• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제11권1호
• /
• 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
• /
• 제29권1호
• /
• pp.50-54
• /
• 2007

This report constitutes a 7-year study of facial fractures based on a series of 616 patients who were treated for facial fractures as in-patients at Chosun University Dental Hospital between 1998 and April 2005. The following results were obtained : 1. The ratio of men to women was 5 : 1. 2. The major etiological factors were falls (36.2%), traffic accidents (23.4%), punches (18.1%), sports (8.3%), and accidents related to work (2.8%). 3. They were most frequent in the second (28.8%), first (26.6%), and third (12.3) decades, in that order. 4. The sites of frequent mandible fracture are the symphysis (32%), left mandibular angle (25.3%), and right mandibular angle (10.9%). 5. The most frequent maxillary fractures were zygomatic fractures (46.4%), Le Fort I fractures (28.8%), and Le Fort II (12.0%) fractures.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제19권4호
• /
• pp.435-446
• /
• 1997

본 교실에서는 1992년 1월 1일부터 1996년 12월 31일 까지 최근 5년간 전남대학교병원 응급실에 내원한 구강악안면외과 환자에 대한 실태조사를 시행하여 다음과 같은 결과를 얻었다. 남녀의 성비는 2.5 : 1의 비율로 남성에서 호발하였으며, 하발연령층은 20대, 30대, 9세 이하의 순이었다. 응급실에 내원한 환자의 수는 9월과 10월에 11%로 가장 많았다. 응급실에 내원한 원인으로는 교통사고, 추락사고, 구타사고 순이었다. 손상내용은 악안면열상, 악안면골절, 치아손상 순이었다. 악안면골절은 하악골 단독골절이 가장 많았으며 관골-상악골 복합골절, 하악골-상악골 복합골절 순이었으며 하악골 골절시 정중부, 과두부, 우각부 순으로 발생하였다. 저녁 6시부터 새벽 3시 사이에 응급실에 내원한 환자가 전체의 57%를 차지하였다. 주소 발생에서 응급실 내원까지는 8시간에서 12시간 사이가 가장 많았다. 이상의 결과는 구강악안면외과 영역의 응급환자가 비교적 많이 발생하고 있으므로 이를 전담할 수 있는 구강악안면외과 분양가 시급히 개설되어야 할 것임을 시사하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제47권5호
• /
• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제26권2호
• /
• pp.224-227
• /
• 2000

Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제39권5호
• /
• pp.217-223
• /
• 2013

Objectives: Buccal fracture of the mandibular proximal bone segment during bilateral sagittal split ramus osteotomy (SSRO) reduces the postoperative stability. The primary aim of this study is to evaluate the effect of this type of fracture on bone healing and postoperative stability after mandibular setback surgery. Materials and Methods: Ten patients who experienced buccal fracture during SSRO for mandibular setback movement were evaluated. We measured the amount of bone generation on a computed tomography scan, using an image analysis program, and compared the buccal fracture side to the opposite side in each patient. To investigate the effect on postoperative stability, we measured the postoperative relapse in lateral cephalograms, immediately following and six months after the surgery. The control group consisted of ten randomly-selected patients having a similar amount of set-back without buccal fracture. Results: Less bone generation was observed on the buccal fracture side compared with the opposite side (P<0.05). However, there was no significant difference in anterior-posterior postoperative relapse between the group with buccal fracture and the control group. The increased mandibular plane angle and anterior facial height after the surgery in the group with buccal fracture manifested as a postoperative clockwise rotation of the mandible. Conclusion: Bone generation was delayed compared to the opposite side. However, postoperative stability in the anterior-posterior direction could be maintained with rigid fixation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제42권3호
• /
• pp.144-150
• /
• 2016

Objectives: We compared the transbuccal and transoral approaches in the management of mandibular angle fractures. Materials and Methods: Sixty patients with mandibular angle fractures were randomly divided into two equal groups (A, transoral approach; group B, transbuccal approach) who received fracture reduction using a single 2.5 mm 4 holed miniplate with a bar using either of the two approaches. Intraoperatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postoperatively and evaluated clinically for post-surgical complications like scarring, infection, postoperative occlusal discrepancy, malunion, and non-union. Radiographically, the interpretation of fracture reduction was also performed by studying the fracture gap following reduction using orthopantomogram tracing. The data was tabulated and subjected to statistical analysis. A P -value less than 0.05 was considered significant. Results: No significant difference was seen between the two groups for variables like surgical time and ease of fixation. Radiographic interpretation of fracture reduction revealed statistical significance for group B from points B to D as compared to group A. No cases of malunion/non-union were noted. A single case of hypertrophic scar formation was noted in group B at 6 months postsurgery. Infection was noted in 2 patients in group B compared to 6 patients in group A. There was significantly more occlusal discrepancy in group A compared to group B at 1 week postoperatively, but no long standing discrepancy was noted in either group at the 6 months follow-up. Conclusion: The transbuccal approach was superior to the transoral approach with regard to radiographic reduction of the fracture gap, inconspicuous external scarring, and fewer postoperative complications. We preferred the transbuccal approach due to ease of use, minimal requirement for plate bending, and facilitation of plate placement in the neutral mid-point area of the mandible.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제42권
• /
• pp.6.1-6.6
• /
• 2020

