Treatment Of Maxillofacial Trauma Research Articles

Efficacy of lidocaine vs combination of lidocaine and bupivacaine in management of maxillofacial trauma: a clinical comparative study.

The COVID-19 pandemic has created an unprecedented situation which the treatment of maxillofacial trauma, especially mandibular fractures that were previously managed using general anaesthesia had to be performed under local anaesthesia. In these cases, there was a requirement for an anaesthetic agent that would have a rapid onset but also provide a prolonged effect. The aim of the study was to evaluate the onset, duration, depth, required volume of anaesthesia of lidocaine with epinephrine versus combination of lidocaine and bupivacaine with epinephrine anaesthetic agents in surgical management of isolated mandibular fracture patients. A total of 30 patients with isolated mandibular fractures reported to our hospital included the study group. Patients were randomly distributed to two groups, Group A and Group B. Group A received local anaesthesia using 2% Lidocaine with 1:80,000 adrenaline and Group B received 0.5% Bupivacaine with 1:2,00,000 adrenaline combined with 2% Lidocaine with 1:80,000 adrenaline at a ratio of 1:1. The outcome variables were recorded and the data was tabulated and analysed using un-paired students t test. The combination of anaesthetic agents had longer duration of action (mean: 182.47min, P-value: 0.001) and required lesser volume of anaesthetic solutions (mean: 5.38mL, P-value: 0.001) as compared to usage of lidocaine alone. Although combination group showed quicker onset (mean: 4min 8s), the result was insignificant (p-value: 0.345). The study found that the combination of lidocaine and bupivacaine could serve as a potential anaesthetic cocktail in effective surgical management of isolated mandibular fractures. Maxillofacial injuries can be managed efficiently under local anaesthesia using combination of lidocaine and bupivacaine.

Oral rehabilitation of maxillofacial trauma using fixed corticobasal implant-supported prostheses: A case series.

IntroductionMaxillofacial trauma is associated with severe loss of soft and hard tissues that lead to aesthetic and functional disfigurements, adverse psychological impacts on the patient's general and oral health, and decreased quality of life. Therefore, treatment of maxillofacial trauma is challenging.Presentation of caseWe present three patients with maxillofacial trauma owing to road traffic accidents that were rehabilitated by immediate use of loaded fixed corticobasal implant-supported prostheses with follow-up periods of 6, 5, and 7 years. All treated patients had a 100 % implant survival rate, healthy peri-implant tissues, stable prosthesis with significant improvement in mastication and phonation, and high patient satisfaction.DiscussionRehabilitation of patients with intensive maxillofacial trauma requires a multidisciplinary approach to ensure the standard of care during treatment. The described treatment eliminates the need for bone grafting, reduces susceptibility to grafting complications, shortens treatment time, and provides the patient with a fixed prosthesis with predictable success, excellent implant survival, healthy peri-implant tissue, improved prosthetic stability, and high satisfaction rates.ConclusionCorticobasal implant-supported prostheses are a feasible treatment modality to rehabilitate patients with maxillofacial trauma with high success and survival rates and patient satisfaction.

Treatment of oromaxillofacial fracture in elderly: A literature review

Maxillofacial fracture in elderly patients mostly related to age-related changes and systemic pathologic conditions. However, traumatic injuries in the elderlyhave been increasing in recent years; this is due to increased active life span with advances in medicine that result in a higher percentage of older people in the population. This article ia a review of oromaxillofacial frac-ture in elderly that published since the last 10 years obtained through the search of the electronic database PubMed and Google Scholar, then selected as many as six studies based on the treatment of oromaxillofacial fracture in elderly. Based on the selec-ted literature that has been reviewed, falls were responsible for the majority of fractures in the elderly group. The fracture loca-tions are varied but mostcommon site is zygomatic complex, nasal bone, and condylar. The results of this literature review high-light that majority of elderly patients are treated without surgical procedures.It is concluded that the treatment of maxillofacial trauma in elderly patients is often challenging, as elderly patients require specific attention and multidisciplinary collaboration in the diagnosis and sequencing of trauma treatment.

