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Retrospective analysis of external pin fixation of mandibular fractures: A 25-year single institution experience.

External fixation of mandible fractures is an infrequently utilized fixation treatment modality in comparison to open reduction internal fixation (ORIF) or closed reduction techniques. However, external fixation still provides a necessary modality in the management of select mandibular fractures. Therefore, we aim to draw trends, outcomes, and treatment timelines through a retrospective analysis to better guide, advise and predict realistic treatment outcomes in the future for our patients. This abstract shows trends in indications, complications, airway management and timeline to definitive r…

Management of Edentulous and Atrophic Mandibular Fractures: A Systematic Review of Treatment Modalities and Outcomes.

Fracture of the edentulous mandible presents a significant clinical challenge due to anatomical alterations, reduced bone density, and lack of natural occlusal support, particularly in elderly patients with comorbidities. This systematic review aimed to evaluate and synthesize the available evidence on the treatment of edentulous and atrophic mandibular fractures, focusing on clinical outcomes, treatment success, and associated complications. A comprehensive search of four electronic databases was conducted to identify studies published between 1995 and 2024. Studies were selected based on pre…

Traumatic characteristics and trauma-specific management of the third molars involved in mandibular angle fractures.

BACKGROUND: There is a close relationship between the third molars and mandibular angle fractures. Previous studies focused more on the influence of third molars on the healing of mandibular angle fractures than on the damage condition of the third molars themselves. The aim of this study was to investigate and classify the traumatic characteristics of third molars involved in mandibular angle fractures, and to evaluate the prognostic impact of a stratified trauma-specific management strategy on postoperative outcomes. METHODS: A retrospective analysis was conducted on the patients presenting

Comparison of Strengths of Mandibular Angle Fractures Following Different Plate Designs: A Human Cadaver Study.

STUDY DESIGN: This institutional cross-sectional study using cadaveric mandibles aimed to measure and compare the strengths of three plating designs utilized in osteosynthesis of mandibular angle fractures. OBJECTIVE: There have been prior studies on angle fracture fixation though few biomechanical studies on human cadaveric specimen. This study aims to directly compare the biomechanical strength of different plating designs to the mandibular angle fracture using a human cadaveric specimen substrate. METHODS: After receiving an angle osteotomy and either single plate, two plate, or 3D plate

Impact of Surgical Timing on Postoperative Complications Following Open Reduction Internal Fixation of Mandibular Fractures.

PURPOSE: The mandible is the second most fractured facial bone. The timing of open reduction internal fixation (ORIF) has been a subject of … CI) 23.04 (1.18->10), P =0.039]. CONCLUSION: The authors recommend early ORIF in the management of mandibular fractures to minimize postoperative complications.

Novel Design of Interlocking 3-Dimensional Miniplate in Mandibular Angle Fractures: An In Vitro Study.

The evolution of osteosynthesis has led to the development of novel miniplate designs, including 3-dimensional (3D) miniplates, which offer … el interlocking 3D miniplate design shows an adequate ability to provide stability for fixation for mandibular fractures, as evidenced by finite element analysis and biomechanical testing. Further research is necessary to validate these findings and explore the clinical application of interlocking 3D miniplates in mandibular fracture management.

Clinical efficacy of three plating systems in management of mandibular parasymphyseal fractures: a retrospective study.

BACKGROUND: The main goal of management of the mandibular fracture is to obtain the pre-injury contour of the bone and pre-injury occlusion as well as regain function early. For Parasymphyseal fractures, the ideal fixation method is still debatable. It could range from rigid to semi-rigid fixation. The current study aimed to compare the clinical and radiographic effect of two miniplates, 2.3 high-profile Miniplates, and three-dimensional (3D) Miniplates for internal fixation treatment of mandibular para-symphyseal fractures. METHODS: The study reviewed 240 medical records, dividing 60 patient

The application of artificial neural networks in the detection of mandibular fractures using panoramic radiography.

BACKGROUND: Panoramic radiography is a standard diagnostic imaging method for dentists. However, it is challenging to detect mandibular trauma and fractures in panoramic radiographs due to the superimposed facial skeleton structures. The objective of this study was to develop a deep learning algorithm that is capable of detecting mandibular fractures and trauma automatically and compare its performance with general dentists. MATERIALS AND METHODS: This is a retrospective diagnostic test accuracy study. This study used a two-stage deep learning framework. To train the model, 190 panoramic imag…

Treatment for Adult Mandibular Condylar Process Fractures: A Network Meta-Analysis of Randomized Clinical Trials.

PURPOSE: Using network meta-analyses (NMA) has become increasingly valuable as it enables the comparison of interventions that have not been directly compared in a clinical trial. To date, there has not been a NMA of randomized clinical trials (RCT) that compares all types of treatments for mandibular condylar process fractures (MCPFs). The aim of this NMA was to compare and rank all the available methods used in the treatment of MCPFs. METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was conducted in 3 major databa

Which Factors Affect the Reduction Quality of Open Reduction Internal Fixation of Mandibular Subcondylar Fractures?

BACKGROUND: Open reduction internal fixation (ORIF) of mandibular subcondylar fractures (MSF) involves several variables that could affect d … mechanism of injury, vertical fragment overlap, overlying soft tissue thickness, presence of other mandibular fractures, and severity and direction of displacement. MAIN OUTCOME VARIABLES: The primary outcome variable was the mean radiographic reduction score (RRS), rated by 2 blinded observers on a 1 to 5 scale. The secondary outcome variable was presence of postop …

Infectious complications in compound mandibular fractures undergoing a delayed surgical intervention - a prospective observational study.

