• Imaging Science in Dentistry
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• 제53권1호
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• pp.69-75
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• 2023

Purpose: Maxillofacial trauma predominantly affects young adults between 20 and 40 years of age. Although radioprotection is a legal requirement, the significant potential of dose reduction in computed tomography (CT) is still underused in the clinical routine. The objective of this study was to evaluate whether maxillofacial fractures can be reliably detected and classified using ultra-low-dose CT. Materials and Methods: CT images of 123 clinical cases with maxillofacial fractures were classified by two readers using the AOCOIAC software and compared with the corresponding results from post-treatment images. In group 1, consisting of 97 patients with isolated facial trauma, pre-treatment CT images at different dose levels (volumetric computed tomography dose index: ultra-low dose, 2.6 mGy; low dose, <10 mGy; and regular dose, <20 mGy) were compared with post-treatment cone-beam computed tomography (CBCT). In group 2, consisting of 31 patients with complex midface fractures, pre-treatment shock room CT images were compared with post-treatment CT at different dose levels or CBCT. All images were presented in random order and classified by 2 readers blinded to the clinical results. All cases with an unequal classification were re-evaluated. Results: In both groups, ultra-low-dose CT had no clinically relevant effect on fracture classification. Fourteen cases in group 2 showed minor differences in the classification code, which were no longer obvious after comparing the images directly to each other. Conclusion: Ultra-low-dose CT images allowed the correct diagnosis and classification of maxillofacial fractures. These results might lead to a substantial reconsideration of current reference dose levels.

• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권2호
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• pp.230-236
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• 2008

Purpose: This study was performed to investigate the incidence, types of fracture, treatment, associated fracture and complications in patients with nasal bone fracture. Materials and methods: Clinical examination, patient's records and radiographic images were evaluated in 230 cases of nasal bone fractures who were treated at the Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital for recent 5 years; from January 2002 to December 2006. Results: 1. The age of patient was ranged from 4 to 77 years (mean age=36.6 years); Males was 75.7% (n=174), and females 24.3% (n=56). 2. The cause of the nasal bone fracture in this study was a fall or slip down (28.8%, n=66), sports accident (26.0%, n=60), fighting (21.3%, n=49), traffic accident (9.6%, n=22), industrial trauma (7.8%, n=18), and the others (6.6%, n=15). 3. For the patterns of fracture, simple fracture without displacement occured in 10.4% (n=24). Simple fracture with displacement without septal bone fracture was found in 49.5% (n=114). Simple fracture with displacement in company with septal bone fracture showed in 32.6% (n=75). Commiuted fracture with severe depression was presented in 7.4% (n=17). 4. The reduction the displaced nasal bone was carried out in 2 to 10 days (mean 6.8 days) after the injury. 5. Nasal bone fracture associated with Le Fort I fracture (6.5%, n=6.5), Le Fort II fracture (7.4%, n=17), Le Fort III fracture (1.3%, n=3), NOE fracture (13.9%, n=32), ZMC fracture (17.4%, 40), maxillary bone fracture (8.3%, n=19), orbital blow-out fracture (15.7%, n=36), frontal bone fracture (1.3%, n=3) and alveolar bone fracture (10.9%, n=25). 6. The major type of treatment method was closed reduction in 90% (n=207), open reduction in 3% (n=7), and observation in 7% (n=16). 7. There were some complications such as ecchymosis, hyposmia, hypo esthesia and residual nasal deformity which are compatible. Open rhino-plasty was conducted for 3 patients who had residual nasal deformity. Conclusions: These results suggest that most of nasal bone fractures are occurred physically active aged groups(age 10-49 years) and could be treated successfully with closed reduction at 7 days after the injury.

• 치과방사선
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• 제25권2호
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• pp.545-553
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• 1995

The subjects of this study consisted of 58 patients with Le Fort fractures, who were admitted to Chonbuk National University Hospital from Jan. 1988 to Oct. 1995. The author classified the maxillofacial fractures by Le Fort classification and examined the. incidence of Le Fort fractures by age, sex and etiology. The purpose of this study was to compare the imagings of conventional radiograms with those of computed tomograms and to aid in the diagnosis of patients with Le Fort fractures. The obtained results were as follows: 1. The Le Fort fractures occured mainly in 3rd and 4th decades, but there was no significant difference between decades. A ratio of men to women was 5.5 : 1. The major etiologic factors were traffic accident(69％), assault(14％) and fall-down(12％). 2. The most common type of Le Fort fracture was type I(49.3％). The numbers of Le Fort II, ill fractures were 41.3％, 9.4％ respectively. And 8.6％ were midsagittal splitting fractures. 3. The discontinuity and haziness of the maxillary sinus were easily detected by Waters' view. In skull PI A view, it was difficult to observe fractures due to overlapping of the other structures, but the haziness of the maxillary sinus was sometimes observed. 4. In Le Fort fracture, the fracture pattern of orbit, the wall of maxillary sinus, nasal bone and pterygoid plate were more easily detected in computed tomograms than in conventional radiograms.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권2호
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• pp.120-124
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• 2009