Background: Various types of miniplates have been developed and used for the reduction of facial bone fractures. We introduced Yang's Keyhole (YK) plate, and reported on its short-term stability. The purpose of this study was to evaluate the long-term stability of the YK plate, as a follow-up study, by examining the patients who had used the YK plate among the patients with the reduction of mandible fractures and who visited for plate removal. Methods: We reviewed the medical records of 16 patients who underwent mandibular fracture fixation using a YK plate (group I) and 17 patients who underwent mandibular fracture fixation using a conventional plate (group II). Assessment was then made on malunion, occlusal stability, discomfort during the application, and clinical symptoms. Results: From January 2015 to December 2017, a total of 36 patients underwent mandibular fracture surgery using a YK plate. A total of 16 patients received plate removal. Among them, 15 were male and 1 female. The average age was 26 years. The applied surgical sites were the 12 on mandibular angle, 4 on mandibular symphysis, and 2 on subcondyle. The application period of YK plate was an average of 335 days. During the same period, 45 people underwent surgery on the conventional plate. A total of 17 patients received plate removal. Among them, 15 were male and 2 females. The average age was 36 years. The applied surgical sites were the 8 on mandibular angle, 4 on mandibular symphysis, and 2 on subcondyle. The application period of the conventional plate was an average of 349 days. No malocclusion occurred at the time of removal, and occlusion was stable. No patient complained of joint disease or discomfort. Conclusion: The YK plate system, in which the screw was first inserted and the plate was applied, for clinical convenience did not cause any particular problem and no significant difference from the conventional plate.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제17권3호
• /
• pp.277-282
• /
• 1995

With the use of antibiotics and improved dental care, osteomyelitis of the jaw is less common these days, But sometimes the management of osteomyelitis is more difficult because of appearance of resistant organisms to antibiotics. Treatment of the steomyelitis are incision and drainage, closed catheter irrigations, sequestrectomy, saucerization, hyperbaric ocygen therapy, and resection with or without bone graft. We experienced advanced osteomyelitis due to delayed treatment of left mandibular angle fracture. He have medical history of pschysoprenia. We decided to treat the patient with open reduction and closed cather irrigation. We achived reconsolidation of mandibular fracture accompanied by osteomyelitis by complete removal of inflammatory tissues, rigid fixation with miniplate and closed catheter irrigation.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제31권2호
• /
• pp.127-135
• /
• 2009

Objectives : The titanium fixation system has been used in orthognathic surgery for fixation of bone segments usually, but the biodegradable fixation system was developed and also being used. The strongest point in the biodegradable system is that no extra operation should be needed to remove fixation materials. In spite of this merit, oral & maxillofacial surgeons hesitate to use this system in fracture or orthognathic surgery. In this study, as we got some clinical experiences, we'd like to report the result of clinical study using the biodegradable fixation system in orthognathic surgery. Patients and Methods : A total of 35 patients composed of 17 males and 18 females with 25 osteotomies in maxilla and 34 osteotomies in mandible were fixated with the biodegradable fixation system(Inion $CPS^{(R)}$). We investigated methods of stabilization, fixation time, and complications on the basis of the method as above. Results : Four 2mm thick L shaped plates with 7 holes of which 1 hole was removed were fixed in maxilla with six $2.0{\times}7mm$ screws. Three $2.5{\times}16{\sim}18mm$ screws were used to fix superior ramus area and one mandibular angle area in mandible. It took about 27.4 minutes in maxilla, 25.3 minutes in mandible to perform the fixation which took longer time than the titanium system(9.5 minutes in maxilla, 8 minutes in mandible). Generally, there was no problem except 9 cases in which there were some complications. Conclusions : In most cases, the biodegradable fixation system can be used without problem in usual orthognathic surgery. But, this system is inferior to the titanium fixation one in some respects such as fixation time, size, and physical property. Some supplementations for such weak points as aforementioned should be needed for the universal use of biodegradable materials.