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Luotamo I, Snäll J, Toivari M. Complications and complaints in craniofacial fractures - Finnish national data for 20 years. Acta Odontol Scand 2024; 83:334-339. [PMID: 38804122 DOI: 10.2340/aos.v83.40570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/29/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Research on reasons for malpractice claims in oral and maxillofacial surgery is scarce. The aim of this study was to investigate the causes and prevalence of permanent harm among craniofacial fracture related malpractice claims. MATERIALS AND METHODS A retrospective register study was designed and implemented. All patients with a complaint and a diagnosis of facial or cranial fracture were included. The main outcome was the presence of permanent harm, and the predictor variable was the cause of complaint. Chi-square test was used for estimation of statistical significance. RESULTS Delay in correct diagnosis was the leading cause of malpractice claims (63.2%), and permanent harm was found in 23.1% of the population. 82.4% of injuries were facial fractures in total population. 65.3% (n = 98) of facial trauma were related with delayed diagnostics (p < 0.001). Permanent harm was more frequent in patients with delayed diagnosis (71.4%) than those without (60.7%, p = 0.299). CONCLUSIONS Claims of craniofacial trauma are related with under-diagnostics, and un-diagnosed facial fracture can lead to a high rate of permanent harm. Systematic clinical evaluation and facial trauma specialist consultation is recommended to set early correct diagnosis for and improve treatment of craniofacial trauma patients.
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Affiliation(s)
- Inka Luotamo
- Department of Oral and Maxillofacial Diseases, Kymenlaakso Central Hospital, Kotka, Finland; University of Helsinki, Helsinki, Finland.
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland; Helsinki University Hospital, Helsinki, Finland
| | - Miika Toivari
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland; Helsinki University Hospital, Helsinki, Finland
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Nayak SS, Gadicherla S, Roy S, Chichra M, Dhaundiyal S, Nayak VS, Kamath V. Assessment of quality of life in patients with surgically treated maxillofacial fractures. F1000Res 2023; 12:483. [PMID: 38571567 PMCID: PMC10988203 DOI: 10.12688/f1000research.129579.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 04/05/2024] Open
Abstract
Background: The complex nature of maxillofacial injuries can affect the surgical treatment outcomes and general well-being of the patient. To evaluate the efficiency of the surgical treatment, assessment of the quality of life (QOL) of the patients is of vital importance. Due to the absence of an exclusive QOL assessment tool for maxillofacial fractures, we introduce the 'Twenty-point quality of life assessment in facial trauma patients in Indian population'. The aim of this study was to assess and evaluate the QOL following surgical management of maxillofacial trauma patients based on the severity of the injury. Methods: The study consisted of 182 subjects divided into two groups of 91 each (Group A: severe facial injury and Group B: mild to moderate facial injury). The Facial Injury Severity Scale (FISS) was used to determine the severity of facial fractures and injuries. The twenty-point quality of life assessment tool includes Zone 1 (Psychosocial impact) and Zone 2 (Functional and aesthetic impact), with ten domains each to assess QOL. Results: In Zone 1, the mean scores for Group A and Group B were 38.6 and 39.26, respectively. In Zone 2, Group B (44.56) had higher mean scores compared to Group A (32.92) (p< 0.001). Group B (83.8) had higher mean scores compared to Group A (71.58) when the total of both Zone 1 and Zone 2 were taken into consideration (p<0,001). In Group A, 9 out of 91 patients had a total score of 81- 100 compared to 68 in the same range in Group B. Conclusions: Proper surgical management with adequate care to the hard and soft tissues can improve the QOL by reducing postoperative psychosocial and functional complications. Aesthetic outcomes play an important role in determining the QOL. Mild/ Moderate injuries show better QOL compared to severe maxillofacial injuries.
