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Romeo I, Sobrero F, Roccia F, Dolan S, Laverick S, Carlaw K, Aquilina P, Bojino A, Ramieri G, Duran-Valles F, Bescos C, Segura-Pallerès I, Ganasouli D, Zanakis SN, de Oliveira Gorla LF, Pereira-Filho VA, Gallafassi D, Perez Faverani L, Alalawy H, Kamel M, Samieirad S, Jaisani MR, Rahman SA, Rahman T, Aladelusi T, Hassanein AG, Goetzinger M, Bottini GB. A multicentric, prospective study on oral and maxillofacial trauma in the female population around the world. Dent Traumatol 2022; 38:196-205. [PMID: 35390219 PMCID: PMC9321108 DOI: 10.1111/edt.12750] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIMS Approximately 20% of patients with maxillofacial trauma are women, but few articles have analysed this. The aim of this multicentric, prospective, epidemiological study was to analyse the characteristics of maxillofacial fractures in the female population managed in 14 maxillofacial surgery departments on five continents over a 1-year period. METHODS The following data were collected: age (0-18, 19-64, or ≥65 years), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment, and length of hospitalization. RESULTS Between 30 September 2019 and 4 October 2020, 562 of 2387 patients hospitalized with maxillofacial trauma were females (24%; M: F ratio, 3.2:1) aged between 1 and 96 years (median age, 37 years). Most fractures occurred in patients aged 20-39 years. The main causes were falls (43% [median age, 60.5 years]), which were more common in Australian, European and American units (p < .001). They were followed by road traffic accidents (35% [median age, 29.5 years]). Assaults (15% [median age, 31.5 years]) were statistically associated with alcohol and/or drug abuse (p < .001). Of all patients, 39% underwent open reduction and internal fixation, 36% did not receive surgical treatment, and 25% underwent closed reduction. CONCLUSION Falls were the main cause of maxillofacial injury in the female population in countries with ageing populations, while road traffic accidents were the main cause in African and some Asian centres, especially in patients ≤65 years. Assaults remain a significant cause of trauma, primarily in patients aged 19-64 years, and they are related to alcohol use.
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Affiliation(s)
- Irene Romeo
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Federica Sobrero
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Sean Dolan
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Sean Laverick
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Kirsten Carlaw
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, New South Wales, Australia
| | - Peter Aquilina
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, New South Wales, Australia
| | - Alessandro Bojino
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Francesc Duran-Valles
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Coro Bescos
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Ignasi Segura-Pallerès
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Dimitra Ganasouli
- Department Oral and Maxillofacial Surgery, Hippokration General Hospital, Athens, Greece
| | - Stelios N Zanakis
- Department Oral and Maxillofacial Surgery, Hippokration General Hospital, Athens, Greece
| | - Luis Fernando de Oliveira Gorla
- Department Diagnosis and Surgery, Araraquara Dental School, São Paulo State University, UNESP, Araraquara, São Paulo, Brazil
| | - Valfrido Antonio Pereira-Filho
- Department Diagnosis and Surgery, Araraquara Dental School, São Paulo State University, UNESP, Araraquara, São Paulo, Brazil
| | - Daniel Gallafassi
- Division of Oral and Maxillofacial Surgery, Department of Diagnosis and Surgery, São Paulo State University, UNESP, Araçatuba, São Paulo, Brazil
| | - Leonardo Perez Faverani
- Division of Oral and Maxillofacial Surgery, Department of Diagnosis and Surgery, São Paulo State University, UNESP, Araçatuba, São Paulo, Brazil
| | - Haider Alalawy
- Department Oral and Maxillofacial Surgery, Gazi Alhariri Hospital, Medical City, Baghdad, Iraq
| | - Mohammed Kamel
- Department Oral and Maxillofacial Surgery, Gazi Alhariri Hospital, Medical City, Baghdad, Iraq
| | - Sahand Samieirad
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Sajjad Abdur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Tabishur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Timothy Aladelusi
- Department Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ahmed Gaber Hassanein
- Maxillofacial Surgery Unit, Faculty of Medicine, General Surgery Department, Sohag University, Sohag, Egypt
| | - Maximilian Goetzinger
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Gian Battista Bottini
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
