45) or conventional 2.0- or 2.4-mm plates (n = 42) and had a minimum follow-up of 6 months. Fractures were classified based on the degree of displacement and complexity. Statistical analyses were used to verify possible differences between the groups when separately compared unfavourable and favourable cases (p ≤ 0.050).Results
Despite randomization, systemic diseases were more frequent in the 2.0-mm locking group in favourable cases. Substance abuse occurred predominantly in the 2.0-mm locking group, in unfavourable and favourable fractures. There were more cases of complex fractures in the conventional group in unfavourable cases. One case involving a major postoperative complication occurred in the locking group (2.2%) and three cases occurred in the conventional group (7.1%) but with no significant difference between groups. In this study, there were no major differences between conventional and locking 2.0-mm locking systems with regard to the outcome of treated mandibular fractures, showing that both are adequate as long as the criteria of their indication and requirements for installation are met.Conclusions
It was concluded that the 2.0-mm locking fixation system can replace conventional systems in the treatment of mandibular fractures; in addition, this approach was effective in the treatment of unfavourable fractures that typically require the 2.4-mm conventional system.18.
Pasquale Procacci L. Trevisiol P. F. Nocini V. Favero A. D’Agostino 《Oral and maxillofacial surgery》2017,21(1):91-98
Purpose
The purpose of this study was to describe a modified technique using only biological dura substitute (Lyoplant®) associated or not to a sheet of Medpore® (porous polyethylene plate) avoiding the use of Silastic® or Merocel® packing for endoscopic endonasal reduction of medial orbital wall fracture.Methods
An interventional case report was used involving two patients with medial orbital wall fracture that were treated with the modified technique. Postoperatively, the patients were evaluated for visual acuity, enophthalmos, extraocular motility, and diplopia.Result
Twelve months after surgery, patients recovered completely without any residual eye symptoms or complications, and postoperative CT showed a completely corrected medial orbital wall fractures.Conclusion
The reported technique proved itself to be safe and effective, and it may be expected to have advantages over the conventional endoscopic approach using a non-absorbable packing, avoiding the need for long-term nasal packing and a secondary removal procedure.19.
Joseph Edward Mubarak A. Aziz Arjun Madhu Usha Jyothi K. Narayanan 《Journal of maxillofacial and oral surgery》2017,16(4):424-429
Introduction
Extractions are routine procedures in dental surgery. Traditional extraction techniques use a combination of severing the periodontal attachment, luxation with an elevator, and removal with forceps. A new technique of extraction of maxillary third molar is introduced in this study—Joedds technique, which is compared with the conventional technique.Methods and Material
One hundred people were included in the study, the people were divided into two groups by means of simple random sampling. In one group conventional technique of maxillary third molar extraction was used and on second Joedds technique was used. Statistical analysis was carried out with student’s t test.Results
Analysis of 100 patients based on parameters showed that the novel joedds technique had minimal trauma to surrounding tissues, less tuberosity and root fractures and the time taken for extraction was <2 min while compared to other group of patients.Conclusion
This novel technique has proved to be better than conventional third molar extraction technique, with minimal complications. If Proper selection of cases and right technique are used.20.
Anisha Perepa Ramen Sinha Anmol Agarwal Tahseen Ali Khan 《Journal of maxillofacial and oral surgery》2018,17(1):19-23