• Title/Summary/Keyword: Mandibular fracture

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REMODELLING AFTER CONSERVATIVE TREATMENT OF THE MANDIBULAR CONDYLAR FRACTURES IN CHILDREN (소아에서 하악과두 골절의 보존적 치료 후 골개조)

  • Ryu, Sun-Youl;Hwang, Ung;Yang, Kyu-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.1
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    • pp.49-55
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    • 2004
  • The management of mandibular condylar fractures in children has long been a matter of controversy. The fracture, if not treated appropriately, may result in complications such as disturbance of mandibular growth and temporomandibular joint ankylosis. They are usually treated nonsurgically, which has been proved to be satisfactory in the long term results. Nineteen children with 25 condylar fractures experienced during their growth period (age at trauma from 10 months to 12 years, mean 7.0 years) were studied. All patients were treated by arch bars and intermaxillary fixation for $7{\sim}14$ days. They have been evaluated with clinical and radiographic examination. The maximum mouth opening and lateral movement of the mandible were within normal limits. There was no malocclusion or ankylosis. Beginning of remodelling was evident at postoperative $1{\sim}3$ months. Remodelling of the condyle was good in 21, while partial adjustment occured in the other 4 condyles. These results suggest that the conservative treatment of condylar fractures in growing children results in good functional results and good remodelling of the condyle.

Aneurysmal bone cyst of the mandibular condyle with condylar neck fracture (하악과두골절을 동반한 하악과두의 동맥류성골당)

  • Yu, Jae-Jung;Park, Jeong-Hoon;Kang, Ju-Han;Kim, Gyu-Tae;Choi, Yong-Suk;Hwang, Eui-Hwan
    • Imaging Science in Dentistry
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    • v.39 no.4
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    • pp.205-208
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    • 2009
  • Aneurysmal bone cyst (ABC) is relatively rare, non-neoplastic expansile lesion of bone. The case of a IS-year-old male with a ABC of the left mandibular condyle is presented. Panoramic radiograph showed a unilocular radiolucency with thinned coritces and a subcondylar fracuture which was due to the trauma. Computed tomography (CT) revealed expansile lesion which had similar attenuation soft tissue. The patient was treated surgically including iliac crestal bone graft.

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치조제 분리술을 이용한 임프란트의 식립증례

  • Kim, Mi-Seong;Nam, Ok-Hyeon;Kim, Su-Gwan;Jo, Se-In;Kim, Sik;Kim, Hyeon-Ho;Gwon, Byeong-Gon
    • The Journal of the Korean dental association
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    • v.40 no.9 s.400
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    • pp.709-715
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    • 2002
  • Two patients with sufficient vertical bone height but insufficient bone width in the anterior mandibular edentulous area, less than 6mm in the buccolingual aspect, for implant placement were chosen for treatment with a ridge splitting procedure. The surgical technique involving greenstick fracture is described. This ridge splitting procedure could be simple placement of implants into ideal restorable positions in severely atrophic, knife-edged ridges and predictable for narrow edentulous alveolar ridge augmentation associated with implant placement. We experienced two cases to place implant with insufficient bone width in the anterior mandibular edentulous area for overdenture be ridge splitting technique. Thus, we will report two cases and review of the literature.

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A Case of Multiple Odontogenic Keratocysts in Mandible and Maxilla (상,하악에 발생한 다발성 치성각화낭종 1례)

  • 정대건;노우영;임필규;송승헌
    • Korean Journal of Bronchoesophagology
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    • v.5 no.1
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    • pp.68-72
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    • 1999
  • Odontogenic keratocyst is a central destructive lesion of the jaws characterized by a thin, fragile layer of orthokeratinizing or parakeratinizing stratified squamous epithelium. Correlation between the histologic type and the recurrence ratio remains a subject of controversy, and multiple cysts are known to be associated with the nevoid basal cell syndrome. We experienced a case of multiple odontogenic keratocyst in a 25 year-old male patient involving bilateral mandible and maxilla. The cystic mass of the right maxilla was removed by Caldwell-Luc's approach and the right mandibular mass was removed by intraoral approach but the teeth that were impacted in the mandibular bone were remained in order to prevent an iatrogenic fracture.

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SURGICAL TREATMENT OF CHRONIC RECURRENT TMJ DISLOCATION WITH EMINOPLASTY THROUGH INTERPOSITIONAL BONE GRAFT (개재골 이식술을 이용한 만성재발성 악관절 탈구의 외과적 처치)

  • Kim, Seong-Gon;Choi, You-Sung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.2
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    • pp.209-214
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    • 1999
  • Chronic recurrent TMJ dislocation results in difficulty of mastication, speaking, and swallowing due to the limitation of the mandibular movement. Etiologic factors are considered as the looseness of the capsule and ligaments, the decrease of the articular eminence, condylar morphologic change, muscular disharmony near by TMJ, and the decrease of the vertical length of the mandibular ramus. Treatment approach has been suggested that surgical methods are selected for the correction of the etiologic factors when conservative treatments are not effective. Many surgical methods have been reported such as eminectomy, eminence augmentation, condylotomy, and zygomatic arch down fracture technique. We performed the eminence augmentation through interpositional bone graft in chronic recurrent TMJ dislocation. This method leads to favorable postoperative result without recurrence and complication, so we report the case with related references.