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Bojino A, Roccia F, Carlaw K, Aquilina P, Rae E, Laverick S, Romeo I, Iocca O, Copelli C, Sobrero F, Segura-Pallerès I, Ganasouli D, Zanakis SN, de Oliveira Gorla LF, Pereira-Filho VA, Gallafassi D, Perez Faverani L, Alalawy H, Kamel M, Samieirad S, Jaisani MR, Rahman SA, Rahman T, Aladelusi T, Hassanein AG, Duran-Valles F, Bescos C, Goetzinger M, Bottini GB. A multicentric prospective analysis of maxillofacial trauma in the elderly population. Dent Traumatol 2022; 38:185-195. [PMID: 35150461 DOI: 10.1111/edt.12736] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND/AIMS The growth of the global elderly population will lead to an increase in traumatic injuries in this group, including those affecting the maxillofacial area, with a heavier load on health systems. The aim of this multicentric prospective study was to understand and evaluate the incidences, causes and patterns of oral and maxillofacial injuries in patients aged over 60 years admitted to 14 maxillofacial surgical departments around the world. METHODS The following data were collected: gender, cause and mechanism of maxillofacial fracture, alcohol and drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment and length of hospitalization. Statistical analyses were performed using non-parametric and association tests, as well as linear regression. RESULTS Between 30 September 2019 and 4 October 2020, 348 out of 2387 patients (14.6%), 197 men and 151 women (ratio 1.3:1; mean age 72.7 years), were hospitalized. The main causes of the maxillofacial fractures were falls (66.4%), followed by road traffic accidents (21.5%) and assaults (5.2%). Of the 472 maxillofacial fractures, 69.7% were in the middle third of the face, 28% in the lower third and 2.3% in the upper third. Patients with middle third fractures were on average 4.2 years older than patients with lower third fractures (95% CI 1.2-7.2). Statistical analysis showed that women were more involved in fall-related trauma compared with males (p < .001). It was also shown that road traffic accidents cause more fractures in the lower third (p < .001) and in the middle third-lower third complex compared with upper third (p < .001). CONCLUSIONS Maxillofacial fractures in the elderly were more frequent in European and Australian centres and affected men slightly more than women. Falls were the leading cause of fractures, especially among women. The middle third of the face was most often affected, and conservative treatment was the most common choice for the management of such patients.
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Affiliation(s)
- Alessandro Bojino
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Kirsten Carlaw
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, New South Wales, Australia
| | - Peter Aquilina
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, New South Wales, Australia
| | - Euan Rae
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Sean Laverick
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Irene Romeo
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Oreste Iocca
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Chiara Copelli
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Federica Sobrero
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Ignasi Segura-Pallerès
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Dimitra Ganasouli
- Department Oral and Maxillofacial Surgery, Hippokration General Hospital, Athens, Greece
| | - Stelios N Zanakis
- Department Oral and Maxillofacial Surgery, Hippokration General Hospital, Athens, Greece
| | | | | | - Daniel Gallafassi
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, Araçatuba, São Paulo, Brazil
| | - Leonardo Perez Faverani
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, Araçatuba, São Paulo, Brazil
| | - Haider Alalawy
- Department Oral and Maxillofacial Surgery, Gazi Alhariri Hospital, Medical City, Baghdad, Iraq
| | - Mohammed Kamel
- Department Oral and Maxillofacial Surgery, Gazi Alhariri Hospital, Medical City, Baghdad, Iraq
| | - Sahand Samieirad
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehul Rajesh Jaisani
- Department Oral and Maxillofacial Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sajjad Abdur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Tabishur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Timothy Aladelusi
- Department Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ahmed Gaber Hassanein
- Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Francesc Duran-Valles
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Coro Bescos
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Maximilian Goetzinger
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Gian Battista Bottini
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
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Segura-Palleres I, Sobrero F, Roccia F, de Oliveira Gorla LF, Pereira-Filho VA, Gallafassi D, Faverani LP, Romeo I, Bojino A, Copelli C, Duran-Valles F, Bescos C, Ganasouli D, Zanakis SN, Hassanein AG, Alalawy H, Kamel M, Samieirad S, Jaisani MR, Rahman SA, Rahman T, Aladelusi T, Carlaw K, Aquilina P, Rae E, Laverick S, Goetzinger M, Bottini GB. Characteristics and age-related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study. Dent Traumatol 2022; 38:213-222. [PMID: 35146900 PMCID: PMC9305543 DOI: 10.1111/edt.12735] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 01/29/2023]
Abstract
Background/Aims Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1‐year period. Methods The following data were collected: age (preschool [0–6 years], school age [7–12 years], and adolescent [13–18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software. Results Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0–18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001). Conclusion The main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0–6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.
