Objective: The study aimed to evaluate mandibular fractures in a tertiary military hospital, to determine the age group in which injury occurred most often, to examine the various mechanisms of injury, to determine the anatomical part of the mandible most frequently affected and to determine if there were significant relationships between the various mechanisms of injury and the different fracture sites. Methods: Design: Cross-sectional retrospective study Setting: Tertiary Public Military Hospital Patients: Medical records of 328 active military personnel and their dependents, treated for mandibular fracture at the Department of Otorhinolaryngology – Head and Neck Surgery, Armed Forces of the Philippines Medical Center from January 1999 – December 2009 were retrospectively reviewed for data regarding sex, age, various mechanisms of injury and fractured anatomical part of the mandible. The number of fractures per site according to mechanism of injury was tabulated and prevalence ratios (95% confidence intervals) and p values were computed for the different fracture sites among the various mechanisms of injury. The probability or risk of sustaining fractures in these sites based on mechanism of injury was then computed. Results: The most fractured anatomical part of the mandible was the body (28%), followed by the parasymphysis (24%), angle (17%), symphysis (12%), ramus (8%), condyle (7%), alveolar ridge (3%) and coronoid (1%). There were associated injuries in 54% of those with mandibular fractures. In these patients, zygomaticomaxillary complex fractures occurred in 25%, head and neck abrasions and lacerations in 30%, head injuries in 28%, ocular injuries in 10%, nasal fractures in 8% and cervical spine fractures in 5%. Other injuries present were extremity trauma in 60%, thoracic trauma in 5% and abdominal trauma in 3%. Males dominated with a ratio of 99:1. Males 21 to 30 years of age sustained the most mandible fractures. Most fractures were caused by vehicular accidents (60%), followed by gunshot wounds (31%), falls (4%), violent assault (4%) and sports activities (1%). Alcohol was a contributing factor at the time of injury in 20.6% of fractures. All cases were treated by open reduction and internal fixation with plating or wiring. Conclusion The body was the most commonly fractured anatomic region of the mandible in this series. There appeared to be a statistically significant relationship between violent assault and fractures of the ramus, but not between the other mechanisms of injury and the site of fracture. Its prevalence ratio of 3.32 (95% confidence interval: 1.13; 9.74, p value 0.039) suggests that the prevalence of fractures of the ramus among those exposed to violent assault was 3 times higher than those who were not.
Mandibular Fractures ; Maxillofacial Injuries ; Wounds and Injuries

In the treatment of maxillofacial injuries, proper intermaxillary fixation is very important in improving bone union and restoration of normal occlusion. The traditional methods of intermaxillary fixation consist of interdental wiring and ligating of arch bars to the teeth of each jaw. These methods have their fixation point within the tooth, which may afflict the tooth itself. The tooth ligation method is also unsatisfactory for partially or totally edentulous patients, necessitating adjunctive circumferential wiring and acrylic splint to effect fixation. Furthermore, because of excessive manipulations (about 14-20 wire) during interdental wiring, it increases the possibility of associated gingival and mucosal injuries, and infections acquired during operation due to skin punctures. The authors have devised an improved method of placing miniscrews into the maxilla and mandibular alveolar bone and using these miniscrews for points of intermaxillary fixation. This procedure has been used in 17 patients with variable mandible fracture. In these cases we obtained better results than those with teeth ligating methods. The advantages of author's method include easy placement and removal with minimal wiring, decreased operation time, decreased patient discomfort, reduced risk of tooth, periodontal tissues, and oral mucosa injuries, and reduced risk of delivering blood transmitted diseases (AIDS, hepatitis) by skin puncture. As far as the stabilization and oral hygiene are concerned, fixation method was found to be superior to tooth ligation methods. Moreover, in patients with multiple dental injuries, author's intermaxillary fixation method proved to be simple and safe. With these advantages, new intermaxillary fixation method without tooth ligation is very useful for mandibular fractures and maxillofacial operations.
Humans ; Jaw ; Ligation* ; Mandible ; Mandibular Fractures ; Maxilla ; Maxillofacial Injuries ; Mouth Mucosa ; Oral Hygiene ; Punctures ; Skin ; Splints ; Tooth*

