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Turino FD, Jural LA, da Silva LLA, Magno MB, Maia LC, Risso PA. World trends in publication for maxillofacial and dental trauma in the elderly. Dent Traumatol 2024; 40:333-344. [PMID: 38124460 DOI: 10.1111/edt.12917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/11/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
Aging may increase the risk of maxillofacial and dentoalveolar trauma (MDT). This review assessed global trends in scientific publications on MDT in the elderly. Six databases were searched. Studies about MDT in the elderly (≥60 years old) were included in two text mining stages (S1 and S2). In S1, all studies with elderly subjects were included, while in S2 only studies in which the elderly were assessed in a separate set of data or in a subanalysis by age groups were included. In S1, relevant data were mined using VantagePoint™ software. In S2, data were descriptively analyzed. There were 2265 studies at S1 and 110 at S2. The publication dates spanned from 1963 to 2023. In S1, the most cited keywords and terms were aged (n = 1872), male (n = 1839), female (n = 1777), "mandible fracture" (n = 460), "orbit fracture" (n = 362), and "maxilla fracture" (n = 118). Thirty authors published 10 or more articles with visible collaboration networks. There was a progressive increase in publications, especially in Europe (n = 150). In S2, most studies were case reports/case series (n = 62). The primary etiology was accidental falls (n = 84), the most affected region was the middle third of the face (n = 65), and dental trauma was rarely reported (n = 15). Cone Beam computed tomography was the most used diagnostic tool (n = 67). Of the 81 articles that addressed therapy, 52 opted for surgical treatment. Although there has been an increase in the number of articles on MDT over the years, studies with the elderly population as a specific study group are still needed. Accidental falls were the most reported etiology, while the middle third of the face and the mandible were the anatomic region and bone most affected, respectively. The high number of case reports indicates the need for improvement in the available scientific evidence about MDT in the elderly.
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Affiliation(s)
- Fabiana Dantas Turino
- Department of Dental Clinic, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucas Alves Jural
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leticia Lopes A da Silva
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luciane Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Patrícia A Risso
- Department of Dental Clinic, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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2
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Zhang ZX, Xie L, Li Z. Global, regional, and national burdens of facial fractures: a systematic analysis of the global burden of Disease 2019. BMC Oral Health 2024; 24:282. [PMID: 38418992 PMCID: PMC10900718 DOI: 10.1186/s12903-024-04048-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The incidence of facial fractures has undergone tremendous changes in recent years as a result of socio-economic development and aging populations. Currently, there is a lack of updated and comprehensive analyses of global trends and causes of facial fractures. The Global Burden of Disease (GBD) database is a product of a global research organization used to quantify the global impact of hundreds of diseases, injuries, and risk factors. The aim of this study was to update global burden of facial fractures from 1990 to 2019 by using the GBD2019. MATERIALS AND METHODS The present study extracted the global incidence, prevalence, and years lived with disability (YLDs) for facial fractures, as well as the age-standardized rates (ASRs) of these variables using the Global Burden of Disease (GBD) 2019 database. The estimated annual percentage change (EAPC) was used to assess the trends of ASRs. RESULTS Between 1990 and 2019, the incidence of facial fractures increased from 8,943,707 to 10,676,340, but the age-standardized incidence rate (ASIR) decreased from 161.5 to 138.8 per 100,000. Prevalence and YLDs exhibited the same trend as incidence. Over the 30 years, the incidence of facial fractures was consistently greater in males than in females. However, females aged ˃ 75 years had higher fracture incidence rates than males aged ˃ 75 years in 2019. The leading cause of facial fractures was falls, and both the age-standardized prevalence rate (ASPR) and age-standardized years lived with disability rate (ASYR) of falls increased with age. CONCLUSION Facial fractures still represent a significant burden to the world. Incidence, prevalence and YLDs all showed increasing trends, while ASRs decreased gradually from 1990 to 2019. Enhancing the quality of facial fractures data is helpful for monitoring the burden of facial fractures.
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Affiliation(s)
- Ze-Xing Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430072, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
| | - Long Xie
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430072, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
| | - Zhi Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430072, China.
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.
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Sommacal A, Bingisser R, Filippi A, Bethke M, Thieringer FM, Jaquiéry C, Berg BI. Dental and Maxillofacial Emergency Algorithms in Swiss Emergency Departments. J Clin Med 2023; 12:jcm12082952. [PMID: 37109288 PMCID: PMC10144593 DOI: 10.3390/jcm12082952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/28/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to evaluate the availability and use of dental and maxillofacial emergency algorithms in Swiss hospitals. A survey was performed among physicians at Swiss emergency departments (ED) and participants of the "36th Annual Meeting of the Society for Oral and Cranio-Maxillofacial Surgery". Eighty-nine EDs in Switzerland were questioned about the availability and use of electronic algorithms in their hospitals. Eighty-one (91%) participated in the study. In 75 (93%) of the EDs, electronic algorithms are used, mainly "medStandards". Six have no available algorithms. Fifty-two (64%) use algorithms daily. Eight (10%) Swiss EDs have maxillofacial and dental algorithms, and 73 (90%) have no access to or do not know about them. For dental algorithms, 28 (38%) of the respondents would like to have access, and 16 (22%) do not desire access. For maxillofacial algorithms, 23 (32%) want to have access and 21 (29%) do not want it. Most (74%) of the participating maxillofacial surgeons did not know about the existence of ED algorithms regarding their specialty. Our study shows that the existence of specific algorithms is often not known. Furthermore, there is a demand for dental and maxillofacial algorithms in Swiss EDs.
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Affiliation(s)
- Adelita Sommacal
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
| | - Roland Bingisser
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
- Emergency Department, University Hospital Basel, 4031 Basel, Switzerland
| | - Andreas Filippi
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
- Clinic of Oral Surgery and Center of Dental Traumatology, University Center for Dental Medicine UZB, University of Basel, 4058 Basel, Switzerland
| | - Mascha Bethke
- Emergency Department, University Hospital Basel, 4031 Basel, Switzerland
| | - Florian M Thieringer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
- Swiss MAM Research Group, Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland
| | - Claude Jaquiéry
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
| | - Britt-Isabelle Berg
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland
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Costantinides F, Tonizzo M, Dotto F, Lenhardt M, Borella A, Sclabas M, Rizzo R, Maglione M. Epidemiological aspects of dental trauma associated with maxillofacial injures: Ten years of clinical experience in Trieste, Italy. Dent Traumatol 2023. [PMID: 36872847 DOI: 10.1111/edt.12835] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND/AIMS The prevalence of dental injuries in patients with facial fractures is relevant. Epidemiologically, dental trauma in association with facial fractures generally affects the age group between 20 and 40 years old, with a higher prevalence in males. The aim of this retrospective study was to identify the incidence and etiology of dental trauma associated with facial fractures over a 10-year period. METHODS From January 2009 to April 2019, among 381 patients with facial fractures, 353 were included in this study. Age, gender, trauma etiology, injured teeth and dental treatment were investigated. RESULTS From 353 patients, with a mean age of 49.7 ± 19.9 years, 247 (70%) were males and 106 (30%) were females. Accidental falls were the most common type of injury (n = 118, 33.4%), followed by road accidents (n = 90, 25.5%), assaults (n = 60, 17%) and sports trauma (n = 37, 10.5%). Fifty-five subjects (15.60%) had dental injuries associated with facial fractures. Of the 145 teeth involved, 48 (33.1%) were diagnosed with luxation, 22 teeth (15.2%) were avulsed, 11 teeth (7.5%) suffered a concussion and there were 10 (6.8%) alveolar wall fractures.Uncomplicated enamel-dentin fracture was the more frequent hard tissue injury (n = 21, 14.5%), followed by complicated crown-root fracture (n = 10, 6.9%), infraction (n = 8, 5.5%), enamel fracture (n = 3, 2%) and complicated enamel-dentin fracture (n = 3, 2%). There was a peak in incidence between 21 and 40 years (42%). Males had a significantly higher risk of facial fractures with dental injury (75%). Maxillary incisors and canines (62.8%) were the most affected teeth. CONCLUSIONS There was a high prevalence of dental injuries associated with facial fractures. Maxillary incisors were the most injured teeth, with a higher prevalence in males.