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Affiliation(s)
- Ignasi Segura-Palleres
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Federica Sobrero
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | | | | | - Daniel Gallafassi
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, São Paulo, Brazil
| | - Leonardo Perez Faverani
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, São Paulo State University, UNESP, São Paulo, Brazil
| | - Irene Romeo
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Alessandro Bojino
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Chiara Copelli
- Division of Maxillofacial Surgery, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Francesc Duran-Valles
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Coro Bescos
- Department Oral and Maxillofacial Surgery, Hospital Universitario Vall D'Hebron, Barcelona, Spain
| | - Dimitra Ganasouli
- Department Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Stelios N Zanakis
- Department Oral and Maxillofacial Surgery, Hippocratio General Hospital, Athens, Greece
| | - Ahmed Gaber Hassanein
- Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Haider Alalawy
- Department Oral and Maxillofacial Surgery, Medical City, Gazi Alhariri Hospital, Baghdad, Iraq
| | - Mohammed Kamel
- Department Oral and Maxillofacial Surgery, Medical City, Gazi Alhariri Hospital, Baghdad, Iraq
| | - Sahand Samieirad
- Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Sajjad Abdur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Tabishur Rahman
- Department Oral and Maxillofacial Surgery, Aligarh Muslim University, Aligarh, India
| | - Timothy Aladelusi
- Department Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Kirsten Carlaw
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, Australia
| | - Peter Aquilina
- Department Plastic, Reconstructive and Maxillofacial Surgery, Nepean Hospital, Sydney, Australia
| | - Euan Rae
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Sean Laverick
- Department Oral and Maxillofacial Surgery, University of Dundee, Dundee, UK
| | - Maximilian Goetzinger
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
| | - Gian Battista Bottini
- Department Oral and Maxillofacial Surgery, Paracelsus Medical University, Salzburg, Austria
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Aquilina P, Parr WCH, Chamoli U, Wroe S. Finite element analysis of patient-specific condyle fracture plates: a preliminary study. Craniomaxillofac Trauma Reconstr 2014; 8:111-6. [PMID: 26000081 DOI: 10.1055/s-0034-1395385] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 06/03/2014] [Indexed: 10/24/2022] Open
Abstract
Various patterns of internal fixation of mandibular condyle fractures have been proposed in the literature. This study investigates the stability of two patient-specific implants (PSIs) for the open reduction and internal fixation of a subcondylar fracture of the mandible. A subcondylar fracture of a mandible was simulated by a series of finite element models. These models contained approximately 1.2 million elements, were heterogeneous in bone material properties, and also modeled the muscles of mastication. Models were run assuming linear elasticity and isotropic material properties for bone. The stability and von Mises stresses of the simulated condylar fracture reduced with each of the PSIs were compared. The most stable of the plate configurations examined was PSI 1, which had comparable mechanical performance to a single 2.0 mm straight four-hole plate.
