Site Of Mandibular Fracture Research Articles

Clinical Outcome of Open Reduction and Internal Fixation of Mandibular Condyle Fracture: A Prospective Observational Study

Introduction: Condyle of mandible plays crucial role in functioning of jaw. Untimely and inadequate treatment leads to deformity of face along with range of complications. The purpose of this study was to assess outcomes of open reduction and internal fixation of mandibular condyle fractures in terms of mouth opening, facial nerve function and occlusion.Methods: This was a prospective observational study conducted at Chitwan Medical College. Thirty-two patients of mandibular condyle fracture were treated by open reduction and internal fixation via retromandibular approach and evaluated for mouth opening, facial nerve function, and occlusion on 2nd day, 10th day and 25th day postoperatively. All collected data were entered on SPSS version 21 and analyzed using descriptive statistical methods. The results were presented as graphs and tables.Results: Of 32 patients, 7 patients show abnormal occlusion while 25 patients show normal occlusion. A gradual improvement in mouth opening and facial nerve function was also seen on 25th day.Conclusion: Open reduction and internal fixation gives superior clinical outcomes in terms of mouth opening, facial nerve function and occlusion. It also allows good anatomical repositioning and early function.Keywords: Facial nerve function, Mouth opening, Occlusion, Open reduction internal fixation Layman summary: The mandible is largest and strongest bone of face. However, it is also most common facial bone that is fractured. Condyle of the mandible is highly prevalent site of mandibular fracture. The fracture of mandible is managed by open or closed reduction. Both of the methods have their own merits and demerits. In this study, we planned to assess the outcomes of open reduction and internal fixation of mandibular condyle fractures at a tertiary care center of Nepal. We found that ORIF has a good clinical outcome in mandibular fracture in terms of mouth opening, facial nerve function and occlusion.

The Effect of Mandibular Impacted Third Molar on Fracture of Mandibular Angle and Condyle: An Observational Study

Objective: The factors that may increase the risk of mandibular angle fractures are the abrupt change in angulation and its association with impacted teeth. Condyle, a common mandibular fracture site, is spared if the impact is absorbed in the angle. The study aimed to determine the relationship between the status of impacted mandibular third molars and mandibular angle and condylar fractures in patients with a history of road traffic accidents, within the age group of 18 to 50 years. Methods: In this observational study, 136 patients were examined clinically to diagnose mandibular angle and/or condylar fractures which were confirmed using an orthopantomogram. The status of the mandibular third molars was assessed radiographically. Results: Among the 173 fracture sites detected, 43 were diagnosed at the angle and 130 at the condyle. The demographic assessment demonstrated an age predisposition between 31 and 50 years (44%) in males and 21 and 30 years (47%) in females, with an overall peak incidence in the age group of 21 to 30 years (45%). There was a significant relationship between the status of impacted third molars and the occurrence of angle (P<0.01) and condylar fractures (P=0.05). The incidence of angle and condylar fractures in patients with/without associated impacted mandibular third molars were found to be 91% and 64% and 9% and 36%, respectively. Conclusions: The presence of impacted third molars had a significant relationship with the high incidence of angle fractures and the low incidence of condylar fractures. Knowledge about the common fracture patterns associated with impacted mandibular third molars would alert the clinician to contemplate fractures based on the anatomic distribution.

Epidemiological study of Mandibular Fractures Aetiology and Site Using computed tomography in AL Kut city

The mandible is the largest and only moveable facial bone. It begins as 2 separatebones and unites anteriorly when a child approaches 1 year of age. Being a prominent bone of the facial skeleton, it is fractured most commonly among maxillofacial injuries.This epidemiological study was conducted to evaluate the etiology of mandibular fractures and anatomical site of the fracture in 115 patients treated in the Department of Oral and Maxillofacial department ALZhraa hospital in ALKut city from 2012 to 2014. These patients were examined both clinically and radio-graphically for mandibular fractures. Records related to age, sex, and etiologies of fracture and sites of fracture were evaluated and reviewed. The most common age group affected was 21-30 years (26,08% ). Only 17.39% of patients were less than 10 years of age, and 1.7% was more than 60 years of age. Male to female ratio was 4:1. The most common cause of mandibular fractures was road traffic accidents (52.1%) followed by accidental fall (26.08%), while the least involved group was industrial accidents (1.7%), A total of 146 fractures were sustained by 115 patients at different sites there were multipl fractures in the same person .The most common site of mandibular fracture was parasymphysis (30.43%). All over the world, mandibular fractures have continued to generate discussion among researcher due to their important fuction .The male to female ratio shows 4:1 this is also in agreement with most of the studies due to their freqent participation in high risk activity such as driving vehicles sport that involve physical and active social life .

