• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권6호
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• pp.476-479
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• 2021

For treatment of mandibular condyle fracture, this article introduces the surgical protocol of intraoral reinsertion after extracorporeal fixation. This efficient, anatomically acceptable, extraoral scar-free, and relatively uncomplicated approach for condylar fracture can be compared with conventional extraoral fixation through various approaches. Clinical step-by-step procedures with a scientific basis were described in this technical strategy note.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.507-513
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• 2000

Objective : The purpose of this study is to evaluate the vitality of the teeth in and adjacent to the mandibular fracture line according to variable conditions of fracture and to establish the protocol of treatment of fracture line teeth. Materials and Methods : The vitality of 97 teeth in fracture line and 104 teeth adjacent to fracture line of 52 patients were invested preoperatively. Of these, 66 teeth in fracture line and 72 teeth adjacent to fracture line were monitored at least 6 months after operation. An electric pulp tester was used to measure pulpal response. The relationships between the vitality of teeth in variable time(preoperation, immediate post-operation; within 1 week after operation, and 6 months after operation) and variable conditions of fracture(horizontal, vertical gap of fracture line, the number of fracture line)were evaluated statistically. Result : The vitality of fracture line teeth in the 6 months after operation statistically differed by the vertical gap of fracture line and the number of fracture line. The vitality of fracture line adjacent teeth in the immediate post-operation only statistically differed by the vertical gap of fracture line. There were statistically differences between preoperative EPT value and vitality of fracture line teeth on 6 months after operation. There were 5 cases of complications including periapical and periodontal abscess. Of these, only one tooth was extracted and the others were well treated with endodontic treatment and subgingival curettage. Conclusion : It is recommended to retain teeth and to monitor the vitality of teeth in and adjacent to fracture line, unless there is an absolute indication for extraction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권1호
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• pp.37-41
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• 2017

Objectives: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). Materials and Methods: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods. Results: In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF. Conclusion: If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture.

• Journal of Korean Dental Science
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• 제6권2호
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• pp.96-101
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• 2013

The proper management of mandibular fractures involves reduction, rigid fixation, and immobilization to allow bone healing. Nonunion or malunion at the fractured sites is a well-known complication of fracture when the treatments are inappropriate. We present a case of left mandibular fracture due to shrapnel during the Korean War. The patients did not receive appropriate treatment at that time, so nonunion and malunion developed. Sixty years after the accident, mandibular osteomyelitis on the fracture site developed due to dental-origin inflammation. The treatment was based on relatively conservative care, such as saucerization and administration of antibiotics. There was no complication during the short-term follow-up. We present the case with literature review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권2호
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• pp.90-93
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• 2013

Mandibular fractures in infants are rare. This case report describes management of a mandibular fracture in an 11-month-old infant using a microplate and screws with open reduction. The surgical treatment was successful. Because the bone fragments were displaced and only the primary incisors had erupted, conservative treatment, such as an acrylic splint and circummandibular wiring, was not recommended. Nine weeks after surgery, the microplate was removed. The results showed complete clinical and radiological bone healing with normal eruption of deciduous teeth.

• The Journal of Advanced Prosthodontics
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• 제3권1호
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• pp.51-55
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• 2011

BACKGROUND. Mandibular displacement is a common complication of condylar fracture. In the mandibular displacement due to condylar fracture, it is difficult to restore both esthetics and function without using orthognathic surgery. CASE DESCRIPTION. This clinical report described a full mouth rehabilitation in the patient with bilateral condylar fractures and displaced mandible using bilateral sagittal split ramus osteotomy (BSSRO) and simultaneous dental implant surgery. Mandibular position was determined by model surgery through the diagnostic wax up and restoration of fractured teeth. The precise amount of the mandibular shift can be obtained from the ideal intercuspation of remaining teeth. CLINICAL IMPLICATION. Mandibular displacement by both condylar fractures can be successfully treated by orthognathic surgery. Determination of occlusal plane and visualization from diagnostic wax up are mandatory for mandibular repositioning of model surgery. Stable occlusion and regular recall check up are needed for long-term outcome.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권1호
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• pp.51-62
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• 1994

