جستجوی مقالات مرتبط با کلیدواژه « maxillofacial injuries » در نشریات گروه « پزشکی »

The purpose of the present study was to evaluate the changes in maxillofacial fracture epidemiology and etiology regarding Covid-19-related social distancing restrictions in an Iranian population.

A retrospective cross-sectional study was undertaken in six major trauma center hospitals in Iran in a period of two years (March 2018 until March 2020). The primary outcome variable was the maxillofacial fractures incidence. Patients’ demographic data, date of injury as well as fracture characteristics, fracture etiology, type, and site were all recorded, compared, and analyzed in the control and experimental groups.

 The patients consisted of 520 (83.6%) males and 102 (16.4%) females. Patients sustaining maxillofacial fractures over this two-year period displayed a mean age of 31.24±14.44, with an age range of 2 to 88 years. The incidence of maxillofacial fractures significantly decreased in all age groups (p<0.001). After social distancing restrictions were placed; there was a significant drop in the number of subjects attending due to motorcycle collisions and road traffic accidents, whereas the number of fractures caused by assaults and domestic violence significantly increased (p<0.001 for each).

The investigators realized that social distancing restrictions were able to change the trends and patterns in maxillofacial fracture incidence and etiology.

Fractures of orbital rims are common and restoration of these fractures back toits normal anatomic form is essential to maintain the function and aesthetics of the eyes.Low profile miniplates are the rigid fixation device of choice for such fractures. But in caseof sagittal and grossly displaced fractures of orbital rims it is difficult to achieve stability byusing miniplate osteosynthesis. The low profile miniplates may not be able to withstandthe forces to reduce this kind if grossly displaced fractures, another stable option needs tobe considered in these situations.

This case report presents a simple and effective technique of reductionand fixation of an oblique fracture of infraorbital rim fracture using lag screw principle.A standard titanium screw of 2 mm diameter and 10 mm length is being used in thedescribed technique for stable fixation of fractured segments.

The technique is simple, hardware’s are easily available and can be practisedin emergency circumstances where newer advanced technologies are not available

This study was performed to find the most common types of maxillofacial fractures and their management in 3 to 18-year-old individuals referred to the Department of Oral and Maxillofacial Surgery at Shariati Hospital in Tehran, during a 9-year period.

This retrospective study evaluated the records of 319 patients with maxillofacial fractures between 2012-2020, ranging in age from 3 to 18 years. Data regarding the etiology and location of the fracture, age, gender, and treatment approach were retrieved from the archival records and analyzed.

A total of 319 patients were included in the study, out of which, 255 (79.9%) were males and 64 (20.1%) were females. Motor-vehicle accidents were the most common cause of trauma (N=124, 38.9%). We recorded 605 fractures and among them, the parasymphysis (N=131, 21.6%) was the most common site of isolated fractures. Type of treatment varied depending on the fracture type and degree of displacement of the broken segments. It consisted of open reduction and internal fixation, and closed reduction procedures, which included the use of arch bars, ivy loops, lingual splints, and circummandibular wirings.

Analysis of the results revealed that the severity of injury increased with age. Older individuals had higher a number of fracture sites and experienced greater displacement of the broken segments.

The purpose of this study was to determine the mini-plate and screw removal rate and reasons in maxillofacial surgery patients under previous semi-rigid fixation treatment in the past five years at the main trauma center of Mashhad.

This was a census-based retrospective study. All the candidates who admitted to our department for maxillofacial plate removal due to symptomatic or infected mini-plates were included in this study. The patients’ age and gender, plate removal etiologies, and the time between plate insertion and removal were analyzed.

Mini-plates were inserted for 1026 patients. However, only 94 patients with a mean age of 29.4±11.1 years were candidates for plate removal. The plate removal rate was 9.16%. Infection and exposure were the most common causes of plate removal. The most prevalent removal site was the mandible (angle and body). The interval between mini-plate insertion and removal was an average of 12.9±5.6 months. It is noteworthy that the shortest lasting duration was when plate removal was secondary to pain (6.67 months) and infection (11.45 months).

This research showed that the routine removal of plates does not appear to be generally indicated in healthy subjects unless there is an obvious and definitive clinical indication.

