• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.356-360
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• 1999

PURPOSE : This is to review the complicated jaw fractures that had been referred for revision of the unsatisfactory results, and to provide proper managements for the easily complicated jaw fractures. MATERIALS & METHODS : Twenty-nine patients who had been revised due to malunion or complicated fractures of facial bones for last 3 years were reviewed. The main problems required for revision, type of fractures complicated, the primary managements to be reclaimed, the specialties to be involved, the management to be reclaimed, time elapsed to seek reoperation, type of revision surgeries, residual complication were analysed with medical records, radiographs and final examinations. RESULTS: The major complaints were malocclusion(79.3%), facial disfigurement(41.3%), TMJ problems (13.7%), neurologic problems(10.3%), non-union(10.3%), and infection(6.8%). Unsatisfactory results were occurred most frequently after improper management of the multiple fractures of the mandible (62.2%), combined fractures of maxilla and mandible (20.6%), fracture of zygomatico-maxillary complex and midpalate (17.2%). The complications to be corrected were widened or collapsed dental arches (79.3%), improperly reduced condyles (41.3%), painful TMJ (34.4%), limited jaw excursion (31.0%), over-reduction of zygoma (13.7%), and nonunion with infection(13.7%). and dysesthesia (10.3%). The primary managements were nendereet by plastic surgeons in 82.7%(24/29) and by oral surgeons in 7.6%(2/29). Main causes of malunion are inadequate ORIF in 76%, unawareness & delay in 17%, and delayed due to systemic cares in 17%. 76% of 29 patients had been in state of intermaxillary fixation for over 4 weeks. Revision were done by means of "refracture and ORIF"in 48.2%(14/29), orthognathic osteotomies with bone grafts in 55.1%(16/29), and camouflage countering & alloplastic implantations in 37.9%(11/29), TMJ surgeries in 17.2%, micro-neurosurgeries in 11.6%. Residual complications were limited mouth opening in 24.1% (7/29), paresthesia in 13.7%, resorption of reduced condyle in 10.3%. CONCLUSIONS : Failure of initial treatment of jaw fractures is due to improper diagnosis and inadequate treatment with lack of sufficient knowledge of stomatognathic system. It is crucial to judge jaw fracture and patients accurately, moreover, the best way of treatments has to be selected. Consideration of these factors in treatment could minimize the complication of jaw fractures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.2
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• pp.91-95
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• 2014

The posttraumatic complications of jaw fractures related to jaw function and facial deformity include nonunion, malunion, malocclusion, temporomandibular joint dysfunction and facial asymmetry. This report presents cases referred to our department for revision of malunion and malocclusion following inadequate reduction of jaw fractures. Three patients with posttraumatic malocclusions caused by malunion were treated with a LeFort I osteotomy in one case and re-fracture in two cases. All of the patients exhibited stable results without further complications (e.g., malunion or malocclusion). Accurate preoperative diagnosis and proper anatomical reduction of the fracture segments are essential to preventing post-surgical malunion and malocclusion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.5
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• pp.250-252
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• 2014

Nasotracheal intubation should be performed in patients with jaw fractures because maxillomandibular fixation is required. However, when there are concomitant fractures of the nose and facial bones, an intubation tube positioned at the nose makes it difficult to perform an intricate surgery. In order to overcome these problems, a variety of ways to change the position of the tube have been introduced. We describe a simple technique of switching the tube from a nasal to oral position, which was easily executed in a patient with concomitant nasal and mandibular fractures, accompanied by a literature review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.6
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• pp.332-338
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• 2023

Objectives: This study aimed to compare the effectiveness of a hybrid arch bar (hAB) with the conventional Erich arch bar (EAB) for the management of jaw fractures, focusing on their use for temporary fixation in patients undergoing open reduction and internal fixation (ORIF). Materials and Methods: Patients presenting with maxillary and mandibular fractures at our institution were included in this prospective, comparative study. Placement time and ease of occlusal reproducibility were recorded intraoperatively for Group A (hAB patients) and Group B (EAB patients). The primary outcome was comparison of the postoperative stability of the two arch bars. Postoperative measurements also included mucosal overgrowth, screw loosening or wire retightening, and replacement rates. The data were tabulated and computed with a P<0.05 considered statistically significant. Results: The study included 41 patients. A statistically significant difference was observed in postoperative stability scores (3) between Group A and Group B (85.0% vs 9.5%, P=0.001). The mean placement time in Group A (23.3 minutes) significantly differed from that in Group B (86.4 minutes) (P<0.001). The ease of intraoperative occlusion was not different between the two groups (P=0.413). Mucosal overgrowth was observed in 75.0% of patients (15 of 20) in Group A. Conclusion: The hAB was superior to EAB in clinical efficiency, maxillomandibular fixation time reduction, stability, versatility, and safety. Despite temporary mucosal overgrowth, the benefits of hAB outweigh the disadvantages. The choice between hAB and EAB should be based on specific clinical requirements.

