scholarly journals Surgical treatment of mandibular fracture resulting from first molar extraction: case report

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 ◽  
...  
Keyword(s):  
Severe Pain ◽  
Preoperative Evaluation ◽  
Maxillofacial Surgery ◽  
Mandibular Fracture ◽  
Basic Principles ◽  
Pain Complaint ◽  
Oral Environment ◽  
Mandibular Body ◽  
Bone Fragments ◽  
Molar Extraction

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.

scholarly journals Colles external fixator as alternative in comminuted mandibular fractures treatment

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 ◽  
...  
Keyword(s):  
External Fixation ◽  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Mandibular Fractures ◽  
Anatomical Reduction ◽  
Mandibular Body ◽  
Bone Fragments ◽  
Mandibular Region ◽  
Zone Ii

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.

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
Keyword(s):  
Composite Materials ◽  
Main Part ◽  
Plate Osteosynthesis ◽  
Maxillofacial Surgery ◽  
Mandibular Fracture ◽  
Oral And Maxillofacial Surgery ◽  
Mandibular Fractures ◽  
Rigid Fixation ◽  
Bone Fragments ◽  
Fracture Osteosynthesis

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.

scholarly journals THE APPLICATION OF CONSTRUCTIONS MADE FROM BIODEGRADABLE MATERIAL WITH BIOACTIVE ACTION IN RECONSTRUCTIVE SURGERY OF MAXILLOFACIAL AREA

2019 ◽  
Vol 85 (4) ◽  
pp. 88-95
Author(s):  
О.О. Astapenko ◽  
Т.M. Kostiuk ◽  
N.М. Lytovchenko ◽  
T.V. Tyazhkorob
Keyword(s):  
Maxillofacial Surgery ◽  
Metal Structure ◽  
Additional Stress ◽  
Biodegradable Material ◽  
Facial Skull ◽  
Bone Fragments ◽  
Costs Of Treatment ◽  
Number Of Publications ◽  
Polyurethane Composition ◽  
Positive Properties

Currently, titanium plates and screws are widely used to fix bone fragments in maxillofacial surgery. The need for a second operation to remove the metal structure increases the patient's incapacity for work, the economic costs of treatment and the psychoemotional load on the patient associated with anxiety and additional stress. All this has led to the emergence of an alternative method of osteosynthesis using biodegradable plates and screws, which do not have these disadvantages. With all the positive properties of titanium fixators in recent years there has been a large number of publications on the increase in complications after metal osteosynthesis (MOS) using titanium bone plates and screws, which is from 5 to 18 %, therefore, there is a need to remove them after consolidation of bone fragments. The results of the study were the basis for finding ways to obtain the material without metal defect, from which it would be possible to make fixator in the form of plates and screws for the osteosynthesis in maxillofacial region. It was developed biodegradable material of bioactive action (EPU-GAP-LEV) based on polyurethane composition which contains 20 % hydroxyapatite, and 6 % levamisole for osteosynthesis fixator. It was proved effectiveness of EPU-GAP-LEV fixators for osteosynthesis in the treatment of the patients with fractures and deformations of facial skull. Positive results of own clinical researches in early and long terms testified to efficiency and perspective of use of polymeric (including EPU-GAP-LEV) miniplasts in surgical treatment of fractures of facial skull with shift.

Oral and Dental Emergencies

2020 ◽  
pp. 479-500
Author(s):  
Thomas A. Yamamoto ◽  
Nam S. Cho ◽  
F. Kyle Yip
Keyword(s):  
Emergency Department ◽  
Maxillofacial Surgery ◽  
Basic Principles ◽  
Fundamental Understanding ◽  
Department Evaluation ◽  
Oral Conditions

Pediatric visits to the emergency department for oral and dental complaints are common and may be due to either traumatic or nontraumatic etiologies. Dental or oral–maxillofacial surgery consultants are often unavailable for acute emergency department evaluation. Fortunately, few dental and oral conditions require immediate intervention by a specialist, and basic principles may be applied to their triage and management. A fundamental understanding of the basic triage and management of dental and oral-related conditions, which is the focus of this chapter, is worthwhile for today’s emergency practitioner.

scholarly journals Is The Late Mandibular Fracture From Third Molar Extraction a Risk Towards Malpractice? Case Report with the Analysis of Ethical and Legal Aspects

2017 ◽  
Vol 8 (2) ◽  
Author(s):  
Weuler dos Santos Silva ◽  
Rubens Jorge Silveira ◽  
Michelle Gouveia Benicio de Araujo Andrade ◽  
Ademir Franco ◽  
Rhonan Ferreira Silva
Keyword(s):  
Case Report ◽  
Third Molar ◽  
Legal Aspects ◽  
Mandibular Fracture ◽  
Third Molar Extraction ◽  
Molar Extraction

Late Mandibular Fracture After Lower Third Molar Extraction in a Patient With Stafne Bone Cavity: A Case Report

2010 ◽  
Vol 68 (7) ◽  
pp. 1698-1700 ◽  
Author(s):  
Yu-Hsun Kao ◽  
I.-Yueh Eric Huang ◽  
Chao-Ming Chen ◽  
Chun-Wei Wu ◽  
Kun-Jung Hsu ◽  
...  
Keyword(s):  
Case Report ◽  
Third Molar ◽  
Mandibular Fracture ◽  
Third Molar Extraction ◽  
Molar Extraction

scholarly journals Anchoretic Infection

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
S. Gokkulakrishnan ◽  
Ashish Sharma ◽  
Satish Kumaran ◽  
P. L. Vasundhar
Keyword(s):  
English Literature ◽  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Unknown Etiology ◽  
Oral And Maxillofacial Surgery ◽  
Basic Principles ◽  
Limited Mouth Opening ◽  
Space Infection ◽  
Temporal Space ◽  
Long Run

