Epidemiological analysis of 736 patients who suffered facial trauma in Brazil / Análisis epidemiológico de 736 pacientes que sufrieron trauma facial en Brasil

The etiology of facial fractures is directly related to the studied country, varying according to the socioeconomic, cultural condition of the population, besides the period of investigation. The objective of the present study is to evaluate the epidemiological characteristics of the prevalence, treatment modalities and complications rates of maxillofacial fractures in a hospital in the state of Espírito Santo, over a period of 5 years. A total of 428 patients presented a facial fracture, with a prevalence of males (436), with a mean age of 40 years. Regarding the number of fractures, 291 individuals suffered fractures only in the fixed skeleton, 97 only in the mandible, and 48 suffered fractures in both fixed and mandibular skeletons. The predominant anatomical site in fixed skeletal fractures was zygomatic complex (56.6 %), orbit (31.9 %) and nose (29.2 %); while in the mandible the condyle (33.8 %), body (17.9 %) and angle (13.1 %). The frequent etiology was falls, physical aggression, sports accidents. Regarding the type of treatment, in fixed skeleton 192 fractures were treated conservatively and 303 by surgery. Already in the mandible, the numbers were 43 and 143, respectively. In addition, 24 patients progressed with some type of complication in one or more operated sites. It is worth mentioning that epidemiological assessments provide important support in the creation of legislation in the attempt to reduce important for the establishment of clinical and research priorities, since risk factors and patterns of presentation can be identified. Accordingly in an attempt to reduce these rates.

La etiología de las fracturas faciales está directamente relacionada con el país estudiado, variando según la condición socioeconómica y cultural de la población, además del período de investigación. El objetivo del presente estudio fue evaluar las características epidemiológicas de la prevalencia, las modalidades de tratamiento y las tasas de complicaciones de las fracturas maxilofaciales en un hospital en el estado de Espírito Santo, durante un período de 5 años. Un total de 428 pacientes presentaron fractura facial, con una prevalencia de varones (436), con una edad media de 40 años. Con respecto al número de fracturas, 291 individuos sufrieron fracturas solo en el esqueleto fijo, 97 solo en la mandíbula y 48 sufrieron fracturas tanto en el esqueleto fijo como en el mandibular. El sitio anatómico predominante en las fracturas esqueléticas fijas fue el complejo cigomático (56,6 %), la órbita (31,9 %) y la nariz (29,2 %); mientras que en la mandíbula el cóndilo (33,8 %), el cuerpo (17,9 %) y el ángulo (13,1 %). La etiología frecuente fue caídas, agresión física, accidentes deportivos. En cuanto al tipo de tratamiento, en el esqueleto fijo se trataron 192 fracturas de forma conservadora y 303 mediante cirugía. Ya en la mandíbula, los números eran 43 y 143, respectivamente. Además, 24 pacientes progresaron con algún tipo de complicación en uno o más sitios operados. Cabe mencionar que las evaluaciones epidemiológicas brindan un apoyo importante en la creación de legislación en estos casos, para establecer prioridades clínicas y de investigación, debido a que se pueden identificar factores de riesgo y patrones de presentación. En consecuencia, en un intento de reducir estas tasas.

A study on shotgun injuries to the craniomaxillofacial Region in a Nigerian Tertiary Health Center.

CONTEXT: Short-range shotgun wounds of the craniomaxillofacial region are life-threatening and are as devastating as military rifle wounds. AIMS: This study aimed to evaluate the pattern of presentation of craniomaxillofacial shotgun injuries, types of shotgun injuries, and the outcome of treatments in our environment. SETTING AND DESIGN: This is a prospective observational study. Materials and Methods: This is a prospective observational study conducted from February 2006 to March 2012. All patients with shotgun wounds to the craniomaxillofacial region were included in the study by convenient sampling method. Glezer's shotgun classification scheme was used to categorize the patients into short-, intermediate-, and long-range shotgun wounds. Data collected were analyzed using SPSS version 16. STATISTICAL ANALYSIS USED: Descriptive statistics were used to calculate the data. Mean and standard deviation (SD) were calculated for all quantitative variables such as age. Frequency and percentages were presented for qualitative variables. RESULTS: A total number of 28 patients were seen. Ages ranged from 19 to 64 years with a mean (±SD) of 32.7 (±11.4) years. The two most commonly used shotguns were locally made pistol (25, 42.9%) and the cut-size gun (10, 35.7%) and the least commonly used was Dane gun (1, 3.6%). Close-range injury to the face was 17 (60.7%) while that of intermediate- and long-range injuries were 6 (21.1%) and 5 (17.9%), respectively. CONCLUSION: Wounds sustained from close-range shotguns to the face were the most common in this environment. The outcome of treatment was satisfactory when treated with conservative debridement and early reconstruction.