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Pre-contoured reconstruction plate fabricated via three-dimensional printed bending support

  • Song, In-Seok;Ryu, Jae-Jun;Choi, Young-Jun;Lee, Ui-Lyong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.3
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    • pp.233-236
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    • 2021
  • A mandibular continuity defect can be repaired using either a prosthetic device or autogenous bone. A titanium reconstruction plate can be used with a localized or vascularized flap over the defect of the mandible. Unfortunately, the plate may fail due to plate exposure, screw loosening, fracture, or infection, and will need to be removed. Plate exposure though the skin or mucosa is one of the main reasons for failure. In the present work, the authors introduced a lingually positioned reconstruction plate fabricated via three-dimensional printed bending support. This custom reconstruction plate can avoid plate re-exposure as well as reduce surgical errors and operation time.

In vitro evaluation of fracture strength of zirconia restoration veneered with various ceramic materials

  • Choi, Yu-Sung;Kim, Sung-Hun;Lee, Jai-Bong;Han, Jung-Suk;Yeo, In-Sung
    • The Journal of Advanced Prosthodontics
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    • v.4 no.3
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    • pp.162-169
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    • 2012
  • PURPOSE. Fracture of the veneering material of zirconia restorations frequently occurs in clinical situations. The purpose of this in vitro study was to compare the fracture strengths of zirconia crowns veneered with various ceramic materials by various techniques. MATERIALS AND METHODS. A 1.2 mm, $360^{\circ}$ chamfer preparation and occlusal reduction of 2 mm were performed on a first mandibular molar, and 45 model dies were fabricated in a titanium alloy by CAD/CAM system. Forty-five zirconia copings were fabricated and divided into three groups. In the first group (LT) zirconia copings were veneered with feldspathic porcelain by the layering technique. In the second group (HT) the glass ceramic was heat-pressed on the zirconia coping, and for the third group (ST) a CAD/CAM-fabricated high-strength anatomically shaped veneering cap was sintered onto the zirconia coping. All crowns were cemented onto their titanium dies with Rely $X^{TM}$ Unicem (3M ESPE) and loaded with a universal testing machine (Instron 5583) until failure. The mean fracture values were compared by an one-way ANOVA and a multiple comparison post-hoc test (${\alpha}$= 0.05). Scanning electron microscope was used to investigate the fractured interface. RESULTS. Mean fracture load and standard deviation was $4263.8{\pm}1110.8$ N for Group LT, $5070.8{\pm}1016.4$ for Group HT and $6242.0{\pm}1759.5$ N for Group ST. The values of Group ST were significantly higher than those of the other groups. CONCLUSION. Zirconia crowns veneered with CAD/CAM generated glass ceramics by the sintering technique are superior to those veneered with feldspathic porcelain by the layering technique or veneered with glass ceramics by the heat-pressing technique in terms of fracture strength.

Comparative effects of systemic administration of levofloxacin and cephalexin on fracture healing in rats

  • Golestani, Shayan;Golestaneh, Arash;Gohari, Atousa Aminzadeh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.2
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    • pp.94-100
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    • 2022
  • Objectives: This study aimed to compare the effects of systemic administration of levofloxacin or cephalexin on fracture healing in rats. Materials and Methods: In this animal study, tibial fractures not requiring fixation were artificially induced in 30 male Wistar albino rats using a 1.1 mm surgical bur. The rats were randomly divided into 6 groups (n=5). Groups 1 and 2 received daily subcutaneous saline injections. Groups 3 and 4 received subcutaneous injections of 25 mg/kg levofloxacin twice daily. Groups 5 and 6 received daily subcutaneous injections of 20 mg/kg cephalexin. The rats in Groups 1, 3, and 5 were sacrificed after 1 week, while the rats in Groups 2, 4, and 6 were sacrificed after 4 weeks. The score of fracture healing was determined through histological assessment of sections from the fracture site according to Perry and colleagues. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests. Results: The mean score of fracture healing at 4 weeks was significantly higher than that at 1 week in the saline, levofloxacin, and cephalexin groups (P<0.001). At 1 week, no significant difference was noted among the three groups of saline, levofloxacin, and cephalexin in the mean score of fracture healing (P=0.360). However, this difference was significant at 4 weeks (P=0.018), and the mean score in the saline group was significantly higher compared to that in the levofloxacin group (P=0.015). Conclusion: It is recommended not to prescribe levofloxacin for more than 1 week after surgical management of bone fractures due to its possible adverse effects on fracture healing.