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Affiliation(s)
- Sunil S Nayak
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education,, Manipal, Karnataka, 576104, India
| | - Srikant Gadicherla
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education,, Manipal, Karnataka, 576104, India
| | - Sreea Roy
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education,, Manipal, Karnataka, 576104, India
| | - Muskaan Chichra
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education,, Manipal, Karnataka, 576104, India
| | - Shriya Dhaundiyal
- Graduate Research Apprentice, Post grad, Northeastern university, Boston, USA
| | - Vanishri S Nayak
- Department of Anatomy, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Vinayak Kamath
- Department of Public Health Dentistry,, Goa Dental College and Hospital,, Bambolim, Goa, India
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Liu Y, Enin K, Sciegienka S, Hardi A, Spataro E. Intraoperative Computed Tomography Use in Orbital Fracture Repair: A Systematic Review and Meta-Analysis. Facial Plast Surg Aesthet Med 2023; 25:548-555. [PMID: 37782903 DOI: 10.1089/fpsam.2023.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Abstract
Background: Intraoperative computed tomography (CT) allows surgeons to make adjustments during orbital fracture repair that may impact postoperative outcomes. Learning/Study Objectives: To determine the impact of intraoperative CT use on intraoperative revision and surgical outcomes for orbital fracture repair. Methods: A systematic review was performed in concordance with the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines: the population was patients undergoing orbital fracture repair; intervention was use of intraoperative CT; comparison was patients not undergoing intraoperative CT; and outcomes were intraoperative revision rate, postoperative complications, and secondary revision surgeries. Meta-analysis was performed on the rate of intraoperative revision. Results: The search criteria yielded 790 articles, 377 were eligible for review, and 20 articles met criteria for analysis. In 19, intraoperative imaging led to immediate surgical corrections, with a random pooled effect size of 0.27 (0.20-0.35). Six studies reported secondary revision surgery rates (range 0-10.5%), and six studies reported postoperative complication rates (range 10-30%). Conclusions: Intraoperative imaging helps surgeons make precise, real-time adjustments in 27% of orbital fracture repair cases, which may improve surgical outcomes; however, more research is needed to investigate its impact on health care costs, operating time, and radiation exposure.
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Affiliation(s)
- Yupeng Liu
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kwasi Enin
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sebastian Sciegienka
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Angela Hardi
- Bernard Becker Medical Library, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Emily Spataro
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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Adetayo AM, Somoye MS, Fasesan OA, Oyedele AT, Adetayo MO. Factors Associated with Deterioration in Quality of Life of Subjects after Maxillofacial Fractures - A Prospective Study. Ann Maxillofac Surg 2023; 13:189-194. [PMID: 38405566 PMCID: PMC10883217 DOI: 10.4103/ams.ams_38_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/28/2023] [Accepted: 07/19/2023] [Indexed: 02/27/2024] Open
Abstract
Introduction Maxillofacial fractures (MFs) are quite common and are managed by oral and maxillofacial surgeons. Despite these interventions, a pre-traumatic facial profile is often not achieved with consequent social and psychologic consequences. Materials and Methods Patients with fractures to the middle and lower third of the face that presented within 48 hours and healthy controls (subjects without facial fracture) that were sex- and age-matched with the fracture patients were recruited into the study. World Health Organization Quality of Life - Brief Version (WHOQOL-BREF) questionnaire was used to compare the Quality of Life (QoL) values according to age, gender, educational status, employment status, marital status, site of trauma and type of fracture. Results Only the age of subjects was associated with deterioration in QoL after MF while other variables were not. Discussion Increasing age of the patients was associated with higher QoL possibly because those with age <30 years are single and unemployed and may have fear and anxiety that the fracture could affect their chances of getting married or being employed, causing reduced QoL. Psychosocial rehabilitation is very important in patients with MF, especially for the young age group.