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Affiliation(s)
- Peter Aquilina
- Department of OMFS, Westmead Hospital, Sydney, Australia ; Department of Plastic and Reconstructive Surgery, The Nepean Hospital, Kingswood, Sydney, Australia ; Computational Biomechanics Research Group, School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, Australia
| | - William C H Parr
- Surgical and Orthopaedic Research Laboratory, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Uphar Chamoli
- Department of Orthopaedic Surgery, St. George Hospital Clinical School, University of New South Wales, Sydney, New South Wales, Australia ; School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen Wroe
- Computational Biomechanics Research Group, Zoology Division, School of Environmental and Rural Science, University of New England, Armidale, Australia
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Aquilina P, Parr WCH, Chamoli U, Wroe S, Clausen P. A Biomechanical Comparison of Three 1.5-mm Plate and Screw Configurations and a Single 2.0-mm Plate for Internal Fixation of a Mandibular Condylar Fracture. Craniomaxillofac Trauma Reconstr 2014; 7:218-23. [PMID: 25136411 DOI: 10.1055/s-0034-1375172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/15/2013] [Indexed: 10/25/2022] Open
Abstract
The most stable pattern of internal fixation for mandibular condyle fractures is an area of ongoing discussion. This study investigates the stability of three patterns of plate fixation using readily available, commercially pure titanium implants. Finite element models of a simulated mandibular condyle fracture were constructed. The completed models were heterogeneous in bone material properties, contained approximately 1.2 million elements and incorporated simulated jaw adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. No human subjects were involved in this investigation. The stability of the simulated condylar fracture reduced with the different implant configurations, and the von Mises stresses of a 1.5-mm X-shaped plate, a 1.5-mm rectangular plate, and a 1.5-mm square plate (all Synthes (Synthes GmbH, Zuchwil, Switzerland) were compared. The 1.5-mm X plate was the most stable of the three 1.5-mm profile plate configurations examined and had comparable mechanical performance to a single 2.0-mm straight four-hole plate. This study does not support the use of rectangular or square plate patterns in the open reduction and internal fixation of mandibular condyle fractures. It does provide some support for the use of a 1.5-mm X plate to reduce condylar fractures in selected clinical cases.
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Affiliation(s)
- Peter Aquilina
- Department of Maxillofacial Surgery, Westmead Hospital, Westmead, New South Wales, Australia
| | - William C H Parr
- Computational Biomechanics Research Group, School of Biological, Earth and Environmental Sciences, Sydney, New South Wales, Australia
| | - Uphar Chamoli
- Department of Orthopaedic Surgery, Spine Service, St. George Hospital Clinical School, University of New South Wales, Sydney, Australia
| | - Stephen Wroe
- Division of Zoology, School of Environmental and Rural Science, Armidale, Australia
| | - Philip Clausen
- School of Engineering, University of Newcastle, Newcastle, Australia
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Aquilina P, Chamoli U, Parr WC, Clausen PD, Wroe S. Finite element analysis of three patterns of internal fixation of fractures of the mandibular condyle. Br J Oral Maxillofac Surg 2013; 51:326-31. [DOI: 10.1016/j.bjoms.2012.08.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 08/15/2012] [Indexed: 11/26/2022]
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Elledge RO, Elledge R, Aquilina P, Hodson J, Dover S. The role of alcohol in maxillofacial trauma: a comparative retrospective audit between the two centers. Alcohol 2011; 45:239-43. [PMID: 21051178 DOI: 10.1016/j.alcohol.2010.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Revised: 08/30/2010] [Accepted: 09/01/2010] [Indexed: 10/18/2022]
Abstract
Alcohol abuse and maxillofacial trauma, particularly that due to interpersonal violence, have a well-established relationship in the literature. We present a retrospective audit comparing the role of alcohol in maxillofacial trauma between Selly Oak Hospital in Birmingham, United Kingdom and Westmead Hospital in Sydney, Australia, and the association between alcohol involvement and patient demographics, including age, sex, marital status, and employment status. Also presented are the differences between the two centers in terms of mechanisms and types of injuries and the locations where these injuries were sustained. Alcohol was involved in 34.78 and 30.77% of patients at Westmead and Birmingham, respectively. A multiple logistic regression analysis revealed a reduced likelihood of alcohol involvement in episodes of maxillofacial trauma where patients were unemployed (P=.04), and where injuries were sustained secondary to mechanisms other than assault (P<.001) and in locations other than pubs and nightclubs (P=.024). There appeared to be no statistically significant contribution to the likelihood of alcohol involvement by treating center, marital status, patient sex, or age. Alcohol continues to be a strong driving factor in cases of maxillofacial trauma, particularly those due to alleged assault, with a typical patient demographic of the gainfully employed frequenting drinking establishments being most at risk for alcohol-related trauma, most commonly sustaining their injuries secondary to assault. Identifying patient groups most at risk is a key step in developing public health strategies aimed at prevention, and our findings would appear to suggest this group of patients as being the most worthwhile to target with measures aimed at reducing alcohol-fueled maxillofacial trauma.
