• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.34 no.3
• /
• pp.293-299
• /
• 2008

Bite force is created by the force of adjacent teeth accompanied with tension of masticatory muscle. The bite force value is greater in male than in female and ha maximum value at first molar. Masseter muscle is associated with bite force and during muscle contraction the electric signal is expressed in EMG form. The aim of the study is to assess recovery time for masseter muscle activity and according to each part of bite force after open reduction with internal fixation when mandibular angle fracture and subcondyle fracture occurred. And to determine the appropriate period for mandibular fracture patients to have normal masticatory activity. 30 patients with normal bite condition was selected for control group and from April, 2007 to September, 2007, 20 patients who visited our department of oral and maxillofacial surgery of Dankook University, were selected for the study and were diagnosed as mandibular angle fracture and subcondyle fracture. For control group, the bite force for incisors, canine, premolars and molars and activity of the masseter muscle was measured and compared for 1, 2, 3, 4, 6 and 8 weeks. That was divided as fracture side and normal side. Mann-Whitney U test was performed for significant difference and the following result was obtained. 1. The maximum voluntary bite force for incisors, canine, premolars and molars portion were 0.113 kN, 0.182kN, 0.295kN and 0.486kN and the masseter muscle activity was 0.192 volts in the control group. 2. The maximum bite force at fracture side was recovered by 4th weeks for incisors, 6th weeks for canine and premolars and 8th weeks for molars and the masseter muscle activity was recovered by 6th weeks in the experimental group. 2. The maximum bite force at normal side was recovered by 4th weeks for incisors, 6th weeks for canine, premolars and molars and the masseter muscle activity was recovered by 3rd weeks in the experimental group. 3. The method for internal fixation by 2.0mm miniplates at both superior and inferior border had no complications according for twenty patients and had a satisfactory recovery. According to the result, patient with mandibular angle fracture and subcondyle fracture, 8 weeks was required for bite force recovery. Therefore, patients with open reduction and internal fixation under general anesthesis, it can be assumed that 8 weeks was needed after operation in order to have normal bite force and masseter muscle recovery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.46 no.6
• /
• pp.393-402
• /
• 2020

Objectives: Here, we present cases of mandibular fracture that were managed with the cortical lag screw fixation technique (CLSFT) in order to critically evaluate technique indications and limitations of application at various fracture sites. Materials and Methods: This was a retrospective cohort study. The study sample was composed of patients suffering from mandibular fractures that were treated by the CLSFT. The outcome variables were fracture type, duration of surgery, number of screws, and pattern of application. Other study categories included patient demographics and causes of injury. Chi-square tests were used to assess descriptive and inferential statistical differences, and the P-value was set at 0.05. Results: Thirty-three patients were included in the study sample, with a mean age of 30.9±11.5 years and a male predominance of 81.8%. The technique was applied more frequently in the anterior mandibular region (51.5%) than in other sites. Double CLSFT screws were required at the symphysis and parasymphysis, while single screws were used for body and angle regions. No intraoperative and postoperative variables were significantly different except for surgical duration, which was significantly different between the sites studied (P=0.035). Conclusion: We found that CLSFT is a rapid, cost-effective technique for the fixation of mandibular fractures yielding good treatment results and very limited complications. However, this technique is sensitive and requires surgical expertise to be applied to mandibular fractures that have specialized characteristics.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.11 no.1
• /
• pp.69-77
• /
• 1989

This is a retrospective study on 219 patients with mandibular fracture. The patients were treated in the Dept. of Oral Maxillofacial Surgery of WON KWANG UNIV. HOSPITAL from Aug. 1, 1984 to Sept. 30. 1988. The results were as follows. 1. The mandibular fractures occured most frequently in the twenties(35%) and male were predominant (74.7%) than females. 2. The most frequent etiologic factor was traffic accident(34.3%). 3. The most common location of fracture was symphysis(37.1%). And angle(27.6%), condyle(25.7%), ramus(1.6%) were next in order of frequency. 4. In mandible fracture, they have an average 1.8 fracture line. 5. The use of plate & screw system were more increased in the comparison of each year. 6. Intermaxillary fixation period was more reduced from the concept of 6 weeks fixation, due to the use of Plate & screw system. 7. Postoperative acute wound infection was developed 9.6% in 219 mandibular fracture patients. The compression osteosynthesis was most common cause of acute wound infection than any other treatment method. 8. Postoperative malocclusion was developed 4% in 219 mandibular fracture. And the compression osteosynthesis was most common cause of malocclusion. 9. Acute wound infection was detailed by the approach method. The Intraoral & extraoral combination method was most common cause on acute infection and intraoral, extraoral approach method was next in order of frequency. 10. Normal mouth opening process was proportioned to IMF period. The short IMF period have a fast normal mouth opening process.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.11 no.1
• /
• pp.87-92
• /
• 1989

Transbuccal trocar has been an established method of fixation for the bone plate in the case of mandibular angle fracture. Other than extraoral approaches, this transbuccal approach has many advantages in the treatment of the fracture of mandibular angle. These advantages are as follows ; (1) Damage to the facial nerve branches is minimal. (2) Less postoperative scar is formed. (3) Good vision of occlusion can be easily obtained on the entire operation. (4) Shorter operation time is needed. But, in the clinical procedure of plate fixation, it is has a difficulty in manipulation of the plate and correction of position. To solve these problems, we designed and used a trocar tip which can be easily attached to the trocar, and could make an improvement in the clinical procedures.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.23 no.3
• /
• pp.217-225
• /
• 2001

Any fracture passing through the socket of a teeth is compounded intraorally, even if the fracture is not displaced and the tooth is firm in its socket. Before the advent of antibiotic therapy the danger of infection in a compounded fracture posed severe problems in treatment. Infection is reduced by antibiotic therapy but prolonged use of antibiotics is not justified in an attempt to save a tooth which might eventually be sacrificed. There is still controversy in the management of third molar in mandibualr angle fracture, particulary in regard to their retention or removal at the time of fracture treatment. So we surveyed the 159 patients who were treated with open reduction of mandibular angle fracture containing third molar in fracture line, and compared with the postoperative infection rate depending on time intervals between injury and operation, eruption state of third molar, non-extraction or extraction of third molar related to eruption state, non-extraction or extraction of third molar related to condiition of third molar and its surrounding periodontium and were to propose treatment guidline of third molar in mandibular angle fracture The results obtained were as follows : 1. There were no statistical significance between the time from injury to operation and postoperative infection. 2. There were no statistical significance between eruption state of third molar and postoperative infection. 3. In case of retention of the third molar, there were no statistical significance between eruption state of third molar and postoperative infection, but in case of extraction, postoperative infection was high rate in complete impacted cases. 4. There were no statistical significance between non-extraction or extraction of third molar and postoperative infection depending on condition of third molar. There are no difference in infection rate statistically according to the time from injury to operation, eruption state and condition of third molar, but retention of third molar revealed lowered infection rate in completely impacted cases. By terms of the manegement of third molar, we should extract or preserve third molar in the line of the mandibular angle fracture according to possibility of infection.

• Archives of Craniofacial Surgery
• /
• v.18 no.2
• /
• pp.73-75
• /
• 2017

The management of mandibular angle fractures is often challenging and results in the highest complication rate among fractures of the mandible. In addition, the optimal treatment modality for angle fractures remains controversial. Traditional treatment protocols for angle fractures have involved rigid fixation with intraoperative maxillomandibular fixation (MMF) to ensure absolute stability. However, more recently, non-compression miniplates have gained in popularity and the use of absolute intraoperative MMF as an adjunct to internal fixation has become controversial. In this article, the history of, and current trends in, the treatment of mandibular angle fractures will be briefly reviewed. In addition, issues regarding the management of the third molar tooth will be discussed.

• Archives of Plastic Surgery
• /
• v.38 no.2
• /
• pp.155-160
• /
• 2011

Purpose: Fibrillar collagens like type I collagen, are the major constituent of the extracellular matrix and structural protein of bone. Also, it can be a scaffold for osteoblast migration. The purpose of this study is to estimate the effects of absorbable atelo-collagen sponge (Teruplug$^{(R)}$, Terumo biomaterials Co., Tokyo, Japan) insertion in tooth extraction sites on periodontal healing of the second molar, healing of the fractured mandibular bone and new bone formation of third molar socket after the extraction of the impacted third molar with mandibular angle fracture. Methods: In our study of six cases of mandibular angle fractures, all of them underwent the extraction of the third molar tooth & absorbable atelo-collagen sponge insertion in tooth extraction site. Three of them had a intraoral infection & oral opening to fracture site, two of the six had dental caries, and only one had reduction problem due to third molar position. Six consecutive patients with noncomminuted fractures of the mandibular angle were treated by open reduction and internal fixation using one noncompression miniplates and screws placed through a transoral incision. Results: All of the patients have showed good postoperative functions and have not experienced complications requiring second surgical intervention. There was well healing of the mandibular bone and the most new bone formation of third molar socket after the extraction of the impacted third molar with mandibular angle fracture. Conclusion: The results of this study suggest that absorbable atelo-collagen sponge is relatively favorable bone void filler with prevention of tissue collapse, food packing, and enhance periodontal healing. Thus, the use of atelo-collagen sponge and one noncompression miniplate seems to be relatively easy, safe, and effective for the treatment of fractures of the mandibular angle and third molar extraction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.47 no.5
• /
• pp.365-372
• /
• 2021