Systemic Antibiotic Prophylaxis in Maxillofacial Trauma: A Scoping Review and Critical Appraisal

Infection after maxillofacial trauma remains an important complication, with a significant socio-economic impact. While consensus exists that systemic antibiotic prophylaxis reduces the risk of infection in the management of maxillofacial fractures, the type, and duration remain controversial. Therefore, the purpose of this scoping review was to provide an overview of the current evidence that supports the use of prophylactic antibiotics in the treatment of maxillofacial fractures. A comprehensive literature search on 1 January 2022, in PubMed, Web of Science, Embase, and Cochrane, revealed 16 articles. Most studies focused on the duration of systemic antibiotic prophylaxis and compared a one-day to a five-day regimen. Included studies showed considerable variability in design and research aims, which rendered them difficult to compare. Furthermore, a variety of antibiotic regimens were used, and most studies had a short follow-up period and unclear outcome parameters. This scoping review demonstrates the lack of well-constructed studies investigating the type and duration of systemic antibiotic prophylaxis in the treatment of maxillofacial trauma. Based on the included articles, prolonging antibiotic prophylaxis over 24 h for surgically treated fractures does not appear to be beneficial. Furthermore, there is no evidence for its use in conservatively treated fractures. These results should be interpreted with caution since all included studies had limitations.

Biodegradable versus titanium osteosynthesis in maxillofacial traumatology: a systematic review with meta-analysis and trial sequential analysis

Titanium osteosynthesis is currently the fixation system of choice in maxillofacial traumatology. Biodegradable osteosynthesis systems have the ability to degrade in the human body. The aim of this study was to conduct a systematic review, with meta- and trial sequential analyses, to assess the efficacy and morbidity of biodegradable versus titanium osteosynthesis after maxillofacial trauma. MEDLINE, Embase, and CENTRAL were searched for randomized controlled trials and prospective and retrospective controlled studies. Five time periods were studied: perioperative, short-term (0–4 weeks), intermediate (6–12 weeks), long-term (>12 weeks), and overall follow-up. After screening 3542 records, 24 were included. All had a high risk of performance and detection bias due to the nature of the interventions. Meta-analysis showed no differences in efficacy or morbidity between biodegradable and titanium osteosynthesis. The risk of perioperative screw breakage was significantly higher (risk ratio 17.13, 95% confidence interval 2.19–34.18) and the symptomatic plate removal rate lower in the biodegradable group (risk ratio 0.11, 95% confidence interval 0.02–0.57), which was confirmed by the trial sequential analysis. The quality of evidence ranged from very low to moderate. Based on the narrative review and meta-analyses, current evidence shows that biodegradable osteosynthesis is a viable alternative to titanium osteosynthesis when applied in the treatment of maxillofacial trauma, with similar efficacy but significantly lower symptomatic plate removal rates. Perioperative screw breakage occurred significantly more often in the biodegradable group compared to the titanium group.

The reconstructive approach in the treatment of maxillofacial trauma — when biology and technology work together

The reconstructive approach in the treatment of maxillofacial trauma — when biology and technology work together

Interpersonal Violence Is Associated With Increased Severity of Geriatric Facial Trauma

