• 제목/요약/키워드: Maxillary fractures

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Comparison of the fracture resistances of glass fiber mesh- and metal mesh-reinforced maxillary complete denture under dynamic fatigue loading

  • Im, So-Min;Huh, Yoon-Hyuk;Cho, Lee-Ra;Park, Chan-Jin
    • The Journal of Advanced Prosthodontics
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    • 제9권1호
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    • pp.22-30
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    • 2017
  • PURPOSE. The aim of this study was to investigate the effect of reinforcing materials on the fracture resistances of glass fiber mesh- and Cr-Co metal mesh-reinforced maxillary complete dentures under fatigue loading. MATERIALS AND METHODS. Glass fiber mesh- and Cr-Co mesh-reinforced maxillary complete dentures were fabricated using silicone molds and acrylic resin. A control group was prepared with no reinforcement (n = 15 per group). After fatigue loading was applied using a chewing simulator, fracture resistance was measured by a universal testing machine. The fracture patterns were analyzed and the fractured surfaces were observed by scanning electron microscopy. RESULTS. After cyclic loading, none of the dentures showed cracks or fractures. During fracture resistance testing, all unreinforced dentures experienced complete fracture. The mesh-reinforced dentures primarily showed posterior framework fracture. Deformation of the all-metal framework caused the metal mesh-reinforced denture to exhibit the highest fracture resistance, followed by the glass fiber mesh-reinforced denture (P<.05) and the control group (P<.05). The glass fiber mesh-reinforced denture primarily maintained its original shape with unbroken fibers. River line pattern of the control group, dimples and interdendritic fractures of the metal mesh group, and radial fracture lines of the glass fiber group were observed on the fractured surfaces. CONCLUSION. The glass fiber mesh-reinforced denture exhibits a fracture resistance higher than that of the unreinforced denture, but lower than that of the metal mesh-reinforced denture because of the deformation of the metal mesh. The glass fiber mesh-reinforced denture maintains its shape even after fracture, indicating the possibility of easier repair.

안면골절의 정복 및 고정을 위한 나사-강선의 사용 (The Useful Method on Temporary Fixation with Screw-wire Technique)

  • 김명훈;권용석;허정;이근철;김석권
    • Archives of Plastic Surgery
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    • 제35권2호
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    • pp.181-186
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    • 2008
  • Purpose: Until now, many kinds of treatment modalities for facial bone fractures have been proposed. Among them, the semi-rigid fixation using miniplates has become the most popular procedure due to its simplicity and good clinical results. However, achieving anatomic reduction of bone fragments with miniplates may be difficult because of inadequate instrumentation for fracture fragment stabilization. We examined the use of inter-maxillary fixation screws or titanium screws tied with stainless steel wire to assist in positioning of fractured segment. Methods: We used this method for reduction in 50 cases of facial bone fractures. Inter-maxillary fixation screws or titanium screws tied with stainless steel wire were used to assist in aligning bony segment. Postoperative radiologic and clinical follow-ups were performed.Results: Radiologic follow-up showed correct reduction and fixation in all cases. Nonnunion and malunion were not shown. Clinical follow-up showed an satisfactory results. Conclusion: By using Inter-maxillary fixation screws tied with stainless steel wire, it was shown that reducing the bony segment to their preinjury position is easy to perform and it enables us to make more accurate reduction, ensure wider visual field.

춘천지역의 안면골 골절에 관한 임상적 연구 (A CLINICAL AND STATISTICAL STUDY FACIAL BONE FRACTURE)