Objectives: Mandibular fractures vary significantly with respect to epidemiological and demographic parameters among populations. To date, no study has evaluated these aspects of mandibular fractures in Nuh, Mewat, Haryana, India. To retrospectively analyze the incidence, age and sex distributions, etiology, anatomic distribution, occlusal status, treatment modality provided, and their correlation in patients who suffered isolated mandibular fractures. Materials and Methods: The records of maxillofacial injury patients who reported to the Department of Dentistry, SHKM Government Medical College from January 2013 to December 2019, were retrieved from our database, and necessary information was collected. The data collected were analyzed statistically using IBM SPSS ver. 21. Results: Totals of 146 patients and 211 fractures were analyzed. There were 127 males and 19 females with an age range of 3-70 years (mean age, 26 years). Road traffic accident (RTA) was the most common cause of fracture (64.4%), followed by fall (19.9%), assault (15.1%), and sports injury (0.7%). Of all patients, 42.5% had bilateral fractures, 31.5% had left side fracture, 21.2% had right side fracture, 3.4% sustained midline symphyseal fracture, and 1.4% had symphyseal fracture along one side of the mandible. Site distribution was as follows: parasymphysis (34.6%), angle (23.7%), condyle (20.4%), body (12.8%), symphysis (4.3%), ramus 2.4%, and dentoalveolar 1.9%. The most common facture combination was angle with parasymphysis (17.8%). Occlusion was disrupted in 69.2% patients. Closed reduction was the predominant treatment modality. Conclusion: The data obtained from retrospective analyses of maxillofacial trauma increase the understanding of variables and their outcomes among populations. The results of the present study are comparable to those of the literature in some aspects and different in others.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.30 no.1
• /
• pp.72-82
• /
• 2008

Various surgical approaches in the mandibular condyle fracture have been reported and many advantages of intraoral reduction were also introduced. But there are still controversies about surgical method of condylar fractures up to date. To establish the surgical approach protocol of condylar fracture, from May 2001 to December 2004, total 65 patients with 74 fractures of the mandibular condyle were reviewed during 2 years, retrospectively. All cases were classified according to the treatment considering factors, such as the level of fracture, degree and direction of displacement of fractured segment, patient’s age and gender, surgical approach methods, and their complications. Especially, advantages and surgical limitations of extraoral surgical approach, such as direct reduction and fixation via submandibular approach, Nam’s method, and endaural approach, were compared with those of intraoral surgical approach, such as direct intraoral reduction with transbuccal fixation or right angle driver system, and intraoral reinsertional approach after extraoral fixation of fractured fragment. The guidelines of surgical approach of condylar fracture based on our clilnical retrospective experiences and literature reviews can be suggested.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.41 no.1
• /
• pp.3-10
• /
• 2015

Objectives: We retrospectively evaluated the impact of mandibular third molars on the occurrence of angle and condyle fractures. Materials and Methods: This was a retrospective investigation using patient records and radiographs. The sample set consisted of 440 patients with mandibular fractures. Eruption space, depth and angulation of the third molar were measured. Results: Of the 144 angle fracture patients, 130 patients had third molars and 14 patients did not. The ratio of angle fractures when a third molar was present (1.26 : 1) was greater than when no third molar was present (0.19 : 1; odds ratio, 6.58; P<0.001). Of the 141 condyle fractures patients, the third molar was present in 84 patients and absent in 57 patients. The ratio of condyle fractures when a third molar was present (0.56 : 1) was lower than when no third molar was present (1.90 : 1; odds ratio, 0.30; P<0.001). Conclusion: The increased ratio of angle fractures with third molars and the ratio of condyle fractures without a third molar were statistically significant. The occurrence of angle and condyle fractures was more affected by the continuity of the cortical bone at the angle than by the depth of a third molar. These results demonstrate that a third molar can be a determining factor in angle and condyle fractures.