Risk factors and current trends in maxillofacial trauma: An epidemiologic study at a major Trauma Center of North India

AbstractAimsThis study aimed to obtain an update on the epidemiologic data of maxillofacial injuries with an analysis of current aetiology and associated factors encountered at a major Tertiary Care Centre of North India.Materials and methodsThis retrospective study was conducted in a Tertiary Care Centre in Uttarakhand over 2 years. The demographics, aetiology, seatbelt/helmet use, alcohol consumption at the time of injury, site of the fracture, other associated injuries and type of intervention were recorded.ResultsThe male:female ratio was 4.2:1. A peak prevalence was found in the third decade (mean age 23.6). Road traffic accidents were the most common cause of trauma (76.9%). Maxillofacial injuries were higher in those who did not use a seatbelt or helmet (85.1%). Intoxication at the time of injury was a major factor, especially in accidents. Drivers were found to be injured more (74.7%) than pillion riders or passengers. The incidence of fractures was highest in monsoons (30%). Mandibular (37.8%) and zygomatic (20%) fractures were most commonly encountered. The most common site of mandibular fractures was parasymphysis (30.6%). Fractures were treated by open reduction and internal fixation. Concomitant neurological and orthopaedic injuries were common in patients sustaining maxillofacial injuries.ConclusionRoad traffic accidents continue to be responsible for maximum trauma. A multidisciplinary assessment of every trauma victim is essential. This study can help formulate rigorous injury preventive schemes by distinguishing and analysing maxillofacial trauma. Advocation and strict implementation of helmet and seatbelt use with a heavy penalty for drinking and driving can lead to the reduction of maxillofacial injuries.

Analysis of maxillofacial fractures pattern in a tertiary hospital in Bangladesh: A retrospective study of 329 cases

Objective: The purpose of this retrospective study was to reveal the pattern of maxillofacial fractures in a tertiary hospital in Bangladesh. Materials and Methods: A sum of 329 cases with maxillofacial trauma was treated in the inpatient department of Oral and Maxillofacial Surgery of Dhaka Dental College Hospital from January 2016 to December 2018. The outcome variables included age, gender, etiology and anatomic site of fractures.Results: The age range was 4-82 years with peak frequency occurring in the age group 21-30 years. The mean age was 28.08 ± 14.77 (Mean ± SD) years. The male to female ratio was 4.98: 1. We observed that, 80.85% cases encountered from road traffic accidents (RTAs) followed by assault (8.51%). The mandible (61.7%) was predominantly affected bone followed by zygomatic complex (9.71%), midface (9.42%). The body (35.78%) was the commonest site of mandibular fracture followed by the parasymphysis (23.32%), angle (17.57%) and condyle (14.07%). The least affected site was the ramus (0.4%) and the coronoid (0.64%) process. In midface fractures, the zygomaticomaxillary complex (ZMC) was the most susceptible area (25.40% of midface) followed by maxilla (24.60%). In a nutshell, the incidence of mandibular and zygomatic complex fractures was predominant among maxillofacial fractures.Conclusion: Young men were predominantly affected in maxillofacial trauma, as they were involved in outside activities mostly. Road traffic rules should be strictly implemented. Awareness of safety guidelines should be executed by campaigning. In a nutshell, the incidence of mandibular and zygomatic complex fractures was predominant among all the maxillofacial fractures.

