• Title/Summary/Keyword: maxillofacial trauma

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Are critical size bone notch defects possible in the rabbit mandible?

  • Carlisle, Patricia L.;Guda, Teja;Silliman, David T.;Hale, Robert G.;Baer, Pamela R. Brown
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.2
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    • pp.97-107
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    • 2019
  • Objectives: Small animal maxillofacial models, such as non-segmental critical size defects (CSDs) in the rabbit mandible, need to be standardized for use as preclinical models of bone regeneration to mimic clinical conditions such as maxillofacial trauma. The objective of this study is the establishment of a mechanically competent CSD model in the rabbit mandible to allow standardized evaluation of bone regeneration therapies. Materials and Methods: Three sizes of bony defect were generated in the mandibular body of rabbit hemi-mandibles: $12mm{\times}5mm$, $12mm{\times}8mm$, and $15mm{\times}10mm$. The hemi-mandibles were tested to failure in 3-point flexure. The $12mm{\times}5mm$ defect was then chosen for the defect size created in the mandibles of 26 rabbits with or without cautery of the defect margins and bone regeneration was assessed after 6 and 12 weeks. Regenerated bone density and volume were evaluated using radiography, micro-computed tomography, and histology. Results: Flexural strength of the $12mm{\times}5mm$ defect was similar to its contralateral; whereas the $12mm{\times}8mm$ and $15mm{\times}10mm$ groups carried significantly less load than their respective contralaterals (P<0.05). This demonstrated that the $12mm{\times}5mm$ defect did not significantly compromise mandibular mechanical integrity. Significantly less (P<0.05) bone was regenerated at 6 weeks in cauterized defect margins compared to controls without cautery. After 12 weeks, the bone volume of the group with cautery increased to that of the control without cautery after 6 weeks. Conclusion: An empty defect size of $12mm{\times}5mm$ in the rabbit mandibular model maintains sufficient mechanical stability to not require additional stabilization. However, this defect size allows for bone regeneration across the defect. Cautery of the defect only delays regeneration by 6 weeks suggesting that the performance of bone graft materials in mandibular defects of this size should be considered with caution.

Autograft Surgery Using the Condylar Fragment for Implant Placement

  • Kim, Yeo-Gab;Kwon, Yong-Dae;Yoon, Byung-Wook;Choi, Byung-Joon;Yu, Yong-Jae;Lee, Baek-Soo
    • Journal of Korean Dental Science
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    • v.1 no.1
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    • pp.10-14
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    • 2008
  • The fracture of facial bone usually accompanies alveolar bone fracture and dislocation or fracture of teeth. Thus, aside from the reduction of fracture, the reconstruction of occlusion through the rehabilitation of lost teeth should be considered. The dislocation of tooth after trauma accompanying alveolar bone fracture needs bone grafting in case of implant treatment. Although autogenous bone graft shows good prognosis, it has the disadvantage of requiring a secondary surgery. This is a case of a mandibular condyle head fracture accompanied by alveolar bone fracture. The condylar head fragment removed during open reduction was grafted to the alveolar bone fracture site, thereby foregoing the need for secondary surgery.

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Malocclusion after open reduction of midfacial fracture: a case report

  • Lim, Seong-Un;Jin, Ki-Su;Han, Yoon-Sic;Lee, Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.1
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    • pp.53-56
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    • 2017
  • Malocclusion is a serious complication of open reduction surgery for facial fractures. It is often caused by the lack of adequate consideration for the occlusal relationship before the trauma and intermaxillary fixation during the operation. This is a case report of postoperative malocclusion that occurred in a patient with a midfacial complex fracture.

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.

Trismus Due to Bilateral Coronoid Hyperplasia

  • Choi, Moon Gi;Kim, Dong Hyuck;Ki, Eun Jung;Cheon, Hae Myung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.4
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    • pp.168-172
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    • 2014
  • Bilateral coronoid hyperplasia causes painless progressive trismus, resulting from coronoid process impingement on the posterior aspect of the zygomatic bone. The etiology of coronoid hyperplasia is unclear, with various theories proposed. An endocrine stimulus, increased temporalis activity, trauma, genetic inheritance and familial occurrence have all been proposed, but no substantive evidence exists to support any of these hypotheses. Multiplanar reformatting of axial scans and 3-dimensional reconstruction permit precise reproduction of the shape and size of the coronoid and malar structures, and relationships of all structures of the temporal and infratemporal fossae. This case shows remarkably increased mouth opening by coronoidectomy in a patient who complained of trismus due to hyperplasia of coronoid process.

A STUDY ON THE EFFECTS OF ENDOTRACHEAL INTUBATION TO THE TEMPOROMANDIBULAR JOINT (기도내 삽관이 측두하악과절에 미치는 영향에 관한 연구)

  • Moon, Chang-Soo;Cho, Byoung-Ouck;Lee, Yong-Chan;Song, Young-Wan;Won, Rim-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.4
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    • pp.322-328
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    • 1993
  • The trauma has been known as a major etiologic factor in temporomadibular joint disorders. The endotracheal intubation is suspected as one of the traumatic factor to temporomandibular disorder. But there are few reports about the amount of mouth opening during endotracheal intubation and temporomandibular joint disorder after endotracheal intubation. The authors studied the effects of endotracheal intubation to temporomandibular joint with 70 patients given surgical operation through general anesthesia. The results were as follows. 1. The mean amount of mouth opening for entire patients during endotracheal intubation was 26.3mm (s, d : 2.6), for oral intubation group 25.9mm(s, d : 3.2), for nasal intubation group 26.6mm(s, d : 1.9). There was no difference between two group stastically. (p<0.05) 2. 1 week later endotracheal intubation, the maximum mouth opening increased 1.5mm for entire patients, 1.5mm for oral intubation group, 1.6mm for nasal intubation group than behare endotracheal intubation. 3. Five patients complained the discomforts around temporomandibular joint after endotracheal intubation. The amount of mouth opening during endotracheal intubation was within physiologic range. It seemed that $45^{\circ}$ upward endoscopic lifting for exposure of glottis gave trauma to temporomandibular joint.

