Treatment of caudal mandibular fracture and temporomandibular joint fracture-luxation using a bi-gnathic encircling and retaining device

2010 ◽  
Vol 23 (02) ◽  
pp. 102-108 ◽  
Author(s):  
J. Wyatt ◽  
H. Radke ◽  
S. J. Langley-Hobbs ◽  
I. Nicholson

SummaryFractures of the caudal portion of the mandible and temporomandibular joint (TMJ) fracture-luxation can be challenging to treat with direct fixation methods. This paper describes a simple technique for the indirect treatment of caudal mandibular fracture and TMJ fracture-luxation using a subcutaneous loop of nylon leader line tunnelled around the maxilla, incisive and nasal bones, and under the mandible, placed just caudal to the canine teeth, and crimped ventral to the mandibular skin: a bi-gnathic encircling and retaining device (BEARD). A BEARD was used to treat two immature dogs with simple, unilateral caudal mandibular fractures, six cats with unilateral injury (two with TMJ luxation, three with TMJ fracture-luxation, one with caudal mandibular fracture), and two cats with bilateral injury (comminuted caudal mandibular fracture with contralateral TMJ luxation; bilateral condylar neck fracture). The BEARD treatment failed short-term due to poor tolerance in one cat, and concurrent injuries and poor initial reduction in another cat. One cat was lost to long-term follow-up. Rostral dental occlusion was normal in six out of seven cases, and reported jaw function was normal in seven out of seven cases. The case with poor occlusion had imperfect initial reduction. Complications included dorsal nasal skin swelling or discharge, oesophagostomy tube dislodgement or blockage, BEARD loosening, and regurgitation. Treatment of uni- or bilateral caudal mandibular trauma using a BEARD can lead to clinical union, and normal rostral occlusion, provided that case selection is appropriate and immediate-post-surgical occlusion has been corrected.

2021 ◽  
Vol 11 (21) ◽  
pp. 10239
Author(s):  
Carmen Gabriela Stelea ◽  
Doriana Agop-Forna ◽  
Raluca Dragomir ◽  
Codrina Ancuţa ◽  
Roland Törok ◽  
...  

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.


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.


2013 ◽  
Vol 15 (3) ◽  
pp. 211-218 ◽  
Author(s):  
Nicolas Woodbridge ◽  
Martin Owen

Practical relevance: Mandibular fractures occur commonly in cats and appropriate treatment is vital to ensure restoration of dental occlusion and masticatory function. Clinical challenges: Historically, a relatively high complication rate has been reported in association with mandibular fracture repair, and these complications can represent a significant challenge for the veterinary surgeon. Audience: General practitioners as well as specialists in small animal surgery are presented with fractures of the mandible on a regular basis. Patient group: Cats of all ages can suffer mandibular fracture; however, young cats (mean age 30 months) are over-represented. No sex predilection is reported. Equipment: The nature of the equipment required for mandibular fracture repair varies greatly, depending on the fracture type and location. An uncomplicated mandibular symphyseal fracture requires only basic orthopaedic equipment whereas the surgeon must ensure they have access to a wide range of orthopaedic equipment prior to undertaking repair of a complex mandibular fracture. Evidence base: Management of mandibular fractures is a complex subject. Over the past three decades many fixation techniques have been described in the veterinary literature, with authors analysing and discussing the surgical management of these potentially challenging injuries.


2004 ◽  
Vol 17 (04) ◽  
pp. 189-197 ◽  
Author(s):  
S. J. Hobbs ◽  
A. P. Moores ◽  
D. Bennett ◽  
S. Carmichael ◽  
M. R. Owen

SummaryMandibular fractures in 17 dogs and in eight cats were managed using external skeletal fixation (ESF) with acrylic or epoxy resin connecting bars. In order to maintain dental occlusion during fracture repair pha- ryngostomy or tracheostomy was performed in 12 dogs and in six cats to permit inhalational anaesthesia during surgery. All of the fractures healed with the exception of fractures in two dogs. Mandibular external skeletal fixation was well tolerated and there was not any evidence of iatrogenic damage to teeth nor to neurovascular structures within the mandible. Implant loosening was commonly observed at the time of fixator removal, but it did not affect the outcome.