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Elledge R, Khazaee-Farid R, Aquilina P, Dover M. P105 A retrospective audit comparing orbital fracture incidence and management in Birmingham UK and Sydney Australia. Br J Oral Maxillofac Surg 2010. [DOI: 10.1016/s0266-4356(10)60194-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Brown J, Wainohu D, Aquilina P, Suratno B, Kelly P, Bilston LE. Accessory child safety harnesses: do the risks outweigh the benefits? Accid Anal Prev 2010; 42:112-121. [PMID: 19887151 DOI: 10.1016/j.aap.2009.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Revised: 07/01/2009] [Accepted: 07/14/2009] [Indexed: 05/28/2023]
Abstract
Accessory child safety harnesses are available in some countries as alternative restraints for young children or as an accessory restraint used with booster seats. Their use, in Australia at least, is becoming more common. There have been concerns that the risk of misuse of these restraints outweighs any potential benefit this system might have over a retractable lap-shoulder belt system used with a booster seat. However to date there is no evidence to confirm or deny this. This study used laboratory simulated frontal crash tests to examine the performance of accessory child safety harness systems compared to the lap-shoulder belt when used alone and when used with two common designs of Australian booster seat. The performance of the child safety harness system when misused was also investigated. The results demonstrate that the correctly used child safety harness system performed no better than the lap-shoulder system, and in fact allows for a greater risk of submarining. Furthermore, one common form of child safety harness misuse, where the harness is over-tightened causing the lap belt to be positioned high over the abdomen, allowed extremely undesirable dummy motion. This involved gross submarining and direct contact between the harness system and the dummy's neck. These findings suggest that the risks associated with accessory child safety harness systems most likely outweigh any potential benefits, in frontal impacts at least.
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Affiliation(s)
- Julie Brown
- Prince of Wales Medical Research Institute, and University of New South Wales, Barker St., Randwick 2031, NSW, Australia.
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Aquilina P, Vickers R, McKellar G. Reduction of a chronic bilateral temporomandibular joint dislocation with intermaxillary fixation and botulinum toxin A. Br J Oral Maxillofac Surg 2004; 42:272-3. [PMID: 15121281 DOI: 10.1016/j.bjoms.2004.01.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2004] [Indexed: 11/27/2022]
Abstract
A 71-year-old man was referred to the Department of Oral and Maxillofacial Surgery at Westmead Hospital for investigation of limited jaw movement and facial pain after a cerebrovascular event eight weeks previously. He was found to have bilateral dislocations of the temporomandibular joints (TMJ) and was successfully treated with a combination of intermaxillary fixation (IMF) screws and botulinum toxin A.
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Affiliation(s)
- Peter Aquilina
- Department of Oral and Maxillofacial Surgery, Westmead Hospital, Sydney, Australia
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Abstract
We present a patient with extensive surgical emphysema following the dental restoration the upper left first molar (tooth 26) with a high speed turbine handpiece. The clinical findings and management of subcutaneous cervical emphysema are discussed.