• Journal of Veterinary Clinics
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• v.37 no.6
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• pp.363-366
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• 2020

A 2-month-old, 50 kg male Korean native calf was referred with bilateral mandibular fractures. The bilateral mandible was hanging loose, with inability to use the jaw, indicated by excessive salivation. Radiography revealed a long oblique fracture in the right mandible, and a short oblique fracture in the left mandible. Computerized Tomography, a different form of radiography, revealed the fracture in the left mandible to be a comminuted fracture. In order to stabilize the bilateral mandible fractures, a combination of bone plate and wiring was applied; in addition, resin was applied to enhance stabilization of the mandible. Six weeks after surgery, the calf was able to masticate and ruminate well. In this case, application of the plate and wiring with resin to bilateral mandibular fractures presented a successful functional recovery. Accordingly, the combination of bone plate and wiring with resin can be an effective technique for treating mandibular fractures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.4
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• pp.272-275
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• 2017

Bisphosphonates are drugs used to treat osteoclast-mediated bone resorption, including osteoporosis, Paget disease, multiple myeloma, cancer-related osteolysis, and malignant hypercalcemia. The use of these drugs has increased in recent years as have their complications, especially bisphosphonate-related osteonecrosis of the jaw (BRONJ), which more frequently affects the mandible. Here we report a case of BRONJ with a particularly unfavorable course due to cervical inflammation that developed into necrotizing fasciitis, followed by multiorgan involvement leading to septic shock and death.

• Journal of Veterinary Clinics
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• v.20 no.1
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• pp.138-141
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• 2003

First case, a one-year-old female Shih Tzu weighing 3 kg with closed transverse fractures of bilateral mandibular body between 2nd and 3rd premolar teeth were treated surgically with bone plates and screws, and cranial luxation of temporomandibular joints were reduced to closed method. Second case, a 8.4 years old male Yorkshire terrier weighing 2.6 kg with closed transverse/oblique fractures of bilateral mandibular body between premolar and molar teeth were treated surgically with bone plates and screws. Radiographic examination revealed that the fractures in two cases fixed well and temporomandibular joint was stabilized. One month after operation, jaw activity was excellent and malocclusion wasn't observed.

• Archives of Craniofacial Surgery
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• v.21 no.5
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• pp.301-304
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• 2020

Orthognathic surgeries often utilize rigid fixation for stabilization of the osteotomy site. The longterm fate of rigid fixations is still under investigation, and whether they should be routinely removed is under debate despite their low complication rates. Here, we report a case where a 26-year-old man suffered high-velocity trauma to his face 7 years after a two-jaw surgery. Computed tomography examination revealed a zygomaticomaxillary complex fracture, and open reduction and internal fixation was performed along with anterior maxillary wall reconstruction using absorbable mesh. Intraoperative examination revealed a broken L-shaped titanium plate near the fracture site with multiple bony fragments near each titanium screw. The rigid titanium system may have caused comminution of the fracture pattern, worsening the severity of the fracture.

• The Journal of the Korean dental association
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• v.25 no.10 s.221
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• pp.963-981
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• 1987

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.5
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• pp.207-213
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• 2014

Fractures of the mandible occur with a greater frequency in the elderly. This study reports three cases of edentulous atrophic mandible fracture in elderly patients treated with open reduction technique. Three patients who presented with edentulous atrophic mandible fractures underwent surgical management using open reduction and internal fixation. After treatment, clinical evaluations and postoperative complications were examined with postoperative x-ray. Patients were followed with clinical and radiographic examinations. In the postoperative clinical evaluation, two male patients healed well, but one female patient complained of pain and swelling. In radiographic examinations, no union delay or lack of fusion was observed in the edentulous area. Open reduction technique is a viable treatment option for the edentulous atrophic mandible fractures in geriatric patients.