2020 ◽  
Vol 77 (6) ◽  
pp. 647-650
Author(s):  
Ivan Tusek ◽  
Miroslav Ilic ◽  
Jasmina Tusek ◽  
Stojan Ivic ◽  
Branislav Tusek

Introduction. Frequency of pediatric mandibular fractures is relatively uncommon. Apart from rare exceptions, there is minimal invasive access in the treatment of those injuries in order to avoid the future developmental disorders. Case report. During the game with a colt, a 6-year-old boy was kicked by hoof in the chin. The child did not lose consciousness and did not experience nausea or vomiting. According to clinical examination and radiological analysis, diagnosis was assigned as dislocated mandibular fracture in the parasymphysis part of the jaw and luxation injury of teeth 31 and 72. The surgical treatment under general anesthesia encompassed reduction and bimanual manipulation of bone fragments up to the optimal restoration of the dental occlusion, along with osteosynthesis with titanium miniplates. Luxated deciduous tooth 72 at the fracture line was extracted and luxated permanent tooth 31 was fixed to tooth 41 with wire. The patient was given antibiotic therapy. Additional immobilization of the luxated tooth 31 and mandibular fracture was performed after surgery by composite resin splint. During five-month follow-up period there were no signs of pathological movements in the fracture line, no luxation of tooth 31 and no restriction in mouth opening. Conclusion. Osteosynthesis with miniplates is adequate and very efficient treatment method in dislocated mandibular fracture that is recommended in children with both deciduous and mixed dentition. It is necessary to remove miniplates after fracture consolidation.


Author(s):  
Dr. Kavita Wadde ◽  
Dr. Nazmul Alam ◽  
Dr. Ashwini Chapane ◽  
Dr. Sandip Rathod

The fracture of the comminuted type has a prevalence of 30 to 50 % when related to the affecting mandibular bone. They are characterized by the presence of multiple bone involving several lines of fracture, resulting in small fragments within the same area. Treatment modalities for the management of comminuted mandibular fractures include closed reduction, external pin fixation, internal wire fixation, and open reduction and internal fixation using miniplates, titanium mesh tray and screws. The following case report highlights open reduction and internal fixation of a comminuted mandibular fracture in a 24-year-old male patient. The patient treated with open reduction and with a reconstruction plate followed by a short period of maxillomandibular fixation.


2009 ◽  
Vol 79 (6) ◽  
pp. 1057-1062 ◽  
Author(s):  
Marinka Twilt ◽  
Alcuin J. M. Schulten ◽  
Birte Prahl-Andersen ◽  
Lisette W. A. van Suijlekom-Smit

Abstract Objective: To investigate changes in the craniofacial skeleton in relation to the changes in condylar alterations that occur during long-term follow-up in patients with juvenile idiopathic arthritis. Materials and Methods: Temporomandibular joint (TMJ) involvement is defined as a condylar alteration that is observed on the orthopantomogram. Lateral cephalograms were used to determine linear and angular measurements. Results: Seventy of 97 patients from the initial study cohort were included, with a mean follow-up of 68 months. The overall prevalence of condylar alterations and posterior rotation of the mandible decreased; however, the prevalence of retrognathia remained the same. Patients showed improvement in the degree of retrognathia and posterior rotation (40% ANB, 51% OP-SN, and 44% GO-GN-SN). Improvement in the degree of retrognathia was seen more often in patients with improved condylar alterations than in patients with persistent alterations and in those without alterations (50%, 33%, and 28%, respectively). The degree of posterior rotation improved almost equally in patients without TMJ involvement and in patients with improved condylar alterations (57% and 50% by OP-SN, and 67% and 38% GO-GN-SN, respectively) and did not improve in patients with stable persistent alterations. Conclusion: Both condylar and craniofacial alterations can improve in patients with juvenile idiopathic arthritis.


2011 ◽  
Vol 26 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Adelina Maria da Silva ◽  
Wilson Machado de Souza ◽  
Patrícia de Athayde Barnabé ◽  
Marion Burkhardt de Koivisto ◽  
Nair Trevizan Machado de Souza

Purpose: To evaluate the application of the maxillofacial miniplate 1.5 in the repair of unilateral mandibular osteotomies in cats. Methods: Twelve adult cats were divided into two groups. In group 1 (n=6), the osteotomy was performed in the body of the mandible, behind the 1st molar. In group 2 (n=6), the osteotomy was performed between the 4th premolar and 1st molar. The osteotomy was fixed with a titanium miniplate 1.5. Oral alimentation was reinitiated 24 hours after surgery. Cats were euthanized at 12 weeks postoperative. Results: Radiographs taken 1 week after surgery showed a radiolucent line. The osteotomy line was not more visible on the radiographs taken at 12 weeks postoperative. Macroscopic examination confirmed alignment and bone union of operated hemimandibles. Histological examination showed formation of woven bone within the osteotomy line. The percentage of bone tissue at these areas was measured by the histometry. There was no statistically significant difference between the values of group 1(75.07 ± 5.99) and group 2 (74.76 ± 8.54) (Mann-Whitney's test p= 0.469). Conclusion: We concluded that the use of miniplate 1.5 for the fixation of mandibular osteotomy in cats provided the main goals in the treatment of mandibular fractures: bone union, normal dental occlusion and immediate return to oral alimentation.


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

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.


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