scholarly journals CLINICAL AND RADIOLOGICAL OUTCOMES OF MANDIBULAR CONDYLAR FRACTURES AFTER CONSERVATIVE TREATMENT

2021 ◽  
Vol 71 (2) ◽  
pp. 667-71
Author(s):  
Humaira Sarwar ◽  
Irfan Shah ◽  
Ali Akhtar Khan ◽  
Adnan Babar ◽  
Saad Mehmood ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Conservative Management ◽  
Maxillofacial Surgery ◽  
Radiological Finding ◽  
Mouth Opening ◽  
Armed Forces ◽  
P Value ◽  
Oral And Maxillofacial Surgery ◽  
Condylar Fractures

Objective: To assess the clinical as well as radiological outcomes of the conservative management of mandibular condyle fractures. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Oral and Maxillofacial Surgery (OMFS), Armed Forces Institute of Dentistry (AFID), Rawalpindi, from Feb 2018 to Aug 2019. Methodology: A total of 60 patients diagnosed as isolated mandible trauma with unilateral condyle fractures were studied. All patients were assessed radiologically on orthopantomogram (OPG) before the start of treatment. They were assessed clinically for maximum mouth opening (MMO), occlusion, pain and masticatory satisfaction before the start of treatment and after conservative management. Conservative Management includes soft diet only or maxillomandibular fixation (MMF) followed by active physical therapy. After 6 months of follow up, pre-treatment and post-treatment clinical parameters and radiological finding were compared. Results: Sixty patients were managed conservatively, among them 37 (62%) were male and 23 (38%) were female with age range of 21-53 years. There was statistically significant decrease in pain (p-value 0.002) and improvement in mastication (pvalue 0.079) before and after the conservative treatment of mandibular condylar fractures. Overall 46 (77%) patients treated with conservative management were satisfied with their mastication and 40 (67%) patients had mild pain on mastication. All the patients showed satisfactory occlusion and had no occlusal discrepancy on last follow up visit. Maximum mouth opening improved from 32.38 ± 4.54 to 40.90 ± 1.75 after treatment. The mean of preoperative ramus length difference of both sides of the mandible was 4.23 ± 2.3 mm............

scholarly journals Conservative Approach to Unilateral Condylar Fracture in a Growing Patient: A 2.5-Year Follow Up

2012 ◽  
Vol 6 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Elif Bahar Tuna ◽  
Aysun Dündar ◽  
Abdülkadir Burak Çankaya ◽  
Koray Gençay
Keyword(s):  
Conservative Treatment ◽  
Mouth Opening ◽  
Facial Asymmetry ◽  
Mandibular Growth ◽  
Fractures In Children ◽  
Facial Swelling ◽  
Direct Pressure ◽  
Condylar Head ◽  
Condylar Fractures

Condylar fractures in children are especially important because of the risk of a mandibular growth-center being affected in the condylar head, which can lead to growth retardation and facial asymmetry. The purpose of this article is to follow up the two and half year clinical and radiological evaluation of the conservative treatment of a 10 year-old patient, who had a unilateral green-stick type fracture. The patient presented with painful facial swelling localized over the left condylar region, limited mouth-opening and mandibular deviation to the left. Panoramic radiography and computed tomography confirmed the diagnosis of incomplete fracture on the left condyle with one side of the bone fractured and the other bent. Closed reduction was chosen to allow for initial fibrous union of the fracture segments and remodeling with a normal functional stimulus. A non-rigid mandibular splint was applied in order to remove the direct pressure on the fracture side of the mandible. Clinical and radiologic examination after 30 months revealed uneventful healing with reduction of the condylar head and remodeling of the condylar process following conservative treatment.

Long-term Complications of Isolated and Combined Condylar Fractures: A Retrospective Study

2021 ◽  
pp. 194338752110267
Author(s):  
Margaux Nys ◽  
Tim Van Cleemput ◽  
Jakob Titiaan Dormaar ◽  
Constantinus Politis
Keyword(s):  
Conservative Treatment ◽  
Initial Treatment ◽  
Late Onset ◽  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Secondary Treatment ◽  
Condylar Fracture ◽  
Mandibular Body ◽  
Condylar Fractures

