Estudo epidemiológico do trauma bucomaxilofacial em um hospital de referência da Paraíba / Epidemiological study of bucomaxilofacial trauma in a Paraíba reference hospital

RESUMO Objetivo: estudar os dados epidemiológicos de pacientes vítimas de traumas bucomaxilofaciais atendidos em um hospital de referência da Paraíba. Métodos: estudo transversal de abordagem indutiva com procedimento estatístico comparativo e técnica de pesquisa por documentação direta em campo. O universo foi constituído dos prontuários hospitalares obtidos de janeiro de 2016 a dezembro de 2017 de pacientes atendidos pelo Serviço de Cirurgia e Traumatologia Bucomaxilofacial desse hospital. A amostra foi composta por 332 pacientes de acordo com os critérios de elegibilidade do estudo. A coleta de dados foi realizada por dois examinadores previamente calibrados e os dados foram analisados descritiva e inferencialmente. Resultados: os pacientes do sexo masculino foram mais acometidos por trauma facial (83,1%), principalmente na terceira década de vida (32,2%). Acidentes motociclísticos foram a etiologia mais comum de trauma para ambos os sexos. Em relação à estatística inferencial com margem de erro fixada em 5%, não foi observada associação significativa (p>0,05) entre os sexos e os fatores etiológicos do trauma. Os ossos do nariz (38,2%) foram os ossos mais afetados e a lesão mais frequente de partes moles foi o edema, em 50,9% dos casos. Apenas 20,8% dos pacientes com fraturas ósseas foram politraumatizados. Conclusão: as vítimas de traumatismo bucomaxilofacial atendidas em nosso hospital são predominantemente homens na terceira década de vida, envolvidos em acidentes motociclísticos e com lesões em ossos do nariz.

ABSTRACT Objective: to study the epidemiological data of patients suffering from buccomaxillofacial trauma treated at a referral hospital in the State of Paraíba. Methods: we conducted a cross-sectional study of inductive approach, with a comparative statistical procedure and research technique by field direct documentation. The sample comprised hospital records obtained from January 2016 to December 2017 of patients attended by the Service of Buccomaxillofacial Surgery and Traumatology of this hospital, and consisted of 332 patients according to the study's eligibility criteria. Two previously calibrated examiners collected and analyzed the data, both descriptively and inferentially. Results: males sustained the majority of facial trauma (83.1%), mainly in the third decade of life (32.2%). Motorcycle accidents were the most common etiology of trauma for both genders. In relation to inferential statistics with a margin of error of 5%, there was no significant association (p>0.05) between the genders and the trauma etiological factors. The bones of the nose (38.2%) were the most affected bones and the most frequent soft tissue injury was edema, in 50.9% of cases. Only 20.8% of the patients with bone fractures were polytraumatized. Conclusion: the victims of oral and maxillofacial trauma attended at our hospital are predominantly men in the third decade of life, involved in motorcycle accidents and sustaining lesions in the nose bones nose.

Lesiones radiopacas en tejido blando bucofacial. Comportamiento clínico-epidemiológico y manejo terapéutico en pacientes implantológicos / Radiopaque lesions in orofacial soft tissue. Clinical and epidemiological behavior and therapeutic management in indwelling patients

Introducción: Las radiopacidades en tejido blando bucofacial, aparecen habitualmente de manera incidental en radiografías panorámicas, exhibiendo una frecuencia relativamente baja. Objetivo: Identificar la frecuencia de lesiones radiopacas en tejido blando bucofacial en pacientes implantológicos, las implicaciones clínicas presentes y el manejo terapéutico implementado. Material y Métodos: Se realizó un estudio descriptivo, de corte transversal en una muestra constituida por 578 pacientes, evaluados en la consulta multidisciplinaria de implantología de la Facultad de Estomatología Raúl González Sánchez, quienes contaban con estudio radiográfico panorámico, en el período comprendido entre enero de 2014 y enero de 2016 con criterios de inclusión debidamente establecidos. Cada paciente se sometió a interrogatorio, examen clínico y al análisis exhaustivo de su radiografía panorámica. Se analizaron las variables edad, sexo, tipo de desorden de la radiopacidad, denominación, presencia de entidades patológicas previas, hallazgos clínicos al examen actual y modalidad terapéutica implementada. Resultados: Se encontraron lesiones radiopacas en 4,7 por ciento de la muestra; predominaron en el sexo masculino (3,1 por ciento); prevalecieron las calcificaciones idiopáticas (66,6 por ciento) y los sialolitos (55,5 por ciento). El 66,6 por ciento de los hallazgos fue asintomático. Un 33,4 por ciento requirió exéresis de la radiopacidad con el tejido asociado. Conclusiones: Las lesiones radiopacas de tejido blando bucofacial en pacientes implantológicos son poco frecuentes, predominan las calcificaciones idiopáticas particularmente los sialolitos, y la mayoría de las lesiones requiere manejo terapéutico(AU)