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Affiliation(s)
- Fulvia Costantinides
- School of Specialization in Oral Surgery, University of Trieste, Trieste, Italy.,Department of Maxillofacial Surgery and Stomatology, "Maggiore" University Hospital of Trieste, Trieste, Italy
| | - Matteo Tonizzo
- School of Specialization in Oral Surgery, University of Trieste, Trieste, Italy
| | - Federica Dotto
- School of Specialization in Oral Surgery, University of Trieste, Trieste, Italy
| | | | - Alberto Borella
- School of Specialization in Oral Surgery, University of Trieste, Trieste, Italy
| | | | - Roberto Rizzo
- School of Specialization in Oral Surgery, University of Trieste, Trieste, Italy.,Department of Maxillofacial Surgery and Stomatology, "Maggiore" University Hospital of Trieste, Trieste, Italy
| | - Michele Maglione
- School of Specialization in Oral Surgery, University of Trieste, Trieste, Italy.,Department of Maxillofacial Surgery and Stomatology, "Maggiore" University Hospital of Trieste, Trieste, Italy
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Analysis of Pediatric Maxillofacial Fractures: A 10-year Retrospective Study. J Craniofac Surg 2023; 34:448-453. [PMID: 36441830 DOI: 10.1097/scs.0000000000008846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/10/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The aim of this study is to analyze patterns of maxillofacial fractures in children and adolescent in southeast of China,in a period of 10 years. MATERIAL AND METHODS In this retrospective study, the medical records of 162 hospitalized patients under 18 years old were analyzed in the Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Wenzhou Medical University, China. Age, gender, etiology, site, and type of fracture, monthly distribution, weekly distribution, dental complications, and treatment were evaluated. The cases were divided into 3 age groups: group A: 0 to 6 years, group B: 7 to 12 years, and group C: 13 to 18 years. RESULTS Three hundred thirty-four maxillofacial fractures in 162 patients younger than 18 years were analyzed. The male to female ratio was 2.24:1 and mean age of these patients was 9.85 years old . Falls were the leading cause of maxillofacial fractures.The most frequent fracture site was mandible. Most patients with maxillofacial fractures were treated by open reduction. And it was done more in adolescents than in children. CONCLUSIONS Falls were the main reason for maxillofacial fracutres in childern, and traffic accidents was the leading cause in adolescent. Preventive measures should be applied to reduce occurrences of pediatric facial fractures .Children can not be left at home alone, and monitoring is very necessary when children play in the high place. The government can consider related e-bike driving skills training. Teenagers must pass the relevant electric vehicle test before they can drive. Make the law that the driver of e-bike must wear a safety helmet. Our study shows that open reduction was a good choice for pediatric facial fractures, but usually conservative treatment is a better choice for condylar fractures.
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Xu X, Zhu F, Yang C, Xu B, Yuan Z, Zhang W, Shi J. OCCS Classification and Treatment Algorithm for Comminuted Mandibular Fractures Based on 109 Patients and 11 Years Experiences: A Retrospective Study. J Clin Med 2022; 11:6301. [PMID: 36362540 PMCID: PMC9657356 DOI: 10.3390/jcm11216301] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 11/15/2023] Open
Abstract
Comminuted mandibular fractures (CMFs) pose significant challenges to surgeons for their serious complications and poor outcomes. We aimed at proposing a classification with treatment algorithm of each category for CMFs. Patients with CMFs were retrospectively reviewed and classified into five categories: Type I: relatively good occlusion, no or slightly displaced fragments, no continuity destruction or bone defect; Type II: relatively good occlusion, damaged morphology, low comminution degree but intact continuity without bone defect; Type III: damaged morphology and higher comminution degree with intact continuity and relatively good occlusion; Type IV: high comminution, impaired continuity and poor occlusion without segmental bone defect; Type V: segmental bone defect. Conservative treatment, open reduction and internal fixation or microvascular osteocutaneous free flap transplantation was performed, accordingly. Demographics, perioperative data, complications and reasons for reoperations were recorded. The chi-square test was used for statistical analysis. In total, 109 patients were included in the study. After surgery, in the following group, 5 manifested infections, 1 manifested bone non-union, and 2 experienced reoperations, while in the unfollowing group, 10 manifested infections, 5 manifested bone non-union and 8 experienced reoperations. The OCCS classification and algorithm for CMFs achieve better outcomes and with lower complication rate.
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Affiliation(s)
- Xiaofeng Xu
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, Shanghai 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
- Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Fangxing Zhu
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, Shanghai 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
- Shanghai Research Institute of Stomatology, Shanghai 200011, China
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Chengshuai Yang
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, Shanghai 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
- Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Bing Xu
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
- Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Zhaoqi Yuan
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- Shanghai Key Lab of Tissue Engineering, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Wenbin Zhang
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, Shanghai 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
- Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Jun Shi
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, Shanghai 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
- Shanghai Research Institute of Stomatology, Shanghai 200011, China
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Abstract
A dentoalveolar fracture requires thorough clinical and radiographic examination for an accurate diagnosis to guide appropriate treatment. Dentoalveolar fractures can be classified into the following 4 groups: (1) crown/root fractures, (2) luxation/displacement of teeth, (3) avulsion, and (4) alveolar fractures. Treatment can be divided into nonrigid fixation (splinting with wires and composite) and/or rigid fixation (Erich arch bars, Risdon cable wires) depending on the extent of dentoalveolar fractures. Special considerations must be made for primary teeth and mixed dentition to avoid injuring tooth buds and arising permanent dentition.
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Affiliation(s)
- Jungsuk Cho
- Temple University School of Dentistry, 3223 North Broad Street, Philadelphia, PA 19140, USA
| | - Alex Sachs
- University of Pittsburgh Department of Oral and Maxillofacial Surgery, School of Dental Medicine, 3501 Terrace Street, G-32 Salk Hall, Pittsburgh, PA 15261, USA
| | - Larry L Cunningham
- University of Pittsburgh Department of Oral and Maxillofacial Surgery, School of Dental Medicine, 3501 Terrace Street, G-32 Salk Hall, Pittsburgh, PA 15261, USA.
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Hino S, Iizuka T, Saulacic N, Lang NP, Burkhard JPM. No apparent association between dental implants and mandibular fractures resulting from external forces. Clin Oral Investig 2021; 26:2065-2072. [PMID: 34559318 DOI: 10.1007/s00784-021-04188-w] [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: 06/29/2021] [Accepted: 09/18/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Dental implants are cylindrical metallic screws inserted into the jawbone to replace missing teeth. Their location may affect the pattern of fractures that occur as a result of the traumatic forces to the mandible. The aim of this study was to investigate possible influences of dental implants on the patterns of mandibular fractures triggered by external forces. MATERIAL AND METHODS In this observational cross-sectional study, a total of 390 patients with mandibular fractures diagnosed between February 2016 and December 2020 were examined and the presence or absence of dental implants in the fracture gap was noted. Clinical and radiological data were analyzed in relation to the fracture line, the dental status, and the location of any implants. RESULTS A total of 16 patients (4.1%) had previously placed dental implants in the mandible. Various fracture patterns were observed. Some yielded typical fracture lines located in the anatomically weak areas along the roots of the incisors, the mental foramina, and long-rooted molars. Occasionally, fracture lines were detected in combination with condylar fractures. Dental implants were not directly involved in any fracture line, except one. In that case, the fracture line extended from the alveolar process straight along the implant body, mimicking initial disintegration of the implant, with erosion of the surrounding bone. CONCLUSIONS Once dental implants have osseointegrated, mandibular fractures are rarely projected along the implant surface. CLINICAL RELEVANCE This observational retrospective cross-sectional study failed to associate mandibular fracture lines with the presence of dental implants.
