• Title/Summary/Keyword: maxillofacial injury

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A CLINICAL STUDY ON REPLANTATION OF AVULSED PERMANENT TEETH (결출치아의 재식술후 효과에 관한 임상적 연구)

  • Lee, Eui-Wung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.1
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    • pp.73-79
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    • 2000
  • A material of 48 patients with 60 avulsed and replanted permanent teeth were followed retrospectively in the period of 1996. 1 to 1998. 12 (mean observation period=1year 7months). The age of the patients at the time of replantation ranged from 9 to 63 years (mean=24 years). Clinical records of patients were reviewed to obtain valid data concerning the extent of injury and treatment provided. Pulpal and periodontal healing states were examined with periapical x-rays and clinical examination procedures (i.e. percussion test and mobility test) at their recall visit. Root ankylosis was found in fifty-two teeth(87%) and root resorption in twenty-four(40%). Only two of the replanted teeth(3%) showed partial regeneration of the periodontal ligament. Six teeth(10%) resulted in tooth loss, but the remaining fifty-four were clinically well functioning. Most of teeth have mild marginal bone loss accompanied by gingival retraction without pathological periodontal pockets. The incidence of root resorption was much higher in younger age group. However, it was not affected by the interval between avulsion and replantation, the condition of supporting tissues, the degree of root formation and the type of splinting, indicating that multiple factors involved in determining the prognosis of replanted teeth. Based on these findings, avulsed teeth in unfavorable conditions (i.e. long extra-alveolar periods, etc.) should be preserved if possible.

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Incidence of Oral and Maxillofacial Injuries of a Elementary School Children in Suwon City (수원지역 초등학교 학생의 구강악안면 외상에 관한 실태 조사)

  • Jung, Young-Chan;Oh, Sang-Chun;Lee, Sang-Kwon;Dong, Jin-Keun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.16 no.3
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    • pp.229-236
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    • 2000
  • The purpose of this study was to analyze the prevalence of Oral and maxillofacial injuries of elementary school children in Suwon, Korea. The sample consisted of 850 boys and girls in a elementary school children in the city. This study conducted a survey by sending questionnaires to school-aged boys and girls, to study a condition of traumatic injuries of teeth. 1. The students who had a traumatic injuries in a oral & maxillofacial area are 125 persons(14.7%); boys 93 persons(21%), girls 32 persons (7.9%). 2. Incidence of traumatic injuries was 1 time 102 persons(81.6%), 2 times 14 persons(11.2%), others 9 persons(7.2%). 3. The causes of traumatic injuries were fall down 65.6%, blow 10.4%, sports 9.6%, traffic accidents 7.2%, tripping 3.2%, others 4%. 4. The distributions of sports related traumatic injuries were roller blade 7 persons, bicycle 2 persons, football 1 person, baseball 1 person, basketball 1 person. 5. Types of traumatic injuries were soft tissue injury(40.8%), tooth fracture(36.8%), extrusion(8.0%), jaw fracture(3.2%), others(11.2%).

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Cortical lag screw fixation for the management of mandibular injuries

  • Elsayed, Shadia Abdel-Hameed
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.6
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    • pp.393-402
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    • 2020
  • Objectives: Here, we present cases of mandibular fracture that were managed with the cortical lag screw fixation technique (CLSFT) in order to critically evaluate technique indications and limitations of application at various fracture sites. Materials and Methods: This was a retrospective cohort study. The study sample was composed of patients suffering from mandibular fractures that were treated by the CLSFT. The outcome variables were fracture type, duration of surgery, number of screws, and pattern of application. Other study categories included patient demographics and causes of injury. Chi-square tests were used to assess descriptive and inferential statistical differences, and the P-value was set at 0.05. Results: Thirty-three patients were included in the study sample, with a mean age of 30.9±11.5 years and a male predominance of 81.8%. The technique was applied more frequently in the anterior mandibular region (51.5%) than in other sites. Double CLSFT screws were required at the symphysis and parasymphysis, while single screws were used for body and angle regions. No intraoperative and postoperative variables were significantly different except for surgical duration, which was significantly different between the sites studied (P=0.035). Conclusion: We found that CLSFT is a rapid, cost-effective technique for the fixation of mandibular fractures yielding good treatment results and very limited complications. However, this technique is sensitive and requires surgical expertise to be applied to mandibular fractures that have specialized characteristics.