Introduction: The radiopacities in the orofacial soft tissue appears habitually as an incidental finding in panoramic x-rays, exhibiting a relatively low frequency. Objective: To identify the frequency of orofacial radiopaque lesions in soft tissue in indwelling patients, its clinical consequences and therapeutic management. Material and Methods: A descriptive transversal study was carried out in the Dentistry Faculty Raúl Gómez García, from January 2014 to January 2016. The sample was constituted by 578 patients evaluated by the multidisciplinary Implantology service, who had a panoramic study with properly established inclusion criteria. To each patient was performed an interrogatory, clinical exam and exhaustive analysis of his panoramic x-ray. The analyzed variables included: age, sex, denomination, presence of pathological previous entities, presence of clinical findings at the moment of examination, and therapeutic management. Results: The radiopaque lesions appeared in 4,7 percent of the sample analyzed, they prevailed in males (3,1 percent), the idiopathic calcifications reported a 66,6 percent and the sialoliths a 55,5 percent. A 66,6 percent of discoveries were asymptomatic. A 33,4 percent needed removal of radiopacities with associate tissue. Conclusions: The radiopaque lesions of orofacial soft tissue in indwelling patients are not very frequent, the idiopathic calcifications prevails, particularly the sialoliths, and most of the lesions require therapeutic handling(AU)

Epidemiological Profile and Characterization of Oral and Maxillofacial injuries in Women Victims of Interpersonal Violence / Perfil Epidemiológico y Caracterización de las Lesiones Orales y Maxilofaciales en Mujeres Víctimas de Violencia Interpersonal

The objective of this study was to determine the epidemiological profile of women victims of violence and characterize the injuries affecting their maxillofacial region. This was an analytic study using secondary data from 470 expert reports of domestic violence involving women, collected from January 2007 to December 2011 in the Department of Dentistry of the Institute of Legal Medicine in the city of Feira de Santana, Bahia, Brazil. The majority of the examined women were Afro-caucasian (72.6 %), single (74.9%), and with mean age of 30.4 years. The buccal (51 %) and orbital (8.8 %) regions were the most affected extraoral sites. As to the oral cavity, the most affected sites were teeth (50.8 %) and the lip mucosa (35 %). In most cases the lesions against women were associated with an aggressor having a close relationship with the victim. The most prevalent lesions were edema; fracture; tooth dislocation; and bruise. These findings can subsidize the development of policies to prevent violence against women, and for public safety.

El objetivo fue determinar el perfil epidemiológico de mujeres víctimas de violencia y las lesiones que les acometieron la región oral y maxilofacial. Se trata de un estudio sobre datos secundarios realizado a partir del análisis de 470 informes periciales de violencia doméstica contra mujeres, recopilados entre enero del 2007 a diciembre del 2011, en el área de Odontología del Instituto Médico Legal de Feira de Santana (Bahía/Brasil). La mayoría de las mujeres estudiadas eran afrocaucásicas (72,6 %), solteras (74,9 %), con un promedio de edad de 30,4 años. En relación a la localización extraoral, las regiones bucal (51 %) y orbital (8,8 %) fueron las más afectadas. Los dientes (50,8 %) y la mucosa labial (35 %) fueron las estructuras intraorales más afectadas. En la mayoría de los casos, las lesiones estaban asociadas a un agresor con una relación cercana a las mujeres. Las lesiones más prevalentes fueron edemas, fracturas, luxación dental y equimosis. Estas hallazgos pueden colaborar en el desarrollo de acciones para combatir la violencia contra la mujer y para la seguridad pública.

Prevalência de lesões bucais em crianças de 6 a 12 anos / Prevalence of oral lesions in children 6 to 12 years

