Mandibular Fractures—What to Do When

1995 ◽  
Vol 112 (5) ◽  
pp. P178-P178
Author(s):  
William D. Clark ◽  
John M. Morehead
Keyword(s):  
Mandibular Fracture ◽  
Mandibular Fractures ◽  
Educational Objectives ◽  
Mandible Fractures ◽  
Special Circumstances

Educational objectives: To determine the appropriate techniques to treat a variety of mandible fractures and to access the special circumstances of the patient with a mandibular fracture and modify treatment accordingly.

scholarly journals Recovery of Post-Traumatic Temporomandibular Joint after Mandibular Fracture Immobilization: A Literature Review

2021 ◽  
Vol 11 (21) ◽  
pp. 10239
Author(s):  
Carmen Gabriela Stelea ◽  
Doriana Agop-Forna ◽  
Raluca Dragomir ◽  
Codrina Ancuţa ◽  
Roland Törok ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Real Life ◽  
Mandibular Fracture ◽  
Temporomandibular Joint Disorders ◽  
Treatment Modalities ◽  
Mandibular Fractures ◽  
Traumatic Injuries ◽  
Joint Fractures ◽  
Post Traumatic ◽  
Mandible Fractures

Considered as one of the most common traumatic injuries of the maxillofacial region, mandibular fractures remain among the complex causes of temporomandibular joint disorders (TMDs). Due to the complexity of the temporomandibular joint, the management of TMDs represents a challenge in real-life practice; although many treatment modalities have already been proposed, ranging from conservative options to open surgical procedures, a consensus is still lacking in many aspects. Furthermore, despite continuous improvement of the management of mandible fractures, the duration of immobilization and temporary disability is not reduced, and the incidence of complications remains high. The aim of the present study is to (i) review anatomophysiological components of temporomandibular joint; (ii) review concepts of temporomandibular joint fractures; and (iii) describe methods of the recovery of the temporomandibular joint after mandibular fracture immobilization.

scholarly journals Mandibular Fractures: Pre-Operative Panoramic Radiography and Duplication Sign Patterns

2021 ◽  
Vol 5 (5) ◽  
pp. 57-66
Author(s):  
Oleksandr Nosyr ◽  
Serhii Khrulenko
Keyword(s):  
Cortical Bone ◽  
Management Strategy ◽  
Panoramic Radiography ◽  
Mandibular Fracture ◽  
Fracture Line ◽  
Mandibular Fractures ◽  
Panoramic Radiographs ◽  
Sign Patterns ◽  
Precise Diagnosis ◽  
Mandible Fractures

The purpose of this essay is to present the multiple patterns of the duplication sign at the mandibular fracture line/gap visualized at the panoramic radiography as two-line fracture gap or pseudocomminuted fracture. We retrospectively reviewed the orthopantomography of patients with mandible fractures and presented nine patients with 12 duplication signs (also known as lambda course fracture line). On panoramic radiographs the fracture line/gap with duplication sign is visualized as two-line cortical bone discontinuity with or without dislocation due to the fact that the fracture gap runs asymmetrically on the external and internal cortical plates of the jaw. Knowledge of duplication sign patterns, artifacts is also crucial for the precise diagnosis and choice of correct management strategy.

scholarly journals Atrophic mandibular fracture treatment: prototyping as a tool in surgical planning

2020 ◽  
Vol 9 (9) ◽  
pp. e796997986
Author(s):  
Reginaldo Fernandes da Silva ◽  
Rebeca Valeska Soares Pereira ◽  
Joana de Ângelis Alves Silva ◽  
Gustavo José de Luna Campos ◽  
Mário César Furtado da Costa ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Clinical Case ◽  
Mandibular Fracture ◽  
Facial Trauma ◽  
Mandibular Fractures ◽  
Surgical Time ◽  
3D Technology ◽  
Mandible Fracture ◽  
Intraoperative Period ◽  
Mandible Fractures

