Experiencia en la introducción de resultados científicos desde la formación doctoral / Experience in the introduction of scientific results from the doctoral training i: en

Durante estos años, condicionados por los efectos de una pandemia y la situación económica global, la incorporación oportuna de los resultados científico-técnicos es necesidad y responsabilidad de la comunidad científica. En este trabajo se expone una experiencia en la introducción de resultados científicos desde la formación doctoral, dirigida al área de la atención inicial al paciente con traumatismo maxilofacial. La importancia de esta práctica radica en los aportes social, científico y profesional y en la formación de recursos humanos para lograr la transformación y el mejoramiento de la realidad.

During these years, conditioned by the effects of a pandemic and the global economic situation, the opportune incorporation of the scientific technical results is necessity and responsibility of scientific community. An experience in the introduction of scientific results from the doctoral training, directed to the area of initial care to the patient with maxillofacial traumatism, is presented in this work. The importance of this practice resides in the social, scientific, professional contributions and in the formation of human resources to achieve the transformation and improvement of reality.

Conhecimento e atitudes de indivíduos leigos sobre avulsão de dentes permanentes / Knowledge and atitudes of lay individuals about avulsion of permanente teeth / Conocimientos y actitudes de los legos sobre la avulsión de los dientes permanentes

Introdução: A avulsão dentária é caracterizada pelo deslocamento total do elemento dentário para fora do alvéolo em decorrência de um trauma externo e as medidas emergenciais prestadas ainda no local do acidente são imprescindíveis para um bom prognóstico. Objetivo: Investigou-se o nível de conhecimento e atitudes de leigos sobre possíveis condutas frente à avulsão de dentes permanentes. Métodos: A coleta de dados foi realizada a partir de um questionário contendo perguntas sobre características gerais da lesão e as atitudes que os pacientes tomariam em um caso de avulsão. Os dados foram analisados pelo teste de Mann Whitney, considerando um nível de significância de 5% (p <0,05). Resultados: Questionários foram respondidos por 120 pacientes enquanto aguardavam atendimento. A média geral de respostas corretas / atitudes esperadas foi de 3,74. Os participantes que possuíam informação prévia acerca do tema, obtiveram médias significativamente maiores, o mesmo não foi verificado com aqueles que possuíam experiência prévia com trauma. Conclusão: Conclui-se que o conhecimento sobre avulsão dentária dos pacientes é baixo e que a educação em saúde, através da informação da população pode ser um fator relevante para a melhora da conduta emergencial no local do trauma pela população leiga... (AU)

Introduction: Tooth avulsion is characterized by the total displacement of the tooth out of the socket as a result of an external trauma and emergency measures provided at the accident site are essential for a good prognosis. Objective: We investigated the level of knowledge and attitudes of lay people about possible behaviors in the face of avulsion of permanent teeth. Methods: Data collection was performed using a questionnaire containing questions about general characteristics of the lesion and the attitudes that patients would take in a case of avulsion. Data were analyzed using the Mann-Whitney test, considering a significance level of 5% (p <0,05). Results: Questionnaires were answered by 120 patients while waiting for care. The overall average of correct answers/expected attitudes was 3.74. Participants who had previous information on the subject had significantly higher averages, the same was not verified with those who had previous experience with trauma. Conclusion: It is concluded that the knowledge about dental avulsion of patients is low and that health education, through population information can be a relevant factor for the improvement of emergency management at the trauma site by the lay population... (AU)

Introducción: La avulsión dentaria se caracteriza por el desplazamiento total del diente fuera del alvéolo como consecuencia de un traumatismo externo y las medidas de urgencia en el lugar del accidente son fundamentales para un buen pronóstico. Objetivo: Indagamos el nivel de conocimientos y actitudes de los legos sobre posibles comportamientos ante la avulsión de dientes permanentes. Métodos: La recolección de datos se realizó mediante un cuestionario que contenía preguntas sobre las características generales de la lesión y las actitudes que tomarían los pacientes en caso de avulsión. Los datos fueron analizados mediante la prueba de Mann-Whitney, considerando un nivel de significación del 5% (p<0,05). Resultados: Los cuestionarios fueron respondidos por 120 pacientes en espera de atención. La media global de aciertos/ actitudes esperadas fue de 3,74. Los participantes que tenían información previa sobre el tema tuvieron promedios significativamente más altos, lo mismo no se verificó con aquellos que tenían experiencia previa con el trauma. Conclusión: Se concluye que el conocimiento sobre la avulsión dentaria de los pacientes es bajo y que la educación en salud, a través de la información poblacional, puede ser un factor relevante para la mejora del manejo de la emergencia en el sitio del trauma por parte de la población no especializada... (AU)

Alcohol consumption and maxillofacial fractures in times of Covid-19: a cross-sectional study in a cuban university hospital / Consumo de alcohol y fracturas maxilofaciales en tiempos de Covid-19: un estudio transversal en un hospital universitario cubano

Introduction: The consumption of alcoholic beverages reduces the body's ability to deal with dangerous situations and exposes people to trauma. Objective: To determine the association between the consumption of alcoholic beverages and the characteristics of maxillofacial fractures treated at a Cuban university hospital in the context of COVID-19. Material and Methods: An observational, analytical, and cross-sectional study was carried out in the Maxillofacial Surgery unit at the "Carlos Manuel de Céspedes" General University Hospital during the year 2020. Prevalence ratios, 95% confidence intervals and p-values were obtained using generalized linear models. Results: In 58.23% of the cases, fractures were related to the consumption of alcoholic beverages. The fundamental etiology was interpersonal violence (47.75%), regardless of the consumption of alcoholic beverages. There was a prevalence of patients with nasal fractures (n=98; 55.06%), among which, 35.71% had consumed alcoholic beverages at the time of the trauma. Being male (p=0.005), the lack of university studies (p=0.007), the need for surgical treatment (p<0.001), the fractures of the zygomaticomaxillary complex (p=0.023), and the traumas that occurred during the weekends (p<0.001) or during the month of June (p=0.029) were factors associated with a higher frequency of fractures related to the consumption of alcoholic beverages. There was a lower frequency of fractures associated with alcohol consumption during the months of January (p=0.006) and March (p=0.001). Conclusion: Six out of ten cases were under the influence of alcoholic beverages. There was a greater number of young and male patients, mainly due to interpersonal violence.

Introducción: La ingestión de bebidas alcohólicas disminuye la capacidad del organismo para enfrentar situaciones de peligro y lo predispone a sufrir traumatismos diversos. Objetivo: Determinar la asociación entre el consumo de bebidas alcohólicas y las características de las fracturas maxilofaciales atendidas en un hospital universitario cubano en el contexto de la COVID-19. Material y Métodos: Estudio observacional, analítico y transversal realizado en el servicio de Cirugía Maxilofacial del Hospital General Universitario "Carlos Manuel de Céspedes" durante el 2020. Se obtuvieron razones de prevalencia, intervalos de confianza a 95% y valores p mediante modelos lineales generalizados. Resultados: En el 58.23% de los casos las fracturas se relacionaron con la ingestión de bebidas alcohólicas. La etiología fundamental fue la violencia interpersonal (47.75%), independientemente del consumo o no de bebidas alcohólicas. Predominaron los pacientes con fracturas nasales (n=98; 55.06%), en los que el 35.71% había consumido bebidas alcohólicas en el momento del trauma. El sexo masculino (p=0.005), la carencia de estudios universitarios (p=0.007), la necesidad de tratamiento quirúrgico (p<0.001), las fracturas del complejo cigomático-maxilar (p=0.023), los traumas sucedidos durante los fines de semanas (p<0.001) o durante el mes de junio (p=0.029) fueron factores asociados a una mayor frecuencia de fracturas relacionadas con el consumo de bebidas alcohólicas. Hubo menor frecuencia de fracturas asociadas a este consumo durante los meses de enero (p=0.006) y marzo (p= 0.001). Conclusión: Seis de cada diez casos estuvieron bajo los efectos de la ingestión de bebidas alcohólicas. Existió una mayor afectación de pacientes jóvenes, masculinos, a causa principalmente de la violencia interpersonal.

Manejo de las fracturas maxilofaciales y sus complicaciones / Management of maxillofacial fractures and its complications

RESUMEN Antecedentes: el trauma maxilofacial corresponde a toda lesión traumática del macizo facial. Actualmente representa uno de los problemas de salud más importantes en el mundo. Nuestro objetivo es realizar un análisis de nuestra experiencia en las intervenciones realizadas en pacientes internados y sus complicaciones. Material y métodos: se realizó un estudio descriptivo, retrospectivo y observacional de 205 pacientes con fracturas maxilofaciales desde el año 2011 hasta el año 2019. Resultados: el 81,46% fueron hombres (n: 167) y el rango etario más afectado osciló entre los 21 y 30 años con el 38,54% (n:79). El accidente de tránsito 56,1% (n:115) fue el mecanismo de trauma más frecuente. Los tipos de fracturas faciales fueron: panfaciales 12,2% (n: 25), tercio superior 1,46% (n:3), tercio medio 72,2% (n:148) y tercio inferior 14,15% (n:29). Dentro del tercio superior, el 66,67% (n:2) fueron fracturas del seno frontal asociadas al hueso frontal, en el tercio medio las combinadas en un 54,73% (n:81) y en el tercio inferior, las complejas en el 34,48% (n:10). Fueron intervenidos 199 pacientes (97,07%). Solo el 11,56% (n:23) presentó alguna complicación. No se observaron complicaciones graves. Discusión: según nuestra serie, la mayoría de los pacientes fueron hombres jóvenes; la causa más frecuente, el accidente de tránsito, y el tercio medio, el más afectado, resultados estos similares a los de otros estudios publicados. El tratamiento quirúrgico fue principalmente reducción abierta y fijación con material de osteosíntesis de titanio, un procedimiento seguro y fiable, que permite restablecer la funcionalidad previa al traumatismo, con un índice muy bajo de complicaciones posoperatorias.

ABSTRACT Background: Maxillofacial trauma corresponds to all traumatic injuries affecting the facial bones. Nowadays, it represents one of the main healthcare issues worldwide. The aim of this study is to analyze our experience in the interventions performed in hospitalized and their complications. Material and methods: We performed a retrospective and observational study of 205 patients with maxillofacial fractures from 2011 to 2019. Results: 81.46% were men (n = 167) and 38.54% (n = 79) of the patients were between 21 and 30 years of age. Traffic collision was the most common mechanism of trauma (56,1%, n = 115). The types of facial fractures were panfacial (12.2%; n = 25), of the upper-third (1.43%; n = 3), of the middle-third (72.2%; n = 148) and of the lower third (14.15%; n = 29). In the upper third of the face frontal sinus fractures associated with the frontal bone were the most common (66.67%; n =2); in the middle-third combined fractures were most prevalent (54.73%; n = 81) while complex fractures were most frequent in the lower third (34,48%; n = 10). One-hundred and ninety-one patients were operated on (97.07%). Complications occurred in only 11.56% (n = 23) and were not serious. Discusion: In our series, most patients were young men, traffic collisions were the most common cause of trauma, and the middle third of the face was the most affected region. These results are similar to our publications. Surgical management, mostly by open reduction and fixation with titanium-based osteosynthesis material, is an effective, safe and reliable procedure, which allows the restoration of pre-trauma function, with very low rate of postoperative complications.

Fratura complexa de teto de órbita associada disjunção traumática do complexo zigomático / Complex Orbit Roof Fracture Associated with Traumatic Disjunction of the Zygomatic Complex / Fractura Compleja del Techo de la Órbita Asociada a Disyunción Traumática del Complejo Cigomático

Objetivo: As fraturas do complexo zigomático-maxilar (CZM) constituem as principais fraturas do terço médio da face. O diagnóstico é complexo, por envolver uma área alternente sensorial e nobre da face. Portanto o tratamento não visa apenas devolver os contornos ósseos, mas também preservar as funções oculares. No presente caso paciente apresentou severo trauma facial associado a TCE com afundamento do frontal e teto de órbita. Relato de caso: Paciente do sexo masculino, 33 anos, vítima de queda da própria altura. No exame físico notou-se FCC extenso em região frontal, se estendendo para a região supra-orbital esquerda, blefaroedema periorbital esquerdo, com oclusão palpebral e distopia ocular. Escoriações em face e afundamento em região fronto parietal esquerda e perda de consciência. O diagnóstico apontou para fratura do complexo zigomático-maxilar associada a afundamento do osso frontal. Paciente submetido à osteossíntese das fraturas com por meio da ferida e complementado com acesso subciliar e caldwel luc. Foi alcançada boa reabilitação estética e funcional. Conclusão: Portanto, a redução aberta com fixação funcional estável com placas e parafusos segue sendo o padrão ouro para o tratamento de fraturas complexas do CZM. Sendo imperativo uma adequada redução e o reestabelecimento do continente orbitário... (AU)

Objective: Fractures of the zygomatic-maxillary complex are the main fractures of the middle third of the face. The diagnosis is complex, as it involves an alternating sensory and noble area of the face. Therefore, the treatment is not only aimed at restoring bone contours but also preserving ocular functions. In the present case, the patient presented severe facial trauma associated with TBI with frontal and orbital sinking. Case Report: Male patient, 33 years old, victim of a fall from standing height. Physical examination revealed extensive CCF in the frontal region, extending to the left supraorbital region, left periorbital blepharoedema, with eyelid occlusion and ocular dystopia. Excoriations on the face and sinking in the left fronto-parietal region and loss of consciousness. The diagnosis pointed to fracture of the zygomatic-maxillary complex associated with frontal bone sinking. Patient undergoing osteosynthesis of fractures through the wound and complemented with subciliary access and caldwell luc. Good aesthetic and functional rehabilitation were achieved. Conclusion: Therefore, open reduction with stable functional fixation with plates and screws remains the gold standard for the treatment of complex ZMC fractures. An adequate reduction and reestablishment of the orbiting continent is imperative... (AU)

Objetivo: Las fracturas del complejo cigomático maxilar son las principales fracturas del tercio medio de la cara. El diagnóstico es complejo, ya que involucra una zona sensorial y noble alternada de la cara. Por lo tanto, el tratamiento no solo está dirigido a restaurar los contornos óseos sino también a preservar las funciones oculares. En el presente caso, el paciente presentó trauma facial severo asociado a TCE con hundimiento frontal y orbitario. Caso Clínico: Paciente masculino, 33 años, víctima de caída desde altura de pie. A la exploración física destacaba FCC extensa en región frontal, con extensión a región supraorbitaria izquierda, blefaroedema periorbitario izquierdo, con oclusión palpebral y distopía ocular. Excoriaciones en la cara y hundimiento en la región fronto-parietal izquierda y pérdida del conocimiento. El diagnóstico apuntó a fractura del complejo cigomático-maxilar asociada a hundimiento del hueso frontal. Paciente con osteosíntesis de fractura a través de herida y complemento acceso subciliar y calwell luc. Se logró una buena rehabilitación estética y funcional. Conclusión: Por lo tanto, la reducción abierta con fijación funcional estable con placas y tornillos sigue siendo el estándar de oro para el tratamiento de fracturas CCM complejas. Es imperativo una adecuada reducción y restablecimiento del continente en órbita... (AU)

Remoção de corpo estranho impactado em região maxilofacial / Removal of impacted foreign body in maxillofacial region

Traumas na região da face são comuns devido a sua topografia e à grande exposição do local. As lesões na região maxilofacial são normalmente causadas devido a traumas por acidentes de trânsito, agressão física, acidentes cotidianos como queda da própria altura e de nível. O objetivo deste trabalho é relatar um caso clínico de trauma facial com a presença de corpo estranho impactado na face, bem como o tratamento cirúrgico empregado. Paciente do sexo feminino, 17 anos, foi regulada para o Hospital Geral Cleristón Andrade com histórico de queda de cavalo, cursando com fragmento de madeira (galho de arbusto) tranfixado em região maxilofacial. A paciente foi encaminhada ao centro cirúrgico para a remoção do galho de arbusto transfixado. O procedimento foi rápido, e sua remoção se deu por meio do movimento contrário ao mecanismo de trauma. Lesão como esta possui aspectos singulares e devem ser avaliados multidisciplinarmente na emergência. A remoção desses objetos deve ser realizada de forma a preservar as estruturas dentro do possível, levando em consideração também os fatores estéticos e funcionais envolvidos(AU)

Traumas in the face region are common due to its topography and the great exposure of the place. Injuries in the maxillofacial region are usually caused due to trauma from traffic accidents, physical aggression, everyday accidents such as falling from height and level. The aim of this paper is to report a clinical case of facial trauma with the presence of a foreign body impacted on the face, as well as the surgical treatment used. A 17-year-old female patient was treated at the Cleristón Andrade General Hospital with a history of falling from a horse, taking a wood fragment (shrub branch) transfixed in the maxillofacial region. The patient was referred to the operating room for removal of the transfixed bush branch. The procedure was quick, and its removal took place through a movement contrary to the trauma mechanism. Injuries like this have unique aspects and must be evaluated multidisciplinary in an emergency. The removal of these objects must be carried out in order to preserve the structures as much as possible, also taking into account the aesthetic and functional factors involved(AU)

Retiro de elementos de osteosíntesis en trauma maxilofacial / Osteosynthesis elements removal in maxillofacial trauma

Resumen Objetivo: Analizar la prevalencia y los factores en la remoción de elementos de osteosíntesis (OTS) de pacientes tratados quirúrgicamente debido a fracturas maxilofaciales. Materiales y Método: Estudio retrospectivo descriptivo, donde fueron incluidos todos los pacientes con diagnóstico de fractura maxilofacial y tratados mediante reducción abierta y fijación interna rígida en un intervalo de 10 años, en el Servicio de Cirugía Oral y Maxilofacial en el Hospital Clínico Mutual de Seguridad (HCMS). Resultados: En un total de 807 pacientes intervenidos, con un rango etario entre 22-66 años, fueron utilizados 2.421 OTS. Entre ellos, 58 pacientes (7,2%) fueron sometidos a un segundo procedimiento quirúrgico, retirándose un total de 129 OTS (5,3%). La principal causa de retiro fue infección (41,1%), comúnmente de carácter tardío. El tercio inferior facial fue el más afectado, específicamente, la zona parasinfisiaria. El 39% fue retirado antes de los 12 meses de posicionados. Conclusiones: El retiro de OTS, posterior a trauma maxilofacial tiene una baja prevalencia. El sitio más afectado es el hueso mandibular y la mayoría se retira dentro de los primeros 12-24 meses. La etiología es variable, sin embargo, la infección se mantiene como una de las principales. Los hallazgos sugieren que no sería recomendable realizar este procedimiento de forma universal para todos los pacientes.

Aim: To analyse the prevalence and factors regarding to osteosynthesis elements (OTS) removal from patients surgically treated due to maxillofacial fractures. Materials and Method: Retrospective study in which all patients with diagnosis of maxillofacial fractures and treated with open reduction and internal rigid fixation were included, in an interval of 10 years, in the Maxillofacial Surgery Service of HCMS. Results: In 807 surgically treated patients, with an age between 22-66 years, 2.421 OTS were used. Among them, 58 patients (7.2%) underwent a second surgical procedure, with a total of 129 OTS removed (5.3%). The main cause of removal was infection (41.1%), commonly of a chronic nature. The lower third of the face was the most affected, specifically, the parasymphysis region. 39% of OTS were withdrawn before 12 months. Conclusions: OTS removal after maxillofacial trauma has a low prevalence, the most affected site is the mandibular bone, within the first 12-24 months. The aetiology is variable, however, infection remains one of the main. The findings suggest that it would not be advisable to perform this procedure universally for all patients.

Multicenter epidemiological study of maxillofacial trauma: a one-year retrospective- descriptive assessment of 1356 cases in a colombian metropolitan region / Estudio epidemiológico multicéntrico de trauma maxilofacial: evaluación retrospectiva-descriptiva de un año, de 1356 casos en una región metropolitana de Colombia

Background: This retrospective study was conducted to identify the epidemiological profile and treatment modalities linked to the maxillofacial trauma (MFT) managed in the Maxillofacial Surgery Departments of seven hospital centers in Antioquia, Colombia. Material and Methods: Clinical records with specific attention to sociodemographic characteristics, mechanisms of injury, type of MFT, location of injuries, and treatment modalities of MFT were collected from January to December 2017. Descriptive analyses using Pearson's chi-square tests were performed. Results: A total of 1356 records were retrieved. Males were significantly more affected, with a male-to-female ratio of 3.85:1. The most susceptible age group involved was young adults (18 to 40 years). A low percentage of alcohol (9.3%) and drugs consumption (2.5%) was recorded. Most common causes of MFT were road traffic accidents (RTA), falls, and interpersonal violence (IPV). Most injuries involved both soft and hard tissues followed by hard tissues and isolated open soft tissue injuries. Among fractures, the middle third was the most commonly affected site and the utmost method of treatment was open reduction and internal fixation. Conclusion: Within the limitations of the evidence available, this study has demonstrated that the gender, age stratum, and etiological factors, such as RTA, falls, and IPV, but no alcohol and/or psychoactive substances consumption, may have a significant influence on the prevalence, patterns, and treatment modalities of MFT in this sample population.

Antecedentes: Este estudio retrospectivo se realizó para identificar el perfil epidemiológico y las modalidades de tratamiento vinculados al Trauma Maxilofacial (TMF) atendido en los Servicios de Cirugía Maxilofacial de siete centros hospitalarios de Antioquia, Colombia. Material y Métodos: Se recopilaron historias clínicas con atención específica a las características sociodemográficas, mecanismos de lesión, tipo de TMF, ubicación de las lesiones y modalidades de tratamiento de TMF de enero a diciembre de 2017. Análisis descriptivos utilizando el chi-cuadrado de Pearson fueron realizados. Resultados: Se recuperaron un total de 1356 registros. Los hombres se vieron significativamente más afectados, con una relación hombre-mujer de 3,85:1. El grupo de edad más susceptible involucrado fue el de los adultos jóvenes (18 a 40 años). Se registró un bajo porcentaje de consumo de alcohol (9,3%) y drogas (2,5%). Las causas más comunes de TMF fueron los accidentes de tránsito (ADT), las caídas y la violencia interpersonal (VIP). La mayoría de las lesiones involucraron tejidos blandos y duros, seguidas de tejidos duros y lesiones abiertas aisladas de tejidos blandos. Entre las fracturas, el tercio medio fue el sitio afectado con mayor frecuencia y el método de tratamiento más utilizado fue la reducción abierta y la fijación interna. Conclusion: Dentro de las limitaciones de la evidencia disponible, este estudio ha demostrado que el género, el estrato etario y los factores etiológicos, como ADT, caídas y VIP , pero no el consumo de alcohol y/o sustancias psicoactivas, pueden tener una influencia significativa en la la prevalencia, los patrones y las modalidades de tratamiento de TMF en esta poblaión muestral.

Reação de corpo estranho após reconstrução órbito-zigomático-maxilar com polimetilmetacrilato: relato de caso / Strange body reaction after orbit-zygomatic-maxillary reconstruction with polymethyl methacrylate: case report

Pacientes com históricos de defeitos ósseos provocados por infecções, malformação congênita, neoplasias, deformação por iatrogenia, radioterapia e trauma buscam contornos faciais mais harmônicos através da reabilitação cirúrgica. Para facilitar a reconstrução maxilofacial dois grupos de materiais podem ser utilizados, os enxertos ósseos e os materiais aloplásticos. O objetivo é relatar um caso incomum de infecção e exposição de material utilizado para enxertia a base de polimetilmetacrilato, bem como a sua posterior reabordagem cirúrgica. Embora o Polimetilmetacrilato aparente ser seguro, ele exibe complicações diversas em função da imunologia do hospedeiro, que poderá reagir de diferentes formas. Desse modo, faz-se necessário ressaltar a importância da prevenção e proservação de cada caso de forma individualizada(AU)

Patients with a history of bone defects caused by infections, congenital malformation, neoplasms, iatrogenic deformation, radiotherapy and trauma seek more harmonious facial contours through surgical rehabilitation. To facilitate maxillofacial reconstruction, two groups of materials can be used, bone grafts and alloplastic materials. The objective is to report an unusual case of infection and exposure of material used for grafting with polymethylmethacrylate, as well as its subsequent surgical approach. Although Polymethylmethacrylate appears to be safe, it exhibits different complications depending on the host's immunology, which may react in different ways. Thus, it is necessary to emphasize the importance of preventing and preserving each case individually(AU)

Manejo de la vía aérea mediante intubación submental en fracturas maxilofaciales / Airway management by submental intubation in maxillofacial fractures

La intubación submentoniana es útil en procedimientos quirúrgicos en donde la intubación nasotraqueal está contraindicada y la intubación orotraqueal no es ideal debido a la fijación intermaxilar. Este informe describe dos pacientes masculinos que se presentaron al Hospital Nacional Rosales, en el servicio de Cirugía Maxilofacial de El Salvador, con historia de sufrir accidente de tránsito. El primer caso evidenció al examen radiológico fractura simple y desplazada de sínfisis mandibular, fractura simple huesos propios nasales y desviación del tabique nasal. El segundo caso es un paciente con fractura de sínfisis y doble cóndilo mandibular que presentaba imposibilidad a la apertura bucal. A través de la técnica del cirujano maxilofacial Hernández Altemir (España), el tubo endotraqueal atraviesa una incisión extraoral en la región submentoniana del suelo de la boca, para poder practicar reducción abierta de fracturas faciales, logrando adecuada oclusión, con mínimos cuidados posoperatorios y con una cicatriz estética. Al terminar la cirugía, la posición del tubo endotraqueal regresa a su posición original y el paciente evoluciona satisfactoriamente

Submental intubation is useful in surgical procedures where nasotracheal intubation is contraindicated and orotracheal intubation is not ideal due to intermaxillary fixation. This report describes two male patients who presented to the Rosales National Hospital, in the Maxillofacial Surgery service of El Salvador, with a history of suffering a traffic accident. The first case showed a simple and displaced fracture of the mandibular symphysis, simple nasal bone fracture and deviation of the nasal septum on radiological examination. The second case is a patient with a symphysis fracture and a double mandibular condyle that presented an inability to open the mouth. Through the technique of the maxillofacial surgeon Hernández Altemir (Spain), the endotracheal tube passes through an extraoral incision in the submental region of the floor of the mouth, in order to perform open reduction of facial fractures, achieving adequate occlusion, with minimal postoperative care and with an aesthetic scar. At the end of the surgery, the position of the endotracheal tube returns to its original position and the patient evolves satisfactorily

Perfil dos casos de traumas bucomaxilofaciais de vítimas de violência interpessoal atendidas em um hospital de referência do Nordeste / Profile of bucomaxillofacial trauma cases of interpersonal violence victims treated in a reference hospital of the Northeast

A violência interpessoal tem se configurado como um grave problema social e de saúde pública, em que lesões na região bucomaxilofacial são importantes consequências. O objetivo desse estudo foi analisar o perfil das vítimas de violência interpessoal que tiveram lesões na região maxilofacial e foram atendidas no hospital da Restauração em Recife, Pernambuco-Brasil durante o ano de 2017. Foi realizada uma pesquisa retrospectiva e exploratória baseada nas informações contidas nos prontuários do hospital e em seguida foi utilizado o software Statistical Package for the Social Sciences (SPSS) para análise das medidas descritivas. No período de um ano foram encontrados 455 prontuários, de forma que 87,9% corresponderam ao sexo masculino e 12,1% ao feminino. Do total, 34,9% tinham idade entre 20-29 anos e 43,3% foram vítimas de força corporal/espancamento. O tipo de trauma mais frequente foi fratura dos ossos maxilofaciais (45,3%). Outrossim, o dia e horário mais comum de atendimento foi o domingo (23,1%) no período noturno (58,2%). Homens jovens com traumas dos ossos maxilofaciais foi o principal perfil encontrado no estudo, sendo necessário o fortalecimento de políticas públicas a fim de evitar o aumento de casos nessa população... (AU)

Interpersonal violence has been configured as a serious social and public health problem in which injuries on the maxillofacial region are important consequences. This study aimed to analyze the profile of interpersonal violence victims who had maxillofacial injuries and were treated at Hospital Da Restauração in Recife, Pernambuco-Brazil during 2017. A retrospective and exploratory research was conducted based on information from the medical records of the hospital and then the Statistical Package for the Social Sciences (SPSS) Software was used for descriptive measures analysis. In the period of one year, 455 medical records were found, in which 87,9% corresponded to male and 12,1% to female. Of the total, 34,9% were aged between 20-29 years old and 43,3% were victims of physical strength/beating. The most frequent type of trauma was fracture of the maxillofacial bones (45,3%). Otherwise, the most common day and time of treatment at the hospital was on Sundays (23,1%) and in the evening (58,2%). Young men with trauma on the maxillofacial bones was the main profile found in this study, requiring the strengthening of public policies to avoid the increase in cases in this population... (AU)

Necesidad y tipo de tratamiento en cirugía bucomaxilofacial durante la pandemia por COVID-19 en un servicio de urgencias odontológicas del AMBA / Need and type of treatment in maxillofacial surgery during the COVID-19 pandemic in a dental emergency department in the AMBA

Objetivo: Analizar y describir los requerimientos de atención quirúrgica bucomaxilofacial de urgencia en el Servicio de Urgencias Odontológicas y Orientación de Pacientes de la Facultad de Odontología de la Universidad de Buenos Aires durante el aislamiento social preventivo y obligatorio por la pandemia de COVID-19. Materiales y métodos: Se realizó un estudio observacional descriptivo de análisis retrospectivo durante el período de aislamiento social preventivo y obligatorio inicial de 93 días, comprendido entre el 20 de marzo y el 20 de junio de 2020. Se evaluó la totalidad de historias clínicas de los pacientes que acudieron al Servicio de Urgencias Odontológicas y Orientación de Pacientes de la Facultad de Odontología de la Universidad de Buenos Aires y se caracterizó a aquellos que requerían distintos tipos de tratamiento quirúrgico bucal y maxilofacial. Resultados: Durante el período estudiado, se atendieron 4564 pacientes, de los cuales 1337 (29,3%) requirieron tratamientos quirúrgicos como terapéutica para la resolución de la urgencia. De estos, el 93,2% fueron exodoncias de piezas erupcionadas o retenidas; el 1,7%, biopsias quirúrgicas; el 2,4%, tratamientos agudos de infecciones que involucran espacios anatómicos vecinos; el 0,8%, resolución de traumatismos en los maxilares, y el 1,9%, tratamientos de complicaciones posquirúrgicas. Conclusión: Los resultados ponen de relieve la necesidad de disponer de servicios de guardia odontológica en el ámbito del AMBA que cuenten con recursos humanos calificados y entrenados para resolver urgencias de tipo quirúrgico

Aim: The objective of this study was to analyze and describe the requirements for the emergency care of oral and maxillofacial surgical treatment in the emergency dental department of the School of Dentistry of the University of Buenos Aires during the Preventive and Mandatory Social Isolation. Materials and methods: We conducted a retrospective analysis of a descriptive observational study during the initial period of 93 days of Preventive and Compulsory Social Isolation, from March 20, 2020 to June 20, 2020. All the medical records of the patients who attended the emergency dental department of the School of Dentistry of the University of Buenos Aires were evaluated and those who required different types of oral and maxillofacial surgical treatment were characterized. Results: A total of 4564 patients were attended during the period studied, of which 1337 (29.3%) required surgical treatment as a therapy for the resolution of their emergencies. Of these, 93.2% were exodontia of erupted or retained teeth, 1.7% surgical biopsies, 2.4% acute treatment of infections involving neighboring anatomical spaces, 0.8% resolution of maxillary alveolar trauma and 1.9% treatment of post-surgical complications. Conclusion: The results highlight the need to have dental emergency services in the AMBA area that have qualified and trained human resources to solve the surgical type emergencies that may arise (AU)

As marcas da violência por arma de fogo em face / The marks of gunshot wounds to the face

Resumo Introdução: Este artigo aborda a ocorrência de agravos à saúde em virtude de ferimentos na face por arma de fogo, entre os policiais militares, na Região Metropolitana do Estado do Rio de Janeiro, operados pela Clínica de Cirurgia e Traumatologia Bucomaxilofacial do Hospital Central da Polícia Militar. Objetivo: Identificar o perfil dos pacientes operados em decorrência de ferimentos na face por arma de fogo, a distribuição anatômica das fraturas maxilofaciais, as sequelas e complicações encontradas, as especialidades em saúde envolvidas na reabilitação desses pacientes, além de discutir sobre as repercussões sociais, emocionais e relativas ao desempenho do trabalho entre esses sujeitos. Método: Foi feito um estudo epidemiológico retrospectivo a partir de dados secundários referentes aos policiais militares operados no Hospital Central da Polícia Militar em decorrência de ferimentos por arma de fogo em face, de junho de 2003 a dezembro de 2017. Resultado: Durante o período estudado foram feitas 778 cirurgias em centro cirúrgico pelo serviço de Clínica de Cirurgia e Traumatologia Bucomaxilofacial no Hospital Central da Polícia Militar, 186 em decorrência de ferimentos por arma de fogo (23,9%). Todos os pacientes eram do sexo masculino e com média de 34,7 anos. A perda de segmento ósseo foi a sequela mais encontrada. O comprometimento estético facial e os relatos de insônia foram as repercussões tardias de impacto na saúde e no convívio social mais encontradas. Sobre as repercussões laborais do ferimento sofrido, o tempo médio de afastamento por licença de saúde para tratamento dos ferimentos maxilofaciais foi de 11,7 meses. Conclusão: O tratamento de pacientes vítimas de ferimentos por arma de fogo em face demanda múltiplas intervenções cirúrgicas e o envolvimento de diferentes especialidades da saúde para sua reabilitação. São necessários mais estudos que analisem qualitativamente o impacto desse tipo de traumatismo em face para a vida dos pacientes e seus desdobramentos sociais.

Tratamento cirúrgico de fratura Le Fort II: relato de caso / Surgical Treatment of Le Fort II Fracture: Case Report

Fraturas faciais geralmente resultam traumas, e podem ocorrer de forma isolada ou concomitante a outras lesões. O trauma na região facial resulta em danos não só em tecido ósseo, mas também em tecido mole e dentição, causando um prejuízo na função e na estética do paciente. Os acidentes automotores permanecem sendo uma das causas mais significativas de traumas faciais. As fraturas do terço médio da face incluem a maxila, zigoma e o complexo naso órbito etimoidal; podem ser classificadas em: fraturas Le Fort I, II ou III, fraturas do complexo zigomático maxilar, fraturas de arco zigomático ou fraturas naso órbito etimoidais. Elas podem ser unilaterais ou bilaterais, simétricas ou assimétricas. Este estudo objetiva-se em relatar o caso clínico de um paciente do sexo masculino, 31 anos, vítima de acidente automobilístico (carro/ anteparo). O paciente foi diagnosticado com fratura do tipo Le Fort II e nasal onde foi realizado o tratamento de redução e fixação interna rígida das fraturas de maxila e redução incruenta de fratura nasal, resultando em melhora da condição do paciente. As fraturas Le Fort são predominantemente causadas por colisões de alta energia. Portanto o tratamento é imprescindível para a devolução da função, estética e autoestima do paciente... (AU)

Facial fractures usually result from trauma, and may occur in isolation or concomitantly with other injuries. Trauma in the facial region results in damage not only to bone tissue but also to soft tissue and dental elements, which causes a loss in the patient's function and esthetics. Automotive accidents remain one of the most significant causes of facial trauma. Fractures of the middle third of the face include maxilla, zygoma and the nasoorbitoethmoid; may be classified as: Le Fort I, II or III fractures, maxillary zygomatic complex fractures, zygomatic arch fractures, or nasoorbitoethmoid. They can be unilateral or bilateral, symmetrical or asymmetric. The present study aims to report the clinical case of a 31 years, male patient, victim of an automobile accident (car/fixed shield). The patient was diagnosed with le Fort II and nasal fracture, where the treatment of reduction and rigid internal fixation of maxilla fractures and reduction of nasal fracture were performed, resulting in improvement of the patient's condiction. Le Fort fractures are predominantly caused by high energy collisions. Therefore the treatment is essential for the return of the function, aesthetics and increase of the patient's self-esteem... (AU)

Effect of Oral and Maxillofacial Injuries on the Development of Post-Traumatic Stress Disorder: A Cross-Sectional Study

ABSTRACT Objective: To assess the influence of oral and maxillofacial trauma on the development of Post-Traumatic Stress Disorder (PTSD) and to determine the efficiency of the Impact of Event Scale-Revised (IES-R) as a diagnostic tool for detecting PTSD in patients with Oral and Maxillofacial injuries. Material and Methods: PTSD was assessed one month postoperatively by the diagnostic instrument, IES-R, to arrive at a provisional diagnosis. A structured clinician-administered PTSD Scale then assessed the patients for the Diagnostic and Statistical Manual of Mental Disorders-5th edition (CAPS-5) to establish a final diagnosis. The assessment of the severity of PTSD was done based on various types of oral and maxillofacial injuries. Results: The IES-R scale provisionally diagnosed 54 subjects with PTSD, out of which 42 were diagnosed to have PTSD by the CAPS-5 scale. Subjects with injuries involving the 'orbital complex,' those presenting with a perceptible scar in the maxillofacial region and with multiple avulsed/ luxated anterior teeth, showed a higher affinity to develop PTSD, and this was statistically significant. Conclusion: Higher levels of PTSD in patients with injuries to the maxillofacial region warrants correct diagnosis and detection, and hence the maxillofacial surgeon plays a vital role in this regard. The IES-R is a useful diagnostic tool to detect PTSD early.

Urgent surgical approach for comminuted mandible fracture and considerations regarding airway risk. Case report / Abordagem cirúrgica urgente para fratura cominutiva da mandíbula e considerações sobre o risco das vias aéreas. Relato de caso

Introduction: Jaw fractures are one of the most common sites of maxillofacial injuries. The location of the jaw makes it very vulnerable to direct impacts. The purpose of treatment is to restore aesthetic function. Case Report: The purpose of this report is to present a case of comminuted mandible fracture in a young male patient, treated urgently due to the need for maintenance of the airways, where fracture osteosynthesis surgery was submitted. Conclusion: The initial assessment of these trauma patients should follow the Trauma Life Support protocol, and structural damage should be investigated. Introduction: Jaw fractures are one of the most common sites of maxillofacial injuries. The location of the jaw makes it very vulnerable to direct impacts. The purpose of treatment is to restore aesthetic function. Case Report: The purpose of this report is to present a case of comminuted mandible fracture in a young male patient, treated urgently due to the need for maintenance of the airways, where fracture osteosynthesis surgery was submitted. Conclusion: The initial assessment of these trauma patients should follow the Trauma Life Support protocol, and structural damage should be investigated

Introdução: As fraturas de mandíbula são um dos locais mais comuns de lesões maxilofaciais. A localização da mandíbula a torna muito vulnerável a impactos diretos. O objetivo do tratamento é restaurar a função estética. Relato de Caso: O objetivo deste relato é apresentar um caso de fratura cominutiva de mandíbula em paciente jovem do sexo masculino, atendido com urgência devido à necessidade de manutenção das vias aéreas, onde foi submetido cirurgia de osteossíntese da fratura. Conclusão: A avaliação inicial desses pacientes com trauma deve seguir o protocolo do Suporte de Vida no Trauma, e devem ser investigados danos estruturais.

Effectiveness of simplified predictive intubation difficulty score and thyromental height in head and neck surgeries: an observational study / Eficácia do escore simplificado preditivo de dificuldade de intubação e da altura tiromentoniana em cirurgias de cabeça e pescoço: estudo observacional

Abstract Background and objectives: In this study, we aimed to investigate the predictive value of different airway assessment tools, including parts of the Simplified Predictive Intubation Difficulty Score (SPIDS), the SPIDS itself and the Thyromental Height Test (TMHT), in intubations defined as difficult by the Intubation Difficulty Score (IDS) in a group of patients who have head and neck pathologies. Methods: One hundred fifty-three patients who underwent head and neck surgeries were included in the study. The Modified Mallampati Test (MMT) result, Thyromental Distance (TMD), Ratio of the Height/Thyromental Distance (RHTMD), TMHT, maximum range of head and neck motion and mouth opening were measured. The SPIDSs were calculated, and the IDSs were determined. Results: A total of 25.4% of the patients had difficult intubations. SPIDS scores >10 had 86.27% sensitivity, 71.57% specificity and 91.2% Negative Predictive Value (NPV). The results of the Receiver Operating Curve (ROC) analysis for the airway screening tests and SPIDS revealed that the SPIDS had the highest area under the curve; however, it was statistically similar to other tests, except for the MMT. Conclusions: The current study demonstrates the practical use of the SPIDS in predicting intubation difficulty in patients with head and neck pathologies. The performance of the SPIDS in predicting airway difficulty was found to be as efficient as those of the other tests evaluated in this study. The SPIDS may be considered a comprehensive, detailed tool for predicting airway difficulty.

Resumo Justificativa e objetivos: Neste estudo, avaliamos o valor preditivo de diferentes ferramentas de avaliação das vias aéreas, incluindo componentes do Escore Simplificado Preditivo de Intubação Difícil (ESPID), o próprio ESPID e a Medida da Altura Tireomentoniana (MATM), em intubações definidas como difícies pelo Escore de Dificuldade de Intubação (EDI) em um grupo de pacientes com patologia de cabeça e pescoço. Método: Incluímos no estudo 153 pacientes submetidos a cirurgia de cabeça e pescoço. Coletamos os resultados do Teste de Mallampati Modificado (TMM), Distância Tireomentoniana (DTM), Razão Altura/Distância Tireomentoniana (RADTM), MATM, amplitude máxima de movimentação da cabeça e pescoço e da abertura da boca. Os ESPIDs foram calculados e os EDIs, determinados. Resultados: Observamos intubação difícil em 25,4% dos pacientes. Os escores de ESPID > 10 tiveram sensibilidade de 86,27%, especificidade de 71,57% e valor preditivo negativo de 91,2% (VPN). O resultado da análise da curva de operação do receptor (curva ROC) para os testes de avaliação das vias aéreas e ESPID mostrou que o ESPID tinha a maior área sob a curva; no entanto, foi estatisticamente semelhante a outros testes, exceto para o TMM. Conclusões: O presente estudo demonstra o uso prático do ESPID na previsão da dificuldade de intubação em pacientes com patologia de cabeça e pescoço. O desempenho do ESPID na predição de via aérea difícil mostrou-se tão eficiente quanto os demais testes avaliados neste estudo. O ESPID pode ser considerado ferramenta abrangente e detalhada para prever via aérea difícil.

Herramientas pronósticas de la gravedad del trauma maxilofacial en la atención de urgencia / Prognostic Tools for Maxillofacial Trauma Severity in Emergency Care

RESUMEN Introducción: La utilización de herramientas pronósticas que permitan valorar la gravedad del trauma, la supervivencia y mortalidad de los lesionados, permite la estratificación de los pacientes y la toma de decisiones acertadas para el tratamiento más efectivo en el área hospitalaria. Objetivo: Realizar una revisión bibliográfica sobre las herramientas pronósticas más utilizadas en la atención de urgencia para detectar la gravedad del trauma maxilofacial. Métodos: Se realizó una revisión bibliográfica desde octubre de 2018 hasta enero de 2019. Fueron examinados libros y artículos publicados en revistas de impacto, en idioma español, inglés y portugués, con atención prioritaria a aquellos que tuvieran cinco años o menos. Se consultaron las bases de datos MEDLINE, EBSCO, PubMed, SciELO, ClinicalKey, utilizando los descriptores: "Trauma Severity Indices", "Maxillofacial Injuries", "Traumatology", "Indexes". Se recuperaron dos libros y 50 artículos, aunque la revisión se circunscribió solamente a los 33 que mejor describían los elementos estudiados. Análisis e integración de la información: El puntaje Cooter David, el de gravedad de lesiones maxilofaciales, la escala de severidad de lesiones faciales, la de severidad de fracturas faciales y el modelo ZS, son los principales instrumentos utilizados en el pronóstico de gravedad existentes de la región facial. Conclusiones: Constan en la literatura escalas, índices y puntajes para pronosticar la gravedad del trauma maxilofacial en la urgencia, cada una exhibe ventajas que las convierte en una herramienta coadyuvante de la atención del trauma; sin embargo, poseen también desventajas que complejizan su aplicación en el medio hospitalario. Entre las herramientas más utilizadas está la escala de severidad de lesiones faciales; fácil de aplicar en los servicios de urgencia, pero con deficiencias a la hora de tratar los componentes de tejido blando y óseo. En Cuba hay escasas evidencias de la utilización de estos instrumentos en la especialidad de cirugía maxilofacial(AU)

ABSTRACT Introduction: The usage of prognostic tools that allow assessing trauma severity, as well as injury survival and mortality, allows patient stratification and making right decisions for the most effective treatment in the hospital area. Objective: To carry out a bibliographic review about the prognostic tools most widely used in emergency care to identify maxillofacial trauma severity. Methods: A bibliographic review was carried out from October 2018 to January 2019. We examined books and articles published in high-impact magazines, in Spanish, English and Portuguese, with priority attention on those five years old or less. We consulted the MEDLINE, EBSCO, PubMed, SciELO, Clinical Key databases using the descriptors Trauma Severity Indices, Maxillofacial Injuries, Traumatology, and Indexes. Two books and 50 articles were retrieved, although the review was limited to only 33 which described best the elements studied. Information analysis and integration: The Cooter-David scoring system, the maxillofacial injury severity score, the facial injury severity scale, the facial fracture severity scale, and the ZS model are the main instruments used for existing severity forecast in the facial region. Conclusions: There literature includes scales, indexes and scoring systems for predicting the maxillofacial trauma severity in the emergency department, each one showing advantages that make them an adjunct tool for trauma care; however, they also have disadvantages that complicate their application in the hospital setting. The facial injury severity scale is among the most widely used tools, as far as it is easy to apply in the emergency services, but with deficiencies for treating soft tissue and bone components. In Cuba, there is little evidence about the use of these instruments in the specialty of maxillofacial surgery(AU)

Caracterización del trauma maxilofacial grave en dos servicios de urgencia de La Habana, Cuba / Characterization of severe maxillofacial trauma in two emergency departments in Havana, Cuba

RESUMEN Introducción: Las lesiones faciales pueden afectar la capacidad del paciente para comer, hablar e interactuar. Objetivo: Caracterizar el trauma maxilofacial grave en el servicio de urgencia del Hospital Universitario "General Calixto García" y "Miguel Enríquez", La Habana, Cuba. Métodos: Se realizó un estudio descriptivo transversal multicéntrico en los servicios de urgencia del Hospital Universitario "General Calixto García" y Hospital "Miguel Enríquez" de marzo 2017 a marzo 2019. Se estudió el universo de pacientes con diagnóstico de trauma maxilofacial grave. Las variables cualitativas fueron sexo, etiología, ingestión de bebidas alcohólicas y lesiones, y la cuantitativa fue edad. Se confeccionó una planilla de recolección de datos y la información se introdujo en una base de datos. Se emplearon números enteros, porcentajes y tablas estadísticas. Se buscó la asociación entre variables. Resultados: El sexo masculino constituyó un 80,6 por ciento. El grupo de edad más representado fue el de 18-30 años (33,3 por ciento), seguido por el de 31-40 (25,0 por ciento). En el 41,7 por ciento de los pacientes el trauma estuvo relacionado con accidentes del tránsito, y en el 30,6 por ciento con violencia interpersonal. En el 51,9 por ciento de los pacientes se detectó aliento etílico, con mayoría de los atendidos en el Hospital "Miguel Enríquez". Predominaron las heridas mayores de 2 cm, seguidas por las de menos de esa longitud (61,1 por ciento y 32,4 por ciento, respectivamente) y la fractura mandibular (51,9 por ciento). Conclusiones: Hubo predominio del sexo masculino y grupo de edades de 18-30; como principal etiología estuvieron los accidentes de tránsito, seguidos de la violencia interpersonal; las lesiones de tejidos blandos más frecuentes fueron las heridas mayores de 2 cm y las de tejidos duros, las fracturas mandibulares. Hubo una asociación significativa de la ingestión de bebidas alcohólicas en los pacientes tratados en el Hospital "Miguel Enríquez"(AU)

ABSTRACT Introduction: Facial injuries may affect patients' capacity to eat, speak and interact. Objective: Characterize severe maxillofacial trauma in the emergency departments of General Calixto García University Hospital and Miguel Enríquez Hospital in Havana, Cuba. Methods: A descriptive cross-sectional multicenter study was conducted in the emergency departments of General Calixto García University Hospital and Miguel Enríquez Hospital from March 2017 to March 2019. The study universe was patients diagnosed with severe maxillofacial trauma. The qualitative variables were sex, etiology, consumption of alcoholic beverages and injuries, whereas the quantitative variable was age. A data collection form was developed and the information was stored in a database. Data were expressed in whole numbers, percentages and statistical tables. A search was performed for the relationship between the variables. Results: Male sex constituted 80.6 percent of the sample. The best represented age group was 18-30 years (33.3 percent), followed by 31-40 (25.0 percent). In 41.7 percent of the patients the trauma was related to traffic accidents, and in 30.6 percent to interpersonal violence. Alcohol breath was detected in 51.9 percent of the patients, among them most of those cared for at Miguel Enríquez Hospital. There was a predominance of wounds larger than 2 cm, followed by wounds under that length (61.1 percent and 32.4 percent, respectively) and mandibular fracture (51.9 percent). Conclusions: A predominance was found of the male sex and the 18-30 years age group; the main etiology was traffic accidents, followed by interpersonal violence; the most common soft tissue injuries were wounds larger than 2 cm, whereas the most common hard tissue injuries were mandibular fractures. A significant association was found with consumption of alcoholic beverages among the patients treated at Miguel Enríquez Hospital(AU)

Maxillofacial Injuries in Brazilian Children and Adolescents Victims of Physical Violence: A Single Forensic Center Analysis

Abstract Objective: To identify the prevalence of maxillofacial injuries resulting from interpersonal violence in Brazilian children and adolescents. Material and Methods: This is a retrospective study conducted at a Center of Forensic Medicine and Forensic Dentistry with a sample of 335 medical reports of victims aged up to 19 years. Variables involved sex and age group, perpetrator, occurrence of the event, characterization of injuries, presence of maxillofacial injuries, type of tissue involvement, and injuries in the oral cavity. Data were analyzed using descriptive, and the Chi-square was used for categorical data. Results: Most victims were female (60.3%) and aged 15-19 years (57.6%). Aggressions occurred at home (50.6%), in the evening (39.5%) and involved perpetrators known to the victim (91.5%). Most victims had multiple injuries (75.8%), involving up to three regions of the body (93.4%). Injuries with blunt objects were the most frequent (86.2%). The prevalence of maxillofacial injuries was 36.7%, with low involvement of the oral cavity (8.4%). A significant association between the presence of injuries on the face and variables "perpetrator" (p=0.015) and "number of injuries" (p=0.006) was observed. Conclusion: Female adolescents were the main victims of physical violence, with repercussions in different regions of the body. The prevalence of maxillofacial injuries was high, although with little involvement of oral cavity structures.