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Affiliation(s)
- Peter Aquilina
- Department of Oral and Maxillofacial Surgery, Westmead Hospital, Sydney, New South Wales, Australia.
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Abstract
BACKGROUND A case of Crohn's disease (CD) was diagnosed following recognition of oral and systemic signs and symptoms in a 19-year-old male patient. METHODS Clinical investigation utilized included blood tests (full blood count, electrolytes, urea, creatinine, liver function tests), computed tomogrphy scans, magnetic resonance imaging scans, oral biopsies, colonoscopy and biopsies of the terminal ileum and colon. RESULTS A diagnosis of CD was made which then allowed appropriate medical treatment to be initiated. CONCLUSION The importance of a thorough medical history and full physical examination with appropriate investigations as dictated by clinical findings is demonstrated.
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Affiliation(s)
- P Aquilina
- Oral and Maxillofacial Surgery, Royal Brisbane Hospital.
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Cox MC, Maffei L, Buffolino S, Del Poeta G, Venditti A, Cantonetti M, Aronica G, Aquilina P, Masi M, Amadori S. A comparative analysis of FISH, RT-PCR, and cytogenetics for the diagnosis of bcr-abl-positive leukemias. Am J Clin Pathol 1998; 109:24-31. [PMID: 9426514 DOI: 10.1093/ajcp/109.1.24] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Philadelphia (Ph) chromosome-positive leukemias, with the bcr-abl gene translocation, have a dismal prognosis. The identification of Ph-positive patients is vitally important because only aggressive therapeutic approaches, such as allogeneic bone marrow transplantation, may result in long-term disease-free survival. Routine diagnostic methods, such as Southern blot analysis and cytogenetics, may lead to false-negative results. Reverse transcriptase-polymerase chain reaction (RT-PCR) analysis is considered the most sensitive tool for the detection of the bcr-abl translocation, and it is widely used alone or in combination with karyotyping or Southern blot analysis to identify Ph-positive cases. In this study, we used fluorescence in situ hybridization (FISH) with BCR and ABL double-color probes for detecting Ph-positive leukemias. The FISH results were compared with the results of cytogenetic and RT-PCR analyses in 75 patients with leukemia or other myeloproliferative syndromes (chronic myeloid leukemia, 30; acute lymphoblastic leukemia, 24; acute myelogenous leukemia, 6; essential (hemorrhagic) thrombocythemia, 12; chronic myelomonocytic leukemia, 2; and polycythemia vera, 1). FISH analysis proved to be simple, extremely reliable and sensitive; bcr-abl fusion detection was successful in the presence of all types of molecular junctions i.e., (b2a2, b3a2, and e1a2). Furthermore, a Ph-positive case that proved fusion negative by RT-PCR was identified as positive by FISH. The sensitivity of RT-PCR and FISH related to Ph-positive cases were 97% and 100%, respectively. Regarding specificity, in 4 (5%) of 75 patients, RT-PCR provided false-positive results. Cross-contamination was identified because a new specimen was harvested and reanalyzed when FISH, cytogenetics, and RT-PCR results were contradictory. We believe FISH is an optimal diagnostic method to detect bcr-abl translocation that can be used alone or to validate the results of RT-PCR analysis.
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MESH Headings
- Bone Marrow/chemistry
- Chromosome Banding
- Fluorescent Dyes/analysis
- Fusion Proteins, bcr-abl/genetics
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myelomonocytic, Chronic/genetics
- Leukocytes/chemistry
- Myeloproliferative Disorders/genetics
- Oncogene Proteins/genetics
- Polycythemia Vera/genetics
- Polymerase Chain Reaction
- Protein-Tyrosine Kinases
- Proto-Oncogene Proteins
- Proto-Oncogene Proteins c-abl/genetics
- Proto-Oncogene Proteins c-bcr
- RNA, Neoplasm/analysis
- Thrombocythemia, Essential/genetics
- Translocation, Genetic
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Affiliation(s)
- M C Cox
- Department of Hematology, University of Tor Vergata, Ospedale S'Eugenio, Rome, Italy
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