This study aimed at analyzing the epidemiological features and complications of different types of maxillofacial traumas in patients who referred to Alzahra hospital, Isfahan during 2005-2019.   This descriptive-analytical cross-sectional study included all patients with maxillofacial traumas who had been admitted to Alzahra hospital from March 1, 2005 to February 31, 2019. Several parameters were registered, consisting of patients’ demographic information, and time, location and the etiology of the accident, and clinical details related to injury and treatment procedures were recorded as well. Finally, the data were analyzed using chi-square and Fisher exact tests, and P < 0.05 was considered statistically significant.   A total of 1677 documents of traumatized patients were evaluated, including 79.66% men (n=1336) and 20.33% women (n=341). The statistical difference between the number of male and female patients was significant (P < 0.001) and maxillofacial traumas were more prevalent in the third decade of life (35.4%). Eventually, the highest number of referents was from Isfahan province (79.2%).   In general, traumatic accidents related to face and jaws are more prevalent in 21-30-year-old male patients mostly due to driving accidents, and driving accidents with vehicles was the most frequent cause of trauma.

The management of maxillofacial injuries is one of the most common challenges in the healthcare field as surgeons, who treat these patients have additional responsibilities in terms of esthetic reconstruction as well as restoration of the patient’s appearance and function.

The aim of the present studywas to evaluate the epidemiology and etiology of trauma at BualiHospital of Tehran during 2008 to 2016.

In this retrospective study, the files of all the trauma patients (n = 293) that had referred to Buali Hospital were investigated, and demographic data and etiologic factors were extracted. Radiographs were analyzed with regards to fracture patterns. The results were statistically analyzed using the SPSS 22 software.

The mean age was 29.18 ± 14.74 years in males and 34.48 ± 19.81 years in females. Fractures were more frequent at ages between 21 and 30 years (39.9%) and less common among 71- to 84-year-olds (2.4%). Most patients were males (78.8%). Of all 474 fractures in 293 patients, zygomatic fractures were the most common fractures (18.6%), while Lefort III in the maxilla was the least common type (1.3%). The main cause of fracture was motor vehicle accidents (51.5%), whereas workplace injuries were uncommon (11.4%).

According to the results, fractures often occur in males in the third decade of life due to their roles in the community. In the current study, similar to other studies carried out in developing countries, the main cause of fractures was motor vehicle accidents. Most of the patients were treated by open reduction. The most frequent side effect was sensory disorders.

Objectives This study aimed to assess the identification of traumatic foreign bodies in the head and neck region using cone-beam computed tomography (CBCT).
Methods In this study, samples (1×1×0.1 cm) were fabricated from 6 different types of materials commonly found in various head and face traumas. These materials included iron, glass, stone, wood, asphalt, and tooth. They were located in 3 different areas, including the tongue, airway, and vestibule of 3 sheep heads. Ten scans were acquired from these materials embedded in different regions. A total of 180 images were analyzed by 2 observers and rated in terms of visual clarity of the foreign body. The results were analyzed by the Kruskal-Wallis test.
Results In 100% of images, stone, asphalt, and glass were observed in all 3 areas with high resolution. On the other hand, 100% of images were unclear in all evaluated areas with metal artifacts. Tooth images were found to be excellent in 100% of cases in the muscle and airway regions and 80% of cases in the vestibule region (unclear in 20% of cases). However, wood was not detected in 100% of images from the tongue and vestibule regions. It was not detected on 60% of images from the airway, while it was found on 40% of images with low resolution.
Conclusion CBCT detected and located all opaque objects such as iron, glass, stone, asphalt, and tooth. However, it showed limited potential in detecting radiolucent objects such as wood.

Statement of the Problem: Ignoring anatomic variations may lead to iatrogenic injuries by surgeons.
The aim of this study was to examine the relationship between the course of infraorbital canal and maxillary sinus using cone beam computed tomography scans (CBCT).
One hundred and ninety two CBCT scans were reviewed for 384 infraorbital canals. The anatomic variants of infraorbital canals were classified into three types based on the protrusion degree of the infraorbital nerve from the maxillary roof into the sinus. Measurements were made on infraorbital canal as vertical distance from the infraorbital rim to the infraorbital foramen, the maximum horizontal distance from the infraorbital canal to the canine root, the maximum diagonal length of the nerve protruded in sinus, the maximum vertical distance from the center of the nerve to the sinus roof.
26.5% of infraorbital canals were entirely contained within the sinus roof. 50.3% of infraorbital canals were located below the roof but remaining juxtaposed to it. In 23.2%, the nerve canal descended into the sinus. The prevalence of type3 of infraorbital canal significantly increased from 14.8% in cases without an ipsilateral Haller cell to 29.1% when a Haller cell was present. The average distance between the infraorbital foramen and the infraorbital rim were increased proportionally to the degree of protrusion of the nerve course into the maxillary sinus (ANOVA p The infraorbital canal protrusion into the sinus is a common variation that must be considered during surgical procedures to avoid iatrogenic injury.