BACKGROUND: Zygoma is a major buttress of the midfacial skeleton, which is frequently injured because of its prominent location. Zygoma fractures are classified according to Knight and North based on the direction of anatomic displacement and the pattern created by the fracture. In zygomaticomaxillary complex (ZMC) fracture many incisions (lateral eyebrow, lateral upper blepharoplasty, transconjunctival, subciliary, subtarsal, intraoral, direct percutaneous approach) are useful. We reviewed various approaches for the treatment of ZMC fractures and discussed about incisions and fixation methods. METHODS: A retrospective review was conducted of patients with ZMC fracture at a single institution from January 2005 to December 2014. Patients with single zygomatic arch fracture were excluded. RESULTS: The identified 694 patients who were admitted for zygomatic fractures from which 192 patients with simple arch fractures were excluded. The remaining 502 patients consisted of 439 males and 63 females, and total 532 zygomatic bone was operated. Orbital fracture was the most common associated fracture. According to the Knight and North classification the most frequent fracture was Group IV. Most fractures were fixated at two points (73%). CONCLUSION: We reviewed our cases over 10 years according to fracture type and fixation methods. In conclusion, minimal incision, familiar approach and fixation methods of the surgeon are recommended.
Blepharoplasty ; Classification ; Eyebrows ; Female ; Humans ; Male ; Maxillary Fractures ; Maxillofacial Injuries ; Methods* ; Orbital Fractures ; Retrospective Studies ; Skeleton ; Zygoma ; Zygomatic Fractures

mandibular fractures that were treated at the Seoul National University Boramae Hospital in order to analyze the characteristics of mandibular fractures and the relationship between the causes and injury patterns. A total of 141 patients with mandibular fractures who were treated between 1996 and 2004 were analyzed retrospectively. The male to female ratio in the patient group was 5.13:1, and the mean age was 33.7 years. The most common etiologic factor was assaults (45.4%), and which was followed by activities associated with daily-life (40.4%) includeding falls, stumbling, collisions, and traffic accidents (11.3%). Single fracture sites were present in 75 patients (53.2%), two or more fracture sites were observed in other patients, and a total of 211 fracture sites were observed. The mandibular angle fractures (46.7%) was the most common in case of single fractures, and symphysis and angle fractures (45.4%) was most common in multiple fractures. Through out overall fracture sites, the most common fracture site was the symphysis (41.2%), followed by the angle (32.2%) and condyle (18.5%). Among assault and falls-related injuries, the common involving sites were the symphysis, and followed by the body and condyle. In case of traffic accidents, the symphysis fracture was the most common, and which was followed by the condyle and angle fractures. This study documented the characteristics of the mandibular fractures. The results demonstrate that preventive measures according to these characteristics will need to be implemented in order to minimize the risk of maxillofacial injuries.]]>
Accidents, Traffic ; Female ; Humans ; Male ; Mandibular Fractures ; Maxillofacial Injuries ; Retrospective Studies ; Seoul

PURPOSE: Different patterns in the causes of maxillofacial injury are thought to correlate with socioeconomic status and regional environment. This study investigated maxillofacial fractures in order to analyze maxillofacial trauma characteristics and the relationship between the causes and injury patterns in Korea. MATERIAL AND METHODS: A total of 518 patients with maxillofacial fractures who were treated at the Seoul National University Boramae Hospital between 1996 and 2004 were retrospectively analyzed. Data were obtained from the patients' medical records and radiographs. The male to female ratio in the patient group was 2.78:1, and the mean age was 32.3 years. RESULTS: Midfacial fractures were the most common location of injury (46.1%). The most common etiologic factor was an activity associated with daily life (42.6%) including falls, stumbling, and collisions. The second most common cause was assault (32.4%), followed by traffic accidents (13.7%). In the case of midfacial fractures and mandibular fractures, assault was the most common etiologic factor, whereas in the case of alveolar bone fractures, activities associated with daily life were the most common cause. With regard to age groups, assault was the most common cause for patients between 10 and 39 years old and an activity associated with daily life was the most common cause in those under 10 years and over 40 years. CONCLUSIONS: This study concluded that activities associated with daily life and assault causes a large proportion of Korean maxillofacial injuries and that preventive measures should be implemented in order to minimize these risks.
Accidents, Traffic ; Female ; Fractures, Bone ; Humans ; Korea ; Male ; Mandibular Fractures ; Maxillofacial Injuries ; Medical Records ; Retrospective Studies ; Social Class

PURPOSE: To research about maxillofacial traumatic injuries of children in aspects of gender difference, various incidence rates between age, trauma type, cause, monthly and daily incidence rate, type of tooth damage, gingival damage, soft tissue damage, and type of facial bone fracture. MATERIALS AND METHODS: Study group consisted of children under 15 years of age who visited Dental Hospital, School of Dentistry, Kyung Hee University from 2004/7/1 to 2007/6/30 with chief complaint of oral and maxillofacial traumatic injuries. 1,559 cases of traumatic injuries were studied from 1,556 (1,004 male, 552 female) children. CONCLUSION: 1. There were slightly more boys than girls, giving a male-to-female ratio of 1.82:1.0. The 1-3 year old boys and girls had the highest number of traumatic injuries. 2. Of the 1,556 patients, 68.63% had soft tissue injuries, 50.22% had periodontal injuries, 29.89% had teeth injuries, and 3.85% had maxillofacial bone fractures. 3. Falling down was the most common cause of injury in both sexes. 4. The months with the highest incidence rates were in order May (12.12%), June (11.74%), and October (11.13%). Most of the injuries occurred on weekends. 5. The most common tooth injury was uncomplicated crown fracture, and the most common periodontal injury was subluxation. The majority of traumatizes teeth were the upper central incisors. 6. The most common soft tissue injury was intraoral lacerations. 7. Mandibular fractures were most frequent in facial bone fractures; symphysis, condylar head, and angle fractures were most frequent in mandibular fractures; maxillary and nasal bone fractures were most frequent in midfacial bone fractures.
Child ; Crowns ; Dentistry ; Facial Bones ; Fractures, Bone ; Head ; Humans ; Incidence ; Male ; Mandibular Fractures ; Maxillofacial Injuries ; Nasal Bone ; Soft Tissue Injuries ; Tooth ; Tooth Injuries

Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.
Adolescent ; Adult ; Ankylosis ; Child ; Health Resorts ; Humans ; Incidence ; Mandible ; Mandibular Fractures ; Maxillofacial Injuries ; Regeneration ; Splints ; Temporomandibular Joint ; Tooth ; Tooth, Unerupted

maxillofacial trauma were increased. Because of the mandible relatively protruded among the facial bone, the most frequent associated oral and maxillofacial injuries was mandible fracture in the trauma center setting. A clinical study on 411 patients with mandibular fracture who visited in Department of Oral and Maxillofacial Surgery, Chun-chon Sacred Heart Hospital during 10 years(1997-2006) was done by analysing sex, age, mode, fracture site and treatment method]]>
Accidents, Occupational ; Facial Bones ; Heart ; Humans ; Mandible ; Mandibular Fractures ; Maxillofacial Injuries ; Motor Vehicles ; Sports ; Surgery, Oral ; Trauma Centers ; Urbanization

PURPOSE: To establish management protocol for mandibular angle fracture, we describe pertinent factors including cause, impacted third molar and recent treatment tendency. METHODS: We examined the records of 62 patients who had unilateral mandibular angle fracture. Sixty patients who had open reduction surgery were examined at postoperative weeks 1, 4, 8, 12, and 28. RESULTS: Left mandibular angle fracture is frequent in younger males. Presence of the mandibular third molar can increase fracture risk. Because of attached muscle, favorable fractures occurred primarily in the mandibular angle area. CONCLUSION: Extracting the mandibular third molar can prevent angle fractures, and open reduction with only one plate adaptation is generally the proper treatment method for mandibular angle fracture.
Humans ; Jaw Fractures ; Male ; Mandibular Injuries ; Molar, Third

OBJECTIVETo determine the causes and incidence of facial injuries by an epidemiologic retrospective study.

METHODSA total of 3 958 patients with facial injuries treated at Department of Oral and Maxillofacial Surgery, West China School of Stomatology, Sichuan University from 1955 to 2001 were investigated. Data regarding age, gender, cause of injury, pattern of fracture and associated systemic injuries were reviewed.

RESULTSThe male to female ratio of the patients with facial injury was 4.27:1 and 33.4% of patients were aged between 21 and 30 years. The most common cause of injury was traffic accident (30.6%), followed by falls (21.4%) and collision (15.8%). A total of 794 patients (20.1%) showed only soft tissue injuries. 1 100 patients (27.8%) had multiple fractures in facial bones and 2,064 patients (52.1%) had single fracture. The mandibular fracture was most frequently seen, followed by the maxilla and the zygoma. The most common site of mandible fracture was the body (31.2%), followed by the symphysis (22.7%), the condylar (20.5%) and the angle (13.7%). Accompanied injuries to brain and skull happened in 916 patients (23.1%).

CONCLUSIONSBone fractures were more common in hospitalized patients with facial injuries. The numbers and sites of fracture were related to the causes of injuries and anatomic structure of the bone. The brain and skull injuries, the most often and seriously accompanied injuries, would not be neglected.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Brain Injuries ; etiology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mandibular Fractures ; complications ; epidemiology ; etiology ; Maxillofacial Injuries ; complications ; epidemiology ; etiology ; Middle Aged ; Retrospective Studies ; Sex Factors ; Young Adult