The concept of biostimulation of wounds by low-level laser therapy(LLLT) is attracting considerable attention. Although its effect on whole tissues has been studied quite extensively, the biological and cellular mechanisms underlying LLLT have not been clarified. In an experimental radius fracture in rabbits, Tang and Chai reported that LLLT enhanced the activity of red blood cells, macrophages, fibroblasts, chondrocytes, and osteoclasts within the fracture area. The purpose of the present study was to evaluate the effect of LLLT with a GaAlAs diode laser device on bone healing in rabbit mandibular fractures. We use 12 rabbits for this study. All rabbits were fractured mandible angle area using saw in anesthetic condition. In control group(n=6), none treatment was performed at fracture site. In experimental group(n=6), LLLT with a GaAlAs diode laser was radiated at fracture site daily for 7 days. All rabbits were sacrificed at 6 weeks later from performed fracture day. We studied the immunohistochemical staining of CD34 and Vimentin and the histochemical analysis for calcium and phosphorus content. The results were as follows. 1. In the histological and immunohistological staining, after 6week, fibroblasts, osteogenic cells and collgen fibers were observed more in experimental group than in control group. 2. In the histochemical analysis, the amount of calcium and phosphorus contents of the experimental group were more than the control group. From the results obtained, we suggest that the bone healing is stimulated by low-level laser irradiation in bone fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권5호
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• pp.471-477
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• 2001

Failure to use effective methods of reduction, fixation, and immobilization may lead to nonunion with osteomyelitis, owing to the compound nature of most fractures of the mandible. Nonunion results in fibrous pseudoarthrosis at the fracture site with instability that, once formed, does not improve spontaneously. Once the nonunion with osteomyelitis secondary to fractures has become established, intermaxillary fixation and drainage of infected tissue should be instituted as early as possible, because the fixation & drainage enhances the patient comfort and hinders ingress of microorganisms & debris by movement of bone fragments. The authors treated three cases of nonunion with osteomyelitis by intermaxillary fixation, incision & persistent drainage on the previous fistula site and endodontic drainage of infected teeth in the fracture site of mandible. The localization & sequestration of the infected bone around the fracture was better performed persistently by natural homeostatic mechanism in $8{\sim}10$ weeks and the bony union was then attained without bone grafting.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권2호
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• pp.177-182
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• 2005

Malocclusion can be often found after improper reduction of facial bone fractures, especially by the plastic surgeon or other medical doctor. This causes lots of problem in esthetics, mastication, or facial symmetry. We present four cases which are related above problems. These were well treated by orthognathic surgery or orthodontic treatment.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권1호
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• pp.72-78
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• 1994

A naso-orbito-ethmoid(NOE) fracture is very complex diagnostically and therapeutically. The diagnosis of this fractures is usually made by physical findings aided by a CT scan. The primary treatment of NOE fracture must be directed toward the reconstruction of medial canthal ligament and bony skeleton. We prefer to correct lacrimal system abnormalities secondarily A 32-year old male patient visited emergency room of our hospital with NOE fracture. After emergency treatment and consultation with neurosurgery and ophthalmology, we treated this patient by performing reconstruction of medial canthal ligament, bone graft of media orbital rim blowout fracture, and dorsal nasal cantilever bone graft with calvarial bone. The authors present a case report with literature review.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.12-20
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• 1989

This is a retrospective study on 452 patients with maxillofacial bone fracture. The patients were treated at the Dept. of Oral and Maxillofacial Surgery, WON KWANG UNIV. HOSPITAL from Aug. 1, 1984 to Sept. 30, 1988. The results were as follows. 1. The facial bone fractures occured most frequently in the twenties (35.3%)and male were predominant(75%) than female. 2. The most frequent etiologic factor was traffic accident. 3. The most common location of facial bone fracture was mandible(57%). Zygomatic bone & arch(39.9%) were most common on middle 1/3 of the face and symphysis(37.1%) were most common on the mandible. 4. The time from injury to treatment was variable from under the 1 week (65%) to over the 1 week(35%). In most case of the patients were treated beyond the 3 days(51.5%). 5. The relationship of intermaxillary fixation period and treatment method was an intimate relationship. The IMF period was reduced by the use of plate and screw osteosynthesis. 6. The weight loss was proportioned to intermaxillary fixation period.