  • 이정구;한명수;김상봉;김학범
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권1호
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    • pp.103-113
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    • 1990
  • The study was based on a series of 252 patient with facial bone fractures who visited to Chun Cheon Sacred Heart Hospital, College of Medicine, Hallym University during the period of Dec., 1984 trough Nov., 1989. The results obtained are as follows; 1. The most frequent etiologic factor was traffic accident(45.2%). 2. The ratio of male to female was 5.5 : 1 and 2nd decade(44%) was the highest age group in incidence. 3. Monthly incidence was the highest in Aug(14.3%). 4. The most common site of fracture was mandible(55.3%) and zygoma complex(24.2%), nasal bone(11.6%), maxilla(8.9%) were next in order of frequeny. 5. In mandible fractures, the most frequent site was symphyseal area(36.9%) and 142 cases(85%) had fractures only in mandible. 6. In maxillary fractures, fracture with other facial bones(85.2%) was more frequent than fracture on maxilla only. The major fracture type on maxilla was Le Fort II type. 7. In fracture of zygoma complex, zygoma & zygomatic arch was the most frequent site(52.0%) and zygomatic arch(24.7%), zygoma(23.3%) were next in order. 8. Open reduction was major method of treatment in facial bone fractures except nasal bone ; mandible(62.9%), maxilla(77.8%), zygoma complex(65.8%). 9. Maxillofacial fractures were most frequently combined with head & neck injury(43.1%), and upp. & low. extremities(29.4%), chest and abdomen(11.9%) were in order of frequency.

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Fracture patterns and causes in the craniofacial region: an 8-year review of 2076 patients

  • Jin, Ki-Su;Lee, Ho;Sohn, Jun-Bae;Han, Yoon-Sic;Jung, Da-Un;Sim, Hye-Young;Kim, Hee-Sun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제40권
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    • pp.29.1-29.11
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    • 2018
  • Background: For proper recovery from craniofacial fracture, it is necessary to establish guidelines based on trends. This study aimed to analyze the patterns and causes of craniofacial fractures. Methods: This retrospective study analyzed patients who underwent surgery for craniofacial fractures between 2010 and 2017 at a single center. Several parameters, including time of injury, region and cause of fracture, alcohol intoxication, time from injury to surgery, hospitalization period, and postoperative complications, were evaluated. Results: This study analyzed 2708 fracture lesions of 2076 patients, among whom males aged 10 to 39 years were the most numerous. The number of patients was significantly higher in the middle of a month. The most common fractures were a nasal bone fracture. The most common causes of fracture were ground accidents and personal assault, which tended to frequently cause more nasal bone fracture than other fractures. Traffic accidents and high falls tended to cause zygomatic arch and maxillary wall fractures more frequently. Postoperative complications-observed in 126 patients-had a significant relationship with the end of a month, mandible or panfacial fracture, and traffic accidents. Conclusions: The present findings on long-term craniofacial fracture trends should be considered by clinicians dealing with fractures and could be useful for policy decisions.

Clinical usefulness of fixation of absorbable implants with cyanoacrylate in comminuted fractures of the maxilla

  • Ju, Gang San;Son, Kyung Min;Choi, Woo Young;Cheon, Ji Seon
    • 대한두개안면성형외과학회지
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    • 제20권4호
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    • pp.233-238
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    • 2019
  • Background: The open reduction of craniofacial bone fractures requires internal fixation using metal plates and screws, which have been considered the gold standard. However, metal implants pose a risk of palpation, protrusion, and foreign body reaction, and they may require an additional operation for removal. Recently, good results have been reported for absorbable implants which complement the disadvantages of metal implants. This study presents the results of using absorbable mesh, plates, and screws with cyanoacrylate for more accurate and firmer fixation of comminuted fractures of the maxilla. Methods: In total, 235 patients underwent operations for comminuted fractures of the maxilla. From January 2012 to December 2014, absorbable mesh and screws were used in 114 patients, while from January 2015 to December 2017, absorbable mesh, plates, and screws with cyanoacrylate were used in 121 patients. Open reduction of the bone fragments was performed, after which absorbable implants were accurately molded and fixed by screws. Results: All patients underwent postoperative computed tomography scans, which showed highly accurate reduction and firm fixation in the patients who underwent procedures using absorbable implants, screws, and cyanoacrylate. There were no postoperative complications or cases of abnormal facial contour. Conclusion: When absorbable implants and screws are used for maxillary fractures, no additional surgery to remove the metal plate is required. In addition, the use of cyanoacrylate enables accurate and firm fixation of the tiny bone fragments that cannot be fixed with screws.