The characteristics of mandibular fractures in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

Background: Mandibular fractures may lead to several complications, including infection, nonunion, malunion, and temporomandibular joint ankylosis. The incidence of mandibular fractures is quite common in maxillofacial trauma. The characteristics of mandible fractures could be different among countries concerning the condition of the population. The etiological differences depend on age, demographic patterns of a country, environmental conditions, social conditions, socioeconomic status and cultural configuration. This study aimed to perceive the characteristic of mandibular fractures among patients attending The Oral and Maxillofacial Surgery Department in Dr. Hasan Sadikin General Hospital during 2017- 2020.Methods: This study was a retrospective descriptive study. Samples included medical records of patients with mandibular fractures attending The Oral and Maxillofacial Surgery Department in Dr. Hasan Sadikin General Hospital during January 2017- December 2020. Samples were chosen using inclusion and exclusion criteria. The characteristics of mandibular fracture were based on gender, fracture etiology, mandibular fracture location, and treatment.Results: This study presented that the incidence of mandibular fracture rate was higher in males with 284 cases (82.08%) than females with 62 cases (17.92%) with a ratio of 4.5 to 1. Based on age, mandibular fractures were often found in the adult age group (20-60 years old) with 215 cases (62.14%). The most common etiology was road traffic accidents, with 287 cases (82.95%). Parasymphisis region was the most common site of mandibular fracture with 94 cases (25.26%). Most treatments performed were open reduction internal fixation with 199 cases (57.51%).Conclusion: Mandibular fracture characteristics vary considerably among different study populations depending on demographic characteristics and socioeconomic status. The most frequent mandibular fracture site in Dr. Hasan Sadikin General Hospital Bandung was the parasymphisis region in a young adult age group.

Identification of malocclusion risk factors after closed treatment of condylar fractures using a novel three-dimensional computed tomography approach.

The condyle is the most common site of mandibular fracture. In the present study, an attempt was made to utilize three-dimensional computed tomography (3D-CT) images to evaluate mandibular condyle fractures and identify prognostic indicators of malocclusion after closed treatment. Accurate morphometric measurements were performed using 3D-CT images obtained before trauma, after trauma, and after healing. Morphometry revealed significant differences in loss of ramus height (LRH) and lateral movement length in patients with malocclusion, and significant LRH differences in patients with other maxillomandibular fractures after healing, or in those with dislocation-displacement. The present method of 3D-CT image analysis appears useful for evaluation of condylar fractures.

Maxillofacial trauma in children: Association between age and mandibular fracture site

PurposeTo describe the association between age and location of facial fractures in the pediatric population. Materials and methodsA retrospective analysis of the Healthcare Cost and Utilization Project (HCUP) from the 2016 Kids' Inpatient Database (KID) in children aged ≤18 years was conducted. International Statistical Classification of Diseases, 10th Revision (ICD-10) codes were used to extract facial fracture diagnoses. Logistic regression was used to evaluate and compare the contribution of various demographic factors among patients who had different types of facial fractures. ResultsA total of 5568 admitted patients were identified who sustained any type of facial bone fracture. Patients who had facial fractures were significantly more likely to be male (68.2% versus 31.8%; p<0.001) and were older with a mean age of 12.86 years (95% confidence interval [CI]: 12.72–12.99). Approximately one-third of patients with a facial fracture had a concomitant skull base or vault fracture. Maxillary fractures were seen in 30.9% of the cohort while mandibular fractures occurred in 36.9% of patients. The most common mandibular fracture site was the symphysis (N=574, 27.9% of all mandibular fractures). Condylar fractures were more common in younger children while angle fractures were more common in teenagers. Regression analysis found that age was the only significant contributor to the presence of a mandibular fracture (β=0.027, p<0.001) and race was the only significant contributor to maxillary fractures (β=−0.090, p<0.001). ConclusionsFacial fractures increase in frequency with increasing age in children. The mandible was the most commonly fractured facial bone, with an age-related pattern in fracture location.

