scholarly journals Transoral versus extraoral approach for mandibular angle fractures: A comparative study

2014 ◽  
Vol 47 (03) ◽  
pp. 354-361 ◽  
Author(s):  
Sathya Kumar Devireddy ◽  
R.V. Kishore Kumar ◽  
Rajasekhar Gali ◽  
Sridhar Reddy Kanubaddy ◽  
Mallikarjuna Rao Dasari ◽  
...  
Keyword(s):  
Masseter Muscle ◽  
Third Molar ◽  
Fracture Line ◽  
Difficulty Level ◽  
Mandibular Angle ◽  
Group I ◽  
Maxillofacial Fractures ◽  
Severe Difficulty ◽  
Group Ii ◽  
Angle Fractures

ABSTRACT Introduction: Mandibular fractures represent approximately two-thirds of all the maxillofacial fractures (nearly 70%) out of which fractures of mandibular angle represent for 26-35%. Aim of the Study: The aim of this study is to compare the transoral and extraoral (submandibular) approaches for fixation of mandibular angle fractures. Objectives of Study: The objectives of the following study are to evaluate ease of accessibility, time taken for the procedure, ease of anatomic reduction and complications. Materials and Methods: A prospective study was carried out in 30 patients reporting to the Department of Oral and Maxillofacial surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh during the period of months from November 2011 to August 2013 who were randomly divided in two groups based on computer generated simple randomization chart. Group I patients underwent transoral reduction and fixation and Group II patients underwent extraoral reduction and fixation. The ease of accessibility was analysed by visual analogue scale by the operating surgeon, time taken from incision to closure with digital clock, difficulty level index of surgeon based on the time taken for the procedure and approach related complications. Results: The ease of accessibility in Group I was good in 53.3% while in Group II patients approached extraorally it was good in 86.7%. Group I patients approached transorally showed a mean of 49.7 min while that of Group II patients approached extraorally showed a mean of 73.4 min. Group I had a minimum difficulty level index in 60%, moderate difficulty level in 33.3% and severe difficulty level in 6.7% while Group II had a minimum and moderate difficulty level in 46.7% and severe difficulty level in 6.7%. There was 1 (6.7%) complication reported in each group. Conclusion: The statistical analysis of this study concludes that fracture line starting anterior to mandibular third molar and ending at anteroinferior border of the insertion of the masseter muscle or posterior body of mandible can be approached transorally. Fracture line starting posterior or distal to the third molar or posterior to the insertion of the masseter muscle to the angle of the mandible or fracture line extending high in the ramus, extraoral approach provides a better choice for reduction and fixation of the fractured segments with restoration of anatomical and functional occlusion.

Should Degree of Third Molar Eruption Influence Operative Management of Mandibular Angle Fractures? A Systematic Review

2021 ◽  
pp. 194338752110593
Author(s):  
Vikas S. Kotha ◽  
Brandon J. de Ruiter ◽  
M. Grace Knudsen ◽  
Marvin Nicoleau ◽  
Edward H. Davidson
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Third Molar ◽  
Cochrane Library ◽  
Third Molars ◽  
Mandibular Angle ◽  
Group I ◽  
Group Ii ◽  
Angle Fractures ◽  
Third Molar Eruption

Objective There is a growing trend toward evidence-based management of third molars in the fracture line of mandibular angle fractures (MAFs). This study aimed to differentiate MAF fixation complications by degree of third molar eruption and by extraction strategy in patients undergoing Champy fixation. Methods PubMed, EMBASE, OVID, SCOPUS, the Cochrane Library, and clinicaltrials.gov were queried through May 2020 for English-language publications for MAFs with third molar involvement for this systematic review. Bias was assessed using author-defined criteria. Relative risk (RR) of post-operative complications associated with extracted unerupted and retained partially erupted third molars (Group I) was calculated against controls of retained unerupted and extracted partially erupted third molars (Group II). Results Ten studies reported complications by eruption or extraction; however, only one study stratified complications by both eruption and extraction to meet inclusion criteria. The risk of bias was medium as only cases meeting defined follow-up were included. 73 cases (N) were included: 34 qualified for Group I and 39 for Group II. Quantitative synthesis of individual case data demonstrated significantly higher complication rate in Group I compared to Group II (23.5% vs 5.1%) (RR 4.6, 95% CI 1.04–20.1). No significant differences were observed between groups for infectious complications, mechanical complications, nonunion, or dehiscence. Reoperation was required significantly more often for Group I ( P = .043). Conclusions For MAFs involving the third molar, concomitant extraction of unerupted as well as retention of partially erupted third molars increases risk of complications with Champy fixation technique. For these patients, alternative strategies for fixation should be considered.

scholarly journals Assessment of Pain and Trismus and Determining the Difficulty Level of Tooth Extraction with Modified Parant Scale