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Affiliation(s)
- Shunsuke Hino
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland. .,Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama , 350-8550 , Japan.
| | - Tateyuki Iizuka
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Niklaus P Lang
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - John-Patrik M Burkhard
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
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Hino S, Yamada M, Araki R, Kaneko T, Iizuka T, Horie N. What Are Possible Contributors to Associated Dental Injury in Mandibular Fractures? J Oral Maxillofac Surg 2021; 80:127-136. [PMID: 34627743 DOI: 10.1016/j.joms.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/30/2021] [Accepted: 09/03/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE Among previous reports on dental injuries associated with mandibular fractures, there are few investigating the conditions under which dental injuries commonly occur. The aim of this study was to determine specific characteristics of mandibular fractures accompanied by dental injuries. METHODS This retrospective cohort study included dentate patients with mandibular fractures treated at a tertiary trauma center between 2011 and 2019. The data were analyzed according to 2 outcome variables: patients with additional dental injuries and patients without. The predictor variables were patient age, sex, accident mechanism, number and location of mandibular fractures, and presence of submental lacerations. Odds ratios for the risk factors for dental injury were calculated in conjunction with descriptive statistics. Binary logistic regression analysis was also performed to identify the factors associated with dental injuries as dependent variables. RESULTS Of 252 patients who had only mandibular fractures, 95 (37.7%) had associated dental injuries. In the group with dental injuries, 55.8% of mandibular fractures were caused by a fall (P = .003). Condyle fractures (77.9%) with dislocation (67.6%) and bilateral involvement (41.9%) were more common than in the group without dental injuries (P < .001). In patients with dental injuries, the incidence of 3 or more fractures (29.5%) was significantly higher than in the group without dental injuries. Dental injuries were more likely to occur in patients with concomitant submental lacerations (confidence interval (CI) 1.135-4.983, P = .02), and the risk of dental injury was significantly lower in the presence of angle fractures (CI 0.113-0.999, P = .045). CONCLUSIONS A frontal impact involving the anterior part of the mandible is often associated with condyle and multiple mandibular fractures. This seems to be the typical mechanism for concomitant dental injuries. Submental laceration can be considered a prime sign of associated dental injuries.
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Affiliation(s)
- Shunsuke Hino
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan; Clinical and Scientific Fellow, Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Miki Yamada
- Instructor, Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Ryuichiro Araki
- Adjunct Assistant Professor, Medical Education Center, Saitama Medical University, Saitama, Japan
| | - Takahiro Kaneko
- Professor and Chair, Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Tateyuki Iizuka
- Professor and Chair, Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Norio Horie
- Professor, Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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10
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Kannari L, Marttila E, Thorén H, Snäll J. Dental injuries in paediatric mandibular fracture patients. Oral Maxillofac Surg 2021; 26:99-104. [PMID: 33913044 PMCID: PMC8843920 DOI: 10.1007/s10006-021-00966-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/18/2021] [Indexed: 11/28/2022]
Abstract
Purpose Dental injuries (DIs) are associated with facial fractures, particularly mandibular fractures. As paediatric mandibular fractures have special features, we sought to clarify the occurrence and types of DIs among this patient group. We assessed how age, injury type, and fracture location affects the occurrence of DIs and thereby defined which patients are most susceptible. Methods This retrospective study included patients < 18 years with a recent mandibular fracture. Predictor variables were gender, age group, mechanism of injury, type of mandibular fracture, and other associated facial fracture(s). Types and locations of DIs and tooth loss due to injury were also reported. Results DIs were detected in 34.7% (n = 41) out of 118 patients. Patients with tooth injury had on average 3.5 injured teeth. A total of 16.2% of injured teeth were lost, typically at the time of the injury. Loss of at least one tooth was seen in approximately 10% of patients. Avulsion was the most common cause of tooth loss (52.2%). Non-complicated crown fracture (50.7%) was the most common DI type. Statistically significant associations between studied variables and DIs were not detected. Conclusion DIs are common and often multiple in paediatric mandibular fracture patients regardless of background factors. DIs often lead to tooth loss. Prompt replantation of an avulsed tooth, early detection of DIs, and prevention of tooth loss whenever possible are important to avoid permanent tooth defects.
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Affiliation(s)
- Leena Kannari
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00029, Helsinki, Finland.
| | - Emilia Marttila
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00029, Helsinki, Finland
| | - Hanna Thorén
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Turku, Finland.,Department of Oral and Maxillofacial Diseases, Turku University Hospital, Turku, Finland
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00029, Helsinki, Finland
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Døving M, Galteland P, Eken T, Sehic A, Utheim TP, Skaga NO, Helseth E, Ramm-Pettersen J. Dentoalveolar injuries, bicycling accidents and helmet use in patients referred to a Norwegian Trauma Centre: A 12-year prospective study. Dent Traumatol 2020; 37:240-246. [PMID: 33220164 DOI: 10.1111/edt.12627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM Despite its many benefits, bicycling carries the risk of accidents. Although numerous studies have reported the effect of helmet use on traumatic brain injury, it remains unclear if, and to what extent, helmet use reduces the risk of facial injuries. This is particularly true in regard to injuries of the lower face. In addition, there is limited evidence of the effect of helmet use on dentoalveolar injuries. Thus, the aim of this study was to determine the frequency and distribution of dentoalveolar injuries in bicycling accidents and to explore the influence of helmet use. MATERIAL AND METHODS A total of 1543 bicyclists were included from the trauma registry of a Norwegian tertiary trauma center over a 12-year period. Data were collected prospectively, including patient characteristics, type of injury, and helmet use. The prevalence of dentoalveolar injuries was assessed in conjunction with helmet use and facial fractures. RESULTS Twenty-five percent of the patients had maxillofacial injuries, and 18% of those with facial fractures exhibited concomitant dentoalveolar injuries. The most common type of dentoalveolar injury was tooth fracture (39%). The most frequent location of facial fractures with combined dentoalveolar injuries was the maxilla, which had fractured in 32 patients. Women had a higher risk of sustaining dentoalveolar injuries compared to men (odds ratio 1.50, 95% confidence interval 1.02-2.22). There were 1257 patients (81%) who had reliable registration of helmet use; 54% of these wore a helmet, while 46% did not. Helmet users had an increased risk of dentoalveolar injuries compared to non-helmeted bicyclists (adjusted odds ratio 1.54, 95% confidence interval 1.02-2.31). CONCLUSIONS Dentoalveolar injuries are fairly common in trauma patients admitted to a trauma center following bicycling accidents. Bicycling helmets are associated with an increased risk of dentoalveolar injuries.
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Affiliation(s)
- Mats Døving
- Department of Maxillofacial Surgery, Oslo University Hospital Ullevål, Oslo, Norway
| | - Pål Galteland
- Department of Maxillofacial Surgery, Oslo University Hospital Ullevål, Oslo, Norway
| | - Torsten Eken
- Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital Ullevål, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Amer Sehic
- Department of Maxillofacial Surgery, Oslo University Hospital Ullevål, Oslo, Norway.,Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Tor Paaske Utheim
- Department of Maxillofacial Surgery, Oslo University Hospital Ullevål, Oslo, Norway.,Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Nils Oddvar Skaga
- Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital Ullevål, Oslo, Norway
| | - Eirik Helseth
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Neurosurgery, Oslo University Hospital Ullevål, Oslo, Norway
| | - Jon Ramm-Pettersen
- Department of Neurosurgery, Oslo University Hospital Ullevål, Oslo, Norway
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Injury Prevention, Safety Education and Violence in Relation to the Risk of Tooth Fracture among Korean Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228556. [PMID: 33218100 PMCID: PMC7698954 DOI: 10.3390/ijerph17228556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 12/20/2022]
Abstract
This study aimed to determine the injury prevention-, safety education-, and violence-related factors pertaining to tooth fracture experience (TFE) in Korean adolescents. We used data from the 14th Korea Youth Risk Behavior Survey (KYRBS) in 2018. The 60,040 participants were selected using a complex sampling design from middle and high schools. The participants completed a self-administered questionnaire. The explanatory variables, including school safety education and violence, were assessed in relation to prevention of traumatic injuries. Complex-samples multivariable logistic regression models were applied to explain the factors related to TFE over the past 12 months. The overall prevalence of TFE was 11.4%. Risk factors related to tooth fractures were not wearing a seatbelt on an express bus, not wearing helmets while riding motorcycles and bicycles, clinical treatment due to injuries at school, injuries associated with earphone/smartphones use, and lack of school safety education such as danger evacuation training. The top risk factor was injuries associated with earphone/smartphone usage, followed by lack of familiarity with school safety education. Thus, to prevent tooth fractures among adolescents, schools should strengthen their safety education, including education regarding mobile device usage, and wearing a seatbelt and wearing a helmet. Care should be taken to manage facilities around the school and to prevent injury related to tooth fracture. Further studies on various risk factors related to tooth fractures are warranted.