Introduction: Atrophic mandibular fractures are injuries found in old age due to facial trauma. Its treatment is a challenge, even for experienced surgeons, due to the different approaches that can be taken from clinical decisions. Taking into consideration the limitations that the age presented by most of the affected patients brigs, there are devices that stand out by seeking benefits in terms of predictability and time gain in the intraoperative period. The additive manufacturing is a valuable resource in the surgical planning and rehabilitation of these patients. Objective: To expose a clinical case that demonstrates the success in the use of surgical planning through a prototype printed in 3D technology. Clinical case: Elderly woman, 75 years old, victim of a fall from her own height who had a bilateral atrophic mandible fracture due to facial trauma. The surgical procedure was planned using a prototype printed in 3D technology providing predictability and reduced surgical time. The patient evolved in the postoperative period without complaints, with function immediately restores and without signs of infection or plate exposure. Conclusions: Atrophic mandible fractures are still related to a challenging treatment, therefore, adequate surgical planning and the use of auxiliary strategies such as 3D prototyping provide greater predictability of results, as well as time gain during the intraoperative.

scholarly journals Evaluation of the effectiveness of early or delayed treatment upon healing of mandibular fractures: A retrospective study

2015 ◽  
Vol 09 (01) ◽  
pp. 087-091 ◽  
Author(s):  
Giath Gazal
Keyword(s):  
Clinical Trial ◽  
Substance Abuse ◽  
Retrospective Study ◽  
Mandibular Fracture ◽  
Mandibular Fractures ◽  
Operating Theater ◽  
Delayed Treatment ◽  
Treatment Analysis ◽  
Mandible Fractures ◽  
Fracture Types

ABSTRACT Objectives: This study was aimed to assess the impacts of delay treatment of mandibular fracture and its complications. In addition risk variables related such as time to repair, fracture types, substance abuse, causes, surgical management, muddling or complications and duration of clinic stay were also evaluated. Materials and Methods: The data of patients attending the Newcastle General Hospital, UK for the management of mandibular fractures were probed. This retrospective clinical trial conducted over 6 months, included 91 patients attending trauma operating theatre during weekdays or weekends. Data were analyzed for time to admission and treatment and its relationships to various factors using SPSS version 20 (SPSS Inc., Chicago, IL). Results: Time to treatment from the point of admission was 31.50 ± 3.83 h during week days that has been significantly more for patients attending the hospital at weekends or nights. Similar trend was observed for total summative time from the incident to treatment analysis. Conclusions: This investigation has demonstrated that the rate of infection and postoperative complications following surgical treatment of mandible fractures can be eased off by reducing the waiting time from presentation to the emergency and to the operating theater.

scholarly journals Exposure to Ti4Al4V Titanium Alloy Leads to Redox Abnormalities, Oxidative Stress, and Oxidative Damage in Patients Treated for Mandible Fractures

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Jan Borys ◽  
Mateusz Maciejczyk ◽  
Bożena Antonowicz ◽  
Adam Krętowski ◽  
Danuta Waszkiel ◽  
...  
Keyword(s):  
Titanium Alloy ◽  
Oxidative Damage ◽  
Activity Concentration ◽  
Maxillofacial Surgery ◽  
Redox Balance ◽  
Passive Layer ◽  
Oxidative Modification ◽  
Mandibular Fractures ◽  
Mandible Fractures ◽  
Increased Activity

Due to the high biotolerance, favourable mechanical properties, and osseointegration ability, titanium is the basic biomaterial used in maxillofacial surgery. The passive layer of titanium dioxide on the surface of the implant effectively provides anticorrosive properties, but it can be damaged, resulting in the release of titanium ions to the surrounding tissues. The aim of our work was to evaluate the influence of Ti6Al4V titanium alloy on redox balance and oxidative damage in the periosteum surrounding the titanium miniplates and screws as well as in plasma and erythrocytes of patients with mandibular fractures. The study included 31 previously implanted patients (aged 21–29) treated for mandibular fractures and 31 healthy controls. We have demonstrated increased activity/concentration of antioxidants both in the mandibular periosteum and plasma/erythrocytes of patients with titanium mandibular fixations. However, increased concentrations of the products of oxidative protein and lipid modifications were only observed in the periosteum of the study group patients. The correlation between the products of oxidative modification of the mandible and antioxidants in plasma/erythrocytes suggests a relationship between the increase of oxidative damage at the implantation site and central redox disorders in patients with titanium miniplates and screws.

scholarly journals The use of Portland cement in the repair of mandibular fractures in rats