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Maxillofacial Trauma Trends at a Tertiary Care Hospital: A Retrospective Study

  • Jeon, Eun-Gyu;Jung, Dong-Young;Lee, Jong-Sung;Seol, Guk-Jin;Choi, So-Young;Paeng, Jung-Young;Kim, Jin-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.6
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    • pp.253-258
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    • 2014
  • Purpose: Maxillofacial fractures are rapidly increasing from car accidents, industrial accidents, teenaged criminal activity, and sports injuries. Accurate assessment, appropriate diagnosis, and preparing individual treatment plans are necessary to reduce surgical complications. We investigated recent trends of facial bone fracture by period, cause, and type, with the objective of reducing surgical complications. Methods: To investigate time trends of maxillofacial fractures, we reviewed medical records from 2,196 patients with maxillofacial fractures in 1981~1987 (Group A), 1995~1999 (Group B), and 2008~2012 (Group C). We analyzed each group, comparing the number of patients, sex ratio, age, fracture site, and etiology. Results: The number of patients in each period was 418, 516, and 1,262 in Groups A to C. Of note is the increase in the number of patients from Group A to C. The sex ratios were 5.6:1, 3.5:1, and 3.8:1 in Groups A, B, and C. The most affected age group for fracture is 20~29 in all three groups. Traffic accidents are the most common cause in Groups A and B, while there were somewhat different causes of fracture in Group C. Sports-induced facial trauma was twice as high in Group C compared with Group A and B. Mandible fracture accounts for a large portion of facial bone fractures overall. Conclusion: We observed an increase in facial bone fracture patients at Kyungpook National University Dental Hospital over the years. Although facial injury caused by traffic accidents was still a major cause of facial bone fracture in all periods, the percentage decreased. In recent years, isolated mandible fracture increased but mandible and mid-facial complex fracture decreased, possibly because of a reduction in traffic accidents.

AN HISTORY OF MAXILLOFACIAL PROSTHESES (악안면 보철물의 역사)

  • Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.4
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    • pp.383-396
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    • 2000
  • Before the advent of early plastic or maxillofacial reconstructive surgery, facial features could only be replaced and mimicked by prosthetic, artificial means. Facial deformity or dysfunction, whether congenital or acquired by trauma or mutilating disease, has long been an area of constant research, development and innovation in many cultures of the world. One of the greatest contributors to the need for maxillofacial prosthetics has been physical conflict and warfare. The use of maxillofacial prostheses is not merely the replacement of a missing or disfigured aspect of the face, but the rehabilitation of that individual back into the society from which they originate. Rehabilitation includes the restoration of the person's self worth and confidence, not just physically but psychologically. In sixteenth century, Ambroise Pare, French military surgeon, first have tried many maxillofacial prosthetics for injured war soldiers with papier-mache, silver, gold and copper. According to patient's demand who lost their maxillofacial figures, maxillofacial personnel have increased and prosthetic's skill have been advanced all of the world. Over the last decade, there has been a very rapid development in technical possibilities to provide patients with facial prostheses retained by skin penetrating implants. This article will present overall history of maxillofacial prostheses and some background information on the materials used from the old world. And to overcome still many limitation of prosthetic, new minds and new ideas for technique and materials should be developed.

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MULTIPLE FACIAL TRAUMA PATIENT ACCOMPANIED WITH SEVERE BLEEDING: REPORT OF A CASE (과도한 출혈을 동반한 다발성 안면부 외상 환자의 치험례)

  • Oh, Seong-Seob;Yoo, Dae-Jin;Kim, Il-Kyu;Choi, Jin-Ho;Kim, Hyung-Don;Oh, Nam-Sig;Hwang, Hong-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.1
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    • pp.65-68
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    • 1999
  • Multiple facial trauma patient should be carefully treated because of severe bleeding on extraoral and intraoral wound, possibilty of airway obstruction and hypovolemic shock. Hypovolemic shock may be divided to hemorrhagic shock and non-hemorrhagic shock. Also hemorrhagic shock is divided to mild, moderate and severe shock according to the degree of blood volume depletion. Mild shock occurs in blood loss of less than 20% of blood volume and moderate shock does in blood loss of 20-40% of blood volume. And Severe shock occurs in blood loss of more than 40% of blood volume. The goal of emergency care of trauma patient is that respiration and perfusion should be recovered to satisfactory level and that normal vital sign is maintained. We reported the case of multiple facial trauma patient with severe bleeding and hopovolemic shock and metabolic acidosis who was treated with adequate supply of fluid transfusion, intubation, tracheostomy and emergency operation.

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