Study Design: Fractures of the mandibular condyle are a common injury in maxillofacial trauma. Both conservative treatment (i.e., analgesic therapy and soft diet) and intermaxillary fixation (IMF) or open reduction internal fixation (ORIF) have satisfactory and functional outcomes, though severe late-onset complications have been reported. Objective: We compared the long-term complications of patients with condylar fractures treated conservatively, with IMF, or with combined ORIF and IMF. Methods: We retrospectively analyzed all patients diagnosed with unilateral or bilateral condylar fracture, isolated or combined with a fracture of the mandibular body, admitted to the Department of Maxillofacial Surgery at UZ Leuven between January 2013 and January 2020. We collected data on age, gender, side of condylar fracture, presence of associated fracture of the mandibular body, referrals, initial treatment, long-term complications and secondary treatment. Long-term complications were defined as sequelae still present 6 weeks after initial treatment. Results: Among 192 patients, 68.8% had unilateral and 31.2% bilateral condylar fractures; an associated fracture of the mandibular body was seen in 45.8%, 31% received conservative treatment, 51% IMF only, and 18% combined ORIF and IMF. Forty-eight percent of all patients suffered from 1 or more long-term complications, most frequently malocclusion (24%), reduced mouth opening (15.1%), nerve disturbances (13.5%), pain (8.9%), and facial asymmetry (2.6%). Surgery as a secondary treatment was necessary in 25% of all cases. Conclusions: The presence of bilateral condylar fractures or associated fracture of the mandibular body is a risk factor for developing long-term complications. Most patients with long-term complications were initially treated with combined ORIF and IMF, but long-term complications after initial conservative or IMF treatment were treated with secondary surgery.

Assessment of complications of open treatment of mandibular condylar fractures

2021 ◽  
pp. 1-10
Author(s):  
Muhammad Adil Asim ◽  
Waseem Ahmed ◽  
Muhammad Wasim Ibrahim ◽  
Syed Gulzar Ali Bukhari ◽  
Muhammad Nazir Khan ◽  
...  
Keyword(s):  
Maxillofacial Surgery ◽  
Armed Forces ◽  
Categorical Variables ◽  
Surgical Approaches ◽  
Oral And Maxillofacial Surgery ◽  
Chi Square ◽  
Open Treatment ◽  
Chi Square Test ◽  
Nerve Paresis ◽  
Condylar Fractures

ABSTRACTObjective: To analyze the complications of open treatment of mandibular condylar fractures via various surgical approaches. Methods: The study was conducted at the department of oral and maxillofacial surgery at Armed forces institute of dentistry, Rawalpindi. All adult patients with moderate to severely displaced mandibular condylar fractures were included in our study. Open reduction and internal fixation of fractures was performed by five consultant maxillofacial surgeons via four surgical approaches. Patients were assessed for complications of open treatment in terms of facial nerve paresis, unaesthetic scar, salivary fistula/sialocele, trismus and malocclusion 6 months postoperatively. Frequency and percentages were calculated for the categorical variables while chi square test was applied to compare the categorical variables. Continuous...

scholarly journals Causes of Removal of metallic hardware employed in oral and maxillofacial surgery - A cross sectional survey.

2021 ◽  
Vol 28 (10) ◽  
pp. 1508-1512
Author(s):  
Gulmina Saeed Orakzai ◽  
Eruj Shuja ◽  
Kausar Niazi ◽  
Zarah Afreen ◽  
Ammarah Afreen ◽  
...  
Keyword(s):  
Maxillofacial Surgery ◽  
Armed Forces ◽  
P Value ◽  
Oral And Maxillofacial Surgery ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Plate Removal ◽  
Common Cause ◽  
Metallic Hardware ◽  
Metallic Plates

Objective: This study was conducted to evaluate the causes of removal of titanium bone plates used routinely in maxillofacial region. Study Design: Cross Sectional Survey. Setting: Department of Oral & Maxillofacial Surgery, Armed Forces Institute of Dentistry (AFID). Period: January 2016 to June 2018. Material & Methods: A total of 60 patients previously operated in maxillofacial surgery department with open reduction and internal fixation with tru-dynamic titanium plating system in Operation Theater, who reported with complaints due to metallic hardware were included in the study. Data was collected regarding age, gender, time between plate insertion and removal, cause and site of plate removal was also recorded for each patient. Data was analyzed using SPSS 23.0 version. Results: During the study period, 60 patients underwent titanium plate removal out of which 34 were male and 26 were females. Most common cause of plate removal was infection followed by non-union. Majority of plates (43.3%) were removed within 6 to 12 months of insertion. Mandible was found to be the most common site of plate removal (60%). Gender was significantly associated with causes while age was associated with cause, site and duration of removing the metallic plates (P-Value, < 0.05). Conclusion: Removal of symptomatic titanium plates is likely to occur within first year of insertion. Infection was identified as the most common cause for removing the metallic plates.

