• Title/Summary/Keyword: Mandibular fracture

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RADIOLOGICAL EVALUATION OF FRACTURE LINE STABILITY DURING FUNCTIONAL LOADING AFTER MINIPLATE FIXATION OF MANDIBULAR ANGLE FRACTURES (하악 우각부 골절의 소형금속판 내고정 후 기능시 골접합선의 안정도에 관한 방사선학적 평가)

  • Suh, Chang-Ho;Bae, Jung-Soo;Chin, Byung-Rho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.428-434
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    • 2001
  • After miniplate fixation of mandibular angle fractures, fracture line stability during functional loading was evaluated. Using panoramic radiographs, 15 mandibular angle fracture patients who were treated by open reduction and one miniplate fixation along the external oblique ridge, were evaluated at postoperative 1, 4 and 8 weeks. At each time, 2 radiographs were taken: one taken during maximum biting of hardened silicone sheet on the affected side molar area and the other on the non-affected side. The distraction gap of inferior border of mandible at each time and each side was measured and these data were analysed statistically with clinical findings. The differences of inferior border distraction gap during hardened silicone sheet biting on the affected side molar area and on the non-affected side molar area at 4 week radiographs were smaller than those of 1 week's except one case. At 8 week's radiographs, the fracture lines were so stabilized that it was almost impossible to find the gap differences except one case and there were increased radiopacity along the entire fracture lines. Clinically, bony union was confirmed in all cases during plate removal performed at postoperative 6 month. By statistical analysis(paired t-test), the inferior border distraction gap during biting of hardened silicone sheet on the affected side was significantly reduced during 1 and 4 week interval(p<0.01). The differences of inferior border distraction gap during biting on the affected side molar area and on the non-affected side molar area were also significantly reduced at 1 and 4 week interval(p<0.01). But the inferior border distraction(compression) gap during non-affected side biting was not significantly changed. From these findings, it could be concluded that fracture line stability during functional loading after one miniplate fixation of mandibular angle fractures stems mainly from reduction of inferior border distraction gap during affected side biting on time interval. According to these radiographic and clinical findings, the clinical superiority of one miniplate fixation technique in mandibular angle fracture treatment could be confirmed.

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Surgical Reconstruction of the Severe Tongue Laceration with Mandibular Fracture in a Siberian Husky Dog

  • Lee, Jae-Hoon;Kim, Tae-Hoon;Yang, Wo-Jong;Kang, Eun-Hee;Chang, Hwa-Seok;Chung, Dai-Jung;Choi, Chi-Bong;Lee, Jeong-Ik;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.25 no.6
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    • pp.545-548
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    • 2008
  • A 3-year-old castrated male Siberian husky was presented for evaluation after being hit by a car. On physical examination, the dog showed open-mouth, displacement of mandible and hypersalivation with blood ting. The base of tongue was transected almost 80% on the bias from right dorsal side to the left ventral side. Radiography demonstrated separation of mandible symphysis, and fracture of right condyle and vertical ramus. After debridement of the necrotic tissue, tongue apposition with simple interrupted suture was performed. Mandibular symphysis, condyle and mandibular vertical ramus fractures were fixed using pin, cerclage wire, T-plate, and K-wires. The mouth was irrigated daily using chlorhexidine after surgery. The sutures that were loose here or untied at tongue were re-sutured under sedation. The transected tongue was healed and recovered its normal movement after 6 weeks.

Coronoidectomy for reduction of superolateral dislocation of mandible condyle

  • Seok, Hyun;Ko, Seung-O;Baek, Jin-A;Leem, Dae-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.3
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    • pp.182-187
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    • 2022
  • Superolateral dislocation of the condyle is a rare mandibular fracture. The treatment goal is to return the dislocated condyle to its original position to recover normal function. This study reports on superolateral dislocation of the condyle with mandibular body fracture. The mandibular body was completely separated, and the medial pole of the condyle head was fractured. The condyle segment was unstable and easily dislocated after reduction. The temporalis muscle on the condyle segment might have affected the dislocation of the condyle. A coronoidectomy was performed to disrupt the function of the temporalis muscle on the condyle segment in order to successfully reduce the dislocated condyle. Coronoidectomy is a simple procedure with minimal complications. We successfully performed a coronoidectomy to reduce the superolateral displaced condyle to its original position to achieve normal function. Coronoidectomy can be effectively used for reduction of superolaterally displaced condyles combined with severe maxilla-mandibular fractures.