Zygomatic fractures are among the most common maxillofacial injuries.
This study aimed to assess the incidence and causes of zygomatic fractures in patients referring to Tehran Taleghani hospital during a 10-year period.
This descriptive, retrospective, cross-sectional study was conducted on 294 records of patients (248 males and 46 females) with zygomatic fractures selected via census in Tehran Taleghani hospital from 2003 to 2013. Age, gender, cause of fracture, type of treatment modality, and post-operative complications were extracted and reported by using descriptive statistics. Data were analyzed using chi square and Fisher’s exact tests.
Most patients were aged 20 - 30 years (n = 121, 42.1%). Car accident (n = 97, 33%), motorcycle accident (n = 89, 30.3%), and fall from height (n = 44, 15.1%) were the most common causes of fractures. The most common associated fracture was mandibular fracture (n = 104, 35.4%). The most common type of zygomatic fracture was zygomaticomaxillary complex (ZMC) fractures (87.3%) treated by open reduction with internal fixation (84.8%). Paresthesia or hypoesthesia of the infraorbital nerve (n = 177, 64.6%) was the most common complication. Periorbital ecchymosis (n = 159, 58%) was the most common ocular complication. Epistaxis (P = 0.01), paresthesia and hypoesthesia of infraorbital nerve (P = 0.016), enophthalmos (P = 0.014), step formation at the inferior orbital rim (P Zygomatic fractures comprised 22.8% of all maxillofacial injuries and they occurred mainly due to traffic accidents with a higher prevalence in males aged 20 - 30 years. They were mostly treated by open reduction with internal fixation.

The naso-orbito-ethmoid (NOE) area is an intricate structure composed of the nasal, lacrimal, maxillary, frontal, and ethmoid bones. The treatment of NOE fractures is one of the most challenging issues in the management of maxillofacial injuries. The management of these fractures requires a thorough knowledge of midfacial anatomy, surgical techniques, and the available implements in order to obtain optimal aesthetic and functional results. The aim of this study was to review current knowledge (i.e., from the past ten years) concerning NOE fractures and the related surgical techniques. Evidence Acquisition: An extensive electronic literature search was performed via international and national databases, including MEDLINE/PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), DOAJ, Iranian Science Information database (SID), Iranmedex, and Irandoc. Literature published between October 2004 and October 2014 was searched for using specific keywords. The references from each study were also searched. Finally, all articles relevant to the selected keywords and the topic of the study were reviewed.

High-energy blunt or penetrating traumas are themost common cause of NOE fractures. NOE fractures account for some 5% and 15% of adult and pediatric facial fractures, respectively. These fractures are characterized by three major post-injury symptoms, namely increased intercanthal distance, diminished nasal projection, and impaired nasofrontal and lacrimal drainage. The prompt management of NOE fractures is of the utmost importance in avoiding secondary deformities. Surgical treatment is guided by the pattern and classification of the injury. The surgical approach also varies according to the fracture type and other concomitant facial injuries. If the fractured fragment cannot be reduced satisfactorily by closed reduction, the operation should be converted into an open reduction and internal fixation. The most common method for medial canthopexy is transnasal wiring.