Analysis of pediatric maxillofacial trauma in North China: Epidemiology, pattern, and management

PurposeTo analyze epidemiology, pattern, and management of pediatric maxillofacial trauma in North China. Patients and MethodsClinical records of patients aged 0–18 years with maxillofacial trauma, from January 2008 to December 2016 were reviewed. 390 patients with an average age of 9.8 ±5.8 years (range: 8 months–18 years) and a male:female ratio of approximately 2:1 were included in the study. Epidemiological features (age, sex, etiology), characteristics of injuries (locations, types, associated injuries), treatments, and complications were analyzed. ResultsAmong 55 patients with soft tissue injuries, palate was the most common site (32.7%). Among 335 fracture cases, the most common age group was 16–18 years (25.1%); falls was the main cause (38.2%). Overall, there were 450 fractures (1.78 per capita), primarily mandible (69.3%), followed by zygoma (12.9%), maxilla (7.7%) and other sites. Multiple fractures occurred in 61.5% of patients. The most common site of mandibular fractures was condyle. The proportion of mid-face fractures to mandibular fractures increased with age (p < 0.01) and stabilized gradually after 12 (approximately 1.14:1). 77.5% of fractures were treated surgically. There was an independent association of surgical intervention with age older than 6 years old (p < 0.05). Absorbable plates were mainly applied to mandibular fractures in patients aged 0–7 and only 1 was removed because of insufficient fixation strength. ConclusionsThe primary cause of pediatric maxillofacial fractures in North China was falls; traffic accidents led more multiple fractures and associated injuries. Palate and mandible were the most common sites of pediatric maxillofacial soft tissue injuries and fractures, respectively. The proportion of mandibular fractures to mid-face fractures decreased with the increase of age until 12.

Comparative study of outcomes between locking plates and three-dimensional plates in mandibular fractures.

Objectives:The objective was to compare the efficiency and assess postoperative complications of 2.00 mm unicortical locking plates and three-dimensional (3D) plates in surgical correction of uncomplicated mandibular fracture.Materials and Methods:A prospective cohort study of twenty patients of uncomplicated mandibular fractures, who were operated either by noncompression unicortical 2-mm locking mini-plate or by noncompression unicortical 2-mm 3D mini-plate, were enrolled and followed up for the study outcomes such as operative time, postoperative infection, and postoperative occlusion.Results:Majority of the patients (90%) were male who had road traffic accident. In 80% of cases, mandibular fracture site was parasymphysis. The mean operating time for 3D plates (43.20 min) was significantly lower than that for locking plates (54.82 min), P < 0.001. All cases operated by 3D plates compared to 60% by locking mini-plates did not need intermaxillary fixation, P = 0.025. The 80% of cases operated by 3D plates did not require postoperative occlusion correction compared to 30% in another group, P = 0.01. For other parameters such as postoperative sensory disturbance, postoperative infection, incidence tooth damage, vertical displacement of mandible, feeling of plate after platting, and chewing efficiency after 1 week, there were no statistical significant differences between the two groups.Conclusions:The outcome of 2.0mm 3D mini-plate is better in terms of operating time required, post-operative need of intermaxillary fixation and occlusal correction. While the outcome is similar to the use of non-compression unicortical 2.00mm locking miniplate in parameters like infection rate and incidence of tooth damage etc.

The characteristics of mandibular fractures among patients attending Plastic Surgery Unit in Sanglah General Hospital, Bali, Indonesia: A preliminary study

Background: Trauma is the fourth leading cause of death in the world and occurs at all ages. The high incidence of traffic accidents is equivalent to the increasing incidence of maxillofacial trauma, especially mandibular fracture. This study aims to determine the characteristics by age, gender, mechanism of injury and anatomical site of mandibular fractures among patients attending the Plastic Surgery Unit of Sanglah General Hospital as a preliminary studyMethods: A descriptive cross-sectional study was enrolled among 45 patients attending plastic surgery who recorded in medical records from January 2014 until December 2016 as well as met the inclusion criteria. Data were analyzed using SPSS version 17 and presented in percentage regarding Age, mechanism of injury, gender, and fracture siteResults: There were 45 patients with 61 mandibular fracture sites. Most of the patients were male (84.4%). Based on age, the mandibular fracture is most common in the productive age (20-30 years old) at 22 cases (36.1%). Majority cause of fractures was road traffic accident (82.2%). Parasymphysis region was the most common site of fracture (39.3%).Conclusion: The characteristics of mandibular fracture patients describe trauma patterns in the community. This finding is similar with some readily available literature with RTAs was the most common etiology and parasymphysis was the most common fracture site.

MANDIBULAR SYMPHYSIS FRACTURES

Introduction: Mandible is one of the most commonly fractured bones inmaxillofacial trauma. Mandibular symphysis is a common site of mandibular fractures. Compareto conventional miniplates, three dimentional plates were found more effective in terms of postoperative occlusion, post operative mobility of reduced fractured segments and the degree ofanatomic reduction. Objectives: Compare the conventional 2.0mm mini plates versus 3D miniplates in the fixation of isolated mandibular symphysis fractures. Study Design: Interventionalstudy. Setting: Oral &amp; Maxillofacial Surgery Department, Abbasi Shaheed Hospital Karachi.Period: Two years from 1st January 2013 to 2nd January 2015. Material &amp; Methods: Onehundred and fifty four patients were randomly selected and allocated into two groups. Group‘I’in which patients were treated with conventional mini plates and group‘II’ where patients weretreated with 3D mini plates. Results: Mean (+SD) age of patients was 29.53 (±7.88) years.Among 154 patients in this study, majority (75.3%) of cases had age 20 - 35 years. Majority,124 (81.2)were males and 29 (18.8%) were females. In Group I, anatomic reduction at 3 monthpost-operative was observed in 30 (39%). In Group II (3D Plates) at 3 months post-operatively,ideal molar relationship was higher (89.6% Vs. 98.7%; p-value = 0.016), fracture mobility waslower (14.3% Vs. 2.6%; p-value = 0.009) and higher anatomic reduction. Conclusion: Threedimensional miniplates are more effective compared to conventional miniplates.

Etiology, Patterns And Treatment Modalities For Mandibular Fractures

Objective: The objective of current study was to evaluate the etiology, patterns of presentation, frequency and different treatment modalities for mandibular fractures in patients treated at Lahore Medical and Dental College/Ghurki Trust Teaching Hospital (LMDC/GTTH). Methodology: This descriptive – cross sectional study was conducted at Lahore Medical and Dental College, Lahore/Ghurki Trust Teaching Hospital (LMDC/GTTH) from March 2015 to September 2017. The current study included one hundred and twelve (112) patients who were indentified having mandibular fractures. Data were collected regarding patient’s age, gender, etiology, site of fracture, patterns and treatment modalities and analyzed using SPSS version 20. Results: The patients’ ages were between 3 to 55 years (24.87±10.867, mean/SD). The majority of fractures occurred amongst 21-30 years of age group having female to male ratio of 1:5.6. Road traffic accident (RTA) was the most frequent etiological factor for mandibular fractures in 89 (79.47%) of patients, followed by assaults 11(09.82%) and fall 07 (06.25%). A total of 189 fractures were recorded in 112 patients giving a mean of 1.7 fractures per patient. Out of 189 fractures, the parasymphysis was the most prominent site of mandibular fractures(43.39%), followed by condyle (22.75%) and angle (15.87%). The treatment modality of open reduction and internal fixation (ORIF/ORIF with IMF) was performed in 88(78.57%) of patients while closed reduction and indirect fixation (IMF with eyelet wiring/arch bar elastics &amp; splint fixation) was done in 24 (21.43%) of patients. Conclusion: As evidenced by the present study, road traffic accidents are the most common cause of mandibular fractures in young adults, mostly due to violation of traffic rules. These findings highlight the need to reinforce legislation for prevention of such injuries both in children and adults

Management of Mandible Fracture by Plating and Wiring: An Otolaryngologist Perspective at Teritiary Care Center.

The facial area is one of the most frequently injured parts of the body (Abiose in Br J Oral Maxillofac Surg 24(1):319, 1986; Adi et al. in Br J Oral Maxillofac Surg 28(3):1949, 1990; Allan and Daly in Int J Oral Maxillofac Surg 19(5):26871, 1990), and the mandible is one of the most commonly fractured maxillofacial bones (1990; Azevedo et al. in J Trauma 45(6):10847, 1998; Bremerich et al. in Acta Stomatol Belg 93:511, 1996). Mandible is the only mobile bone of the skeleton, and hence vulnerable to fracture. This is a retrospective study of 50 mandibular fracture cases managed at the Department of ENT, Govt. Medical College Bhavnagar during the 2years period from 2014 to 2016. Maximum subjects were in age group 21-30years with a male preponderance. Road traffic accident is the main cause followed by falls and assault. Symphysis is the most common site of Mandibular fracture. Mandible fracture is a common entity in Road traffic accidents. Multiple fractures are seen in 40% of mandibular fracture cases. The results were equally good in patients requiring only MMF (Maxillo Mandibular Fixation) and inpatients requiring MMF and Plating, during the follow up up to 8weeks. Physiotherapy was advised for all the post op patients after 2months.

Patterns of Maxillofacial Fractures in Uttar Pradesh, India.

This study aimed to obtain dependable epidemiologic data of the variation in cause and characteristics of maxillofacial fractures by identifying, describing, and quantifying trauma. This retrospective study was conducted in the state of Uttar Pradesh, India, over 1 year, based on a systematic computer-assisted database search from March 2015 to March 2016 for maxillofacial fractures. The demographics, etiology, geographic distribution, date of injury, site and number of fractures, and type of intervention were recorded for each. The study population consisted of 1,000 patients with 1,543 fractures. The male:female ratio was 8:1. A peak incidence of fractures was seen in the third decade (mean age: 30.3) with maximum patients younger than 40 years (80.8%). The incidence of fractures was highest in spring (42.9%). Road traffic accidents were the most common cause of trauma (64.4%) and mainly involved two wheelers (60.2%). Single-site fractures were most common. Mostly zygomatic (45.1%) and mandibular fractures (44.4%) were encountered, accounting for approximately 90% of all fractures. The main site of mandibular fractures was the body (34.4%); 46.2% of fractures underwent open reduction and internal fixation (ORIF) while 53.8% were treated by closed methods. The study provides important data to contrive future plans for injury prevention. The trend of most traffic-related injuries continues with the increasing traffic on roads. Zygomatic complex and mandibular fractures remain the most frequent. The major populations at risk are young men and those driving two wheelers. The use of helmets could achieve a large reduction in maxillofacial fractures. Awareness for preventive measures and safety guidelines should be propagated and legislation on traffic rules strictly reinforced.

Mental Foramen Relation to Mandibular Fracture.

To detect site of the mental nerve foramen in patients of mandibular fracture and study its relation to mandibular fracture site using radiology and operative findings during open reduction and internal fixation. This study was carried out on 46 patients who had traumatic mandibular fractures. All patients were managed by open reduction and internal fixation during which mental foramen site and fracture site were reported and analyzed and compared to preoperative radiography. By both radiology and operative findings, the mental foramen was found in 78.3% between the first and second premolar, and in 21.7% below the first premolar. While no other mental foramen sites were reported. There were no statistically significant differences between both detected sites as regard age and sex. By operative dissection, mental foramen and neurovascular bundle could be detected, dissected, and preserved in all patients. To the best of the authors' knowledge, this is the first operative and radiological work that highlights the site and relation of mental foramen site to mandibular fracture in Arab people. The authors' study provides useful data of mental foramen among Arab population for the surgeons, anesthetists, and dentists to carry out procedures without complications.

The Relationship of the Facial Nerve to the Condylar Process: A Cadaveric Study with Implications for Open Reduction Internal Fixation.

Introduction. The mandibular condyle is the most common site of mandibular fracture. Surgical treatment of condylar fractures by open reduction and internal fixation (ORIF) demands direct visualization of the fracture. This project aimed to investigate the anatomic relationship of the tragus to the facial nerve and condylar process. Materials and Methods. Twelve fresh hemicadavers heads were used. An extended retromandibular/preauricular approach was utilized, with the incision being based parallel to the posterior edge of the ramus. Measurements were obtained from the tragus to the facial nerve and condylar process. Results. The temporozygomatic division of the facial nerve was encountered during each approach, crossing the mandible at the condylar neck. The mean tissue depth separating the facial nerve from the condylar neck was 5.5 mm (range: 3.5 mm–7 mm, SD 1.2 mm). The upper division of the facial nerve crossed the posterior border of the condylar process on average 2.31 cm (SD 0.10 cm) anterior to the tragus. Conclusions. This study suggests that the temporozygomatic division of the facial nerve will be encountered in most approaches to the condylar process. As visualization of the relationship of the facial nerve to condyle is often limited, recognition that, on average, 5.5 mm of tissue separates condylar process from nerve should help reduce the incidence of facial nerve injury during this procedure.

