Abstract
IntroductionDentition is one of the main concerns while managing pediatric mandibular fractures. The aim of this study was to assess the results of the usage of intraoperative images with C-arm to identify and protect the roots of nonerupted teeth during open reduction and internal fixation (OR/IF) of pediatric mandibular fractures.Patients and MethodsThis prospective study was conducted on children who had mandibular fractures with unerupted mandibular teeth appearing on panoramic examination. All patients were managed by OR/IF by titanium miniplates using manual maxillomandibular fixation treated under general anesthesia. Titanium miniplate was positioned according to preoperative radiology. Then C-arm images were taken to confirm the screws position away from the nonerupted teeth. Lastly, the screws were inserted at C-arm-confirmed safe position. Then the results were assessed such as reliability, difficulties of the procedures, operative time, dental occlusion, average intrinsic vertical mouth opening, and complication.ResultsA total of 20 children with parasymphyseal fractures, with mean age of 6.5 (range: 4–9) years, were included. No difficulties were detected during application of the C-arm during surgery regarding position or projection, and the registered views were clearly seen and easily interpreted. Thus, added duration for C-arm use did not significantly elongate the operative time. Postoperative radiology confirmed proper position of all fixed screws away for the teeth root or unerupted teeth.ConclusionOperative C-arm-guided plate screws positioning and fixation can effectively obviate the risk of injury to tooth root or bud during OR/IF of mandibular.
Highlights
Dentition is one of the main concerns while managing pediatric mandibular fractures
Displaced mandibular fractures in children need to be reduced and immobilized. Such fixation can be achieved with maxillomandibular fixation (MMF) or open reduction and internal fixation (OR/IF) or a combination of both
The aim of this study was to assess the use of intraoperative images with a C-arm as an intraoperative tool to identify and protect the teeth roots and nonerupted teeth during OR/IF of pediatric mandibular fractures to achieve successful protection of tooth buds
Summary
The aim of this study was to assess the results of the usage of intraoperative images with C-arm to identify and protect the roots of nonerupted teeth during open reduction and internal fixation (OR/IF) of pediatric mandibular fractures. Patients and methods This prospective study was conducted on children who had mandibular fractures with unerupted mandibular teeth appearing on panoramic examination. Displaced mandibular fractures in children need to be reduced and immobilized Such fixation can be achieved with maxillomandibular fixation (MMF) or open reduction and internal fixation (OR/IF) or a combination of both. Fewer teeth may be available, roots of deciduous may be resorbed, their surfaces are not retentive, and the crowns of incisors and canines and partially erupted permanent teeth may be unfavorably shaped for fixation of interdental wires and arch bars [2]
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