The geriatric population is rapidly increasing in number with increased demand on health care resources including those spent on the treatment of maxillofacial trauma. The purpose of this analysis was to investigate the independent and cumulative associations between potential risk factors (age, gender, mechanism of injury, drug use, and alcohol use) for and the severity of geriatric facial trauma. This was a cross-sectional analysis of secondary data of geriatric (individuals aged ≥65years) facial trauma using the Allegheny General Hospital Trauma Registry database. Data were collected for diagnosis codes that reflected facial trauma (International Classification of Diseases, Ninth Revision codes 802.0 to 802.9, 800.1 to 801.9, and 803.0 to 804.9) and specific mechanisms of injury (E810 to E819, motor vehicle traffic accidents; E880 to E888, accidental falls; and E960 to E969, injury purposely inflicted by other persons). The Facial Injury Severity Scale (FISS) is a validated measurement that was used to determine the severity of the facial trauma and calculated through analysis of the abstracted data obtained from the trauma registry and patient records. Pearson correlations, 2-way independent t test, 1-way analysis of variance, and multiple linear regression were used to test hypotheses for independent and cumulative associations between the risk factors for and the severity of geriatric facial trauma. Statistical significance was set at the P < .05 level. The sample was composed of 229 patients with a mean age of 72.3 ± 4.5years. A statistically significant association between mechanism of injury and the severity of geriatric facial trauma (P= .019) was found. Specifically, interpersonal violence (assault) was associated with the greatest facial trauma severity (FISS score, 4.2) when compared with motor vehicle collisions (FISS score, 2.2; P= .011) and falls (FISS score, 2.4; P= .016). Interpersonal violence (assault) is associated with increased severity of geriatric facial trauma compared with other risk factors.

Frontal sinus and naso-orbital-ethmoid fractures.

Frontal sinus and naso-orbital-ethmoid (NOE) fractures are among the most challenging injuries in the treatment of maxillofacial trauma. To summarize the current knowledge regarding frontal sinus and NOE fractures and to present some of the more recent, evidence-based literature to support current treatment recommendations. A PubMed search of articles from 1990 through 2013 was performed. Search terms included frontal sinus fracture, NOE fracture, naso-orbito-ethmoid fracture, naso-ethmoid-orbital fracture, and nasoethmoid fracture. Advances in sophisticated imaging and evolution in minimally invasive surgical techniques are introducing more conservative options that may provide better patient outcomes while minimizing the risks and morbidity associated with more traditional treatment approaches. The treatment of frontal sinus and NOE fractures is challenging, given the complex anatomy and associated pattern of injuries. Traditional treatment paradigms are evolving and support the role of more conservative treatment algorithms in selected patients.

Cognition of registered nurse on emergency treatment for oral and maxillofacial injury in Jeju province

The purposes of this work were to assess the cognition of the registered nurse(RN) on oral and maxillofacial emergency treatment and to compare cognition of the RN with that of the 119 emergency medical technician(EMT). 450 RNs who were working at each of secondary hospitals in Jeju province had responded to the questionnaire. Independent sample t-test and chi-square test were used to assess the state of RN on dental emergency treatment and to compare RN with EMT. The question 'education time on dentistry in formal education' that marked '0 hour' and '1-3 hours' were 73.3% and 20.0%, respectively. The question 'refresher training class on dentistry' that marked '0 hour' and '1-3 hours' were 92.9% and 6.7%, aggregately 99.6%. The results showed low score in the question 'reduction of temporo-mandibular joint(TMJ)'(1.67pm0.857), 'fixation of dislocated TMJ'(1.70pm0.853) and 'post-avulsed tooth treatment'(1.78pm0.774) by 5-point Likert scale. Likewise, the scores were 2.02pm0.806 in the question 'treatment of maxillofacial trauma', 2.76pm1.061 in the question 'emergent care of avulsed tooth', 2.70pm1.095 in the question 'treatment time of avulsed tooth' and 2.79pm1.056 in the question 'mouth guard', respectively. Compared to EMT, results of RN showed a statistically lower figure(p&lt;0.05) in all items compared except the question 'medicine control', and the question 'doctor care in emergency room' was borderline(p=0.069). From this study, it is necessary for RN and student of nursing science to be educated on the oral and maxillofacial emergency treatment for the initial management of injuries. Authors suggest further co-study and nation-wide research with nursing care.