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Affiliation(s)
- Adekunle Moses Adetayo
- Department of Surgery, Psychiatry Unit, Benjamin Carson (Snr) School of Medicine, Babcock University, Ogun State, Nigeria
| | - Mayowa Solomon Somoye
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - Oluwatoyin Adetutu Fasesan
- Department of Internal Medicine, Psychiatry Unit, Benjamin Carson (Snr) School of Medicine, Babcock University, Ogun State, Nigeria
| | - Ayodeji Titus Oyedele
- Department of Surgery, Psychiatry Unit, Benjamin Carson (Snr) School of Medicine, Babcock University, Ogun State, Nigeria
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Walshaw EG, Taylor R, Anderson J, Sexton P, Parmar JD, Carter LM. The psychological sequelae of maxillofacial trauma: a scoping review of the literature. Br J Oral Maxillofac Surg 2022; 60:1303-1320. [PMID: 36446645 DOI: 10.1016/j.bjoms.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/05/2022] [Indexed: 11/27/2022]
Abstract
Managing the physical sequelae of facial trauma is routine for the maxillofacial surgeon. However, managing the psychological consequences is more challenging. The often violent mechanism of injury, changes in appearance, altered self-perception, and self-confidence can significantly impact daily life. This review summarises the literature regarding post-traumatic stress disorder (PTSD) and facial trauma, highlighting evidence to guide clinical practice. PubMed and MEDLINE were searched for relevant keywords and MeSH headings. Articles between 2000-2022 were independently reviewed by two authors. Articles were excluded if the full text was not available in English, did not relate to facial trauma, or was not related to PTSD/psychological sequelae. A total of 211 articles were retrieved. The most common reasons for exclusion were papers not reporting psychological outcomes (n = 68) or not relating to facial trauma (n = 35). Articles were sub-categorised to enable evaluation of key themes. Categories included children and adolescents, cross sectional, longitudinal studies, and interventional studies. Whilst there were potential confounders such as socioeconomic factors, overall, patients who had experienced facial trauma (regardless of the mechanism of injury) had an increased risk of PTSD and anxiety/depression. PTSD following facial injury is increasingly recognised as an important issue. A robust evidence base is desirable to inform clinical practice and provide holistic care to often vulnerable patients. Identifying those at increased risk of negative psychological sequelae is essential. We have appraised the literature relevant to OMFS trauma clinicians.
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Affiliation(s)
- Emma G Walshaw
- University of Leeds, Worsley Building, University of Leeds, Woodhouse, Leeds LS2 9JT, United Kingdom.
| | - Richard Taylor
- University of Leeds, Worsley Building, University of Leeds, Woodhouse, Leeds LS2 9JT, United Kingdom.
| | - Jane Anderson
- University of Huddersfield, Queensgate, Huddersfield HD1 3DH, United Kingdom.
| | - Paul Sexton
- Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom.
| | - Jiten D Parmar
- Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom.
| | - Lachlan M Carter
- Leeds Teaching Hospitals Trust, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom.
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Lin Y, Lv W, Xu J, Jiang Y, Chen Z. Effectiveness of Cognitive Behavior Therapy Combined with Eye Movement Desensitization and Reprocessing on Psychological Problems and Life Quality in Patients' Postfacial Trauma. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7822847. [PMID: 36118833 PMCID: PMC9473919 DOI: 10.1155/2022/7822847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 11/22/2022]
Abstract
Objective To investigate the effectiveness of cognitive behavior therapy (CBT) combined with eye movement desensitization and reprocessing (EMDR) on the esteem, anxiety, depression, posttrauma stress disorder (PTSD), and posttraumatic growth in patients with facial trauma. Methods A total of 92 facial trauma patients in Wenzhou People's Hospital from January 2017 to December 2019 were enrolled in this study. The patients were randomly divided into control group (n = 46) and intervention group (n = 46). Both of the control group and the intervention group received routine treatment, while the intervention group further received CBT combined with EMDR. Questionnaires were used to explore and record the general patient information. The Self-Esteem Scale (SES), Self-Anxiety Scale (SAS), Self-Depression Scale (SDS), Posttraumatic Stress Disorder Checklist Civilian Version (PCL-C), Posttraumatic Growth Inventory (PTGI), and World Health Organization Quality of Life-brief (WHOQOL-BREF) scores between the two groups were compared. Results After CBT combined with EMDR intervention, the SDS and SAS scores in the intervention group were significantly decreased compared with the scores before intervention with statistically significance (P < 0.001). Furthermore, the PCL-C score in the intervention group showed significant decrease in comparison with the control group (P < 0.001), while the PTGI score in the intervention group was significantly higher than the control group (P < 0.001). The WHOQOL-BREF scores were increased after treatment in the two groups compared with the scores before treatment, and the scores in the intervention group were higher than those in the control group after treatment (P < 0.01). Conclusion Psychological intervention therapy can effectively alleviate the anxiety, depression, and PTSD and improve the life quality and the recovery of facial trauma patients.
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Affiliation(s)
- Yue Lin
- Department of Emergency, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, China
| | - Wang Lv
- Department of Emergency, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, China
| | - Jun Xu
- Department of Endoscopy Center, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, China
| | - Yingying Jiang
- Department of Emergency, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, China
| | - Zheyan Chen
- Department of Plastic Surgery, Wenzhou People's Hospital, Wenzhou, Zhejiang 325000, China
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Pauli N, Grinups M, Folkestad L, Gudnadottir G. Patient-Reported Symptoms after Midfacial Trauma. Surg J (N Y) 2022; 8:e22-e27. [PMID: 35059499 PMCID: PMC8763470 DOI: 10.1055/s-0041-1742174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background
The aim of this study was to assess patient-reported symptoms and health-related quality of life, 12 to 24 months after injury in patients with midfacial fractures.
