Comparison of Bite Force in Patients After Treatment of Mandibular Fractures With 3-Dimensional Locking Miniplate and Standard Miniplates

Background: Fractures of the mandible can be studied and described in anatomic terms, functional considerations, treatment strategies, and outcome measures. The performance of any fixation system depends on multiple factors including plate adaptation, screw placement, bone quality, drilling conditions, and postoperative patient compliance. Bite force assesses masticatory muscle function under clinical and experimental conditions. Method: 30 patients with isolated, noncomminuted mandibular fractures were randomly divided into two equal groups. Group 1 patients were treated using 3-dimensional locking miniplates and group 2 patients were treated with standard miniplates. The bite forces were recorded at definite time intervals: preoperatively, and second week, sixth week, third month, and sixth month postoperatively. Result: At 6 weeks postoperative, 3 month postoperative, and 6 month postoperative, the mean bite force was found to be significantly higher among group 1 patients as compared to those in group 2 in all the sites. While at 2 week postoperative, the mean bite force was found to be significantly higher in Group 2 as compared to Group 1 at incisor region. Conclusion: The overall results of the present study show better performance in bite force for the 3-dimensional locking miniplate when compared with standard miniplates.

Provision of Dental Trauma Care in a Remote and Rural Setting

Advanced oral surgery such as the treatment of fractures of the mandible is difficult to be performed in rural and remote settings. Within India, the bulk of the population reside in the countryside rather than in urban settings, leading to a lack of provision of secondary care services. Within the Chitrakoot Project, a modern, fully equipped dental surgery has evolved, which with the assistance of Indian specialists from secondary care, and visitors from abroad, has become a rural clinic capable of treating mandibular fractures using maxillomandibular fixation. The concept of training for remote and rural dental surgeons is explored, and three cases are chronicled. The experience in Chitrakoot is something which could be usefully rolled out to suitable rural surgeons to receive training in teaching hospitals, which would improve the provision of acute oral surgery within the rural population of India, and other countries.

Correction of Posttraumatic Enopthalmos: Still a Challenge

Orbital reconstruction is very challenging due to complex anatomy of the orbit and desirable functional and aesthetic results. Timing of intervention, indications for open reduction, choice of implant material, and placement play a very crucial role in the treatment protocol. Correction of posttraumatic enophthalmos and residual diplopia remain difficult to achieve and even sometimes need secondary revision. In the present case, we have discussed about the correction of posttraumatic enophthalmos and the challenges faced during and postsurgery and review about the management protocol for orbital reconstruction.

Evaluation of Efficacy of 3-Dimensional Delta Versus Trapezoidal Condylar Plates in Internal Fixation of Mandibular Subcondylar Fractures: A Clinical Study

Introduction: Among condylar fractures, surgical treatment is most commonly done for subcondylar fractures. Although 2 plate system is most commonly recommended, specially designed delta plate or trapezoidal condylar single 3-dimensional plate have been found to provide early functional rehabilitation with similar stability. Though studied in vitro, not much in vivo study has been done in clinical scenario. Aim and Objectives: Comparative assessment of functional and radiographic outcomes of patients who underwent subcondylar fracture fixation with trapezoidal and delta condylar plate. Methods: 20 patients presenting with subcondylar fracture requiring open reduction and internal fixation were included in this 2-year study from 2014 to 2016. Patients were randomly assigned to either one of the groups, with 10 being treated by each plate. Patients were evaluated regularly during 3 months follow-up on clinical parameters, such as occlusion, mouth opening, range of jaw movements, and radiologic parameters, such as fracture alignment, plate fracture, plate bending, screw loosening, secondary displacement of condylar fragment and its direction, ramus height, and any deviation. Results: In both groups, statistically significant improvement in occlusion seen from the third day to the third month ( P value = .04). Postoperative mouth opening, right and left lateral movements, and protrusive movements were statistically nonsignificant in both group A and group B. But within a group, improvements in the results were variable with regard to all these parameters at different intervals. Clinical and radiographic complications were nonsignificant in both group A and group B. Conclusion: This study is a preliminary effort to evaluate and compare different special plating systems in the management of condylar fractures with the new 3-dimensional trapezoidal and delta plating system, which gives excellent stability and rigidity. Improvement in occlusion was found to be gradual in both the plating system over a period of 3 months. Delta plate showed significant improvement in mouth opening at all intervals in comparison to Trapezoidal plate. Improvement in protrusive movement was found to be gradual and better with delta plate. A trapezoidal condylar plate holds goods for low subcondylar fractures owing to its wider dimension, though delta plate is versatile for both high and low subcondylar fracture.

Angle Fracture: An Outcome in Bareilly Population

Introduction: Mandibular angle fracture is a very common fracture of the mandible. These account for approximately 30% of all fractures. These fractures are treated by many techniques such as open reduction or maxilla-mandibular fixation. These fractures have high complication rate accounting for 0% to 32% postoperatively. Material and Methods: This study was conducted on 50 patient reported in Institute of dental sciences, Bareilly and Rohilkhand medical college and hospital, Bareilly to evaluate the outcome of mandibular angle fracture in our institute. Result: Out of 50 patients of mandibular angle fracture, 30 were treated surgically, 17 were treated conservatively, and 3 patients were not interested in any kind of treatment. Males are more commonly affected and road traffic accidents was a very common cause of angle fracture.

Bicoronal Approach in Correction of Post-traumatic Frontal Bone Deformity: Report of Two Cases

Presence of head injury in patients with maxillofacial trauma is a potentially life threatening condition. Frontal bone injuries are uncommon but significant and may appear with facial deformation and impaired aesthetics. Bicoronal approach provides excellent surgical access for frontal bone reconstruction with a very low rate of morbidity. This paper present two cases of posttraumatic frontal bone deformity treated with bicoronal approach.

Weight Changes (in kg) in Mandible Fracture Patients After IMF: A Prospective Study

Background: This prospective study is done to assess weight loss due to maxillomandibular fixation (MMF) in patients who have undergone treatment for maxillofacial fractures. This fixation method is a closed reduction technique that can interfere with normal nutrition intake of solid and semisolid foods and thus can result in weight loss and malnutrition. Therefore, in this study we explain the degree and pattern of weight loss in patients treated with MMF. Materials and Methods: We treated 300 patients for 4 to 6 weeks of MMF. We measured and compared the weight before and after MMF. Results: The loss of weight was statistically significant ( P < .001) with MMF treatment. Conclusion: MMF caused mild to moderate malnutrition in some cases so protein diet was recommended to such patients post treatment.

Bear Maul Injury in Maxillofacial Region: A Case Report

Face, has always been the point of attraction in a person’s physique, any disfigurement of that, caused either due to any sort of trauma or by animal attack, would lead to not only functional impairment but also severe psychological disturbance. The reasons for these injuries may vary from one country to another and even within the same country. Injuries due to bear mauling are most commonly seen in rural areas, but in developing countries like ours, stripping the wildlife of their natural habitation brings them close to more populated areas in the search of food. Increase in tourism may be another cause of these types of injuries. We herein report a rare presentation of bear maul injury in adult patient in maxillofacial region, and the purpose of this clinical report is to discuss the increase in incidence of such injuries and its subsequent management.