Active and passive mouth opening exercises are a very common practice in oral and maxillofacial surgery especially for various conditions causing limited mouth opening like space infections, trauma, and ankylosis. But most of the practitioners do not follow basic principles while advocating these active mouth opening exercises and also take it for granted that it would benefit the patient in the long run. Because of this, the mouth opening physiotherapy by itself can at times lead to unwanted complications. We report a case wherein due to active physiotherapy, the patient had complications leading to persistent temporal space infection which required surgical intervention and hospitalization. This could have been because of hematoma formation during physiotherapy which got infected due to anchoretic infection of unknown etiology and resulted in temporal space infection. Hence, our conclusion is that whenever mouth opening exercises are initiated, it should be done gradually under good antibiotic coverage to avoid any untoward complications and for optimum results. According to the current English literature, such a complication has not been documented before.

scholarly journals Postoperative dysphagia caused by a delay in mandibular fracture treatment in a patient with severe intellectual disability: a case report

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Shinsuke Yamamoto ◽  
Masanori Nashi ◽  
Keigo Maeda ◽  
Naoki Taniike ◽  
Toshihiko Takenobu
Keyword(s):  
Intellectual Disability ◽  
Mandibular Fracture ◽  
Fracture Treatment ◽  
Disuse Atrophy ◽  
Postoperative Dysphagia ◽  
Endoscopic Gastrostomy ◽  
Severe Intellectual Disability ◽  
Body Fracture ◽  
Mandibular Body ◽  
Dysphagia Rehabilitation

Abstract Background The postoperative complications of mandibular fracture include malocclusion, infection, nonunion, osteomyelitis, and sensorial mental nerve dysfunction. However, there are no reports regarding postoperative dysphagia as a complication of mandibular fracture. Herein, we report a rare case of postoperative dysphagia caused by delayed mandibular fracture treatment in a patient with severe intellectual disability. Case presentation A 46-year-old Japanese male patient with severe intellectual disability fell down and struck his chin. The patient was referred to our department 10 days after the accident. Upon examination, he could not close his mouth because of severe left mandibular body fracture. Open reduction and internal fixation was performed under general anesthesia 16 days after sustaining the injury, and normal occlusion was eventually achieved. However, the patient could not swallow well a day after surgery. He was then diagnosed with postoperative dysphagia caused by disuse atrophy of muscles for swallowing based on videoendoscopic examination findings. Adequate dysphagia rehabilitation could not be facilitated because of the patient’s mental status. Postoperative dysphagia did not improve 21 days after surgery. Therefore, percutaneous endoscopic gastrostomy was required. Conclusions The treatment course of the patient had two important implications. First, postoperative dysphagia caused by disuse atrophy may occur if treatment is delayed in severe mandibular body fracture. Second, in particular, if a patient with severe intellectual disability develops postoperative dysphagia caused by disuse atrophy, adequate dysphagia rehabilitation cannot be facilitated, and percutaneous endoscopic gastrostomy may be required. Therefore, early open reduction and internal fixation is required for mandibular fracture in a patient with severe intellectual disability.

scholarly journals Iatrogenic Fracture of the Lower Jaw: A Rare Complication of Lower Molar Extraction

2021 ◽  
Vol 64 (2) ◽  
pp. 101-107
Author(s):  
Radovan Mottl ◽  
Martina Kunderová ◽  
Radovan Slezák ◽  
Jan Schmidt
Keyword(s):  
Tooth Extraction ◽  
Rare Complication ◽  
Third Molar ◽  
Mandible Fracture ◽  
Stable Osteosynthesis ◽  
Bone Fragments ◽  
Mandible Fractures ◽  
Tooth Removal ◽  
Lower Molar ◽  
Molar Extraction

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.

scholarly journals Systemic Alterations in patients submitted to exodontics at the Bauru School of Dentistry (USP)

2021 ◽  
Vol 10 (3) ◽  
pp. e4810312781
Author(s):  
Angie Patricia Castro-Merán ◽  
Gustavo Moreno Braga ◽  
Eduardo Stedile Fiamoncini ◽  
Bruno Gomes Duarte ◽  
Osny Ferreira Júnior ◽  
...  
Keyword(s):  
Medical Records ◽  
Systemic Disease ◽  
Preoperative Evaluation ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Medical Treatments ◽  
Initial Care ◽  
High Prevalence ◽  
School Of Dentistry ◽  
Care Period

Objective: To verify the rate of systemic changes observed in individuals seen at the Oral and Maxillofacial Surgery and Traumatology clinics of the Undergraduate Dentistry course at the Faculty of Dentistry of Bauru (FOB-USP). Methodology: a retrospective study of the medical records of individuals seen at the Oral and Maxillofacial Surgery and Traumatology clinics of the third and fourth years of the Dentistry course at FOB-USP, from January 1, 2015, to June 30, 2017. Data collection was performed based on information from the anamnesis obtained during the initial care of the patients and recorded in the medical records. The selected data were name, age, address, diagnosed systemic disease, current and/or past medical treatments, proposed surgical treatment, and, if there was, patient return after medical treatment for surgery. The medical records of individuals under the age of 18, patients who did not have any systemic changes, or those with systemic changes observed outside the initial care period were excluded. RESULTS: The sample consisted of 266 medical records and 119 of these were from individuals who had systemic changes (44.7%), with systemic arterial hypertension being the most common (33.1%), followed by diabetes mellitus (17.8%). Conclusion: the high prevalence of individuals with systemic alterations and who require dental surgical intervention was proven, which implies the need for a correct anamnesis and preoperative evaluation so that these cases are managed to avoid trans and/or post-operative, systemic, and/or local.

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