Primary Closure of Deep Penetrating Wounds under Local Anesthesia with Dental Lidocaine HCL 28 Ampules in Maxillofacial Regions -Report of two cases - (치과용 Lidocaine 28 앰플로 국소마취 하에 1차 봉합한 악안면 심부 관통성 열창 -증례 보고-)

  • Kim, Jong-Bae;Yoo, Jae-Ha
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.1 no.1 s.1
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    • pp.26-31
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    • 2001
  • The wide deep penetrating wound of maxillofacial region should be early closed under emergency general anesthesia for the prevention of complications of bleeding, infection, shock & residual scars. But, if the emergency general anesthesia wound be impossible because of pneumoconiosis, obstructive pulmonary disease & hypovolemic shock, early primary closure should be done under local anesthesia by use of much amount of the anesthetic solution. The maximum dose of dental lidocaine (2% lidocaine with 1 : 100,000 epinephrine) is reported to 7 mg/kg under 500 mg (13.8 ampules) in normal adult. But the maximum permissible dose of dental lidocaine can be changed owing to the general health, rapidity of injection, resorption, distribution & excretion of the drug. The blood level of overdose toxicity is above $4.0{\mu}g/ml$ in central nervous & cardiovascular system. The injection of dental lidocaine 1-4 ampules is attained to the blood level of $1{\mu}g/ml$ in normal healthy adult. The duration of anesthetic action in the dental 2% lidocaine hydrochloride with 1 : 100.000 epinephrine is 45 to 75 minutes and the period to elimination is about 2 to 4 hours. Therefore, authors selected the following anesthetic methods that the first injection of 6 ampules is applied into the deeper periosteal layer for anesthetic action during 1 hour, the second injection into the deeper muscle & fascial layer, the third injection into the superficial muscle and fascial layer, the fourth injection into the proximal skin & subcutaneous tissue and the fifth final injection into the distal skin & subcutaneous tissue. The total 26-28 ampules of dental lidocaine were injected into the wound as the regular time interval during 5-6 hours, but there were no systemic complications, such as, agitation, talkativeness, convulsion and specific change of vital signs and consciousness.

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Open reduction of mandibular fracture without maxillomandibular fixation: retrospective study (악간고정 없는 하악골 골절의 관혈적 정복술: 후향적 연구)

  • Lee, Chung-Hyun;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.4
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    • pp.255-263
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    • 2011
  • Introduction: Maxillomandibular fixation (MMF) is essential before surgery under general anesthesia in maxillofacial trauma patients. MMF is used basically to reconstruct the occlusion and occlusal stability to recover the facial shape and oral functions. The arch bar and wire is a traditional method for MMF, but it can not only bring pressure to the periodontal ligaments and teeth but also cause a penetrating injury to the surgeons. Materials and Methods: In this study, 198 patients with an open reduction using a manual reduction without MMF from September 2005 to May 2010 in Dankook University Dental Hospital were subjected to a follow-up evaluation during the postoperative 4 months periods. This study evaluated the incidence of complications according to the condition of the patient (gender, age), the state of bony union of the fracture sites and a numeric rating scale evaluation for postoperative pain scoring. Results: 1. The complications were classified into major and minor according to the seriousness, and the major complication rate was as low as 2.02%. Only 2 cases of re-operations (1.01%) were encountered. In the classification according to the fracture line, plate fracture was observed in both cases of mandibular symphysis fracture, and angle fractures and loosening of two screws were noted in the case of mandibular angle fracture. 2. The complication rate was similar regardless of gender and age. 3. The degree of bony union was satisfactory, and the complication rate was reduced as the bony union improved. 4. More patients complained of pain as the operation time was increased. Conclusion: The use of MMF is not always necessary if a skilled assistant is provided to help manually reduce the fracture site. Compared to other studies of mandibular fracture surgery using MMF, the complication rate was similar using only manual reduction and the patients' discomfort was reduced without MMF.

EVALUATION OF EFFICACY OF TMJ ARTHROCENTESIS IN THE PATIENTS WITH MANDIBULAR FRACTURE (하악골 골절 환자의 치료시 상관절강 세정술의 유용성 평가)

  • Kim, Young-Kyun;Yun, Pil-Young;Kim, Ji-Hong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.6
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    • pp.532-535
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    • 2005
  • The objective of this study is assessment of the efficacy of upper joint space arthrocentesis on prevention of TMJ injury from patient with mantibular fractures. We divided the patients into two groups, one which consist of 24 patients who are taken arthrocentesis while open reduction of mandibular fracture, the other which consist of 27 patients without arthrocentesis from Jan 1999 to Dec 2001. We measured maximum mouth opening, excursive movement range respectively one week, one month, three months later after operation. The patients were instructed to mark on 10 cm VAS for evaluation of TMJ pain during resting, mouth opening, and mastication. We evaluated the signs and symptoms of temporomandibular disorder clinically and radiographically 6 months later. The result of this study is that there is a reduction of pain and increase of range of mandibular motion in both groups but in patients with arthrocentesis there is relatively reduction of pain and increase of range of mandibular motion compared with control group. On the points of 6 months later, temporomandibular disorder occurred in 4 patients (16.7%) in group with arthrocentesis and 13 patients (47.1%) in control group. In conclusion, we think that supplemental therapy such as arthrocentesis is helpful for the recovery of jaw function and prevention of the development of temporomandibular disorder after facial trauma.