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Dentoalveolar Fractures: New Orthodontic Protocol Proposal and Pilot Study. J Craniofac Surg 2020; 31:e755-e760. [PMID: 33136902 DOI: 10.1097/scs.0000000000006682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The goal of fracture treatment that includes the dentoalveolar process is to obtain the anatomic bone healing and the pre-injury occlusion restoration with functional and aesthetic recovery, avoiding dental or periodontal lesions. Fractures activates, in the damaged tissue, the Regional Acceleratory Phenomenon, a physiological healing process that can also be activated during orthodontic overloads. Orthodontic treatment in the traumatized area could exploit this phenomenon in order to sustain the cellular activity.The aim of this study is to propose a treatment protocol for dentoalveolar fractures based on the use of orthodontics in order to sustain the physiological healing process known as Regional Acceleratory Phenomenon.The authors present 2 cases of an 18 year old woman and 23 year old man affected by dentoalveolar fracture. The operative protocol the authors applied foresaw three steps of treatment: orthodontic brackets application, surgery, orthodontic treatment.The patients showed complete healing at the 3 months follow-up and were treated up to 18 months for further orthodontic treatment.The operative protocol proposed by the Authors appears to be a rational choice since it allows a single orthodontic device to be an "active splinting system", with fast application time, good acceptance by the patient, low complications rate; moreover, it produces any planned dental movements for further orthodontic treatments.
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Kim HN, Kwon YB, Jun EJ, Kim JB. Health-Risk Behavior-, Mental Health-, and Physical Exercise-Related Risk Factors for Tooth Fractures in Korean Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217815. [PMID: 33114513 PMCID: PMC7662374 DOI: 10.3390/ijerph17217815] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/13/2020] [Accepted: 10/21/2020] [Indexed: 12/25/2022]
Abstract
We aimed to determine factors related to tooth fracture experience in Korean adolescents. This study used data from the 14th Korea Youth Risk Behavior Survey in 2018, a cross-sectional web-based survey of health-risk behaviors among a representative sample of Korean middle- and high-school students aged 12–17 years. A total of 60,040 participants were selected using a complex sampling design of the survey from 400 middle schools and 400 high schools. They answered a self-administered questionnaire survey in classrooms. Explanatory variables included those pertaining to health-risk behaviors, mental health, and physical exercise. Complex-sample multivariable logistic regression models were applied to identify factors related to tooth fracture experience in the past 12 months. The overall prevalence of dental fracture experience was 11.4%. Risk factors related to tooth fractures in Korean adolescents were unhealthy behaviors such as alcohol and tobacco consumption; mental health problems including stress, depression, and suicidal ideation; and intensive physical exercise. The major risk factor related to tooth fractures was depression. To prevent tooth fractures among adolescents, schools should strengthen mental health education, encourage mouthguard use during intensive physical exercise, and develop school environments to prevent orofacial injuries. Further studies on various risk factors related to tooth fractures are warranted.
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Affiliation(s)
- Han-Na Kim
- Department of Dental Hygiene, College of Health and Medical Sciences, Cheongju University, Cheongju 28503, Korea;
| | - Yong-Bong Kwon
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (Y.-B.K.); (E.-J.J.)
| | - Eun-Joo Jun
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (Y.-B.K.); (E.-J.J.)
| | - Jin-Bom Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Korea; (Y.-B.K.); (E.-J.J.)
- BK21 FOUR Project, School of Dentistry, Pusan National University, Yangsan 50612, Korea
- Correspondence: ; Tel.: +85-51-510-8223
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Which Surgical Specialties Provide Craniomaxillofacial Trauma Services at American College of Surgeons Level I Trauma Centers. J Oral Maxillofac Surg 2020; 78:1883-1885. [PMID: 32828720 DOI: 10.1016/j.joms.2020.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/21/2022]
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Violence as the Most Frequent Cause of Oral and Maxillofacial Injuries among the Patients from Low- and Middle-Income Countries-A Retrospective Study at a Level I Trauma University Emergency Department in Switzerland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134906. [PMID: 32646020 PMCID: PMC7369963 DOI: 10.3390/ijerph17134906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/01/2020] [Accepted: 07/03/2020] [Indexed: 01/10/2023]
Abstract
Preventive strategies can be developed by gathering more information about oral and maxillofacial injuries and oral pathologies in immigrants from low- to middle-income countries (LMIC). Additional information on the quality of care can also improve the allocation of clinical resources for the management of these patients. We studied immigrants from LMIC who presented in the emergency department (ED) at Berne University Hospital with dental problems or oral or maxillofacial injuries. The patient data included age, gender, nationality, the etiology and type of trauma and infection in the oral-maxillofacial area, and overall costs. The greatest incidence of maxillofacial injuries was observed in the age group of 16-35 years (n = 128, 63.6%, p = 0.009), with males outnumbering females in all age groups. Trauma cases were most frequent in the late evening and were mostly associated with violence (n = 82, 55.4%, p = 0.001). The most common fracture was fracture of the nose (n = 31). The mean costs were approximately the same for men (mean = 2466.02 Swiss francs) and women (mean = 2117.95 Swiss francs) with maxillofacial injuries but were greater than for isolated dental problems. In conclusion, the etiology of dental and maxillofacial injuries in immigrants in Switzerland requires better support in the prevention of violence and continued promotion of oral health education.
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Facial fractures: classification and highlights for a useful report. Insights Imaging 2020; 11:49. [PMID: 32193796 PMCID: PMC7082488 DOI: 10.1186/s13244-020-00847-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/06/2020] [Indexed: 11/16/2022] Open
Abstract
In patients with facial trauma, multidetector computed tomography is the first-choice imaging test because it can detect and characterize even small fractures and their associated complications quickly and accurately. It has helped clinical management and surgical planning, so radiologists must communicate their findings to surgeons effectively. In Le Fort fractures, there is a breach between the pterygoid plates and the posterior maxilla. These fractures are classified in three basic patterns that can be combined and associated with various complications. Conceptualized when low-speed trauma was predominant, the Le Fort classification system has become less relevant giving more importance on maxillary occlusion-bearing segments. The classification of naso-orbito-ethmoid depends on the extent of injury to the attachment of the medial canthal tendon, with possible complications like nasofrontal duct disruption. Displaced fractures of the zygomaticomaxillary complex often widen the angle of the lateral orbital wall, resulting in increased orbital volume and sometimes in enophthalmos. Severe comminution or angulation can lead to wide surgical exposure. In orbital fractures, entrapment of the inferior rectus muscles can lead to diplopia, so it is important to assess its positioning and morphology. Orbital fractures can also result in injuries to the globe or infraorbital nerve. Frontal sinus fractures that extend through the posterior sinus wall can create a communication with the anterior cranial fossa resulting in leakage of cerebrospinal fluid, intracranial bleeding. It is essential to categorize fracture patterns and highlight features that may affect fracture management in radiology reports of facial trauma.
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Craniofacial Morphometric Features Associated With Pericondylar Fractures of the Mandible. J Craniofac Surg 2019; 30:2065-2068. [PMID: 31490441 DOI: 10.1097/scs.0000000000005960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The research aimed at investigating potential correlations between craniofacial morphological measurements and mandibular pericondylar fractures, based on a retrospective study of 380 mandible fractures treated in our department, during 2010 to 2017. Predictors included morphological measurements and features. Primary outcome was presence of pericondylar fracture; 133 pericondylar fractures were found, including subcondylar, condylar neck, and condylar head fractures. Condylar neck fractures showed negative correlations with condylar neck width (5.7 mm versus 6.7 mm sagittaly, and 6.1 mm versus 6.8 mm coronally, respectively). Gonial angle (117.3 degrees versus 128.7), and mandibular length 106.2 mm versus 110.4 mm, respectively) showed negative correlation with all pericondylar fractures. Ramus height correlated positively with pericondylar fractures (53.6 mm versus 51.2 mm, respectively). Thus, our results showed condylar neck width was a predictor for condylar neck fractures. In addition, individuals suffering from pericondylar fractures had significantly smaller gonial angles, longer ramus height, and shorter mandibular length. These morphologic features are characteristic of individuals with decreased anterior facial height. Our results corroborated a previous study we had conducted, which suggested that increased anterior vertical growth correlates with angle fractures.
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Firmiano TC, Oliveira MTF, de Souza JB, Soares CJ, Versluis A, Veríssimo C. Influence of impacted canines on the stress distribution during dental trauma with and without a mouthguard. Dent Traumatol 2019; 35:276-284. [DOI: 10.1111/edt.12477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/27/2019] [Accepted: 04/29/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Tainah C. Firmiano
- Department of Oral Rehabilitation Federal University of Goiás Goiânia Brazil
| | - Maiolino T. F. Oliveira
- Department of Buco‐Maxillo‐Facial Surgery and Traumatology, School of Dentistry Federal University of Uberlândia Uberlândia Brazil
| | - João B. de Souza
- Department of Oral Rehabilitation Federal University of Goiás Goiânia Brazil
| | - Carlos J. Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry Federal University of Uberlândia Uberlândia Brazil
| | - Antheunis Versluis
- Department of Bioscience Research, College of Dentistry University of Tennessee Health Science Center Memphis Tennessee
| | - Crisnicaw Veríssimo
- Department of Oral Rehabilitation Federal University of Goiás Goiânia Brazil
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Gupta M, Das D, Soodan K, Singh C. Dental injuries in patients associated with fracture of facial bones. Oral Maxillofac Surg 2019; 23:63-69. [PMID: 30739261 DOI: 10.1007/s10006-019-00743-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/25/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To assess different types of dental injuries associated with facial bone fractures. METHOD One hundred dentate patients were selected randomly of all age and gender who had maxillofacial trauma only and having dental injury in association with facial bones fractures were included. They were thoroughly examined for injury/fracture to facial region as well as for dental injuries (teeth). Tooth injuries were noted according to Ellis classification. The data was collected, compiled, and put to statistical analysis. RESULTS Dental injuries were more in females than males found to be statistically significant with (p < 0.05).Crown fracture of maxillary teeth was more as compared to mandibular except molars found to be statistically significant (p < 0.05). Root fracture was more in maxillary incisors followed by canine as compared to mandibular incisors and canines found to be insignificant. Avulsion, extrusion and luxation were more in maxilla as compared to mandible found to be significant. CONCLUSION Different types of tooth injuries associated with facial bone fracture found more in females and maxillary teeth.
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Affiliation(s)
- Monika Gupta
- M.M College of Dental Sciences & Research,, House No. 879, sector- 8, Mullana, Panchkula, Ambala, Haryana, 134109, India.
| | - Debdutta Das
- M.M College of Dental Sciences & Research,, House No. 879, sector- 8, Mullana, Panchkula, Ambala, Haryana, 134109, India
| | - Kanwaldeep Soodan
- M.M College of Dental Sciences & Research,, House No. 879, sector- 8, Mullana, Panchkula, Ambala, Haryana, 134109, India
| | - Chandandeep Singh
- M.M College of Dental Sciences & Research,, House No. 879, sector- 8, Mullana, Panchkula, Ambala, Haryana, 134109, India
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Abstract
AIMS AND OBJECTIVES The aim of this study is to retrospectively analyze the incidence of facial fractures along with age, gender predilection, etiology, commonest site, associated dental injuries, and any complications of patients operated in Craniofacial Unit of SDM College of Dental Sciences and Hospital. MATERIALS AND METHODS This retrospective study was conducted at the Department of OMFS, SDM College of Dental Sciences, Dharwad from January 2003 to December 2013. Data were recorded for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, complications, concomitant injuries, and different treatment protocols.All the data were analyzed using statistical analysis that is chi-squared test. RESULTS A total of 1146 patients reported at our unit with facial fractures during these 10 years. Males accounted for a higher frequency of facial fractures (88.8%). Mandible was the commonest bone to be fractured among all the facial bones (71.2%). Maxillary central incisors were the most common teeth to be injured (33.8%) and avulsion was the most common type of injury (44.6%). Commonest postoperative complication was plate infection (11%) leading to plate removal. Other injuries associated with facial fractures were rib fractures, head injuries, upper and lower limb fractures, etc., among these rib fractures were seen most frequently (21.6%). CONCLUSION This study was performed to compare the different etiologic factors leading to diverse facial fracture patterns. By statistical analysis of this record the authors come to know about the relationship of facial fractures with gender, age, associated comorbidities, etc.
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Park J, Choi H, Shin D, Kim J, Lee M, Kim S, Jo D, Kim C. The effect of the dental root on single mandibular bone fractures. Arch Craniofac Surg 2018; 19:190-193. [PMID: 30282428 PMCID: PMC6177676 DOI: 10.7181/acfs.2018.01963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 08/15/2018] [Indexed: 11/11/2022] Open
Abstract
Background This study was conducted to determine the effect of the distributional relationship between dental roots and the mandibular bone on single mandibular bone fractures, which are common craniofacial fractures. Methods This was a retrospective, single-center study in Seoul, Korea. Patients with single mandibular fractures in the symphysis, parasymphysis, body, and angle area, with tooth structure involvement were included. The control group included patients with simple, bone-level lacerations without fractures. In total, 94 patients (72 males and 22 females) were included in the treatment group, and 125 (71 males and 54 females) were included in the control group. The height of the mandibular bone and the dental root were measured with panoramic radiography. The central incisor represented the symphysis area, the canine represented the parasymphysis area, the first molar represented the body area, and the second molar represented the angle area. Results In the treatment group, symphysis fractures occurred in 16 patients (17%), parasymphysis fractures in 36 patients (38%), body fractures in 17 patients (18%), and angle fractures in 25 patients (27%). The ratios of the dental roots to the total height of the mandibular bone in the treatment group were 30.35%, 39.75%, 39.53%, and 36.27% for symphysis, parasymphysis, body, and angle areas, respectively, whereas in the control group, they were 27.73%, 39.70%, 36.76%, and 35.48%. The ratios of the treatment group were significantly higher than those of the control group. Conclusion The results show that the higher ratio of the dental root to the height of the mandibular bone increases the fracture risk.
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Affiliation(s)
- Jongohk Park
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Hyungon Choi
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Donghyeok Shin
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Jeenam Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Myungchul Lee
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Soonheum Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Chungju, Korea
| | - Dongin Jo
- Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Chungju, Korea
| | - Cheolkeun Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Chungju, Korea
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Schmid M, Schädelin S, Kühl S, Filippi A. Head and dental injuries or other dental problems in alpine sports. Clin Exp Dent Res 2018; 4:125-131. [PMID: 30181909 PMCID: PMC6115871 DOI: 10.1002/cre2.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 06/11/2018] [Accepted: 06/13/2018] [Indexed: 11/11/2022] Open
Abstract
In the hectic daily life, spending our leisure time outdoor in the mountains becomes more and more popular. Although information describing dental injuries in various sports is available, data specifically on dental trauma and other dental problems in alpine sports are lacking. Data of 1,128 alpinists were generated by using a standardized questionnaire. The questions focused on the frequency of head and dental injuries and other dental problems. The participating alpinists have been recruited through the network of alpine clubs and an outdoor equipment supplier. Injuries were most frequently caused by a fall while doing alpine sports (14.7%, = 154). Of the participants, 8.2% (n = 93) suffered from a facial injury: 16% (n = 15) of these had a dental trauma. Other dental problems such as barodontalgia were more common than dental traumas. A sensation of pressure or pain was noticed in 13% (n = 135) of the participants at least once. Of all the participants who suffered pain, 54.1% reported one or several previous restorations. Pain medication was beneficial in 92.1%. Dental traumas are rare while doing alpine sports but not negligible because of its requirement of lifelong therapy and incurs substantial treatment costs. An intraoral pain of a usually asymptomatic tissue occurred, in this sample of participants, nearly as often as in pilots and divers. Pain killer is an efficient tool for the alpinists to reduce the pain until they reach a lower altitude.
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Affiliation(s)
- Martina Schmid
- Department of Oral Surgery, Oral Radiology and Oral Medicine and Centre of Dental TraumatologyUniversity of BaselSwitzerland
| | - Sabine Schädelin
- Clinical Trial Unit, Department of Clinical ResearchUniversity Hospital Basel, University of BaselSwitzerland
| | - Sebastian Kühl
- Department of Oral Surgery, Oral Radiology and Oral Medicine and Centre of Dental TraumatologyUniversity of BaselSwitzerland
| | - Andreas Filippi
- Department of Oral Surgery, Oral Radiology and Oral Medicine and Centre of Dental TraumatologyUniversity of BaselSwitzerland
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Evaluation of Dentoalveolar Trauma in Children and Adolescents: a Modified Classification System and Surgical Treatment Strategies for Its Management. J Craniofac Surg 2018; 28:e383-e387. [PMID: 28328609 DOI: 10.1097/scs.0000000000003720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective. PATIENTS AND METHODS Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed. RESULTS A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department. The most common injury mechanism was falls. The trauma was graded as class II in most patients (41.65%). The anterior maxilla was injured in the majority of the patients (78.35%). In 230 patients (63%) the trauma involved the primary dentition. Two hundred eighty-nine of the patients were treated with local anesthesia on an emergency basis, while in the rest 76 patients general anesthesia was considered mandatory. CONCLUSIONS Accurate diagnosis, timely treatment, and follow-up are critical for the management of dentoalveolar trauma in pediatric patients. A modified more detailed and severity-specific classification and guidelines for its surgical management may assist practitioners in decision making and effective treatment planning.
