A Prospective Randomized Clinical Trial Comparing 3D and Standard Miniplates in Treatment of Mandibular Symphysis and Parasymphysis Fractures

Purpose

To compare the efficacy of the 3D miniplates to standard miniplates in the osteosynthesis of mandibular symphysis and parasymphysis fractures on the basis of clinical parameters and radiographic evaluation.

Patients and Methods

A prospective randomized clinical trial was conducted to treat consecutive mandibular symphysis and parasymphysis fractures. The patients were randomly divided into 2 groups. The patients underwent osteosynthesis in group A with 3D titanium miniplates and in group B with conventional titanium miniplates. The cause of trauma, the number of days from injury to surgery, average age and gender were all reviewed. The assessment of the patients was done at 1, 3, and 6 weeks and 3 months using the clinical parameters and radiographic evaluation.

Results

Eighty patients with isolated symphysis or parasymphysis fracture met the inclusion criteria. In our study, a statistically significant difference was not found in the clinical parameters such as pain, swelling, infection, paresthesia, hardware failure, and mobility between the fracture segments. Similarly Radiological evaluation did not show any statistically significant difference in reduction between the 2 groups. 3D plates are difficult to adapt and use sometimes, but operative time is less with them in treatment of symphysis and parasymphysis fractures.

Conclusion

The use of 3D miniplates for symphysis and parasymphysis fracture fixation was efficacious enough to bear the masticatory load during osteosynthesis of the fracture. Although 3D miniplate system is difficult to adapt and difficult to use in cases of fractures involving the mental nerve, they provide the advantage of less operative time and less implant material in treatment of symphysis and parasymphysis fracture, with clinical results almost similar to those seen with conventional miniplate osteosynthesis.     

医用小夹板在急诊口腔颌面部骨折处理中的应用

本文介绍医用小夹板骨内固定在口腔颌面外科急诊骨折手术中的应用，方法简便、实用。与传统治疗手段比较，由于即时修复和重建了被破坏的解剖结构，其临床疗效更佳。它不仅减少了长期颌间固定的使用工增加了骨折固位的稳定性，减少了住院时间，有利于患者局部和全身情况的尽快恢复。     

Scientific Abstracts of 40th Annual Conference of Association of Oral and Maxillofacial Surgeons of India

Introduction

Bone marrow (BM) derived pleuripotent undifferentiated stem cells represent a promising population for supporting new concepts in cellular therapy.

Aim

The aim of this study is to evaluate the versatility of pleuripotent undifferentiated stem cells derived from BM aspiration and its applications in oral and maxillofacial surgical procedures.

Materials and Methods

A total of 30 patients out of which 15 were with hard tissue defects (cystic lesions n = 6, post surgical alveolar defects n = 4, peri implant defects n = 3, alveolar clefts n = 2) and 15 soft tissue lesions (leukoplakia and lichen planus n = 6, oral submucous fibrosis n = 7, post traumatic soft tissue loss n = 2) were included in the study on randomized clinical basis. The patients received autologous BM derived mononuclear cells which were being locally delivered into the lesion and followed up. The parameters used were (1) To compare and evaluate the bone regeneration by radiographic assessment at the end of 3rd and 6th month postoperatively. (2) Duration of the procedure. (3) Clinical improvement in the management of soft tissue lesions. (4) Assessment of wound healing by Vancouver burn scar assessment of wound. (5) Safety, postoperative infections and complications.

Results

For hard tissue lesions CT scans and OPG revealed adequate regenerated bone, bridging the defect after 3 months. Hounsfield units of regenerated bone after 6 months were more or less similar to native bone which was statistically significant (unpaired t test = p < 0.05). For soft tissue lesions (1) 7 cases of OSMF showed adequate clinical mouth opening (one way anova test = p < 0.05), reduction in burning sensation and blanching of mucosa, (2) 6 cases of leukoplakia and lichen planus and 2 cases of post traumatic soft tissue defects showed good clinical improvement by Vancouver burn scar assessment of wound index.

Conclusion

The study shows that there is a definite beneficial effect in bone regeneration and soft tissue wound healing with the use of BM-derived mononuclear cells.

     

The Benefit of the Smartphone in Oral and Maxillofacial Surgery: Smartphone Use Among Maxillofacial Surgery Trainees and iPhone Apps for the Maxillofacial Surgeon

The use of smartphones has soared among healthcare professionals in recent years, with estimated figures reporting that the majority of clinicians own and use smartphones in the workplace. Smartphones allow the clinician to carry textbooks in their pocket, write documents on the move and use email and internet to enhance productivity and clinical decision making. These advances in smartphone technology have enabled access to healthcare information for the clinician and transfer of data between team members, giving rise to the phenomenon of telemedicine. With the ability to instantly transfer clinical data to the off-site surgeon, combined with purpose-built medical apps, the smartphone is rapidly becoming an invaluable tool for the modern surgeon. Many studies have linked the benefits of smartphones and apps in other surgical specialities, but no article to date has highlighted the merits and full scope of this technology to the Oral and Maxillofacial Surgeon. We report that 94 % of British maxillofacial surgery trainees own a smartphone, with 61 % owning an iPhone. 89 % of trainees questioned had downloaded medical apps and used them regularly during clinical activities. We discuss the clinical application of the smartphone in the field of oral and maxillofacial surgery and review a list of useful and relevant apps for the modern maxillofacial surgeon using the iPhone as an example platform.     

三维CT在颌骨骨折中的应用

目的：探讨三维ＣＴ成像技术在面中部骨折中的应用价值,尤其是对凳面部复合,多发骨折的术前诊断和手术计划制定的意义。方法：对４７例面中部骨折进行螺旋ＣＴ扫描和三维成像。结果：４７例例患者中３８例经手术治疗,９例为保守治疗,所有手术病例都证实了术前三维ＣＴ的诊断,结论：三维ＣＴ成像可使颌面部复杂性骨折的移位情况近似模型殷再现,有益于选择最合适的手术方案。