Methods
Patients diagnosed with midfacial fractures were assessed regarding symptoms related to the fracture as well as assessment of the patients overall health-related quality of life using the Gothenburg Trismus Questionnaire (GTQ), the Folkestad facial trauma questionnaire, and EuroQol five-dimensional (EQ-5D). Questionnaires were distributed to the study patients 12 to 24 months after the trauma. Medical records were retrospectively surveyed for age, gender, trauma etiology, date of injury, fracture classification, treatment regimen, and time of surgery.
Results
Sixty-seven percent of the study group reports sensibility disturbance in the face 12 to 24 months after trauma and 52% reported cosmetic consequences related to the trauma. Numbness in the face was the symptom reported to be most disturbing for the patients. Few of the patients reported severe jaw-related problems, problems with muscular tension, or eating limitation according to the validated questionnaire GTQ.
Conclusion
Sensibility disturbance remains a significant and common symptom 12 to 24 months after midfacial trauma. There is a need for a validated patient-reported outcome instrument for facial trauma that covers multiple aspects of facial trauma such as vision disturbance and diplopia, jaw-related problems, and facial pain as well as sensibility disturbance and cosmetic consequences.
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Affiliation(s)
- Nina Pauli
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martina Grinups
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lena Folkestad
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunnhildur Gudnadottir
- Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
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Mishra P, Khan P, Salunkhe S, Pendyala S, Mathur M, Ummadisingh L, C. Tiwari R. Factors affecting quality of life in zygomatic fractures: An original research. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S242-S244. [PMID: 36110726 PMCID: PMC9469359 DOI: 10.4103/jpbs.jpbs_702_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 11/30/2021] [Accepted: 12/30/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction: Zygoma is one of the facial bones that are impacted in the accidents. Hence, we aim to evaluate the patient's profiles in the fracture associated with zygomatic bone. Materials and Methods: We conducted a prospective clinical study with 60 subjects who were divided equally into cases (30) and controls (30); controls were general population and the cases underwent surgery of zygomatic complex fracture. Health-related quality of life (HRQoL) was assessed by the means of the questionnaire. The values were compared for the significance keeping P < 0.05 as significant. Results: The preoperative 15D score was lesser for cases than controls. Soon after surgery, it was statistically least and after a month, the mean score surpassed the controls. Infraorbital sensory loss was seen even after 6 months. Conclusions: As expected, the HRQoL decreases only to improve after the surgery. However, the infra-orbital nerve sensory loss may continue for over 6 months after the zygomatic complex fracture.
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Somoye MS, Adetayo AM, Adeyemo WL, Ladeinde AL, Gbotolorun MO. A comparative study of quality of life of patients with maxillofacial fracture and healthy controls at two tertiary healthcare institutions. J Korean Assoc Oral Maxillofac Surg 2021; 47:351-359. [PMID: 34713809 PMCID: PMC8564083 DOI: 10.5125/jkaoms.2021.47.5.351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 11/07/2022] Open
Abstract
Objectives Despite treatment, the pre-traumatic facial appearance of patients with maxillofacial fractures might not be able to be restored, and this difference can affect the person's quality of life (QoL). This study was designed to evaluate changes in QoL of people with maxillofacial fractures. Materials and Methods The study population was comprised of participants with maxillofacial fracture and age- and sex-matched healthy controls without history of such fracture. QoL was measured using the World Health Organization Quality of Life BREF (WHOQOL-BREF) questionnaire, which was administered to the patients before treatment (Time 1), at 6 weeks post-treatment (Time 2), and at 12 weeks postoperatively (Time 3). The values were compared with those of healthy controls. The QoL was compared between closed reduction group and open reduction and internal fixation group. Results The QoL scores of people with maxillofacial fracture before treatment were significantly lower (P=0.001) than those of healthy controls in all domains of the WHOQOL-BREF. The QoL scores in the psychological and social domains of patients with maxillofacial fracture at Time 3 were still lower than those of healthy controls (P=0.001). Conclusion The QoL of patients with maxillofacial fracture was significantly reduced before treatment in all domains and remained reduced in both psychological and social domains weeks after treatment. Therefore, clinicians must be aware of and manage the residual psychosocial issues that can accompany the post-treatment period of maxillofacial injury.
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Affiliation(s)
- Mayowa Solomon Somoye
- Department of Oral & Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Nigeria
| | - Adekunle Moses Adetayo
- Department of Surgery, Benjamin Carson Snr School of Medicine, Babcock University, Ilisan-Remo, Nigeria
| | - Wasiu Lanre Adeyemo
- Department of Oral & Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Nigeria
| | - Akinola Ladipo Ladeinde
- Department of Oral & Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Nigeria
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Rajantie H, Kaukola L, Snäll J, Roine R, Sintonen H, Thorén H. Health-related quality of life in patients surgically treated for orbital blow-out fracture: a prospective study. Oral Maxillofac Surg 2020; 25:373-382. [PMID: 33280065 PMCID: PMC8352817 DOI: 10.1007/s10006-020-00923-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022]
Abstract
Purpose The purpose of this study was to evaluate patients’ health-related quality of life (HRQoL) before and after surgical treatment of orbital blow-out fracture. Methods This prospective study comprises of all adult patients undergoing a surgical reconstruction of an orbital blow-out fracture in 2006–2010. Their HRQoL was evaluated for 6 months postoperatively with the aid of the standardized 15D instrument and was compared with that of an age- and gender-standardized sample of the general Finnish population. A complementary questionnaire for more detailed information was also administered. Results Twenty-six patients completed the study. Mean 15D score among the patients preoperatively (0.898) was statistically significantly and clinically importantly worse than the score of the control population (0.936). Six months postoperatively, the mean 15D score was 0.920, with no significant difference compared with the control population and the significant differences on the different dimensions had disappeared. The most common complaint at 6 months postoperatively was diplopia in daily life (19%). Disturbances in facial sensation (27%) and defects in facial appearance (15%) were the most unpleasant subjective outcomes. Conclusion The HRQoL is significantly decreased after orbital blow-out fracture compared with the general population but will recover completely in 6 months. Thus, the negative impact of orbital blow-out fracture on HRQoL is only transient. Disturbances in facial sensation, defects in facial appearance, and diplopia are the most common subjective complaints after the injury and its surgical treatment. However, these do not appear to affect the overall quality of life in the long term. Supplementary Information The online version contains supplementary material available at 10.1007/s10006-020-00923-x.
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Affiliation(s)
- Hanna Rajantie
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Leena Kaukola
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Risto Roine
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
- Helsinki and Uusimaa Hospital District, Administration, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Hanna Thorén
- Department of Oral and Maxillofacial Surgery, University of Turku, Turku, Finland
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
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Tan PG, Soh CL. Quality of life assessments in maxillofacial trauma patients – A systematic review. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2020. [DOI: 10.1016/j.ajoms.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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The Quality of Life of Patients with Surgically Treated Mandibular Fractures and the Relationship of the Posttraumatic Pain and Trismus with the Postoperative Complications: A Prospective Study. ACTA ACUST UNITED AC 2019; 55:medicina55040109. [PMID: 30999698 PMCID: PMC6524021 DOI: 10.3390/medicina55040109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/12/2019] [Accepted: 04/12/2019] [Indexed: 11/17/2022]
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.
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Self-esteem following maxillofacial and orthopedic injuries: preliminary observations in sub-Saharan Africans. Oral Maxillofac Surg 2018; 23:71-76. [PMID: 30470958 DOI: 10.1007/s10006-018-0735-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 11/16/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND The face is a vital component of one's personality and body image while extremities are important in function (mobility, routine daily activities). Recovery and rehabilitation from acquired maxillofacial and orthopedic traumas are psychological in nature. METHODS This was a prospective study of recruited subjects in a Nigerian University teaching hospital. A total of 160 participants (80 with maxillofacial injuries and 80 with orthopedic injuries) had repeated review assessments within 1 week of arrival in the hospital (time 1), 4-8 weeks after initial contact (time 2), and 10-12 weeks thereafter (time 3), using Rosenberg's Self-Esteem Questionnaire. RESULTS Thirty-three (41.3%) participants in the maxillofacial injured and 12 (15.0%) in the orthopedic injured subjects scored between 0 and 14 at time 1. At time 2, 39 (51.3%) subjects in the maxillofacial fracture group and 20 (29.0%) in the orthopedic injured group scored between 0 and 14, while at time 3, 7 (9.2%) in the maxillofacial fracture group and 1 (1.5%) in the orthopedic injured group scored between 0 and 14. There was a statistical significant difference between the two groups when compared at times 1, 2, and 3 with p < 0.001, p = 0.006, and p = 0.041 respectively. Subjects with maxillofacial fracture consistently had lower self-esteem compared to subjects with orthopedic injured for times 1, 2, and 3. CONCLUSIONS Self-esteem may be reduced following maxillofacial injuries; therefore, measures should be taken by surgeons to minimize the risk of facial scarring by careful handling of tissues. Also, management of these injuries should integrate multidisciplinary care that will address psychological needs of patients. TRIAL REGISTRATION Not applicable.
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Gibson JAG, Ackling E, Bisson JI, Dobbs TD, Whitaker IS. The association of affective disorders and facial scarring: Systematic review and meta-analysis. J Affect Disord 2018; 239:1-10. [PMID: 29960147 DOI: 10.1016/j.jad.2018.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/29/2018] [Accepted: 06/04/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Facial scarring can have a dramatic effect on a patient's psychological health and wellbeing and present unique management challenges. This patient population remains poorly characterised in the contemporary literature. AIMS To evaluate the prevalence of, and risk factors associated with affective disorders in adult patients with facial scars. METHODS A systematic review was conducted using a protocol registered with PROSPERO and in line with the PRISMA statement. A comprehensive search of the literature was conducted using PubMed, MEDLINE, EMBASE, PSYCHInfo and The Cochrane Library. RESULTS Twenty one studies were included, with a total of 2,394 participants. Using a random effects model, the weighted pooled prevalence of anxiety was 26.1% (95% CI 17.9%-36.3%) and the weighted pooled prevalence of depression was 21.4% (95% CI 15.4%-29.0%). Studies identified female gender, past psychiatric history and violent causation as factors associated with anxiety and depression. LIMITATIONS Included studies were limited to those published in peer reviewed journals. Longitudinal trends in both anxiety and depression were limited by a short duration of follow up. CONCLUSIONS There is a high and persistent burden of affective disorders in patients with facial scars. Additional research is required to further characterise this population and develop effective management strategies.
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Affiliation(s)
- John A G Gibson
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science 2, Swansea University Medical School, Swansea, UK, SA2 8PP; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK, SA6 6NL.
| | - Edward Ackling
- School of Medicine, Cardiff University, Cardiff, UK, CF14 4XN
| | - Jonathan I Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK, CF14 4NX
| | - Thomas D Dobbs
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science 2, Swansea University Medical School, Swansea, UK, SA2 8PP; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK, SA6 6NL; School of Medicine, Cardiff University, Cardiff, UK, CF14 4XN
| | - Iain S Whitaker
- Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science 2, Swansea University Medical School, Swansea, UK, SA2 8PP; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK, SA6 6NL; School of Medicine, Cardiff University, Cardiff, UK, CF14 4XN
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Tetteh S, Bibb RJ, Martin SJ. Maxillofacial prostheses challenges in resource constrained regions. Disabil Rehabil 2017; 41:348-356. [PMID: 29065718 DOI: 10.1080/09638288.2017.1390697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study reviewed the current state of maxillofacial rehabilitation in resource-limited nations. METHOD A rigorous literature review was undertaken using several technical and clinical databases using a variety of key words pertinent to maxillofacial prosthetic rehabilitation and resource-limited areas. In addition, interviews were conducted with researchers, clinicians and prosthetists that had direct experience of volunteering or working in resource-limited countries. RESULTS Results from the review and interviews suggest rehabilitating patients in resource-limited countries remains challenging and efforts to improve the situation requires a multifactorial approach. CONCLUSIONS In conclusion, public health awareness programmes to reduce the causation of injuries and bespoke maxillofacial prosthetics training programmes to suit these countries, as opposed to attempting to replicate Western training programmes. It is also possible that usage of locally sourced and cheaper materials and the use of low-cost technologies could greatly improve maxillofacial rehabilitation efforts in these localities. Implications for Rehabilitation More information and support needs to be provided to maxillofacial defect/injuries patients and to their families or guardians in a culturally sensitive manner by governments. The health needs, economic and psychological needs of the patients need to be taken into account during the rehabilitation process by clinicians and healthcare organizations. The possibility of developing training programs to suit these resource limited countries and not necessarily follow conventional fabrication methods must be looked into further by educational entities.