2011 ◽  
Vol 26 (6) ◽  
pp. 426-432
Author(s):  
Reginaldo Inojosa Carneiro Campello ◽  
Belmiro Cavalcanti do Egito Vasconcelos ◽  
Gerhilde Callou Sampaio ◽  
Antonio Rolim ◽  
Gabriela Granja Porto
Keyword(s):  
Portland Cement ◽  
Bone Healing ◽  
Soft Tissues ◽  
Lethal Dose ◽  
Mandibular Fracture ◽  
Point Of View ◽  
Control Group ◽  
Mandibular Fractures ◽  
Male Wistar Rats ◽  
Experimental Group

PURPOSE: To evaluate the bone healing of mandibular fractures following the use of Portland cement. METHODS: Thirty-two male Wistar rats were divided into control and experimental groups. In the control group the rats were submitted to a mandibular fracture, which was reduced, and the soft tissues were sutured. In the experimental group the rats had the mandibular fracture reduced and maintained with the Portland cement. The animals were euthanized 7 and 21 days after surgery by injecting a lethal dose of anesthetic. The following variables were studied: weight of the animals, radiographic images, histopathological features and time of surgery. RESULTS: A weight loss was observed in the specimens of both groups at the different times of evaluation, a greater difference in weight before and after surgery being found in the experimental group, which was statistically significant (p <0.05, p = 0.041). From the histological point of view, with a margin of error (5.0%) the only two significant differences (p <0.05) recorded in the variables were "Material deployed" and "Bone resorption" during the evaluations at 7 and 21 days, respectively. CONCLUSION: The Portland cement served to promote bone healing.

scholarly journals Concepts and Challenges in the Surgical Management of Edentulous Mandible Fractures: A Case Series

2019 ◽  
Vol 3 (1) ◽  
pp. s-0039-1693038
Author(s):  
Venkatesh Anehosur ◽  
Twinkle Thakker ◽  
Nikhil Nagraj ◽  
Niranjan Kumar
Keyword(s):  
Mineral Content ◽  
Bone Fractures ◽  
Case Series ◽  
Mandibular Fractures ◽  
Rigid Fixation ◽  
Functional Rehabilitation ◽  
Edentulous Mandible ◽  
High Incidence ◽  
Choice Of Treatment ◽  
Mandible Fractures

Functional rehabilitation of complex edentulous or atrophic mandibular fractures is surgically demanding. The high incidence of bone fractures in geriatric age group is secondary to the loss of bone mineral content with age. So far, there is no consensus regarding the best treatment for repair of fractures of the severely atrophic mandible. Thus, the choice of treatment for such fractures should be based on the degree of atrophy, considering its inverse relationship to the amount of rigid fixation required. Hence, open reduction and internal fixation (ORIF) is considered to be a reliable method for treating the edentulous mandible fractures. The authors present a case series of patients treated with ORIF with load bearing (LB; reconstruction plate) and load sharing (LS; miniplates) principles. No complications related to infection, plate exposure, fibrous union, nonunion, and trismus, were observed.

Incidence of Eye Injuries in Facial Fractures: An Analysis of 727 Cases

1983 ◽  
Vol 91 (3) ◽  
pp. 276-279 ◽  
Author(s):  
G. Richard Holt ◽  
Jean Edwards Holt
Keyword(s):  
Mandibular Fractures ◽  
Facial Fractures ◽  
Eye Injuries ◽  
Midfacial Fractures ◽  
Ocular Injuries ◽  
Mandible Fractures ◽  
Nasal Fractures

From 1973 to 1980, 727 patients with facial fractures received formal ophthalmologic consultation. The series included 174 mandible fractures, 29 nasal fractures, 436 midfacial fractures, and 88 frontal fractures. Of these, a total of 67% sustained some degree of ocular injuries. Seventy-nine percent of the eye injuries were categorized as temporary, 18% were serious, and 3% were blinding. Of the mandibular fractures, 29% had ocular injuries, 59% nasal fractures, 59% midfacial fractures, and 89% frontal fractures.

scholarly journals An Evaluation of the Effect of Therapeutic Ultrasound on Healing of Mandibular Fracture

2015 ◽  
Vol 8 (4) ◽  
pp. 299-306 ◽  
Author(s):  
Kiran Patel ◽  
Sanjeev Kumar ◽  
Nishtha Kathiriya ◽  
Sonal Madan ◽  
Ankit Shah ◽  
...  
Keyword(s):  
Pain Perception ◽  
Mandibular Fracture ◽  
Periodontal Pocket ◽  
Control Group ◽  
Mandibular Fractures ◽  
Study Group ◽  
Pulsed Ultrasound ◽  
Pocket Depth ◽  
Significant Difference ◽  
Experimental Group