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Amadori F, Bardellini E, Copeta A, Conti G, Villa V, Majorana A. Dental trauma and bicycle safety: a report in Italian children and adolescents. Acta Odontol Scand 2017; 75:227-231. [PMID: 28116943 DOI: 10.1080/00016357.2017.1279345] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This retrospective study aims to analyze the pattern of oro-facial trauma from bicycle accidents in Italian children and adolescents, focusing on the safety devices used. METHODS The medical records of 1405 patients of the Dental Clinic of the University of Brescia, between the age of 0 to 18, who experienced a dento-facial trauma from the use of a bicycle, were analyzed. Data regarding age, gender, weight, height, dominant hand, type of bicycle, use of safety devices, location and type of dental trauma, teeth involved, bone fractures and soft tissue lesions were recorded. Statistical analysis was performed. RESULTS The majority of the traumatic events occurred in children within the 8-10 years of age-range; 1085 teeth were injured, of which 975 permanent teeth (89.9%) and 110 primary teeth (10.1%). The most common dental lesions were the coronal fractures (complicated and not complicated) while the most frequently involved teeth were the upper central incisors; 11% of patients were also treated for maxillo-facial fractures. A protective helmet was worn only in 3% of the cases; not one patient wore a mouth-guard. The use of helmets was more frequent in children and adolescents riding racing-bikes competitively, compared to those who were mountain bikers (p < 0.05). CONCLUSIONS Bicycle accidents can have serious oro-facial consequences. Therefore, national and regional efforts should be made in Italy to promote head and mouth protection in cycling.
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Affiliation(s)
- Francesca Amadori
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
| | - Elena Bardellini
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
| | - Alessandro Copeta
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Giulio Conti
- Department of Oral Surgery, University Vita-Salute S. Raffaele, Milan, Italy
| | - Valerio Villa
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Alessandra Majorana
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
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Han L, Long T, Tang W, Liu L, Jing W, Tian WD, Long J. Correlation between Condylar Fracture Pattern after Parasymphyseal Impact and Condyle Morphological Features: A Retrospective Analysis of 107 Chinese Patients. Chin Med J (Engl) 2017; 130:420-427. [PMID: 28218215 PMCID: PMC5324378 DOI: 10.4103/0366-6999.199836] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: The treatment of the condylar fractures is difficult. Factors that result in the fractures are complex. The objective of this morphometric study was to investigate the relationship between condylar fracture patterns and condylar morphological characteristics. Methods: We conducted a retrospective analysis of 107 patients admitted to the West China Hospital of Stomatology for bilateral condylar fractures caused by parasymphyseal impact. The patients were divided into five groups according to the type of condylar fracture. Ten parameters were evaluated on three-dimensional (3D) reconstruction mandible models through the Mimics 16.0 (Materialize Leuven, Belgium) anthropometry toolkit. Each parameter of the 3D models was analyzed using multivariate analysis. Multinomial logistic regression analyses were used to examine the relationships between the five groups. Results: The results showed that the differences of condylar head width (M1), condylar neck width (M3), the ratio of condylar head width to condylar anteroposterior diameter (M1/M2), the ratio of condylar head width to condylar neck width (M1/M3), the ratio of condylar height to ramus height (M8/M7), and mandibular angle (M10) were statistically significant (p < 0.05). Type A condylar head fractures were positively associated with M1 (compared to Type B: OR =1.627, 95% CI: 1.123, 2.359; compared to Type C: OR = 1.705, 95% CI: 1.170, 2.484) and M1/M2 (compared to Type B: OR =1.034, 95% CI: 0.879, 2.484). Type B condylar head fractures were negatively associated with M10 (compared to Type C: OR = 0.909, 95% CI: 0.821, 1.007). Condylar neck fractures were negatively associated with M3 (compared to condylar head: OR = 0.382, CI: 0.203, 0.720; compared to condylar base: OR = 0.436, 95% CI: 0.218, 0.874), and positively associated with M1/M3 (compared to condylar head: OR = 1.229, 95% CI: 1.063, 1.420 compared to condylar base: OR = 1.223, 95% CI: 1.034, 1.447). Condylar base fractures were positively associated with M10 (OR = 1.095, 95% CI: 1.008, 1.189) and negatively associated with M8/M7 (OR = 0.855, 95% CI: 0.763, 0.959) as compared with condylar head fractures. Conclusions: Condylar fracture pattern is associated with the anatomical features of the condyles when a fracture occurs from parasymphyseal impact.
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Affiliation(s)
- Lu Han
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, Sichuan 610041; Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ting Long
- Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Tang
- Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Lei Liu
- Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Jing
- Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei-Dong Tian
- Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jie Long
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, Sichuan 610041; Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
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Zhou H, Lv K, Yang R, Li Z, Li Z. Mechanics in the Production of Mandibular Fractures: A Clinical, Retrospective Case-Control Study. PLoS One 2016; 11:e0149553. [PMID: 26900699 PMCID: PMC4763280 DOI: 10.1371/journal.pone.0149553] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 02/02/2016] [Indexed: 02/05/2023] Open
Abstract
As the mandible is susceptible to fracture, the aim of this study was to use multivariate logistic regression analysis to identify and distinguish various internal factors that may influence the location of mandibular fractures. The study included 1131 patients with maxillofacial fractures during the period from January 2000 to December 2009 to evaluate the association of mandibular fracture location (unilateral symphysis, body, angle, condylar, or bilateral condylar fractures) with various internal factors. Among the 1131 patients, 869 had mandibular fractures. Data on age, sex, soft tissue injuries, dental trauma, and maxillofacial fracture type were collected and analyzed using multivariate logistic regression. In total, 387, 210, 139, 319, and 172 patients were diagnosed with unilateral symphysis, body, angle, unilateral, or bilateral condylar fractures, respectively. The dental trauma in patients with bilateral condylar fractures differed from that in patients with unilateral condylar fractures. Patients with mandibular fracture (unilateral symphysis, body, unilateral or bilateral condylar) possessed an approximately equal risk of soft tissue injuries in the mandible. Patients with either unilateral or bilateral condylar fractures were associated with a low risk of mandibular angle fracture (OR < 1). Similarly, patients with mandibular angle fracture were associated with a low risk of unilateral or bilateral condylar fractures (OR < 1). Moreover, patients with symphysis fracture were associated with a low risk of bilateral condylar fractures (90 of 387 [23.3%], OR 0.899). By contrast, patients with bilateral condylar fractures were associated with a high risk of symphysis fracture (90 of 172 [52.3%], OR 17.38). Patients with condylar fractures, particularly those with bilateral condylar fractures, were infrequently associated with secondary mandibular fractures. Mandibular fractures tended to have less of an association with midfacial fractures. The occurrence of mandibular fractures is strongly correlated with age, sex, soft tissue injuries, dental trauma, and the pattern and position of the maxillofacial fractures in patients.
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Affiliation(s)
- Haihua Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People’s Republic of China
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Kun Lv
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People’s Republic of China
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Rongtao Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People’s Republic of China
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Zhi Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People’s Republic of China
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Zubing Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People’s Republic of China
- Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People’s Republic of China
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Soleimani T, Greathouse ST, Sood R, Tahiri YH, Tholpady SS. Epidemiology and resource utilization in pediatric facial fractures. J Surg Res 2015; 200:648-54. [PMID: 26541684 DOI: 10.1016/j.jss.2015.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/21/2015] [Accepted: 10/01/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pediatric facial fractures, although uncommon, have a significant impact on public health and the US economy by the coexistence of other injuries and developmental deformities. Violence is one of the most frequent mechanisms leading to facial fracture. Teaching hospitals, while educating future medical professionals, have been linked to greater resource utilization in differing scenarios. This study was designed to compare the differences in patient characteristics and outcomes between teaching and non-teaching hospitals for violence-related pediatric facial fractures. METHODS Using the 2000-2009 Kids' Inpatient Database, 3881 patients younger than 18 years were identified with facial fracture and external cause of injury code for assault, fight, or abuse. Patients admitted at teaching hospitals were compared to those admitted at non-teaching hospitals in terms of demographics, injuries, and outcomes. RESULTS Overall, 76.2% of patients had been treated at teaching hospitals. Compared to those treated at non-teaching hospitals, these patients were more likely to be younger, non-white, covered by Medicaid, from lower income zip codes, and have thoracic injuries; but mortality rate was not significantly different. After adjusting for potential confounders, teaching status of the hospital was not found as a predictor of either longer lengths of stay (LOS) or charges. CONCLUSIONS There is an insignificant difference between LOS and charges at teaching and non-teaching hospitals after controlling for patient demographics. This suggests that the longer LOS observed at teaching hospitals is related to these institutions being more often involved in the care of underserved populations and patients with more severe injuries.