외과적 정출술을 이용한 치관-치근 파절된 미성숙 영구치의 치험례 (SURGICAL EXTRUSION OF THE CROWN-ROOT FRACTURED INCISORS: CASE REPORTS)

  • 이은미;김태완;김현정;김영진;남순현
    • 대한소아치과학회지
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    • 제35권2호
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    • pp.305-312
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    • 2008
  • 치아의 치관-치근 파절은 치아파절이 치관과 치근에 걸쳐 발생되어 법랑질, 상아질 및 백악질까지 이환된 경우로 정의되며, 치수이환여부에 따라 복잡파절과 비복잡파절로 분류될 수 있다. 치관-치근 파절의 빈도는 유치열에서 2%, 영구치열에서 5%로 나타나며, 보통 상악 전치부에 호발한다. 이러한 치관-치근 파절된 치아의 수복을 위해서는 생물학적 폭경이 유지되어야 한다. 이를 위하여 사용되는 방법은 골삭제 후 치은절제술, 교정적 견인, 외과적 정출 후 수복하는 방법과, 인위적으로 발치하여 근관치료와 수복 후 재식하는 방법 등이 있다. 이중 외과적 정출술은 치아를 발거하여 파절부를 치은 연상으로 이동시켜 재식하는 방법으로서, 이는 치관부 파절편이 임상치근의 1/2 미만인 경우에 적응증이 될 수 있으며, 발견하지 못한 다른 파절편을 직접 시진할 수 있고 때로는 파절선을 순측에 위치시켜 치료시 시야확보 및 접근이 용이하다는 등의 장점이 있다. 본 증례에서는 외상으로 치관-치근 파절된 미완성 치근단의 상악 중절치를 가진 환아에서 외과적 정출술 후 근관치료와 광중합복합레진을 이용한 치관수복을 시행하였으며, 정기적 검진시 양호한 결과가 관찰됨을 확인할 수 있었다.

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Reduction of the Isolated Anterior Wall of the Maxillary Sinus Fracture with Double Urinary Balloon Catheters and Fibrin Glue

  • Kim, Jaehee;Yang, Ho Jik;Kim, Jong Hwan;Kim, Su Jin
    • 대한두개안면성형외과학회지
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    • 제18권4호
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    • pp.238-242
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    • 2017
  • Background: Conservative treatment is performed for isolated anterior wall of the maxillary sinus fractures, in many cases when the fracture is clinically not severe and asymptomatic. Despite the absence of symptoms, complications such as sinusitis, rhinitis, and chronic purulent secretion may develop; therefore, successful reduction is required. We attempted to reduce the risk of complications using an alternative technique: reduction of the fracture with two urinary balloon catheters inserted through the maxillary ostium and fixation using fibrin glue, which minimizes the damage to the bony fragments and sinus mucosa. Methods: In this study, 38 patients who were diagnosed with an isolated anterior wall of the maxillary sinus fracture at our hospital between January 2014 and January 2017 were enrolled. The fracture site was exposed via the Caldwell-Luc approach followed by reduction through the insertion of two urinary balloon catheters using a nasal endoscope and fixation with fibrin glue. The sex, cause of fracture, physical examination, and presence of complications were examined and patient's medical records and facial bone computed tomography scans were analyzed. Results: Radiological evaluation showed that there was no evidence of collapsed reduction fragments. Although some patients had remaining symptoms of hypoesthesia (15%; 3 patients), there were no complications such as infection, rhinitis, sinusitis, and chronic purulent secretion at the surgical site. Conclusion: In this study, we present an alternative surgical technique using two urinary balloon catheters and fibrin glue for the successful reconstruction of an isolated anterior wall of the maxillary sinus fracture. This technique enables precise restoration with a reduced risk of complications.

