Intoxication is a Significant Risk Factor for Severe Craniomaxillofacial Injuries in Standing Electric Scooter Accidents.

PURPOSE: Standing electric scooters are a relatively new mode of transportation that are becoming increasingly popular in large metropolitan areas. The purpose of this study was to characterize injury patterns and identify risk factors for craniomaxillofacial injuries in standing electric scooter accidents. METHODS: This retrospective cohort study used a Clinical Data Warehouse search engine to identify patients who sustained standing electric scooter accidents from 2017 to 2019 using the International Classification of Diseases 10th revision codes. Predictors including patient demographics, presence of intoxication, helmet use, mechanism of injury, and other noncraniomaxillofacial injuries sustained at the time of standing electric scooter injury were identified. Patients were grouped as per the presence or absence of craniomaxillofacial injuries so that risk factors could be identified for craniomaxillofacial injuries in standing electric scooter accidents. Logistic regression analysis was performed to identify potential risk factors and association for craniomaxillofacial injuries. RESULTS: The sample was composed of 165 patients with a mean age of 30.3 years and 73.9% were men. Of them, 38 (23.0%) sustained craniomaxillofacial trauma. They were ten times more likely to have been intoxicated than those who did not have craniomaxillofacial injuries (4.7 vs 52.6%). Concomitant injuries of the extremities and the craniomaxillofacial region were rare indicating that in many cases the arms and legs were not outstretched to "break the fall." The high numbers of mandibular fractures to the condylar, subcondylar, and symphyseal regions (23.8, 33.3, and 28.6%, respectively), Le Fort fractures (18.4%), and frontal sinus fractures (15.8%) indicate that falls in the anterior-posterior direction occur with the main point of impact occurring at the chin, midface, and forehead. CONCLUSIONS: Intoxication may inhibit or depress protective reflexes that leave the face and head vulnerable during standing electric scooter accidents.

Effect of length, diameter, intraoral location on implant stability.

OBJECTIVES: To quantitatively compare stability of dental implants with varying lengths, diameters, and intraoral locations. STUDY DESIGN: Retrospectively, 200 consecutive NobelReplace Tapered Groovy implants of varying lengths and diameters were evaluated via implant stability quotient readings at placement (T1) and follow-up (T2). Data were analyzed by analysis of variance and simple linear regression tests. RESULTS: Intraoral location was statistically significant at T1 and T2. Although implant diameter was not statistically significant, implant length resulted in T1 (P = .08) and T2 (P = .09), which may have a clinically relevant effect on implant stability. An overall implant survival rate of 98% was achieved. Gender and age did not seem to affect implant stability quotient values at placement, follow-up, or implant survival. CONCLUSIONS: Intraoral location is an important factor in implant stability, with implants placed in the mandible being more stable than implants placed in the maxilla both at T1 and T2. Length may have a clinically relevant effect on implant stability.

Resonance Frequency Analysis of Sinus Augmentation by Osteotome Sinus Floor Elevation and Lateral Window Technique.

PURPOSE: To evaluate the use of resonance frequency analysis (RFA) to quantitatively compare the stability of implants placed in the atrophic posterior maxilla using 3 sinus augmentation techniques: osteotome sinus floor elevation (OSFE) and 1- and 2-step lateral window techniques (LWTs). MATERIALS AND METHODS: Data were retrospectively collected from 50 patients, 29 to 85 years old. One hundred twenty-eight implants were subdivided based on sinus augmentation technique as determined by available native bone height. Thirty-three implants were placed using OSFE in at least 8.0 mm of bone. Forty-four implants were synchronously placed using 1-step LWT in 3.0 to 7.9 mm of bone. In cases with less than 3.0 mm of bone, the 2-step LWT was performed and the remaining 51 implants were placed after a period of healing. Implant stability quotient (ISQ) was recorded from RFA at stage 1 and subsequently at stage 2 (follow-up) 3 to 12 months later. Statistical analysis was completed using t test and analysis of variance to assess differences in implant stability over time and among techniques, respectively. RESULTS: ISQ values at placement averaged 70.9, 68.9, and 72.2 for OSFE, LWT, and LWT with delayed placement, respectively. These differences were not statistically significant (P = .2). At stage 2 (follow-up), average ISQ values were 76.7, 77.7, and 78.7 for OSFE, LWT, and LWT with delayed placement, respectively. These differences were not statistically significant (P = .3). In contrast, differences in ISQ at stage 2 (follow-up) versus stage 1 were statistically significant for all 3 techniques (P < .01). OSFE, 1-step LWT, and 2-step LWT yielded average increases in ISQ of 5.8, 8.8, and 6.5, respectively. CONCLUSIONS: The results support the use of OSFE, 1-step LWT, and 2-step LWT to augment bone in the atrophic edentulous posterior maxilla. All 3 methods provide predictable osseointegration and yield statistical increases in ISQ at stage 2 (follow-up) compared with time of placement. With appropriate case selection according to native vertical bone height, there are no statistical differences in ISQ among these 3 techniques at either stage.

Sinus membrane perforations and the incidence of complications: a retrospective study from a residency program.

OBJECTIVE: The purpose of this study is to evaluate sinus membrane perforations and the incidence of complications in a residency program. STUDY DESIGN: Data from 107 consecutive direct sinus augmentation procedures were reviewed retrospectively from 2008 to 2012. DISCUSSION: All perforations were repaired intraoperatively with the use of a collagen tape. Intraoperative membrane perforations were observed in 64 of 107 cases (59.8%). Of the perforations, 58 were less than 5 mm in diameter and 6 were 5 mm or greater in diameter. It was found that there were 6 cases (5.6%) that experienced postoperative complications. Of those, 3 occurred in cases with no perforations, 2 with perforations less than 5 mm in diameter, and 1 with a perforation 5 mm or more in diameter. These differences were not statistically significant (P > .05). All observed post-operative complications were related to symptoms of acute infection. CONCLUSIONS: Although membrane perforation was a frequent intraoperative finding, there was no evidence that the presence and size of membrane perforation influences the likelihood of postoperative complications.