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Affiliation(s)
- Tahereh Soleimani
- Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Rajiv Sood
- Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Youssef H Tahiri
- Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Sunil S Tholpady
- Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
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d'Avila S, Barbosa KGN, Bernardino ÍDM, da Nóbrega LM, Bento PM, E Ferreira EF. Facial trauma among victims of terrestrial transport accidents. Braz J Otorhinolaryngol 2015; 82:314-20. [PMID: 26614044 PMCID: PMC9444685 DOI: 10.1016/j.bjorl.2015.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 05/15/2015] [Indexed: 12/01/2022] Open
Abstract
Introduction In developing countries, terrestrial transport accidents – TTA, especially those involving automobiles and motorcycles – are a major cause of facial trauma, surpassing urban violence. Objective This cross-sectional census study attempted to determine facial trauma occurrence with terrestrial transport accidents etiology, involving cars, motorcycles, or accidents with pedestrians in the northeastern region of Brazil, and examine victims’ socio-demographic characteristics. Methods Morbidity data from forensic service reports of victims who sought care from January to December 2012 were analyzed. Results Altogether, 2379 reports were evaluated, of which 673 were related to terrestrial transport accidents and 103 involved facial trauma. Three previously trained and calibrated researchers collected data using a specific form. Facial trauma occurrence rate was 15.3% (n = 103). The most affected age group was 20–29 years (48.3%), and more men than women were affected (2.81:1). Motorcycles were involved in the majority of accidents resulting in facial trauma (66.3%). Conclusion The occurrence of facial trauma in terrestrial transport accident victims tends to affect a greater proportion of young and male subjects, and the most prevalent accidents involve motorcycles.
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Affiliation(s)
- Sérgio d'Avila
- Universidade Estadual da Paraíba (UEPB), Campina Grande, PB, Brazil.
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Ruslin M, Wolff J, Boffano P, Brand HS, Forouzanfar T. Dental trauma in association with maxillofacial fractures: an epidemiological study. Dent Traumatol 2015; 31:318-23. [DOI: 10.1111/edt.12176] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Muhammad Ruslin
- Department of Oral and Maxillofacial Surgery Faculty of Dentistry; University of Hasanuddin; Makassar Indonesia
- Department of Oral and Maxillofacial Surgery/Oral Pathology; VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - Jan Wolff
- Department of Oral and Maxillofacial Surgery/Oral Pathology; VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - Paolo Boffano
- Department of Oral and Maxillofacial Surgery/Oral Pathology; VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - Henk S. Brand
- Department of Oral and Maxillofacial Surgery/Oral Pathology; VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
- Department of Medical-Dental Interaction; Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Oral Pathology; VU University Medical Center/Academic Center for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
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Viciano J, D'Anastasio R, Capasso L. Timing of maxillofacial-oral injuries in an individual of the ancient city of Herculaneum (79 AD, Naples, Italy): a case report. Dent Traumatol 2015; 31:215-27. [DOI: 10.1111/edt.12170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Joan Viciano
- University Museum; ‘G. D'Annunzio’ University of Chieti-Pescara; Chieti Italy
| | - Ruggero D'Anastasio
- University Museum; ‘G. D'Annunzio’ University of Chieti-Pescara; Chieti Italy
- Department of Medicine and Ageing Science; ‘G. D'Annunzio’ University of Chieti-Pescara; Chieti Italy
| | - Luigi Capasso
- University Museum; ‘G. D'Annunzio’ University of Chieti-Pescara; Chieti Italy
- Department of Medicine and Ageing Science; ‘G. D'Annunzio’ University of Chieti-Pescara; Chieti Italy
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Ogura I, Sasaki Y, Kaneda T. Multidetector computed tomography of maxillofacial fractures. JAPANESE DENTAL SCIENCE REVIEW 2014. [DOI: 10.1016/j.jdsr.2014.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Rahimi-Nedjat RK, Sagheb K, Walter C. Concomitant dental injuries in maxillofacial fractures - a retrospective analysis of 1219 patients. Dent Traumatol 2014; 30:435-41. [PMID: 24890672 DOI: 10.1111/edt.12118] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND/AIM Traumatic dental injuries are frequently combined with maxillofacial fractures, but literature addressing this topic is rare. In a retrospective study, the frequency of dental lesions in inpatients with traumatic facial injuries was analyzed. MATERIAL AND METHODS All patients referred to the Department of Oral and Maxillofacial Surgery of the University Medical Center of the Johannes Gutenberg-University Mainz for inpatient treatment due to facial fractures between January 2001 and December 2007 were analyzed regarding the type of fracture, its localization, and potential concomitant dental injuries. In addition a systematic review was performed to compare the findings of this study with existing data. RESULTS Altogether 1219 facial trauma patients underwent inpatient treatment. 184 (15.87%) out of those had 451 injured teeth, and 4.9% were edentulous. The most frequent causes were assaults (25.1%), followed by falls (19.6%) and bike accidents (10.1%). Avulsion, especially of the upper incisors, occurred in most cases (27.9%). Assaults caused 1.29 dental fractures per patient, while traffic-related accidents led to three to four times higher injury-rates. CONCLUSIONS With almost every sixth patient having at least one kind of dental injury, this study shows that a thorough anamnesis and examination of the dental status are absolutely necessary, especially in patients who suffered from high-speed impacts or collisions with low-resilience surfaces.
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Affiliation(s)
- Roman K Rahimi-Nedjat
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
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A simple approach to reduction and stabilization of segmental fractures of the alveolar housing in complex facial trauma. J Craniofac Surg 2014; 25:1136-7. [PMID: 24777010 DOI: 10.1097/scs.0000000000000670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ogura I, Sasaki Y, Kaneda T. Analysis of mandibular condylar and glenoid fossa fractures with computed tomography. Eur Radiol 2013; 24:902-6. [PMID: 24337861 DOI: 10.1007/s00330-013-3085-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 11/25/2013] [Accepted: 11/29/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the prevalence of glenoid fossa and condylar fractures in patients with mandibular fractures using multidetector computed tomography (MDCT). METHODS A prospective study was performed in 227 patients with mandibular fractures who underwent 64-MDCT. Mandibular fractures were classified into four types: median, paramedian, angle and condylar. Statistical analysis of the relationship between prevalence of condylar fractures and mandibular fracture locations was performed using χ(2) test with Fisher's exact test. A P value less than 0.05 was considered statistically significant. RESULTS The prevalence of condylar fracture was 64.8 % of all patients with mandibular fractures, 66.7 % of median type (P = 0.667), 45.5 % of paramedian type (P = 0.001) and 12.3 % of angle type (P = 0.000), respectively. Furthermore, glenoid fossa fracture was seen in 1.4 % of patients with condylar fractures. CONCLUSIONS The results of the presented study suggest focusing also on incidental findings such as glenoid fossa fractures. KEY POINTS • The prevalence of condylar fracture was 64.8 % in patients with mandibular fractures. • Glenoid fossa fracture was seen in 1.4 % of patients with condylar fractures. • The study suggests a focus on incidental findings such as glenoid fossa fractures.