A ramus cortical bone harvesting technique without bone marrow invasion

  • Jeong-Kui Ku;Min-Soo Ghim;Jung Ho Park;Dae Ho Leem
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.2
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    • pp.100-104
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    • 2023
  • Autogenous bone grafts from the mandibular ramus are a known source of inadequate bone volume scenarios of the residual alveolar ridge. However, the conventional block-type harvesting technique cannot prevent bone marrow invasion, which can cause postoperative complications such as pain, swelling, and inferior alveolar nerve injury. This study aims to suggest a complication-free harvesting technique and present the results of bone grafting and donor sites. One patient received two dental implants with a complication-free harvesting technique that involves creation of ditching holes with a 1 mm round bur. Sagittal, coronal, and axial osteotomies produced grid-type cortical squares using a micro-saw and a round bur to confirm the cortical thickness. The grid-type cortical bone was harvested from the occlusal aspect, and the harvesting was extended through an additional osteotomy on the exposed and remaining cortical bone to prevent bone marrow invasion. The patient did not suffer postoperative severe pain, swelling, or numbness. After 15 months, the harvested site exhibited new cortical bone lining, and the grafted area had healed to a cortico-cancellous complex with functional loading of the implants. Our technique, grid-type cortical bone harvesting without bone marrow invasion, allowed application of autogenous bone without bone marrow invasion to achieve acceptable bone healing of the dental implants and to regenerate the harvested cortical bone.

An alternative approach to extruding a vertically impacted lower third molar using an orthodontic miniscrew: A case report with cone-beam CT follow-up

  • Cortes, Arthur Rodriguez Gonzalez;No-Cortes, Juliana;Cavalcanti, Marcelo Gusmao Paraiso;Arita, Emiko Saito
    • Imaging Science in Dentistry
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    • v.44 no.2
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    • pp.171-175
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    • 2014
  • One of the most common oral surgical procedures is the extraction of the lower third molar (LTM). Postoperative complications such as paresthesia due to inferior alveolar nerve (IAN) injury are commonly observed in cases of horizontal and vertical impaction. The present report discusses a case of a vertically impacted LTM associated with a dentigerous cyst. An intimate contact between the LTM roots and the mandibular canal was observed on a panoramic radiograph and confirmed with cone-beam computed tomographic (CBCT) cross-sectional cuts. An orthodontic miniscrew was then used to extrude the LTM prior to its surgical removal in order to avoid the risk of inferior alveolar nerve injury. CBCT imaging follow-up confirmed the success of the LTM orthodontic extrusion.

Intermaxillary Fixation under Oral Intubation in a Patient with Le Fort I Fracture: a Case Report (상악골 Le Fort I 골절 환자에서 경구 기관 내 삽관 하에서의 악간고정 및 정복: 증례보고)

  • Choi, Eun-Joo;Lee, Seok-Ryun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.4
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    • pp.233-236
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    • 2014
  • In order to reduce jaw fracture accompanied by basal skull or nasal fracture, submental intubation could be generally performed. Albeit submental intubation has been widely accepted, it could develop complications such as nerve injury, glandular duct injury, and orocutaneous fistula. Here, we suggest oral intubation for overcoming complications and providing more stable surgical environment in emergency case. Under oral intubation maintaining in retromolar triangle and buccal corridor space, intermaxillary fixation was successfully underwent in 38-years-old female patient with Le Fort I fracture accompanied by pneumocephalus.

Implant Fixture Installation in the Anterior Mandible by Use of a Mucosa Supported Surgical Template Based on Computer Assisted Treatment Planning (컴퓨터보조 기반 점막지지 서지컬템프레이트를 이용한 하악전치부 임플란트 식립)

  • Lee, Jee-Ho;Kim, Soung-Min;Kim, Myung-Joo;Park, Jung-Min;Seo, Mi-Hyun;Myoung, Hoon;Lee, Jong-Ho;Kim, Myung-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.158-165
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    • 2011
  • A 73-year-old Korean female patient with a fully edentulous mandible was planned to have five implant fixtures installed in the anterior mandible for the fixed prosthesis. After 3-dimensional (3D) computed tomographic scanning was transferred to OnDemand3D$^{(R)}$ (Cybermed Co., Seoul, Korea) software program for the virtual planning, five fixtures of MK III Groovy RP implants of Branemark System$^{(R)}$ (Nobel Biocare AB Co., Goteborg, Sweden) were installed in the anterior mandible between both mental foramens using In2Guide$^{(R)}$ (CyberMed Co., Seoul, Korea) mucosa-supported surgical template with Quick Guide Kit$^{(R)}$ (Osstem Implant Co., Seoul, Korea) systems. Fixture installations were completed successfully without any complications, such as mental nerve injury, bony bleedings, fenestrations and other unexpected events. Postoperative computed tomographic scans were aligned and fused to the planned implant, then angular and linear deviations were compared with the planned virtual implants. The mean angular deviation between the planned and actual implant axes was $3.42{\pm}1.336^{\circ}$. The mean distance between the planned and actual implant at the neck area was $0.544{\pm}0.290$ mm horizontally and $0.118{\pm}0.079$ mm vertically. The average distance between the planned and actual implant at the apex area was $1.166{\pm}0.566$ mm horizontally and $0.14{\pm}0.091$ mm vertically. These results could be considered more precise and accurate than previous reports, and even our recent results. The entire procedures of this case are reported and reviewed.