scholarly journals THE EFFECT OF THERAPUETIC ULTRASOUND AND PHONOPHORESIS ON TMJ PAIN

2020 ◽  
pp. 35-37
Author(s):  
Joyce Sequeira ◽  
Thejas Girishan
Keyword(s):  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Oral And Maxillofacial Surgery ◽  
Pain Status ◽  
Group A ◽  
Tmj Pain ◽  
Group B ◽  
Larger Sample

Temporomandibular disorders (TMD) relate to discomfort of the temporomandibular joint (TMJ). The disorder is multifactorial with a degree of psychogenic influence varying throughout an individual's life with phases of symptoms affecting the quality of life. Taking into consideration the application of different physical therapies for the reduction of this pain, this study is to compare the effect of ultrasonic therapy and phonophoresis on TMJ pain. Material and methods: The study Sample consist of twenty clinically confirmed cases of TMJ pain, visiting the dental clinic of the Department of oral and maxillofacial surgery, Yenepoya Dental College, Mangalore. They were divided into two groups- Group A patients (n=10) received Hydrocortisone Phonophoresis therapy and Group B patients (n=10) received only Ultrasound, daily for a period of 7 days. The outcome were measured by Pain Status & mouth opening, measured using VAS and vernier calliper. Results: After the treatment period score of the Group-A who received Hydrocortisone Phonophoresis is significantly higher than Group-B on the Pain Intensity and Improvement in mouth opening when analysed using independent ‘t’ test at p<0.05 Conclusion: The data suggest that phonophoresis therapy can be used as an treatment modality in controlling pain associated with TMDs. However, further studies on larger sample size with longer follow up periods are required.

scholarly journals Relative Efficacy of Three of Nonsurgical Treatments for Calcific Tendinitis: Physical Therapy vs Steroid Injection vs Ultrasound-Guided Aspiration

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0021
Author(s):  
Mauricio Drummond ◽  
Caroline Ayinon ◽  
Albert Lin ◽  
Robin Dunn
Keyword(s):  
Physical Therapy ◽  
Rotator Cuff ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Corticosteroid Injection ◽  
Calcific Tendinitis ◽  
Ultrasound Guided ◽  
Calcium Deposits

Objectives: Calcific tendinitis of the shoulder is a painful condition characterized by the presence of calcium deposits within the tendons of the rotator cuff (RTC) that accounts for up to 7% of cases of shoulder pain1. The most common conservative treatments typically include physical therapy (PT), corticosteroid injection (CSI), or ultrasound-guided aspiration (USA). When conservative management fails, the patient may require arthroscopic surgery to remove the calcium with concomitant rotator cuff repair. The purpose of this study was to characterize the failure rates, defined as the need for surgery, of each of these three methods of conservative treatment, as well as to compare post-operative improvement in patient-reported outcomes (PROs) – including subjective shoulder values (SSV) and visual analog scale (VAS) pain scores – based on the type of pre-operative conservative intervention provided. A secondary aim was to compare post-operative range of motion (ROM) outcomes between groups that failed conservative management. We hypothesized that all preoperative conservative treatments would have equivalent success rates, PROs, and ROM. Bosworth B. Calcium deposits in the shoulder and subacromial bursitis: a survey of 12122 shoulders. JAMA. 1941;116(22):2477-2489. Methods: A retrospective review of all patients who were diagnosed with calcific tendinitis at our institution treated among 3 fellowship trained orthopedic surgeons between 2009 and 2019 was performed. VAS, SSV, and ROM in forward flexion (FF) and external rotation (ER) was abstracted from the medical records. Scores were recorded at the initial presentation as well as final post-operative follow-up visit for those who underwent surgery. The conservative treatment method utilized by each patient was recorded and included PT, CSI, or USA. Failure of conservative management was defined as eventual progression to surgical intervention. Statistical analysis included chi-square, independent t test and ANOVA. Descriptive statistics were used to report data. A p<0.05 was considered to be statistically significant. Results: 239 patients diagnosed with calcific tendinitis were identified in the study period with mean age of 54 years and follow up of at least 6 months. In all, 206 (86.2%) patients underwent a method of conservative treatment. Of these patients, 71/239 (29.7%) underwent PT, 67/239 (28%) attempted CSI, and 68/239 (28.5%) underwent USA. The overall failure rate across all treatment groups was 29.1%, with injections yielding the highest success rate of 54/67 (80.6%). Physical therapy saw the highest failure rate, with 26/71 (36.7%) proceeding to surgical intervention. Patients undergoing physical therapy were statistically more likely to require surgery compared to those undergoing corticosteroid injection (RR 1.88, p= 0.024). Of all 93 patients who underwent surgery, VAS, SSV, ROM improved significantly in all groups. On average, VAS decreased by 4.02 points (6.3 to 2.3), SSV increased by 33 points (51 to 84), FF improved by 13.8º, and ER improved 8.4º between the pre- and post-operative visits (p<0.05). The 33 patients who did not attempt a conservative pre-operative treatment demonstrated the largest post-operative improvement in VAS (-6.00), which was significantly greater than those who previously attempted PT (-3.33, p<0.05). There was a trend towards greater improvement in SSV in the pre-operative PT group (45 to 81) compared to others, but this did not reach statistical significance (p=0.47). Range of motion was not significantly affected by the method of pre-operative conservative intervention. Conclusions: Conservative treatment in the form of physical therapy, corticosteroid injection, and ultrasound-guided aspiration is largely successful in managing calcific tendinitis of the shoulder. Of these, PT demonstrated the highest rate of failure in terms of requiring surgical management. PRO improvement varied among the conservative modalities used, however patients who did not attempt conservative management experienced the greatest improvements following surgery. If surgery is necessary following failed conservative treatment, excellent outcomes can be expected with significant improvements in ROM and PROs. This information should be considered by the surgeon when deciding whether to recommend conservative treatment for the management of calcific tendinitis, as well as which specific method to employ.

