scholarly journals Clinical and functional rationale for the use of intraosseous composite materials-covered screw retainers for mandibular fracture osteosynthesis

2014 ◽  
Vol 95 (2) ◽  
pp. 219-223
Author(s):  
S A Safarov ◽  
A E Shcherbovskih ◽  
Yu V Petrov ◽  
I M Bayrikov

Aim. To increase the effectiveness of mandibular fracture osteosynthesis by using the composite materials-covered intraosseous screw retainers with active combined cutting edge. Methods. 282 patients with mandibular fractures were examined and operated in the clinic of Oral and Maxillofacial Surgery and Dentistry of Samara State Medical University from 2011 to 2013. Surgeries were performed in 257 (91.1%) patients, including plate osteosynthesis - in 133 (47.2%), intraosseous composite materials-coated screw retainers - in 42 (14.9%), uncoated pins - in 65 (23.0%), bone sutures - in 17 (6.0%). Orthopedic and other methods of bone fragments fixation were used in 25 (8.9%) patients. Proposed composite materials-coated osteosynthesis retainer is a square pin with cutting angle of 60-80° and 4 longitudinal grooves of 5-10 mm. The main part is a two-tier helical ribbon with alternating cutting portions, wherein some areas have the same diameter as the main part of the retainer, and the others are 20-100 microns thinner and are covered with TiC0, 65+25% Ca10(PO4)OH2. RESULTS. A comparative analysis with the traditionally used methods was carried out. The main advantages of the proposed method are rigid fixation of mandibular bone fragments and optimal osteogenesis in complex treatment of patients with trauma. Conclusion. The use of the proposed method of mandibular fractures surgical treatment using intraosseous screw retainers with bioactive coating reduced the risk of complications and the length of hospital stay.

2018 ◽  
Vol 16 (3) ◽  
pp. 369 ◽  
Author(s):  
Karim Husain ◽  
Mohammed Rashid ◽  
Nikola Vitković ◽  
Jelena Mitić ◽  
Jelena Milovanović ◽  
...  

In the oral and maxillofacial surgery, there is a requirement to provide the best possible treatment for the patient with mandibular fractures. This treatment presumes application of reduction and fixation techniques for proper stabilization of the fracture site. The reduction of the bone fragments and their fixation is much better performed when geometry and morphology of the bone and osteofixation elements (e.g. plates) are properly defined. In this paper, a new healthcare procedure, which enables application of personalized plate implants for the fixation of the mandibular fractures, is presented. Geometrical models of mandible and plate implants, presented in this research, were created by means of the Method of Anatomical Features (MAF), which has been already applied to the creation of accurate geometrical models of various human bones, plates and fixators. By using such geometrically and anatomically accurate models, orthopedic and maxillofacial surgeons can better perform pre-operative tasks of simulating and planning the operation, as well as an intraoperative task of implanting the personalized plate into the patient body.


2019 ◽  
Vol 52 (3) ◽  
pp. 147
Author(s):  
Olivia Jennifer Gunardi ◽  
Riska Diana ◽  
David Buntoro Kamadjaja ◽  
Ni Putu Mira Sumarta

Background: The mandible is one of the bones most affected by facial fractures commonly resulting from trauma to the face. The ultimate goal of treatment is to re-establish the pre-injury dental occlusion (bite), mandibular anatomy and jaw function of the patient. Treatment approaches range from conservative non-invasive management by ’closed’ reduction and immobilization using intermaxillary fixation (IMF) to the more invasive surgery-based ’open’ reduction incorporating an internal fixation approach. Purpose: The purpose of this case series was to describe the close reduction method as a form of treatment in cases of neglected mandibular fracture. Cases: Four cases of single or multiple mandibular fracture were presented. Case management: All of the cases were managed using a closed reduction method and IMF. Conclusion: A closed reduction method in this case series produced encouraging results and could be considered an alternative in the treatment of neglected mandibular fractures with displacement.