Pulp necrosis of teeth retained at the mandibular fracture site and the effect of dexamethasone on its occurrence.

The main purpose was to determine the occurrence of pulp necrosis (PN) of teeth retained at the mandibular fracture site. An additional purpose was to investigate whether perioperative use of dexamethasone increases the risk of PN. A follow-up study on 24 adult dentate patients with mandibular body, symphysis or parasymphysis fracture. These patients had been selected from a larger cohort who had participated in a randomized study of maxillofacial fractures and dexamethasone. All patients who were suspected of having a need for endodontic treatment were evaluated by an endodontist. PN was diagnosed in six patients (25.0%) in one or two teeth. Of a total of 33 teeth situated in the fracture line, six (18.2%) were diagnosed as having PN. PN was more common in teeth in which the fracture line ran through the apex (21.7%) than in those in which the fracture line was in contact with the tooth cranially to the apex (10.0%). The association between PN and dexamethasone was not significant. PN is common after mandibular fractures, particularly when the fracture line runs through the apex of the tooth. Use of short-term, high-dose dexamethasone perioperatively did not significantly increase the risk for PN.

Epidemiology and Management of Mandibular Fracture : Two Year Experience in Tertiary Care Dental Hospital

Injuries of the maxillofacial complex represent one of the most important health problems worldwide. The incidence of maxillofacial skeleton fractures is rising globally, the main contributors being road side accidents, interpersonal violence and falls from heights. If not treated properly, such fractures may lead to life long functional and structural disability. This study was designed to determine demographics, clinical features, patterns of mandibular bone fractures, treatment and postoperative evaluation of such fractures. This was a descriptive study, based on data of 30 patients of mandible fractures, from March 2010 to February 2012. Variables examined included demographic &amp; clinical features, patterns of mandibular bone fractures and results of open and closed reduction of isolated mandibular fractures using surgical stainless steel wire and miniplates. Patients were followed up for one year. There were 30 patients, 26 male and 4 females, age ranged from 5-70 years (mean age was 25 years). Most common causes were road traffic accident (50%), and interpersonal violence (30%).Parasymphysis (53%)and angle(20%) of mandible was most common site of mandibular fracture and Postoperative complication rate was higher in closed reduction than in open reduction cases with internal fixation (ORIF). Long-term collection of epidemiological data regarding maxillofacial skeleton and management aspects of mandibular fractures are important for the evaluation of existing preventive measures and useful in the development of new methods of injury prevention and treatment.&#x0D; JCMCTA 2014 ; 25 (1): 37-40

Regenerating Mandibular Bone Using rhBMP‐2: Part 2—Treatment of Chronic, Defect Non‐Union Fractures

To describe a surgical technique using a regenerative approach and internal fixation for reconstruction of critical size bone defect non-union mandibular fractures. Case series. Dogs (n = 6) that had internal fixation of defect non-union mandibular fracture. In 5 dogs, the repair was staged and extraction of teeth performed during the initial procedure. After 21-98 days (mean, 27 days) pharyngotomy intubation and temporary maxillomandibular fixation were performed. Using an extraoral approach, a locking titanium miniplate was contoured and secured to the mandible. A compression resistant matrix (CRM) infused with rhBMP-2 was implanted in the defect. The implant was then covered with a soft tissue envelope followed by surgical wound closure. All dogs healed with intact gingival covering over the mandibular fracture site defect and had immediate return to normal function and correct occlusion. Hard-tissue formation was observed clinically within 2 weeks and solid cortical bone formation within 3 months. CT findings in 1 dog at 3 months postoperatively demonstrated that the newly regenerated mandibular bone had 92% of the bone density and porosity compared to the contralateral side. Long-term follow-up revealed excellent outcome. Mandibular reconstruction using internal fixation and CRM infused with rhBMP-2 is an excellent solution for the treatment of critical size defect non-union fractures in dogs.