scholarly journals Knowledge, attitude, and perception of oral and maxillofacial surgery specialty amongst healthcare professionals, and the General Public from a Gulf Cooperation Council (GCC) Country

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Kamal ◽  
Mohammad Abdulwahab ◽  
Ahmed Al-Zaid
Keyword(s):  
Cosmetic Surgery ◽  
General Public ◽  
Healthcare Professionals ◽  
Maxillofacial Surgery ◽  
P Value ◽  
Oral And Maxillofacial Surgery ◽  
Medical Doctors ◽  
Surgical Specialty ◽  
Cross Sectional ◽  
Clinical Scenarios

Abstract Background Oral and maxillofacial surgery specialty has grown rapidly in Kuwait in recent years. However, the general public and healthcare professionals remain unaware of its expanding scope of practice. The aim of the study is to assess public and professional (dental and medical) perception of the oral and maxillofacial surgical specialty in Kuwait. Methods This is a cross-sectional study evaluating responses of dental professionals, medical professionals, and general public in Kuwait toward the oral and maxillofacial surgical specialty using a previously validated survey instrument with 100 participants in each group. Participants were asked to choose the most appropriate specialist to treat certain procedures across 4 disciplines: reconstruction, trauma, pathology, and cosmetic. Statistical comparison was conducted between dentists and medical doctors using Fisher’s exact test with a p-value of < 0.05. Results Disparities were noted each group’s responses. Oral and maxillofacial surgery was preferred overall for most clinical scenarios in trauma (p < 0.001), pathology (p < 0.001), and reconstructive surgery (p < 0.001). Plastic surgery was preferred for cosmetic surgeries (p < 0.001). Conclusions This study indicates the need to increase awareness especially towards cosmetic surgery procedures, and conduct health campaigns regarding oral and maxillofacial surgery among healthcare professionals, especially medical doctors, and the general public.

scholarly journals Rare Iatrogenic Oronasal Communication after Superior Canine Odontectomy Attempt

2021 ◽  
Vol 2020 (2) ◽  
pp. 1
Author(s):  
Ciprian Roi ◽  
Emilia Ianeș ◽  
Diana Nica ◽  
Alexandra Roi ◽  
Laura Cristina Rusu ◽  
...  
Keyword(s):  
Case Report ◽  
Scientific Literature ◽  
Oral Surgery ◽  
Healing Process ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Unsuccessful Attempt ◽  
One Year ◽  
General Dentist

(1) Background: Oronasal communication is described in the scientific literature as a common complication that occurs after a cleft palate surgery. In some cases, it can also be a consequence of oral surgery procedures; the main problem of this type of rare accident is related to the correct healing process and treatment option. (2) Case report: A patient with oronasal communication caused by an unsuccessful attempt of a superior canine odontectomy presented at the Emergency Department of the Oral and Maxillofacial Surgery Hospital, Timișoara. The case management is described from the first consult to one-year follow-up. We consider that this pathology was optimally treated surgically, and the results are more than satisfactory, taking into consideration the high rates of recurrence. (3) Conclusion: This case report can be a useful to a general dentist who is trying to decide whether to perform the canine odontectomy or refer to a specialist surgeon due to the accidents and complications of this procedure.

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