Mandibular Angle Fracture Treated With New Three-Dimensional Grid Miniplate

Fractures of the mandibular angle deserve particular attention because they represent the highest percentage of mandibular fractures and have the highest postsurgical complication rate, making them the most challenging and unpredictable mandibular fractures to treat. Despite the evolution in the treatment of maxillofacial trauma and fixation methods, no single treatment modality has been revealed to be ideal for mandibular angle fractures. Several methods of internal fixation have been studied with great variation in complications rates, especially postoperative infections. Recently, new studies have shown reduction of postsurgical complications rates using three-dimensional plates to treat mandibular angle fractures. Nevertheless, only few surgeons have used this type of plate for the treatment of mandibular angle fractures. The aim of this clinical report was to describe a case of a patient with a mandibular angle fracture treated by an intraoral approach and a three-dimensional rectangular grid miniplate with 4 holes, which was stabilized with monocortical screws. The authors show a follow-up of 8 months, without infection and with occlusal stability.

Paediatric mandibular fractures: report of a case

The conservative approach in the treatment of maxillofacial trauma in children has been widely adopted. The type of fracture and its presence within the growing facial skeleton along with the presence of tooth buds may result in different management strategies to that employed in adults. An understanding of conservative treatment options is essential to make informed choices which will best manage these injuries, and an example is presented in this paper. This case report describes a 14-year-old boy who sustained trauma to the chin as a result of a fall, causing a mandibular symphyseal fracture. He was successfully treated by the means of applying direct interdental wiring combined with an acrylic splint.

악안면 외상 환자의 치료지연에 대한 임상분석

악안면 외상 환자의 치료지연에 대한 임상분석

Re-thinking on treatment of maxillofacial trauma during the earthquake disaster

汶川地震无情地撕裂川北大地,震惊了中国,震动了世界,牵动着每一位炎黄子孙的心,中华民族体现出了空前的凝聚力.一方有难,八方支援,全国逾万计医务工作者奔赴灾区,为救治骨肉同胞做出了不可磨灭的贡献。

Secondary correction of malocclusion after treatment of maxillofacial trauma

d alocclusion after primary treatment of maxillofaial trauma is not frequently reported in the literaure. Despite many developments in the treatment f facial fractures, the most common hard tissue omplications after maxillofacial trauma are temoromandibular joint (TMJ) dysfunction, followed y infections and malocclusions. When rigid meallic plates and screws became available, the reuirements for accuracy in surgery increased, as ven a mild discrepancy in alignment of bony fragents and osteosynthesis can have a severe effect n occlusion. As with all surgery, the rate of comlications decreases with the greater experience of he operating surgeon. Maxillofacial trauma patients frequently have ther injuries, most often neurologic or orthopedic. f emergency surgery must be carried out, the facial ractures will usually be operated on at the same ime. Emergency situations may lead to poor preperative imaging and inadequate preoperative reatment planning of maxillofacial injuries. On the

Symposium on maxillofacial trauma. presented on saturday, september 13, 8:00 am–10:00 am. Moderator: richard h. haug, DDS, lexington, KY : The Philip Maloney trauma lecture: current concepts in the treatment of maxillofacial trauma

The importance of facial trauma to the emergence of Oral and Maxillofacial Surgery (OMS) as a specialty underscores the urgency that OMS maintain a primary responsibility in the trauma arena. Surgeons must integrate current surgical concepts in the treatment of maxillofacial trauma with societal changes, economic realities, and complex psychosocial issues frequently associated with the trauma patient.

History of the Treatment of Maxillofacial Trauma

History of the Treatment of Maxillofacial Trauma

Pediatric maxillofacial trauma: Unique features in diagnosis and treatment

The purpose of this study was to review mechanisms, etiologies, associated injuries, and treatment of maxillofacial trauma in children and to compare them to similar adult injuries. Thirty blunt injuries (1984-1986) comprised the children's group, and 176 injuries, the adult group. Multiple associated injuries were more common in children, the most frequent being CNS and orthopedic injuries. Detailed anatomy of mandibular fractures required pleuridirectional tomography in 63% of the pediatric cases compared to 12% in adults. In the children's group, the mandibular fractures were favorable in 56% of cases compared to 15% in adults. Children required shorter periods of intermaxillary fixation with no child requiring reapplication of fixation. Based on these comparisons, a protocol for the management of pediatric maxillofacial injuries has been developed.

招待講演

招待講演