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Affiliation(s)
- Sophia Tetteh
- a Loughborough Design School , Loughborough University , Loughborough , UK
| | - Richard J Bibb
- a Loughborough Design School , Loughborough University , Loughborough , UK
| | - Simon J Martin
- b Department of Materials , Loughborough University , Loughborough , UK
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Kaukola L, Snäll J, Roine R, Sintonen H, Thorén H. Health-related quality of life of patients with zygomatic fracture. Med Oral Patol Oral Cir Bucal 2017; 22:e636-e642. [PMID: 28809377 PMCID: PMC5694188 DOI: 10.4317/medoral.21914] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/13/2017] [Indexed: 11/23/2022] Open
Abstract
Background The objective was to evaluate health-related quality of life (HRQoL) before and after surgical treatment of zygomatic complex fracture and assess patients’ perceptions of the aesthetic and functional outcomes of surgery. Material and Methods A prospective study of 79 adult patients before and after surgery for zygomatic complex fracture was conducted. HRQoL was measured using the generic 15-dimensional (15D) instrument, and patient satisfaction was assessed by an additional questionnaire. Results The mean preoperative 15D score for patients was lower than for general population that was matched for age and gender (p=0.011). The mean 15D score was lowest on the first postoperative day (p<0.001) when patients were worse off for 6 of the 15 dimensions of the HRQoL instrument and better off for three dimensions. However, patients achieved, and even exceeded, the mean 15D score of the general population during the first month following surgery. Infraorbital sensory loss at the end of the six-month follow-up appeared to be the single most important factor that plagued the patients. Conclusions HRQoL is significantly reduced after trauma but improves a few weeks after surgery. Infraorbital nerve sensory loss is a notable long-term factor that affects patients after zygomatic complex fracture. Key words:Zygomatic fracture, maxillofacial trauma, health-related quality of life, disturbance of infraorbital nerve, facial sensation.
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Affiliation(s)
- L Kaukola
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, FI-00029 HUH, Finland,
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Krishnan B, Rajkumar RP. Psychological Consequences of Maxillofacial Trauma in the Indian Population: A Preliminary Study. Craniomaxillofac Trauma Reconstr 2017; 11:199-204. [PMID: 30087749 DOI: 10.1055/s-0037-1604426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 04/02/2017] [Indexed: 02/06/2023] Open
Abstract
The aim of this article is to identify the prevalence of posttraumatic psychological symptoms following maxillofacial trauma among an Indian population sample and assess changes in these symptoms over a period of time. Forty-eight adult patients were assessed within 2 weeks of injury with two follow-up visits (4-6 weeks and 12-14 weeks). Patients were administered three self-reporting questionnaires in local language (GHQ-12; HADS; TSQ) on all occasions. Relevant sociodemographic and clinical data were obtained. Forty patients were included in the final analysis. Emotional distress was present in nine participants and five participants satisfied the TSQ criteria for a diagnosis of stress disorder. Anxiety and depression were observed in 10 and 4 patients, respectively. Characteristics associated with abnormal high scores included substance abuse, low education and income levels, facial scars, and complications needing additional intervention. These findings reveal the abnormal psychological response to maxillofacial trauma in immediate and follow-up periods. The use of such screening tools can be considered by the maxillofacial surgeon for early identification of psychological symptoms and referral to the psychiatrist.