서울지역(地域) 중(中).고등학생(高等學生)의 전치외상(前齒外傷)에 관(關)한 연구(硏究) (A SURVEY OF TRAUMATIZED ANTERIOR TEETH IN A SCHOOL POPULATION)

  • 김종철
    • 대한소아치과학회지
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    • 제6권1호
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    • pp.21-25
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    • 1979
  • The author surveyed traumatized anterior teeth of 12~17 year old 9453(male 4740, female 4713) school students. The results were as follows: 1. The prevalence of traumatized anterior teeth was $10.3{\pm}0.6%$. 2. The prevalence of traumatized anterior teeth of male was $12.2{\pm}0.9%$, and that of female was $8.4{\pm}0.8%$. The prevalence of male was higher than that of female. 3. The distribution of traumatized teeth by severity was as follows: Class I-65.3%, Class II-20.7%, Class III-8.2%, Missing teeth-5.4%, Others-0.4%. 4. Maxillary central incisors had the highest trauma frequence. 5. Single fractures were found to occur more commonly than multiple fractures. 6. The percentage of treated person was 5.1%. 7. 72.3% of the sample was not affected by the traumatized anterior teeth, and 27.7% of the sample thought the traumatized anterior teeth ugly.

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하악골 과두경부 골절에 있어서 후하악부 절개법을 이용한 관혈적 정복술의 유용성 (Outcome of Open Reduction Via Retromandibular Approach for Mandibular Subcondyle Fracture)

  • 이형철;강동희;구상환;박승하
    • Archives of Plastic Surgery
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    • 제32권6호
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    • pp.739-743
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    • 2005
  • Subcondylar fractures have generally been treated by intermaxillary fixation except in cases where there is an absolute indication for open reduction. The reason behind a less aggressive surgical approach lies on the inherent difficulties in manipulating fragments in such a small area at the risk of damaging facial nerves or vessels such as the internal maxillary artery. However, long-term follow-up studies showed that conservative treatment of subcondylar fractures results in disturbances of occlusal function, deviation of the mandible, internal derangement of the temporomandibular joint, and ankylosis of the joint. We carried out open reduction of dislocated subcondylar fractures in 14 patients from 2000 to 2004 by a retromandibular approach. After the reduction of fractured bone, two H-shaped miniplates with 6 holes were fixed with screws at the anterior and posterior surfaces of the subcondyle. The retromandibular approach allowed good access and easy manipulation of the subcondyle. Immediate relief from malocclusion and correction of mandibular midline shifting were observed in all patients. Late temporomandibular dysfunction and ankylosis were not observed. Open reduction with plate osteosynthesis made it possible to avoid IMF in 7 of the 14 patients. The present study shows that open reduction through this retromandibular approach can produce good outcome in adult patients with subcondylar fracture.

비-안와-사골 복합골절에 관한 임상적 연구 (A CLINICAL STUDY ON NASO-ORBITO-ETHMOIDAL FRACTURES)

  • 김수남;이동근;민승기;오승환;최문기;박화규
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제21권3호
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    • pp.277-283
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    • 1999
  • This study was aimed at furnishing the data of Naso-orbito-ethmoidal fractures and aiding treatmenting Naso-orbito-ethmoidal fractures A 5-year review of Naso-orbito-ethmoidal fractures and concomitant injuries is presented. The patients were treated in the Dept. of Oral and Maxillofacial Surgery of Wankwang University Hospital from Jan. 1, 1993 to Dec. 31, 1997. The results were as followes: Male predominated over female by a ratio of 4.6 : 1. The most common reasons is traffic accident(88.2%). The elapsed time from injury to operation is average 9.2 days, and the mean admission days were 79 days and removal of plates were average 217.3 days. The most associated facial bone fractures is Zygomatico-Maxillary complex fracture(20%). Associated injuries were neurologic injury(29.4%), orthopedic injury(23.5%), opthalmologic injury(17.6%), body injury(5.8%), neuropsychologic injury(5.8%) and otolaryngologic injury(5.8%) in this order. The most injured teeth were upper and lower incisors. The intubation methods for surgery were orotracheal(29.57%), submental(29.5%), and nasotracheal technique(41%). Most patients had complications, that were post-traumatic telecanthus, nasal depression, scar formation. This results suggest that early diagnosis and treatment is prerequisits to satisfactory result. Aggressive management of NOE fracture with direct or bicoronal exposure with aid of CT is now an accepted norm.

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