TREATMENTS OF COMMINUTED MANDIBULAR FRACTURES (하악골 분쇄골절의 치료)

  • Jeon, Woo-Jin;Kim, Su-Gwan;Kim, Hyeon-Ho;Kim, Hak-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.1
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    • pp.71-75
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    • 2005
  • This study evaluated retrospectively the treatment method and postoperative complications of communited mandibular fractures. We analyzed the clinical and radiologic data of 14 patients with the comminuted mandibular fractures who were admitted to Chosun University Dental Hospital from January 1998 to December 2003. We reviewed the cause of trauma, fracture sites, treatment methods, and postoperative complications. Thirteen patients (93%) had a successful treatment outcome without complications. Only one patient developed postoperative osteomyelitis requiring early plate removal and sequestrectomy. For the comminuted fractures of mandible, internal fixation using micro- or mini-plate was an effective treatment method with a low incidence of major complications.

The conservative treatment of mandibular fracture in a child with circummandibular wiring: case report (환악 결찰술을 이용한 소아 하악 골절의 보존적 치료: 증례보고)

  • Kim, Hyung-Mo;Kim, Tae-Wan;Song, Seung-Il;Lee, Jeong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.145-148
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    • 2010
  • Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.

ANALYSIS OF $PGE_2$ CONCENTRATION IN SYNOVIAL FLUID ASPIRATES FROM TMJS OF PATIENTS WITH MANDIBULAR FRACTURE (하악골절 환자에서 악관절강내 활액의 $PGE_2$ 농도 분석)

  • Lee, Gi-Hyug;Kim, Su-Gwan;Kim, Myung-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.204-208
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    • 2001
  • The purpose of this study is to examine the change of enzymeimmuno-assay for $prostaglandinE_2$ in the synovial fluid lavage specimen of patients with mandibular fracture patients without condylar fracture. For this study, fourteen patients (eight males, six females) with mandibular fractures without condylar fracture was investigated to analyse the synovial fluid from upper temporomandibular joint cavities. Synovial fluid was collected from TMJ cavities of mandibular fracture patients before open reduction and after one week of open reduction, and then stored in liquid nitrogen tank after centrifuge. Two synovial fluid lavage samples of TMJs of 2 asymptomatic served as normal controls referred from other data. The concentrations of $PGE_2$ were measured by use of $PGE_2$ EIA System ($Amersham^{(R)}$). The following results were obtained: 1) In nine patients, the concentrations of $PGE_2$ are lower after open reduction than before. 2) In three patients, the concentrations of $PGE_2$ are higher after open reduction than before. 3) There was no statistical significant between the preoperative group and postoperative 7 days (p>0.05), but there was some difference between the two groups. In conclusion, the results suggest that $PGE_2$ probably does not play as important role in the harm of TMJ.

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THE SHORT-TERM REMOVABLE INTERMAXILLARY FIXATION CARE BY USE OF AN ADDITIVE INCISION & DRAINAGE ON THE ORAL LACERATION WOUNDS ADJACENT WITH MANDIBULAR COMPOUND FRACTURES: REPORT OF A CASE (하악골 복합 골절시 구내 열창부 상에 추가 절개 배농술을 이용한 단기간 가변적 악간고정 관리: 증례보고)

  • Mo, Dong-Yub;Yoo, Jae-Ha;Choi, Byung-Ho;Kim, Ha-Rang;Lee, Chun-Ui;Ryu, Mi-Heon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.3
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    • pp.260-264
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    • 2010
  • Treatment of the mandibular fracture consists of reduction and fixation. The apparatus that is used to keep the jaws together during healing will often reduce the fracture as well. When the jaws are brought together and intermaxillary elastic rubber traction is placed, the occlusion of the teeth will help to orient the fractured parts into good position. Intermaxillary fixation, that is, fixation obtained by elastic bands between the upper & lower jaws to which suitable anchoring devices have been attached, will successfully treat most fractures of the mandible. Arch bars are perhaps the ideal method for intermaxillary fixation. Several types of ready-made arch bars are used. But, daily occupational life and oral hygiene is difficult to maintain during the period of longterm immobilized intermaxillary fixation (commonly 6-8 weeks), owing to malnutrition and emotional disorders in a position of the patient with mandibular fractures. Most mandibular fractures heal well enough to allow removal of fixation in about 6 weeks. Though there are many complications of mandibular fracture, such as infection, hemorrhage, trismus, paresthesia and nonunion, it is favorable to attain the short-term removable intermaxillary fixation care by use of an additive incision & drainage establishment on the oral lacerated wounds of adjacent mandibular compound fractures. The purpose of an additive incision & drainge establishment is the prevention of wound infection & nonunion by removing the hematoma & seroma in the fracture sites.