A CLINICAL STUDY ON THE EMERGENCY PATIENTS OF ORAL AND MAXILLOFACIAL SURGERY DURING RECENT 5 YEARS (최근 5년간 응급실을 내원한 구강악안면외과 환자에 대한 임상적 연구)

  • Kim, Jong-Ryoul;Chung, In-Kyo;Yang, Dong-Kyu;Park, Bong-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.2
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    • pp.155-162
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    • 2001
  • This is a clinical study on patients who had visitied the Emergency Room of Pusan National University Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 5 years, from 1992 to 1996. The results were as follow ; 1. The total number of patients was 2,680 and the ratio of male to female was 1.96:1, The highest monthly incidence was shown in September(12.1%) and October(10.5%) and the age distribution peaks was the third decade(24.3%), followed by the first(23.1%) and the fourth decade(17.2%). 2. Soft tissue injury group(29.1%) was the most prevalent, followed by tooth injury group(16.1%), facial bone injury group (16.0%), toothache group(11.2%), socket bleeding group(11.1%), infection group(9.8%) and TMJ dislocation group(5.9%). 3. The percentage of in-patients and out-patient were 21.6% and 78.4%, respectively. The frequent causes of admission were facial bone fracture(73.8%), infection(20.8%) and soft tissue injury(4.8%) in order. However, soft tissue injury was the most frequent cause in out-patient, followed by tooth injury(20.5%), toothache(14.3%), socket bleeding(14.2%) and TMJ dislocation(7.6%). 4. In the facial bone injury group, the mandibular fractures(70.6%) showed the highest incidence, followed by zygomatic bone and arch fractures(7.5%), maxillary bone fractures(4.0%) and nasal bone fractures(4.0%). 5. In the mandibular bone fracture, the most common location was symphysis(36.7%), followed by the mandibular angles(33.1%) and the condyles(21.8%). 6. The common causes of facial bone fractures were violence, fall and traffic accident in order. 7. The common causes of soft tissue injury were fall down, fight and traffic accident in order and the highest incidence was observed in infants before the age of 10 years(44.0%). 8. In the group of tooth injury, tooth luxation(38.5%) showed the highest incidence followed by tooth fracture(33.2%) and tooth loss(17.1%). The common causes of tooth injury were fall, fight and traffic accident in order. 9. In infected patients group, the ratio of in-patients to out-patients was 1 : 1.28, Buccal(24,7%) and infraorbital space abscess(23.3%) showed the highest incidence. 10. The pain caused by dental caries(39.0%) and pericoronitis(26.6%) showed high incidence in the toothache group. 11. The high incidence was observed during third(34.0%) and fourth (24.5%) decades in TMJ dislocation group. 12. In the group of socket bleeding patients, 92% was post-operative hemorrhage and 8% was accompanied with other systemic hemorrhagic diseases.

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A COMPARATIVE STUDY ON POST-OPERATIVE ANALGESIC EFFECT FOR PATIENT-CONTROLLED AND INTRAMUSCULAR ANALGESIA IN MANDIBULAR FRACTURE PATIENTS (하악골 골절환자에서 술후 자가통증조절장치와 근주용 진통제의 효과에 관한 비교)

  • Lee, Seok-Jae;Kim, Kyung-Wook;Kim, Chul-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.42-48
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    • 2006
  • Open reduction and rigid internal fixation is the most popular treatment method for maxillofacial fracture patients, and it is unevitable that postoperative pain can be developed. Many surgeons including oral & maxillofacial surgeons have made constant efforts to decrease postoperative pain. This study is a comparison of postoperative analgesia and intramuscular analgesia in patients with mandibular fractures. In this study, twenty-one patients (Experimental group) were randomly selected and they were injected with IV patient-controlled analgesia (PCA; Walkmed$^{(R)}$, USA). For control group another twenty-one patients were injected with intramusclar non-steroid anti-inflammatory drugs (Rheoma$^{(R)}$, Samsung Pharm. Co.). And then, we measured visual analogue scale (VAS) scores from first postoperative day to second day at regular time interval. The following results were uptained; 1. In patient group who with open reduction and rigid internal fixation, there was significant difference of postoperative analgesic effect during the first postoperative day(p<0.05). 2. In patient group with over 90 minutes surgery time, there was significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p<0.05). 3. In patient group with less than 90 minutes surgery time, there was no significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p>0.05). 4. In patient group with surgery of open reduction using rigid internal fixation at single fractured site, there was no significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p>0.05). 5. In patient group with surgery at two fractured sites, there was significant difference of postoperative analgesic effect during the first postoperative day when compared between experimental group and control group(p<0.05). As mentioned above, it suggest that patient-controlled analgesia is more effective for postoperative pain relief than intramuscular injection in patients with rigid internal fixation by open reduction after mandibular fracture occurred. Especially, it is considered that in patient with more than 90 minutes surgery time or in cases with multiple fractured sites had more effective results with PCA therapy than conventional intramuscular analgesics.