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Affiliation(s)
- Ichiro Ogura
- Department of Radiology, Nihon University School of Dentistry at Matsudo, 2-870-1, Sakaecho-Nishi, Matsudo, Chiba, 271-8587, Japan,
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Roccia F, Boffano P, Bianchi FA, Ramieri G. An 11-year review of dental injuries associated with maxillofacial fractures in Turin, Italy. Oral Maxillofac Surg 2013; 17:269-274. [PMID: 23138750 DOI: 10.1007/s10006-012-0371-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 10/22/2012] [Indexed: 06/01/2023]
Abstract
INTRODUCTION The aim of the study was to analyze the incidence, characteristics, and correlations between maxillofacial fractures and dental injuries in patients who were treated at a first-level trauma center in a metropolitan center in northwest Italy in the last 11 years. MATERIAL AND METHODS Between January 1, 2001 and December 31, 2011, 2,110 patients with maxillofacial fractures were admitted. Only dentulous patients with complete clinical records who presented with associated dental injuries were included in this study. Data on the age, gender, mechanism of injury, damaged tooth, type of dental injury, site of facial fractures, and concomitant injuries were recorded. RESULTS On the whole, 267 patients (13.1%), mainly males aged 20-29 years, presented with 759 dental injuries associated with maxillofacial fractures, especially following motor vehicle accidents. The maxillary teeth, most often the anterior elements with decreasing involvement from the incisors to the molars, were the teeth most frequently damaged overall. The main types of dental trauma in patients with maxillofacial fractures were luxations and dental fractures. DISCUSSION Our findings show that patients with mandibular fractures were statistically and significantly associated with dental injury, and the teeth in the upper jaw were the most frequently injured teeth, exhibiting mainly luxations and crown fractures. Confirmation of the predominant impact site in patients with dental injuries associated with maxillofacial fractures comes from the 177 lacerations noted in the chin and lip regions in 267 patients.
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Affiliation(s)
- Fabio Roccia
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Corso A.M. Dogliotti 14, 10126, Torino, Italy,
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Winegar BA, Murillo H, Tantiwongkosi B. Spectrum of critical imaging findings in complex facial skeletal trauma. Radiographics 2013; 33:3-19. [PMID: 23322824 DOI: 10.1148/rg.331125080] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Multidetector computed tomography (CT) is the modality of choice for the evaluation of facial trauma because it helps accurately identify and characterize fractures and associated complications, thereby aiding timely clinical management and surgical planning. In particular, CT clearly depicts clinically relevant fractures in the eight osseous struts or buttresses that function as an underlying scaffold for facial structures. Information about the involvement of specific facial buttresses in a complex fracture is helpful for determining the type of fracture present and for identifying associated soft-tissue injuries that may require urgent care or surgery. Various kinds of complications can be expected to occur in Le Fort fractures, which affect the full thickness of the pterygoid plates, with resultant dissociation of part or all of the maxilla from the skull base; naso-orbitoethmoid complex fractures, which involve the medial orbital wall, nasal bone, ethmoid sinuses, and, often, the attachment site of the medial canthal tendon; zygomaticomaxillary complex fractures, which disrupt all four zygomatic sutures and may lead to enophthalmos due to increased orbital volume because of angulation of the lateral orbital wall; orbital "blowout" fractures, which may result in extraocular muscle herniation or entrapment and injuries to the globe or the infraorbital nerve; and fractures of the alveolar process, which are treated as open fractures because of their extension through the gingiva to the oral cavity and their resultant vulnerability to infection. Similarly, extension of a frontal sinus fracture through the posterior sinus wall creates a portal to the anterior cranial fossa and may lead to cerebrospinal fluid leakage, intracranial hemorrhage, or intracranial infection.
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Affiliation(s)
- Blair A Winegar
- Department of Radiology, University of Texas Health Science Center at San Antonio, University Hospital, 7703 Floyd Curl Dr, San Antonio, TX 78229, USA.
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Zhou HH, Ongodia D, Liu Q, Yang RT, Li ZB. Dental trauma in patients with single mandibular fractures. Dent Traumatol 2012; 29:291-6. [DOI: 10.1111/j.1600-9657.2012.01173.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2012] [Indexed: 12/01/2022]
Affiliation(s)
| | - David Ongodia
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology; Wuhan University; Wuhan; Hubei; China
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Zhou HH, Ongodia D, Liu Q, Yang RT, Li ZB. Dental trauma in patients with maxillofacial fractures. Dent Traumatol 2012; 29:285-90. [DOI: 10.1111/j.1600-9657.2012.01169.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2012] [Indexed: 11/28/2022]
Affiliation(s)
| | - David Ongodia
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education; School & Hospital of Stomatology; Wuhan University; Wuhan; Hubei; China
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Dental injuries in pediatric patients with facial fractures are frequent and severe. J Oral Maxillofac Surg 2012; 70:396-400. [PMID: 22260909 DOI: 10.1016/j.joms.2011.08.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 08/24/2011] [Accepted: 08/26/2011] [Indexed: 11/23/2022]
Abstract
PURPOSE This study was carried out to identify the occurrence, type, location, and severity of dental injuries (DIs), as well as predictors for DIs, in pediatric patients with facial fractures. MATERIALS AND METHODS This study examined the files of patients aged 16 years or less who had sustained facial fractures during a 12-year period. The outcome variable was DI. The explanatory variables included gender, age, trauma mechanism, and type of facial fracture. Data analysis was carried out with the χ(2) test and logistic regression analysis. RESULTS A total of 200 patients, 119 (59.5%) of whom were boys, met the inclusion criteria. The mean age was 12.6 years. A total of 45 patients (22.5%) had DIs. Crown fracture, the most common type of DI, occurred in 59.9% of all DIs. The most common location of crown fractures was in the premolars (37.4% of all crown fractures). Multiple DIs occurred in 71.1% of those with DIs and severe DI in 66.7%. DIs were significantly associated with motor vehicle collision (MVC) (P = .02) and mandibular fracture (P = .03). CONCLUSIONS DIs are common in pediatric patients with facial fracture, often being both multiple and severe. In association with pediatric facial fracture, facial surgeons should be especially alert for crown fractures in the lateral parts of the jaws.
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Ogura I, Kaneda T, Mori S, Sekiya K, Ogawa H, Tsukioka T. Characterization of mandibular fractures using 64-slice multidetector CT. Dentomaxillofac Radiol 2012; 41:392-5. [PMID: 22282503 DOI: 10.1259/dmfr/67127210] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to characterize mandibular fracture locations using 64-slice multidetector CT (MDCT). METHODS CT scans of 138 patients with mandibular fractures who underwent 64-slice MDCT were studied. Mandibular fractures were classified into five types: median, paramedian, angle, condylar and coronoid process. Statistical analysis for the relationship between multiple fractures and type of mandibular fractures was performed using χ(2) test with Fisher's exact test. RESULTS The percentage of multiple mandibular fractures was 80.9% median type, 74.3% paramedian type, 52.9% angle type and 60.9% condylar type. The resultant data showed a significant relationship between multiple fractures and the median type (p = 0.000), paramedian type (p = 0.002) and condylar type (p = 0.003). CONCLUSION The results suggest that multiple fractures are related to the type of mandibular fractures.
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Affiliation(s)
- I Ogura
- Department of Radiology, Nihon University School of Dentistry, Matsudo, Chiba, Japan.
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Epidemiology of facial fracture injuries. J Oral Maxillofac Surg 2011; 69:2613-8. [PMID: 21683499 DOI: 10.1016/j.joms.2011.02.057] [Citation(s) in RCA: 167] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2011] [Accepted: 02/04/2011] [Indexed: 11/23/2022]
Abstract
PURPOSE Injuries resulting from accidents are a leading cause of mortality and morbidity. The objective of this study was to present epidemiologic estimates of hospital-based emergency department (ED) visits for facial fractures in the United States. MATERIALS AND METHODS The Nationwide Emergency Department Sample for 2007 was used. All ED visits with facial fractures were selected. Demographic characteristics of these ED visits, causes of injuries, presence of concomitant injuries, and resource use in hospitals were examined. All estimates were projected to national levels and each ED visit was the unit of analysis. RESULTS During 2007 in the United States, 407,167 ED visits concerned a facial fracture. Patients' average age for each ED visit was 37.9 years. Sixty-eight percent of all ED visits concerned male patients, and 85,759 ED visits resulted in further treatment in the same hospital. Three hundred fourteen patients died in EDs, and 2,717 died during hospitalization. Mean charge per each ED visit was $3,192. Total United States ED charges were close to $1 billion. Mean hospitalization charges (ED and inpatient charges) amounted to $62,414. Mean length of stay was 6.23 days, and total hospitalization time in the entire United States was 534,322 days. Frequently reported causes of injuries included assaults (37% of all ED visits), falls (24.6%), and motor vehicle accidents (12.1%). CONCLUSIONS The management of maxillofacial fractures in EDs across the United States uses considerable resources. The public health impact of facial fractures is highlighted in the present study.
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