The aim of this prospective study was to analyse if a delay in the time from injury to definitive surgical intervention of open reduction and internal fixation (ORIF) of compound mandibular fractures predisposed to an increase in postoperative infectious complications. ORIF beyond 72 hours from injury was considered to be delayed intervention. Postoperative surgical site infections (SSI) and non-infectious complications (NIC) were recorded. The Mann-Whitney U test was used to compare the delay in ORIF with SSI. The chi squared test/Fisher's exact test was used to find the association of the in…

Two pathological fractures due to mandibular metastasis, rare in colon cancer; a case report presentation.

We reported on 65 years old patient who has colon cancer and referred to our palliative care center with pain due to enlarging metastatic mass on the dorsal of the right hand. She had swelling and numbness on her jaw. Computed tomography (CT) scan was performed for mandible imaging and two pathologic fractures were detected on the right corpus and right condyle of the mandible. Clinicians should consider possible metastases for terminal stage cancer patients.

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… Pathological mandibular fractures are uncommon and represent less than 2% of all mandibular fractures 1 . Metastases to the oral region represent only 1%–3% of all malignant oral neoplasms and the mandible is the most common location 2 . … Pathologic Mandibular Fracture as First Sign of Multiple Myeloma. J Craniofac Surg. 2016;27(2):e138–e139. doi: 10.1097/SCS.0000000000002386. 6. Kruse AL, Luebbers HT, Obwegeser JA, et al. …

Repairing Facial Fractures with Interrupted Maxillary-mandibular Arches by Computer-assisted Reverse Planning Model Surgery.

BACKGROUND: Management of comminuted facial fractures with maxillary-mandibular arch interruption is difficult, resulting in inadequate bone … r-assisted design splint decreases intraoperative inaccuracies and difficulty in comminuted maxillo-mandibular fractures. It is a useful and reliable alternative. Collaboration with an experienced engineer and patient selection are indispensable in delivering successful outcomes. Patients who have more than three bone fragments in a single dental arch or more than fou …

The influence of wisdom tooth impaction and occlusal support on mandibular angle and condyle fractures.

This study aimed to analyze the relationship of the occlusal support together with the lower third molars to the mandibular fractures of the angle and condyle among patients in our medical institutions. This was a retrospective study that reviewed the medical records and radiographs of all patients treated for mandibular fractures from 2015 to 2019. The data collected by using picture archiving and communicating system. Only records with mandibular angle or condyle fractures were included. The dependent variable was the presence of the fractures of the mandibular angle or condyle. The independ…

Management of Medially Displaced Sub-Condylar Mandibular Fractures in Pediatric Population Using Novel Atraumatic Approach.

The appropriate treatment of pediatric mandibular condyle fractures is subject to much debate and concern among surgeons, with improper treatment potentially resulting in a number of adverse outcomes. Such outcomes include the disruption of mandible growth, decreased posterior facial height, facial asymmetry, and temporomandibular joint ankylosis. Several surgical and nonsurgical approaches to these fractures have been described in the literature; however, each one carries its own risk of various complications. In this study, the authors illustrate a new atraumatic approach for mild to moderat

Articular soft tissue injuries associated with mandibular condyle fractures and the effects on oral function.

The majority of studies debating the optimization of treatment for condylar mandibular fractures focus on the bony aspect first. However, fractures of the mandibular condyle may go together with soft tissue injury of the temporomandibular joint. An electronic literature search for this topic was undertaken. Assessment of quality was carried out using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Sixteen articles were included in this review. The reviewed literature showed that intracapsular fractures and dislocated condylar fractures result in more severe in…

Comparison of Erich arch bar versus embrasure wires for intraoperative intermaxillary fixation in mandibular fractures.

PURPOSE: Intermaxillary fixation (IMF) is a fundamental principle in the management of mandibular fractures but with recent advent of open reduction and internal fixation (ORIF), use of IMF is almost limited intraoperatively. Therefore, we compared the efficacy of Erich arch bar versus embrasure wires for intraoperative IMF in mandibular fractures. METHOD: This prospective study was comprised of 50 patients with mandibular fractures who required ORIF with intraoperative IMF. Patients were categorized into two groups of 25 patients each: Erich arch bar technique was used for group A and embras…

Removal versus retention of asymptomatic third molars in mandibular angle fractures: a randomized controlled trial.

The treatment dilemma provided by asymptomatic third molars in mandibular angle fractures remains controversial. This prospective randomized controlled trial was undertaken to determine whether there is an advantage to extraction or retention of the third molar whilst repairing a mandibular angle fracture. Sixty-four patients were allocated randomly to the two treatment groups. All underwent open reduction and internal fixation (ORIF) with standard postoperative care. The primary outcome measure was uncomplicated fracture healing. Secondary measures were surgical duration, malocclusion, wound

Clinical and radiographic evaluation of biodegradable bone plates in the treatment of mandibular body fractures.

BACKGROUND: Many different systems are available for the treatment of fractures ranging from the heavy compression plates for mandibular rec … s previously reported by titanium bone plates. CONCLUSION: Open reduction and internal fixation of mandibular fractures using bioresorbable fixation system with a brief period of inter-maxillary fixation have evolved to the point where the physical properties are sufficient to withstand the post-operative loads required for fracture repair of mandibular body fracture …