2018 ◽  
Vol 2 (3) ◽  
pp. 282-286
Author(s):  
Manish Agrawal ◽  
Quazi Billur Rahman ◽  
Deependra Naulakha ◽  
Riwaj Karki
Keyword(s):  
Postoperative Pain ◽  
Clinical Examination ◽  
Tooth Extraction ◽  
Third Molar ◽  
Difficulty Level ◽  
Group I ◽  
Number Of Patients ◽  
Tooth Impaction ◽  
Significant Difference ◽  
Group Ii

Introduction: Third molar extraction is the most commonly performed procedure by oral and maxillofacial surgeons and most of the extraction leads to minimum pre and post operative difficulties if proper preoperative planning is done and if surgical principles are strictly followed.Objective: This study evaluated whether pre and post operative pain and trismus were related to difficulty of surgery.Methodology: Total number of patients included in this study were 266 (male 135 and female 131), age range from 18 to 34 years. Preoperative diagnosis was made by clinical examination and radiographs. Clinical examination was done to determine pain, swelling and mucosal coverage of tooth whereas OPG and RVG were taken to assess the angulations, level of tooth impaction and bony coverage of tooth. Standardized technique was used for tooth extraction; buccal guttering, adequate elevation, reflection of mucoperiosteal flap, crown sectioning and ostectomy. Evaluation of pain and trismus was done preoperatively, on first and third post operative day. SPSS version 16 was used to analyse the data. Chi square (x²) test and unpaired 't' test were done. Modified Parant Scale was used to evaluate the difficulty of tooth extraction; Group I: forceps extraction; Group II: ostectomy; Group Ill: ostectomy and crown sectioning; Group IV: difficult extraction.Results: When both preoperative and postoperative results were compared after data analysis, pain was significantly reduced and significant inter incisal opening was achieved, in both the groups P > 0.05. The results were statistically not significant.Conclusion: Postoperative pain and trismus was minimum in (Group I) then in (Group II to IV). The incidence of postoperative pain and trismus among all the groups were more or less similar. Hence, no significant difference was found. Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 282-286

Association between eruption state of the third molar and the occurrence of mandibular angle fractures

2016 ◽  
Vol 32 (5) ◽  
pp. 347-352 ◽  
Author(s):  
Roman K. Rahimi-Nedjat ◽  
Keyvan Sagheb ◽  
Collin Jacobs ◽  
Christian Walter
Keyword(s):  
Third Molar ◽  
Mandibular Angle ◽  
The Third ◽  
Angle Fractures

scholarly journals Qualitative and quantitative assessment of relationship between mandibular third molar and angle fracture on North Indian population: A clinico-radiographic study

2013 ◽  
Vol 07 (02) ◽  
pp. 212-217 ◽  
Author(s):  
Suresh Yadav ◽  
Shallu Tyagi ◽  
Naveen Puri ◽  
Prince Kumar ◽  
Puneet Kumar
Keyword(s):  
Third Molar ◽  
Indian Territory ◽  
Mandibular Angle ◽  
The North ◽  
Mandibular Angle Fracture ◽  
Mandibular Third Molar ◽  
Angle Fracture ◽  
Angle Fractures ◽  
Inferior Border ◽  
The Relationship

ABSTRACT Objective: To assess the relationship between impacted mandibular third molar presence and the risk for mandibular angle fracture with the effect of various positions of mandibular third molar and the risk of mandibular angle fracture. Materials and Methods: In the North Indian territory, a total of 289 patients with mandibular angle fractures were studied and evaluated for the possible relationship with impacted third molar on the basis of clinical and panoramic radiographical findings. Results: Results that confirmed the highest risk for mandibular angle fracture was associated with mesioangular angulations (45.42%) followed by vertical (26.34%), distoangular in sequence and least risk was found with bucco-version angulations (2.67%) according to Winter′s classification. Additionally, the highest risk of mandibular angle fracture was reported with partially erupted third molar (47.75%), followed by erupted (23.53%) and unerupted third molar (19.38%). Conclusion: The risk for mandibular angle fracture is not only affected by status of eruption, angulations, position, number of roots present in third molar but also by the distance of mandibular third molar from inferior border of mandible and the percentage of remaining amount of bone at the mandibular angle region.

scholarly journals Inferior Alveolar Nerve Injuries Associated with Mandibular Fractures at Risk: A Two-Center Retrospective Study

2014 ◽  
Vol 7 (4) ◽  
pp. 280-283 ◽  
Author(s):  
Paolo Boffano ◽  
Fabio Roccia ◽  
Cesare Gallesio ◽  
K. Karagozoglu ◽  
Tymour Forouzanfar
Keyword(s):  
At Risk ◽  
Retrospective Study ◽  
Medical Center ◽  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Mandibular Fractures ◽  
Nerve Injuries ◽  
Mandibular Angle ◽  
Maxillofacial Fractures ◽  
Angle Fractures