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Affiliation(s)
- Balasubramanian Krishnan
- Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Pondicherry, India
| | - Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Pondicherry, India
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Gandjalikhan-Nassab SAH, Samieirad S, Vakil-Zadeh M, Habib-Aghahi R, Alsadat-Hashemipour M. Depression and anxiety disorders in a sample of facial trauma: A study from Iran. Med Oral Patol Oral Cir Bucal 2016; 21:e477-82. [PMID: 26946207 PMCID: PMC4920462 DOI: 10.4317/medoral.21068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 11/24/2015] [Indexed: 11/15/2022] Open
Abstract
Background Various studies have shown that such patients are susceptible to psychological problems and poor quality of life. The aim of the present study was to evaluate and compare the prevalence of depression and anxiety disorders and quality of life in a group of facial trauma. Material and Methods In the present cross-sectional study Hospital Anxiety and Depression Scale (HADS) and Oral Health Impact (OHIP-14) questionnaires were used. In this study, fifty subjects were selected from the patients with maxillofacial traumas based on the judgment of the physicians, referring to hospitals in Kerman and Rafsanjan during 2012-2013. In addition, 50 patients referring to the Dental School for tooth extraction, with no maxillofacial traumas, were included. SPSS 13.5 was used for statistical analysis with two-sample t-test, Mantel-Haenszel technique, Pearson’s correlation coefficient and chi-squared test. Results Seven patients with maxillofacial traumas were depressed based on HADS depression scale, with 5 other borderline cases. However, patients referring for surgery or tooth extraction only 2 were depressed and 1 patient was a borderline case. The results showed that patients with maxillofacial traumas had higher rates of depression and anxiety, with significant differences between this group and the other group (P=0.01). The results of the present study showed a significant prelateship between depression severity and confounding factors. The mean of OHIP-14 parameters were 35.51 ±5.2 and 22.3±2.4 in facial trauma and dental surgery groups, respectively, with statistically significant differences (P=0.01). Conclusions The results of the present study showed depression and anxiety disorders in patients with maxillofacial trauma. The results showed a higher rate of anxiety and anxiety in patients with maxillofacial traumas compared to the control group. Key words:Depression, facial trauma, HADS, OHIP-14, questionnaire.
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Affiliation(s)
- S-A-H Gandjalikhan-Nassab
- Department of Oral Medicine, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran,
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Cillo JE, Holmes TM. Interpersonal Violence Is Associated With Increased Severity of Geriatric Facial Trauma. J Oral Maxillofac Surg 2016; 74:1023.e1-7. [PMID: 26850874 DOI: 10.1016/j.joms.2016.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 01/04/2016] [Accepted: 01/04/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE 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. METHODS This was a cross-sectional analysis of secondary data of geriatric (individuals aged ≥65 years) 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. RESULTS The sample was composed of 229 patients with a mean age of 72.3 ± 4.5 years. 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). CONCLUSIONS Interpersonal violence (assault) is associated with increased severity of geriatric facial trauma compared with other risk factors.
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Affiliation(s)
- Joseph E Cillo
- Assistant Professor and Program Director, Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA.
| | - Talmage M Holmes
- Faculty, College of Health Sciences, Walden University, Minneapolis, MN
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IMF-screws or arch bars as conservative treatment for mandibular condyle fractures: Quality of life aspects. J Craniomaxillofac Surg 2015; 43:1004-9. [DOI: 10.1016/j.jcms.2015.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 04/05/2015] [Accepted: 05/19/2015] [Indexed: 11/24/2022] Open
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Prospective study of the quality of life after treatment of mandibular fractures. Br J Oral Maxillofac Surg 2015; 53:342-6. [DOI: 10.1016/j.bjoms.2015.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 01/14/2015] [Indexed: 11/21/2022]
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Kaukola L, Snäll J, Lindqvist C, Roine R, Sintonen H, Törnwall J, Thorén H. Health-related quality of life after surgical treatment of mandibular fracture. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:402-7. [DOI: 10.1016/j.oooo.2014.11.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 11/17/2014] [Indexed: 11/16/2022]
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Kommers SC, van den Bergh B, Forouzanfar T. Quality of life after open versus closed treatment for mandibular condyle fractures: A review of literature. J Craniomaxillofac Surg 2013; 41:e221-5. [DOI: 10.1016/j.jcms.2013.01.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 12/19/2012] [Accepted: 01/09/2013] [Indexed: 10/27/2022] Open
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A summary of trauma and trauma-related papers published in BJOMS during 2008-2009. Br J Oral Maxillofac Surg 2010; 48:455-8. [PMID: 20727461 DOI: 10.1016/j.bjoms.2010.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Accepted: 05/13/2010] [Indexed: 11/20/2022]
Abstract
This paper provides a summary of the 49 trauma and related papers published in British Journal of Oral and Maxillofacial Surgery during the period January 2008 to December 2009. 16/49 (32%) of these publications were full length articles, which covered areas such as epidemiology, service provision, materials and operative surgery. In addition there were other articles including short communications, technical notes, letters to the editor and interesting cases. Whilst fewer full length articles were published compared to the other sub-specialties, it was reassuring to see that the studies represent all aspects of trauma. More basic science and randomized control studies relating to trauma need to be encouraged.
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