The mandible is the most frequently fractured bone in maxillofacial trauma, the treatment of which consists of reduction and fixation of dislocated fragments by open or closed approach. Innovative techniques toward reducing the period of the postoperative intermaxillary fixation (IMF) are being researched. A relatively unknown treatment that may have an effect on fracture healing is ultrasound. Recent clinical trials have shown that low-intensity pulsed ultrasound (LIPUS) has a positive effect on bone healing. The aim of this study was to evaluate the effect of LIPUS on healing by its application in fresh, minimally displaced or undisplaced mandibular fracture in young and healthy individuals. A total of 28 healthy patients were selected randomly from the outpatient department needing treatment of mandibular fractures. They were then randomly allocated to either of the following two groups—experimental group and study group. After IMF, patients in experimental group received pulsed ultrasound signals with frequency of 1 MHz, with temporal and spatial intensity of 1.5 W/cm2, pulsed wave for 5 minutes on every alternate day for 24 days, whereas patients in control group received no therapy except IMF. Radiographic density at the fracture zone was assessed from the radiograph by Emago (Emago, Amsterdam, Netherlands) Image Analysis software before IMF then at 1st to 5th weeks post-IMF. The amount of clinical mobility between fracture fragments was assessed by digital manipulation of fractured fragment with the help of periodontal pocket depth measuring probe in millimeters at pre-IMF and after 3 weeks. Pain was objectively measured using a visual analogue scale at weekly interval. The data collected were subjected to unpaired “ t“ test. The experimental group showed significant improvement in radiographic density compared with control group at 3- and 5-week interval; pain perception was significantly reduced in experimental group compared with study group in the subsequent weeks. No significant difference was found in clinical mobility between fracture fragments at 3-week interval. The present study provides a basis for application of therapeutic controlled ultrasound as an effective treatment modality to accelerate healing of fresh, minimally displaced mandibular fracture.

Isolated Tympanic Plate Fracture Frequency and Its Relationship to Mandibular Trauma

2014 ◽  
Vol 65 (4) ◽  
pp. 360-365 ◽  
Author(s):  
Canan Altay ◽  
Nezahat Erdoğan ◽  
Ozan Batkı ◽  
Erdem Eren ◽  
Sedat Altay ◽  
...  
Keyword(s):  
Ct Images ◽  
Maxillofacial Trauma ◽  
Mandibular Fractures ◽  
Condylar Process ◽  
Plate Fracture ◽  
Maxillofacial Fractures ◽  
Significant Difference ◽  
Mandible Fractures ◽  
The Right ◽  
Communications System

PurposeThis study evaluated the prevalence of isolated tympanic fractures and their correlation with mandibular fractures by using maxillofacial computed tomography (CT).Materials and MethodsWe retrospectively evaluated the maxillofacial CT of 1590 patients who presented to our emergency department with maxillofacial trauma between December 2010 and December 2012. Maxillofacial CT was used as the criterion standard for evaluating patients with maxillofacial fractures. The CT images were evaluated by using an electronic picture archiving and communications system and interpreted independently by 2 radiologists.ResultsThe maxillofacial CT images revealed mandibular fractures in 167 of the patients and isolated tympanic plate fractures in 35 of these 167 patients. Four patients (11%) had a bilateral tympanic plate fracture, and 31 patients (89%) had unilateral tympanic plate fracture. Of all the tympanic plate fractures, 19 (54%) were on the right side and 16 (46%) were on the left side ( P > .05). In our results, a significant correlation between the presence of a right-sided tympanic plate fracture and fracture of the ipsilateral condylar process was found ( P = .036). However, a statistically significant difference between the presence of a tympanic plate fracture and other mandible fractures, additional soft-tissue findings, or the number of fractures was not determined ( P > .05). Sex had no impact on the presence of tympanic plate fracture ( P > .05).ConclusionThe frequency of isolated tympanic plate fractures in maxillofacial trauma is low, but it is an important anatomic location. Condyle fractures are significantly associated with isolated tympanic plate fractures. The presence of these injuries should raise suspicion of a concomitant isolated tympanic plate fracture.

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