Abstract
Background and objectives: Due to the fact that the mandible is the only movable bone in the face, it is often exposed to the influence of external forces. The incidence of trismus and posttraumatic pain in unilateral mandibular corpus fractures may be related to the occurrence of complications. There is a decrease in the quality of life of these patients. The aim was to study the relationship of the preoperative pain and trismus with the incidence of complications, as well as to investigate the quality of life. Materials and Methods: A prospective study on 60 patients with isolated mandibular fractures was performed, with a follow-up period of six months. The level of preoperative pain was measured on a 0–10 scale, while the mouth opening was measured with a caliper. All patients were treated surgically on the third day after the fracture. The University of Washington Quality of Life (UW-QOL v4) questionnaire was used to analyze the quality of life. Results: The most common types of complications were the occlusal derangement and facial asymmetry. The majority of complications were treated with counseling and physical therapy. The degree of preoperative pain was significantly positively related to the onset of complications (rs = 0.782, p = 0.004). The interincisal distance showed a significant inverse relation with the incidence of complications (rs = −0.722, p < 0.001). The patients regarded the pain, appearance and mood issues as the most important issues during the first postoperative month. Conclusions: The degree of inflammatory symptoms may be positively related to the onset of complications occurring after the rigid fixation of mandibular fractures. The postoperative health-related and overall quality of life was unsatisfactory in nearly half of the patients.
Highlights
Mandibular fractures are a common issue in maxillofacial surgery, with an increasing incidence [1].Due to the fact that the temporomandibular joint is the only mobile joint in the skull, the mandible is often exposed to the influence of external forces—often leading to structural damage, which reflects on the aesthetics and the functionality of the face
The mandibular fractures were most common in ages 21–40 (n = 38, 63.3%)
All fracture lines showed a pattern which was adequate for surgical treatment, enabling surgery in all cases
Summary
Mandibular fractures are a common issue in maxillofacial surgery, with an increasing incidence [1].Due to the fact that the temporomandibular joint is the only mobile joint in the skull, the mandible is often exposed to the influence of external forces—often leading to structural damage, which reflects on the aesthetics and the functionality of the face. The majority of research on mandibular trauma is usually directed towards the epidemiology of mandibular fractures—and, in a lesser amount, the factors which influence the treatment success The complexity of these injuries is seen in the different aspects of Medicina 2019, 55, 109; doi:10.3390/medicina55040109 www.mdpi.com/journal/medicina. A systematic review by Troiano et al showed no difference in the postoperative pain, swelling, and trismus in patients who received dexamethasone via the submucosal or intramuscular route [6]. The incidence of trismus and posttraumatic pain in unilateral mandibular corpus fractures may be related to the occurrence of complications. The aim was to study the relationship of the preoperative pain and trismus with the incidence of complications, as well as to investigate the quality of life.
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