An Experimental study on the effects of Hyperbaric oxygen therapy on the healing process of mandibular fracture of normal rats and streptozotocin-prduced diabetic rats (일반백서와 당뇨백서에서의 하악골절 치유시 고압산소요법이 미치는 영향에 관한 실험적 연구)

  • Yoon, Jung-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.3
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    • pp.93-102
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    • 1990
  • The main objectives of this study was to observe the effects of Hyperbaric oxygen therapy on the healing processes of mandibuar fracture of normal rats & streptozotocin - induced diabetic rats. Author used 120 rats (Sprague - Dawley Strain) dividing into controf (60) & experimental group (60) of normal & diabetic rats. Complete fracture was produced on the left mandibular body of 120 rats, rendered hyperbaric oxygen therapy (2 hrs, daily at 2.5 atm) on experimental group and observed effects of hyperbaric oxygen therapy microscopically. The obtained results were as follows : 1. The experimental group of HBO in normal rats had the good effect until 6th week, especially the better effect at 3rd week, because of decrease of inflammatory cell infiltration, heavy proliferation of fibroblast & capillary and active callus formation. 2. The hyperbaric oxygen therapy in mandibular fracture of diabetic rats influenced especially on the healing process at 5th week, because there were much decrease of inflammatory cell infiltrations, heavy proliferation of fibroblast, capillary, osteoblasts, moderate fibrous callus formation, osteocastic activity and mild bony callus formation.

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A CASE REPORT OF UNCONTROLLED INFECTION IN POSTOPERATIVE PATIENT (술후 감염조절이 어려웠던 환자의 증례보고)

  • Kim, Soo-Min;Yeo, Hwan-Ho;Kim, Young-Kyun;Kim, Su-Gwan;Seo, Jae-Hoon;Park, In-Soon;Park, In-Soo;Kim, Young-Uk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.1
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    • pp.87-92
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    • 1997
  • Treatment of infected mandibular fracture is confronted with various difficult problem, e.g. nosocomial wound infection, non-union of fracture, osteomyelitis. Recently, nosocomial infection has become a major health problem because of excessive morbidity, personal distress, and cost. Frequently, isolated causative microorganisms of nosocomial infection were staphylococcus aureus, pseudomonas aeruginosa, klebsiella species. The various manifestation of the disease related to the pathogenesis and the clinical course tend to give a bad prognosis after operation. This is a report of case that post-operative infected mandibular fracture in 53-year-old man was not healed even through aggressive I & D and antibiotic treatment.

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Comparative study on the osseous changes of the TMJ and mandibular asymmetry after conservative or operative treatment in condylar fracture patients

  • Yu Su-Kyoung;Kim Kyung-A;Kwon Ki-Jeong;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.33 no.4
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    • pp.223-229
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    • 2003
  • Purpose: To compare the effects of the conservative treatment and operative treatment by observation of osseous changes of the TMJ and mandibular asymmetry in condylar fracture patients. Materials and Methods: 33 condylar fracture patients (17 with conservative and 16 with operative treatment) were included in this study. After a minimum of 6 months after the surgical procedure, patients were given a follow up examination of the osseous changes using a transcranial view. Differences in the osseous changes of both groups were compared and the asymmetry indices were calculated on a postero-anterior skull view. Results: The TMJ of the operative treatment group showed more significant osseous changes than the conservative treatment group. The affected TMJ showed more significant osseous changes than the unaffected TMJ in the both groups. The unaffected TMJ of the conservative group and the affected TMJ of the operative group showed significant osseous changes. The mandibular asymmetry indices in the conservative and operative group were 5.12 and 7.30 respectively at the time of treatment, and 2.39 and 3.41 respectively at the follow-up. But the mandibular asymmetry between the both groups showed no statistical differences. Conclusion: The TMJ of the operative group showed more significant osseous changes than the conservative group, but the mandibular asymmetry between the both groups showed no statistical difference.

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