Introdução: na literatura existem poucos levantamentos sobre alterações bucais pediátricas, uma vez que estes apresentam prevalências em faixas etárias mais abrangentes, incluindo jovens ou adultos. Objetivo: apresentar a prevalência das alterações bucais em tecidos moles que mais acometem crianças entre 6 e 12 anos de idade. Método: estudo prospectivo de identificação de lesões bucais da população infantil atendida na Clínica de Odontopediatria, da Faculdade de Odontologia da Universidade do Sagrado Coração, no período de outubro de 2012 a julho de 2013. Neste período, foram atendidas 129 crianças, sendo que 13 (10%) apresentaram alguma manifestação bucal em tecidos envolvendo tecidos moles. Os dados foram registrados por um único examinador em planilha própria, constando identificação do paciente, estado geral, tamanho, aspecto e localização da alteração, sintomas, tempo de instalação, tempo de recuperação, provável diagnóstico e tratamentos odontológicos realizados. Resultados e Discussão: as alterações bucais registradas foram: fístula/abscesso no rebordo alveolar (46,1%); estomatite herpética primária (15,4%); úlcera aftosa (15,4%); herpes simples recorrente (7,7%); língua fissurada (7,7%) e alveólise (7,7%). A localização mais frequente das alterações bucais registradas foi a mucosa alveolar superior (38,5%), seguida da mucosa alveolar inferior (23,1%), lábio superior direito (15,4%), maxila anterior (7,7%), rebordo gengival alveolar superior (7,7%) e dorso da língua (7,7%). A prevalência encontrada neste estudo prospectivo corrobora com outros levantamentos realizados na população infantil. Conclusão: é importante que os profissionais da área da saúde, especialmente o cirurgião-dentista, tenham o conhecimento da prevalência das principais lesões bucais em crianças para que estejam mais preparados para diagnosticá-las e tratá-las.

Introduction: in the literature there are few surveys of pediatric oral lesions, since these have prevalence in wider age groups, including young people or adults. Objective: present the prevalence of oral manifestations in soft tissues that most affect children between 6 and 12 years old. Methods: prospective study of oral lesions identification of children attendances at the Clinic of Pediatric Dentistry, Faculty of Dentistry, University of the Sacred Heart, from October 2012 to July 2013. During this period, 129 children were treated, and 13 (10%) had some oral manifestation in tissues surrounding soft tissues. Data were recorded by a single examiner at a specific note, consisting of patient identification, general condition, size, appearance and location of the oral manifestation, symptoms, installation time, recovery time, possible diagnosis and conducted dental treatments. Results and Discussion: Oral diseases recorded were: fistula/abscess alveolar (46.1%); primary herpetic stomatitis (15.4%), aphthous ulcer (15.4%), recurrent herpes simplex (7.7%), fissured tongue (7.7%) and alveolisys (7.7%). The most frequent location of oral abnormalities recorded was the superior alveolar mucosa (38.5%), followed by the inferior alveolar mucosa (23.1%), right upper lip (15.4%), anterior maxilla (7.7%), gingival superior alveolar (7.7%) and dorsum of the tongue (7.7%). The prevalence found in this prospective study corroborates other surveys in children. Conclusion: It is important that health professionals, especially the dentist, have knowledge of the prevalence of oral lesions in children in order to be better prepared to diagnose and treat them.

Incidence of facial soft tissue injuries among patients attending Surgical Casualty Reception in Rojh-halat Emergency Hospital

Facial soft-tissue injuries are the most common injuries presenting to surgical causality reception. The present study aimed to provide a preliminary data base about the distribution, type, pattern and etiology of facial soft tissue injuries. In a prospective clinical study all patients with facial injury were enrolled in this study, over a ten months period [from 1[st] October 2010- 1[st] July 2011], who attended Surgical Casualty Reception in Rojh-halat Emergency Hospital. A questionnaire was used to collect patients' database and relevant information. The wound configuration was divided as laceration, abrasion and contusion as well as the site of facial soft tissue injuries were recorded using the modified MCFONTZL system. A total of 168 patients with facial soft tissue injuries were received and managed at Surgical Casualty Reception in Rojh-halat Emergency Hospital. The age of the patients were ranged from 1-80 years old. Most of the patients were within the age range of 1-10. Male patients constitute 62.5% of the cases. The most common etiology of facial soft tissue injury was falls. Regarding type of the injury, laceration was the most common type. The lips and chin region were mostly involved. Fall is the most common cause of facial injury. Lower third of the face is mostly involved. road traffic legislations have a role in decreasing road traffic accidents