The sagittal split osteotomy of the mandibular ramus is a common procedure which has been used in the correction of mandibular deformities for a few decades. Although the technical improvements have increased the reliability and stability of SSRO procedure, the postoperative relapse is imperative and clinically more significant than any other complication. One of the major causes of the relapse is due to the displacement of the proximal segment during SSRO procedure, which is well documented in the literature. Therefore it is important to preserve the original position of the proximal segment during SSRO proced and maxillofacial fixation period. In the case of mandibular asymmetry, if one side of mandible is advanced and the other side of mandible is setback during SSRO procedure, the proximal segment in the advancement site will rotate laterally and the proximal segment in the setback site will rotate medially. For the prevention of the lateral rotation or flaring of the proximal segment in the advancment site. we deliberately fracture the posterior protion of the distal segment in green-stick fashion during SSRO procedure, and there is no need to fix the fractured lingual segment. We fix the two osteotomized bony segments in the buccal cortex area rigidly with adjustable monocortical plates and screws. During SSRO procedure the lingual fracture technique was applied to nine patients with severe mandibular asymmetry who underwent orthognathic surgery in our hospital since march, 1992. These clinical experiencies enable us to find the lingual fracture technique has the following advantages. 1. The proximal segment is displaced minimally. 2. The osteotomized bony segments are contacted intimately. 3. The postoperative relapse and the healing period are decreased.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.448-456
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• 2011

Introduction: Condylar fractures are common in the maxillofacial region, comprising 29-40 percent of all mandibular fractures, accounting for about 20-62 percent). Previous studies reported that pediatric condylar fractures can cause disorders in facial growth and function, and the treatment methods have been controversial. Recently, conservative treatment has shown good results in skeletal growth and functional recovery but the conservative treatment of pediatric condylar fractures has shown unpredictable and undesirable results in some cases, such as facial asymmetry and temporomandibular joint disorder. This study examined the specific age groups and specific mandibular condylar fracture type in growing children treated conservatively in the past. Materials and Methods: Eighteen patients (10 men and 8 women) who received conservative treatment for unilateral condylar fractures in Dankook University Dental Hospital between 2000 to 2007 were followed up for a mean period of 7.2 years. Results: In the survey of 18 pediatric patients who received conservative treatment for condylar fractures, the incidence of temporomandibular dysfunction and growth disturbance was 45% and 35%, respectively. Conclusion: In all complications, the symptoms observed most frequently was mouth opening displacement of the mandible exceeding 2 mm. The other complications of functional and growth disturbance included facial asymmetry concentrated along specific condylar types. Complications including facial asymmetry and functional and growth disturbances showed an increasing tendency according to the specific fracture types. Functional and growth disturbances in the undisplaced condylar fracture type showed a lower incidence(P <0.05). Functional and growth disturbances differed according to the fracture type, which has poor relationship with articular fossa and condyle(P <0.05). Functional and growth disturbance in the cases of the high-level condylar fracture type showed a higher incidence(P <0.05). The functional and growth disturbances of the fracture types were similar in the fragment-contact and non-contact groups(P >0.05).

• The Journal of Korea Assosiation for Disability and Oral Health
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• 제7권1호
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• pp.38-43
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• 2011

Treatment of the mandibular fracture consists of reduction and fixation. Primary wire & Arch bar are perhaps the ideal method for intermaxillary fixation. But, daily feeding, swallowing, speech, and in some instances, respiration is difficult to maintain during the period of intermaxillary fixation, owing to muscle weakness, emotional disorder and poor oral hygiene in a position of the long-term bed disabled patient with multiple injuries. Therefore, Intermaxillary fixation is not applied in the disabled bed patient, the alternative methods must be obtained. In the case of the mandibular fracture, because of the absence of weight bearing, osseous union may eventually occur even without immobilization if the patient is maintained without wound infection on a controlled soft diet. For the purpose of the prevention of the wound infection, the establishment of an drainage on the oral lacerated wound is necessary for the removal of the hematoma & seroma in the fracture site. This is the report of a case that was managed conservatively without the intermaxillary fixation in the long-term disabled bed patient with a mandibular compound fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권3호
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• pp.291-299
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• 1991

We retrospectively reviewed 334 inpatients who sustained a total of 518 mandibular fractures and who ewer treated in our department between l980-1990. This results were obtained as follows : 1. In respect of incidence, there were the highest frequency in July, and the lowest frequency in May. The number of patients has not been increased year after year due to competition with other department in our hospital. 2. The age frequency was the highest in the 2nd decade(38.9%) and the ratio of man to women was 4.9 : 1. 3. The most frequent cause of mandibular fracture was traffic accident(43.4%), and the next was fall down(24.3%), fist blow(71%), industrial accident(21%) and others in order. In the traffic accident, autobicycle accident was 14.1%. 4. The most common location of mandibular fracture was symphysis(38.8%), condyle(20.7% ), angle(19.9%) and body(15.1%) were next in order of frequency. The classification by location of fracture, the frequency of single fracture was 54.8%. 5. In 334 patients of mandibular fracture, the frequency of associated injuries was facial laceration(58.4%), teeth injuries(37.7%), extremity injuries(13.2%) were next in order of frequency. 6. The patients arrived in hospital immediately within 24 hours after accident wee 61.4% of all. In respect of treatment, open reduction was 68.7% of all. 7. Complications including infection were present 11.1% of patient. Other complications inclued delayed healing malocclusion, malocclusion and neurologic problem.