Treatment of mandibular condyle fractures. A 20-year review.

BACKGROUND/AIM: The condylar fracture is among the most frequent facial fractures. Despite all the published studies, its treatment remains controversial. The aim of this retrospective study was to evaluate the epidemiology and complications of mandibular condyle fractures managed by surgical and conservative treatments, over a period of twenty years. MATERIAL AND METHODS: The files of 262 patients with 318 condyle fractures were included in this study. One hundred and seven patients had conservative management, and 155 had surgical management for the condylar fractures. The outcomes were assessed by reviewing the patient's clinical records. RESULTS: The prevalence was higher in males and most patients were Caucasians in the third decade of life. The mean age was 30.17 years old. The main causes were motorcycle accidents followed by bike accidents, and the mean follow-up time was 226.5 days. The number of complications found in the two modalities of treatment was low and similar. CONCLUSION: Both treatments achieved their goals. There was no statistical difference in the complication rate between the two groups.

Effect of surgically assisted rapid maxillary expansion on masticatory muscle activity: A pilot study.

BACKGROUND: The aim of the present study was to analyze the electromyographic (EMG) activity of masseter and temporal muscles of adult patients submitted to surgically assisted rapid maxillary expansion (SARME) before and after the surgery. MATERIALS AND METHODS: The sample consisted of 19 adults, with ages ranging from 20 to 47 years (mean 25.4 years), with bilateral posterior cross bite requiring SARME treatment. The electromyographic activity of masseter and temporal muscles was analyzed before treatment (T1) and after the surgical procedure (T2). The mean interval between the two electromyographic analyses was 15 days. RESULTS: The muscular active was electromyographically analyzed during the clinical situation of habitual gum chewing (10 sec), dental clenching (4 sec), mouth opening and closing (10 sec), rest (10 sec), protrusion (10 sec), and right and left laterality (10 sec). The measured differences between T1 and T2 data were evaluated using the paired t-test (SPSS 17.0 for Windows). The electromyographic analysis showed that the activity of the masseter and temporal muscles decreased significantly after the SARME in all the clinical situations after the surgery. CONCLUSION: According to the results of the present study, individuals after SARME surgery presented patterns of electromyographic contraction similar to those developed by dentate individuals during the movements of mandibular excursion.

Reconstruction of mandibular segmental defects using the guided-bone regeneration technique with polylactide membranes and/or autogenous bone graft: a preliminary study on the influence of membrane permeability.

PURPOSE: Bone maintenance after mandibular reconstruction with autogenous iliac crest may be disappointing due to extensive resorption in the long term. The potential of the guided-bone regeneration (GBR) technique to enhance the healing process in segmental defects lacks comprehensive scientific documentation. This study aimed to investigate the influence of polylactide membrane permeability on the fate of iliac bone graft (BG) used to treat mandibular segmental defects. MATERIALS AND METHODS: Unilateral 10-mm-wide segmental defects were created through the mandibles of 34 mongrel dogs. All defects were mechanically stabilized, and the animals were divided into 6 treatment groups: control, BG alone, microporous membrane (poly L/DL-lactide 80/20%) (Mi); Mi plus BG; microporous laser-perforated (15 cm(2) ratio) membrane (Mip), and Mip plus BG. Calcein fluorochrome was injected intravenously at 3 months, and animal euthanasia was carried out at 6 months postoperatively. RESULTS: Histomorphometry showed that BG protected by Mip was consistently related to larger amounts of bone compared with other groups (P