Nowadays, advances in radiographic imaging along with the evolution in minimally invasive surgical techniques have led to more conservative treatment modalities that may minimize post-injury complications and improve aesthetic outcomes

In the past decades, a significant increase has been observed in head and face traumas bleeding during and after surgery is one of the most important and dangerous factors for patients. This study was performed to assess the bleeding amount in patients during maxillofacial surgeries and the necessity of blood transfusion.
In this cross-sectional study, 441 patients were enrolled, of which 83.2% and 16.8% were male and female, respectively. To compare the patients’ mean hemoglobin concentration before and after surgery, paired t-test was used. Furthermore, to compare the mean hemoglobin concentration and mean intraoperative bleeding between males and females, independent t-test was used. The significance level was set as 0.05 for all tests.
Results showed that the mean difference of hemoglobin concentration before and after surgery in patients of the study had a significant difference (P 0.050).
The results of this study demonstrated that there was a decrease in mean hemoglobin concentration after surgery, and also, the amount of blood loss in patients during surgery was not high enough for blood transfusion. However, it should be considered that to prevent any problem during surgery, assessing patients with anemia before surgical operations is necessary.

Postoperative pain from open reduction and internal fixation of mandibular fracture is a serious issue. Amantadine is an N-methyl-D-aspartic acid or N-methyl-D-aspartate (NMDA) receptor antagonist that can be effective against postoperative pain..
The present study examined the efficacy of amantadine in alleviating the postoperative pain of mandibular fracture surgery..
Patients and In this double-blind study, 60 patients (ASA physical status I–II) were randomly divided into two groups. The mean ages of the participants were 31.2 ± 13.1 years and 32.3 ± 18.1 years, respectively. The male/female ratios were 24/6 and 26/4, respectively, in the case and control groups. Randomization was based on a single sequence of random assignments using computer-generated random numbers. Group I was given oral amantadine 100 mg 1 hour before surgery, and group II received a placebo at the identical time. Through PCA pumps, patients received a bolus dose of morphine at 0.02 mg/kg body weight, to a maximum of 1.5 mg. PCA pumps were set at 6 minutes lockout intervals and a maximum dose of 0.15 mg/kg/h, to a maximum of 10 mg/h. Pain was assessed using a visual analog scale (VAS) at 0, 2, 4, 6, 12, and 24 hours and 1, 2, 3, 4, 5, and 6 months after surgery. The amounts of analgesic consumed were recorded for the first 24 hours, and for 6 months after surgery..
There were no significant differences between the two groups with respect to age, gender, nausea and vomiting, sleep quality, blood pressure, and heart rate. No significant differences were observed between the two groups in pain scores (P = 0.39) and analgesic consumption (P = 0.78)..
The results suggest that a single dose of preoperative oral amantadine did not reduce acute or chronic postoperative pain, nor analgesic consumption..

The maxillofacial region is one of the most injury-prone areas during road traffic accidents, personal violence, falls and sports. Maxillofacial trauma can lead to breakage or avulsion of upper anterior teeth, which may cause significant aesthetic and functional problems. There are many treatment options available for rehabilitation including removable partial dentures, fixed partial dentures, crown and bridges and implantsupported prostheses. Herein, two cases are presented where implant placement was done for upper anterior teeth, which were traumatized or avulsed following maxillofacial trauma. Both patients demonstrated a history of maxillofacial trauma and had undergone open reduction and internal fixation. The first patient had a severe maxillary alveolar defect treated via autogenous bone grafting and a six-month period was given for proper integration of the bone graft. The second patient was a smoker with very poor oral hygiene and a deep bite. Thus, implant placement was not initially justified.

Currently, orofacial sequelae are recognized as very influential on the qualityof- life for a victim of orofacial damage. Therefore, correct forensic assessment for indenisation purposes is mandatory. However, orofacial damage is frequently reduced to organic components, which results in a forensic assessment process, which are inadequate. This study aims to improve the orofacial damage assessment through the development of an auxiliary tool, the orohanditest. A preliminary inventory was constructed, using relevant bibliographic elements and retrospective study of forensic examinations reports concerning orofacial trauma. This inventory was then utilized in the assessment of 265 orofacial trauma victims for validation. Validity was studied by analyzing the internal construct validity (exploring factorial validity and assessing internal consistency) and the external construct validity (assessing convergent validity and discriminant validity). The level of significance was defined as P < 0.05. The final inventory (orohanditest) was comprised of the three components of body (8 items), functions (10 items) and situations (24 items), which were found to be statistically reliable and valid for assessment. The final score (orofacial damage coefficient) reflects the orofacial damage severity. Orohanditest provides a reliable, precise, and complete orofacial damage description and quantification. Therefore, this method can be useful as an auxiliary tool in the orofacial damage assessment process. Key Words: