Retrospective analysis of 15 years of horse-related maxillofacial fracture data at a major German trauma center.

PURPOSE: The purpose of this study was to estimate the effect of the mechanism of trauma (fall versus kick), rider demographics, equestrian experience, protective equipment, and whether or not a horse was shod on the anatomic site of a horse-related maxillofacial fracture, operating time, postoperative complication rate, and length of hospital stay. METHODS: We retrospectively reviewed the medical records of patients treated for horse-related maxillofacial fractures at a single institution in Germany between January 2000 and March 2015. We used linear and logistic regression to test the above-mentioned variables for statistical correlations. RESULTS: During the study period, we treated 138 horse-related facial fractures in 71 patients. The mean patient age was 34.5 years, and 80.3% of the injuries occurred in women. Most of the maxillofacial fractures were the result of a horse kick (71.8%) when unmounted and the majority occurred in more experienced riders (70.4%). There was a significant association of wearing of protective equipment with a shorter hospital stay and lower risk of postoperative complications. CONCLUSION: More education is needed in the equestrian community regarding the use of protective equipment when unmounted. Safety helmets should be redesigned to include a faceguard and be worn at all times.

Use of a laser fluorescence device for the in vitro activity assessment of incipient caries lesions.

PURPOSE: To evaluate the progression of demineralization during orthodontic treatment, the assessment of lesion activity is important in addition to the detection of lesion extent. This study aimed to evaluate the ability of laser fluorescence measurements to differentiate between active and inactive initial lesions in vitro. METHODS: In all, 63 extracted, permanent human teeth were available for the study. On each occlusal investigation site, surface extent and activity of caries lesions were classified visually using ICDAS/ICCMS (International Caries Detection and Assessment System/International Caries Classification and Management System) criteria, following laser fluorescence measurements. Teeth were hemisected and assessed for lesion depth. Methyl red dye was applied to validate lesion activity on the sections. A Mann-Whitney U-test was performed to evaluate differences between laser fluorescence measurements for active and inactive lesions. For visual and laser fluorescence findings, diagnostic accuracy (Az, sensitivity and specificity) were calculated. RESULTS: A total of 19 sound surfaces and 44 surfaces with ICDAS codes 1/2 were classified visually. The differences in laser fluorescence measurements between active and inactive lesions were not significant for the initial lesions (p > 0.05). Sensitivity/specificity for lesion depth was 90.5/92.3% (Az = 0.894), respectively, for visual assessment and 69.1/76.9% (Az = 0.745), respectively, for laser fluorescence. Sensitivity/specificity for activity assessment was 68.6/85.0% (Az = 0.768) for the visual method. For laser fluorescence measurements, no diagnostic accuracy values could be calculated for caries activity assessment. CONCLUSION: The visual detection and activity assessment of initial lesions was more suitable than the laser fluorescence method. Based on the results of this in vitro study, use of laser fluorescence cannot be recommended for distinguishing between active and inactive initial caries lesions on occlusal surfaces.