2019 ◽  
Vol 9 (2) ◽  
pp. 97-102
Author(s):  
Vivek Singh ◽  
Ritesh Giri

Background: Mandible is one of the commonly fractured bone due to trauma, assault and falls. Treatment includes closed and open methods. Methods of open reduction and internal fixation have changed and di­versified enormously in the past few years. Champy’s miniplate fixation, dynamic compression plating has become a standard approach. More recently, three dimensional miniplates have been developed by Farmand which may be effectively used in mandibular fractures. The aim of this study was to check the adequacy of three dimensional miniplate in man­agement of mandibular fracture occurring in the interforaminal region. Methods: A prospective clinical study was carried out in patients attend­ing Emergency Department and Department of Oral and Maxillofacial Surgery, Nobel Medical College and Teaching Hospital (NMCTH) suffer­ing from mandibular fractures in interforaminal region from May 2018 to January 2019. Results: A total of 17 patients with 18 fracture in interforaminal region, all male were included in the study. The age ranged from 16 to 50 years with a mean of 29.17 ± 9.48. Road traffic accident was the leading cause of injury with 15 out of 17 patients (88.23%). There was no incidence of wound infection, wound dehiscence, malunion, nonunion, plate fracture within the follow up period of 3 months. One fracture was unstable on 1st postoperative day and also had mildly deranged occlusion which was man­aged with intermaxillary fixation for two weeks. Conclusions: Three dimensional plates fulfills the treatment goals of ad­equate stabilization and fixation of mandibular interforaminal fractures.


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Agata Cieślik-Bielecka ◽  
Justyna Glik ◽  
Rafał Skowroński ◽  
Tomasz Bielecki

This article reports the influence of an autologous leukocyte- and platelet-rich plasma (L-PRP) injection as a minimally invasive method on supporting wound healing processes after a mandibular odontogenic cystectomy and double mandibular fracture fixation. 113 patients were enrolled into a control group (received no L-PRP injection) and 102 patients were enrolled into an L-PRP group with an oral mucosa incision. 18 patients after a double mandibular fracture were operated on using 2 external submandibular approaches receiving no fluids in the right site (a control group) and an L-PRP injection in the left incision (L-PRP group). Clinical observations showed that the oral mucosa healed faster in patients treated with L-PRP, in comparison to cases where inductive biomaterial was not added. Pain at the L-PRP injection site was relieved within few hours after an operation in patients with double mandibular fractures. However, there were no differences observed in the progression of the healing process. L-PRP possesses inductive properties that could stimulate healing processes and it seems to be one of the most promising methods in the future for the treatment of soft tissue defects.


2021 ◽  
Vol 15 (8) ◽  
pp. 1920-1922
Author(s):  
Nabeela Riaz ◽  
Samreen Younas ◽  
Ijaz Ur Rehman ◽  
Ahmad Abdul Haseeb ◽  
Saba Hanif ◽  
...  

Aim: to explore the mandibular bone fractures in elderly patients with reference to etiology of trauma. Methodology: This was a descriptive study conducted in the department of Oral and Maxillofacial Surgery KEMU/ Mayo Hospital Lahore. Elderly patients (age 60-100years) with mandibular bone fractures. Results: Aetiology of trauma leading to mandibular fractures was as follows; there were 79(65.83%) cases of RTA, 32(26.66%) falls, 4(3.33%) assaults and there were only 3(2.5%) cases of industrial injury. Conclusion: To conclude, this study depicts that road traffic accidents were the predominant cause of injury in the studied age group. Elderly patients need more care and attention, especially after traumatic incidents and lead to financial burden in hospitals Keywords: Maxillofacial trauma, Elderly population, Mandibular injuries, Elderly fractures


2019 ◽  
Vol 24 (4) ◽  
pp. 68-72
Author(s):  
Bogdan Ioan Petraşcu ◽  
Dan Sabău

Abstract Traumatology from the oral and maxillofacial area represents a very important and frequent pathology within this specialty, the mandibular fractures occupying the first place in terms of location and frequency due to the anatomical prominent position of the mandible. The first three etiological factors are represented by aggressions, accidental falls and car accidents. This article, accomplished in collaboration with the statistical service of the Sibiu County Clinical Emergency Hospital, aims at analysing the distribution by sex, origin environments, levels of studies, presentation of patients, analysis which was broken down by days of the week, frequent symptoms of these types of pathologies, for a period of 5 years, between 2013-2018.


2021 ◽  
Vol 10 (13) ◽  
pp. e161101320915
Author(s):  
Monique Gonçalves da Costa ◽  
Anderson Maikon de Souza Santos ◽  
Mirela Caroline Silva ◽  
Tiburtino José de Lima Neto ◽  
Eduardo Dallazen ◽  
...  