The aim of the study was to investigate the incidence of the inferior alveolar nerve (IAN) injury in mandibular fractures. This study is based on two databases that have continuously recorded patients hospitalized with maxillofacial fractures in two departments—Department of Maxillofacial Surgery, Vrije Universiteit University Medical Center, Amsterdam, the Netherlands, and Division of Maxillofacial Surgery, San Giovanni Battista Hospital, Turin, Italy. Demographic, anatomic, and etiology variables were considered for each patient and statistically assessed in relation to the neurosensory IAN impairment. Statistically significant associations were found between IAN injury and fracture displacement ( p = 0.03), isolated mandibular fractures ( p = 0.01), and angle fractures ( p = 0.004). A statistically significant association was also found between IAN injury and assaults ( p = 0.03). Displaced isolated mandibular angle fractures could be considered at risk for increased incidence of IAN injury. Assaults seem to be the most important etiological factor that is responsible for IAN lesions.

Effects of different polyvinylpyrrolidone iodine concentrations on trismus and swelling following third molar surgery

2020 ◽  
pp. 1-16
Author(s):  
Esra Yüce ◽  
Omur Dereci ◽  
Nazli Altin ◽  
Cansugul Efeoglu Koca ◽  
Murude Yazan
Keyword(s):  
Povidone Iodine ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Group Iv ◽  
Controlled Study ◽  
Third Molar Surgery ◽  
Group Iii ◽  
Group I ◽  
Facial Swelling ◽  
Group Ii

Abstract Objective: To compare the clinical efficacy of different povidone iodine concentrations for the management of postoperative pain and swelling following mandibular third molar surgery. Methods: The randomised, prospective, double-blind and controlled study was conducted from October 2016 to January 2018 at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biruni University, Istanbul, Turkey, and comprised individuals aged 18-30 years who underwent surgical removal of pathology-free completely unerrupted mandibular lower third molars. The participants were randomly assigned to four groups: Group I had saline-only controls, Group II was given 0.5% concentration of povidone iodine, Group III had 1% concentration of povidone iodine, and Group IV had 3% concentration of povidone iodine. Facial swelling and trismus were assessed on the 2nd and 7th postoperative days. Data was analysed using SPSS 22. Results: Of the 80 patients, 34(42.5%) were males and 46(57.5%) were females with an overall mean age of 24.6±3.68 years. Each group had 20(25%) subjects. All three concentrations of povidone iodine provided significant reduction in postoperative trismus compared to the controls. Trismus was less in Group III and Group IV compared to Group II up to 7 days after surgery. Conclusion: Irrigation with 3% povidone iodine concentration was found to be more effective in reducing the level of facial swelling after impacted third molar surgery. (Clinical Trials.gov Identifier: NCT03894722) Key Words: Maxillofacial surgery, Third molar, Povidone-Iodine, Swelling, Tismus

scholarly journals Effect of Single Dose Intramuscular Methylprednisolone Injection into the Masseter Muscle on the Surgical Extraction of Impacted Lower Third Molars: a Randomized Controlled Trial

2015 ◽  
Vol 12 (1) ◽  
pp. 4-8 ◽  
Author(s):  
N Vyas ◽  
S Agarwal ◽  
N Shah ◽  
D Patel ◽  
P Aapaliya
Keyword(s):  
Single Dose ◽  
Masseter Muscle ◽  
Surgical Removal ◽  
Methylprednisolone Acetate ◽  
Third Molars ◽  
Oral Aperture ◽  
Group I ◽  
Surgical Extraction ◽  
Facial Swelling ◽  
Group Ii

Background Lower impacted third molar surgical extraction usually causes post-surgical sequelae like pain, trismus and swelling as a result of postoperative inflammatory response.Objective The aim of this study was to evaluate and compare the efficacy of single dose 40-mg (1cc) of methylprednisolone acetate, injected into the masseter muscle, preoperatively one hour before the surgery or post-operatively, immediately following the surgical removal of impacted lower third molars, in controlling most common postoperative sequelae, i.e. trismus, pain and swelling of facial soft tissue.Methods A randomized control study was done of 60 patients. Each patient was categorized in two groups, group I and group II, according to the time of receiving methylprednisolone acetate. Group I was injected 40mg of methylprednisolone acetate into the masseter muscle via the intrabuccal approach, one hour before the surgery. Group II was injected 40mg of methylprednisolone acetate into the masseter muscle via the intrabuccal approach, immediately after suturing of the surgical wound. The washout period was one month after the first operation. Evaluation were made of postoperative pain, trismus and swelling. The numeric pain scale (NPS) was used for pain assessment.Results When the patients were administered methylprednisolone acetate preoperatively, showed superior results in terms of oral aperture, pain and all the facial swelling parameters, with statistically significant differences versus the postoperatively administered methylprednisolone acetate (p < 0.05).Conclusions A single dose of 40 mg (1cc) methylprednisolone acetate injected into the masseter muscle preoperatively is more effective in reducing pain, trismus and swelling, when compared to that administered postoperatively.Kathmandu University Medical Journal Vol.12(1) 2014: 4-8

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