Urban-rural differences in oral and maxillofacial trauma

The aim of this research was to assess oral and maxillofacial trauma in urban and rural populations of the same region. The data collected included age, gender, year and month of trauma occurrence, origin (rural and urban), cause of injury, and the type of oral and maxillofacial trauma. Records from 1121 patients with 790 instances of oral and maxillofacial trauma were evaluated. Statistical analysis was performed with the Statistical Package for Social Sciences (SPSS) version 17.0 software and involved descriptive statistics and Pearson's chi-squared test. Male patients were more prone to maxillofacial trauma (n = 537; 68%), and the patients were mostly from urban areas (n = 534; 67.6%). The male-to-female ratio was found to be 2.12:1 (urban zone, 1.72:1; rural zone, 3.49:1). The average age was 25.7 years (SD = 14.1). A traffic accident was the most common cause of oral and maxillofacial trauma (27%). The jaw (18%) was the most commonly fractured bone in the facial skeleton, followed by the zygoma (12.9%). Avulsion (8.5%) was the most common dental trauma. A significant statistical relationship was found between place of origin and gender (p < 0.001). Accidents involving animals were more frequent in rural areas (P < 0.001). Zygomatic fractures (p < 0.001), contusion (p = 0.003), and abrasion (p = 0.051) were the most common injuries among individuals from rural areas. Nasal fracture (p = 0.011) was the most frequent type of trauma in individuals from urban areas. According to these data, it seems reasonable to assume that specific preventive public policy for urban and rural areas must respect the differences of each region.

Risk factors for maxillofacial injuries in a Brazilian emergency hospital sample

BACKGROUND: Maxillofacial injuries occur in a significant number of trauma patients. Epidemiological assessments are essential to reaffirm patterns, identify new trends and develop clinical and research priorities for effective treatment and prevention of these injuries. OBJECTIVE: The aim of this study was to identify the epidemiological profile and risk factors associated with maxillofacial trauma treated at a referral emergency hospital for the Public Health System in the State Capital of Goiás, Brazil. MATERIAL AND METHODS: A cross-sectional study was designed including 530 patients with maxillofacial trauma, 76 percent male, with a mean age of 25.5±15.0 years. Data were collected between May 2003 and August 2004 over weekly shift-working periods. RESULTS: The main causes of trauma were traffic accidents (45.7 percent) and physical assaults (24.3 percent), and differences in etiological factors were identified according to gender (p<0.001). The distribution of patients according to age and etiology showed significant differences for traffic accidents (p<0.01), physical assaults (p<0.001), falls (p<0.001) and sport injuries (p<0.01). In the multinomial logistic regression analysis (R² = 0.233; p<0.05), age was associated with injury in traffic accidents and falls (p<0.01), sports-related accidents were associated with males (p<0.05), and alcohol consumption with assaults and traffic accidents (p<0.001). Facial soft tissue lesions were found in 98 percent of patients and facial fractures in 51 percent. CONCLUSIONS: The significant association of maxillofacial trauma with young males and alcohol consumption reinforces the need for educational strategies and the development of policies for the prevention and reduction of associated damage in this specific risk group.

Estudo epidemiológico de traumatismos dos tecidos moles da face de pacientes pediátricos / Epidemiologic study on facial soft tissue injuries in pediatric patients

Objetivando avaliar o traumatismo facial em crianças, foram estudados, no Pronto-Socorro Municipal da Fundação de Apoio Universitário de Pelotas, durante plantões de 24 horas, 311 casos de pacientes portadores de ferimentos na face, catalogados de janeiro até dezembro de 1997. Os dados foram registrados em ficha de atendimento, sendo posteriormente analisados estatisticamente. Em relação ao sexo, houve uma predominância do masculino, principalmente na idade escolar. Os tipos de ferimentos mais freqüentes foram escoriações e hematomas, sendo 210 casos (58,6 por cento). As causas mais freqüentes foram as quedas, que totalizaram 49,1 por cento dos casos. Em relação à localização do ferimento na face, a região frontal foi a mais acometida, com 23,2 por cento dos casos, seguida pela região nasal (16,1 por cento). A estação do ano, o mês do ano, a semana do mês e o dia da semana não mostraram diferenças estatisticamente significativas. O período do dia, por sua vez, apresentou diferença estatística entre os dois primeiros turnos do dia (0-12 horas) e os dois últimos (12-24 horas). Os dados deste trabalho nos mostram a importância da aplicação de medidas preventivas e a necessidade de realização de novos estudos

Trauma in children

Injury has been the cause of Human suffering through ages, but in this modern era it has assumed epidemic proportions. Accidental injury is one of the major causes of morbidity and mortality. We present one year experience at department of paediatrics Surgery, National Institute of Child health, Karachi. A total of 1,274 cases were managed, including soft tissue injuries 558, fractures 372 [male 262, female 110], burn 192 [male 118, female 74], birth trauma 43, foreign bodies in respiratory tract or oesophagus 69, animal bite 10 and visceral injuries 9. Other miscellaneous causes accounted for 21 cases. Mortality rate in this study was three percent. We stress the importance of protection, education and legislation in prevention of trauma and also emphasize the establishment of Trauma units dealing with children only