Extraction is one of the most common procedures performed by dental surgeons in their daily clinical practice. Among the trans and postoperative complications associated with this procedure can be mentioned the occurrence of trismus, infections, edema, alveolitis, paresthesia or fractures. The purpose of this study was to report a clinical case of a mandibular fracture associated with first molar extraction, approaching its main risk factors and treatment. Patient JSS, 24 years old, female, was referred to the service of Maxillofacial Surgery due to complications resulted from the extraction of element 36. On physical examination, was observed the presence of fragment mobility, communication of bone tissue with the oral environment and pain complaint was reported by the patient. Computed tomography showed the presence of a fracture in the region of the mandibular body on the left side. The planned surgical proposal was the intraoral debridement of bone fragments, extraoral access in the base of the mandible, fixation of the fracture with plate 2.4 and intraoral and extraoral access suture. During the surgical procedure, it is of great importance that the dental surgeon be aware to the signals emitted by the patient, such as clicks associated with severe pain, profuse bleeding or crackling as these symptoms may be the result of mandibular fracture. When any of these signs are found during the operation, the professional must investigate the occurrence of a possible fracture. It is concluded that in addition to performing a good preoperative evaluation, the dental surgeon must carry out a correct planning of the surgical act based on the basic principles of the surgical technique.


2020 ◽  
Vol 9 (10) ◽  
pp. e1879108030
Author(s):  
Luiz Henrique Soares Torres ◽  
Caio Pimenteira Uchoa ◽  
Mateus Barros Cavalcante ◽  
Virgílio Bernardino Ferraz Jardim ◽  
Éwerton Daniel Rocha Rodrigues ◽  
...  

Objective: to report a surgical case of comminuted mandible fracture caused by a firearm projectile treated with external fixation. Methodology: male patient, 18 years old, attended the Emergency Department of the Maxillofacial Surgery service after trauma in the mandibular region by a firearm projectile. On clinical examination, edema was observed in the cervical zone II and mandibular region, penetrating orifice of entry of the projectile in the genial region and mobility in the mandibular body. CT scan revealed a comminuted fracture in the mandible. Transcutaneous perforations were performed with pins, anatomical reduction of the fracture and stabilization to the external nail, adapting to the mandibular anatomy. Following postoperative follow-up, the patient progresses without pain complaints, with functional and satisfactory mouth opening, without mobility in bone fragments, and reestablished mandibular framework. Results and Conclusion: mandibular fractures by firearms are frequent in the routine of the buccomaxillofacial surgeon. Cases of bone comminution present individual peculiarities that must be taken into account in their management. The correct indication of external fixation proved to be adequate and satisfactory for cases of mandible comminution.


Author(s):  
Luke Cascarini ◽  
Clare Schilling ◽  
Ben Gurney ◽  
Peter Brennan

This chapter discusses oral and maxillofacial surgery in the A&E department, including, The paediatric OMFS patient, Overview of maxillofacial trauma, Mandibular fractures, Zygomatic fractures, Orbital floor fractures, Maxillary fractures, Nose, naso-ethmoidal, and frontal bone fractures, Face and scalp soft tissue injuries, Penetrating injuries to the neck, Intra-oral injuries, Dento-alveolar trauma, Dento-alveolar infections, Post-extraction complications, Head and neck soft tissue infections, Salivary gland diseases, and Miscellaneous conditions


2021 ◽  
Vol 15 (8) ◽  
pp. 2137-2140
Author(s):  
Ashfaq ur Rahim ◽  
Sadiq Ali ◽  
Muhammad Nauman ◽  
Tannaza Qayyum ◽  
Abdullah Khan ◽  
...  

Objectives: Surgical treatment of patients with multiple mandibular fractures involving condylar segments may be a difficult proposition for a maxillofacial surgeon. These fractures can be double or triple fractures of the lower mandible and can also be associated with other fractures of the face. While many authors have suggested that the conventional approach to reducing and stabilizing a mandibular symphysis / para-symphysis fracture is appropriate before addressing a fractured condyle, there is another school of thought that suggests that the condylar segment should be reduced and repaired first. This article aims to review the results of operations where the reduction and fixation of a fractured condyle is performed prior to other associated mandible fractures, and to explore the effectiveness of various surgical methods including preauricular and retromandibular proposed in this case. Place and Duration: In the Oral and Maxillofacial surgery department of Faryal Dental College, Lahore for two-years duration from Jan 2018 to Jan 2020. Material and methods: The study included 60 surgically treated patients with multiple mandible fractures (double / triple), including the condyle component. For treatment of the fractured condylar segments, the preauricular and retromandibular (anterior parotid-transmasseteric) approach was used. Results: Condyle fracture was the first segment to be managed during sequencing of surgical treatment, regardless of the method used. First, good reduction and stabilization have been achieved with limited complications in treating a condyle fracture. Conclusion: While it is the surgeon's prerogative to sort multiple mandible fractures, addressing the condylar segment first provides the operator with a viable alternative to the conventional technique. Key words: condylar fractures, multiple mandibular fractures, preauricular approach, retromandibular approach


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