Retrospective analysis of jaw biopsies in young adults. A study of 1599 cases in Southern Brazil

Background: To evaluate the prevalence and the characteristics of jaw lesions diagnosed in young adults aged 20 to 30 years in a southern Brazil reference center, over a period of 25 years. And to analyze the concordance between clinical and histological diagnosis. Material and Methods: In this cross-sectional retrospective study, the biopsies files from this center were retrieved and data regarding sex, age, bone localization, clinical and histological diagnosis were collected. The histological diagnosis were grouped into the categories Cystic lesions of odontogenic origin, Periapical inflammation, Odontogenic tumors, Bone diseases, Health tissue and Nonspecific diagnostic. Absolute and relative frequencies were estimated with descriptive analysis. The agreement between clinical and histological diagnosis was measured through Kappa statistic. Results: A total of 18,181 histopathological analysis were performed during the period of the study, registering 1,599 jaw lesions in young adults. The average age of individuals was 24,59 years (SD 3,1). Nine hundred ninety-one (62%) lesions were found in females and 608 (38%) in males. More than half of pathologies were cystic lesions of odontogenic origin (822/51.4%), followed by periapical inflammation (282/17.6%). Regarding the site of lesions, more than half occurred in posterior mandible (877/54.8%), followed by posterior maxilla (339/21.2%). The most frequent entities were periapical cyst, chronic periapical granuloma, dental follicle and paradental cyst, corresponding to a total of 1,202 (75.2%) evaluated cases. In relation to the analysis of concordance between clinical and histological diagnosis the general Kappa index was 0.5, which is considered moderate. Finally, the findings confirm data from literature about the most frequent jaw pathologies in young adults and serve as aid for preventive measures of some entities. Additionally, they can improve the formulation of differential diagnosis and the patient management (AU)

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Tooth damage in captive orcas (Orcinus orca).

OBJECTIVES: Tooth damage as a result of oral stereotypies is evident in captive orca, yet little research on the topic exists. This study examines the associations between dental pathology, sex, facility, duration of captivity and other factors in captive orca. DESIGN: We evaluated mandibular and maxillary teeth from dental images of 29 captive orca owned by a US-based theme park. Each tooth was scored for coronal wear, wear at or below gum line and bore holes. Fractured and missing teeth were also noted. Summary statistics described the distribution and severity of pathologies; inferential statistics examined how pathologies differed between sexes, between wild-captured and captive-born orcas and between captive orca at four facilities. We also evaluated how dental pathology and duration of captivity were related. RESULTS: Approximately 24% of whales exhibited "major" to "extreme" mandibular coronal tooth wear, with coronal wear and wear at or below gum line highly correlated. More than 60% of mandibular teeth 2 and 3 exhibited fractures. Bore holes were observed primarily among anterior mandibular teeth, with more than 61% of teeth 2 and 3 bearing evidence of having been drilled. Four of five orca with the highest age-adjusted tooth pathology indices were captive-born. CONCLUSIONS: Various dental pathologies were observed across all whales, with pathologies beginning at a young age. Oral stereotypies exhibited by captive orca contributed to the observed dental damage. By making dental and health records of captive whales publicly available, the theme park industry is uniquely positioned to provide further insight into dental pathology and resultant health consequences in captive orca.

Maxillofacial Gunshot Injuries: A Comparison of Civilian and Military Data.

PURPOSE: To compare military with civilian gunshot wounds (GSWs) in the maxillofacial region in order to establish differences in presentation, morbidity, and surgical management. MATERIALS AND METHODS: A cross-sectional study design was used. The University of Florida at Jacksonville oral and maxillofacial surgery operating room census and hospital trauma registry were both reviewed to identify maxillofacial GSW cases from 2005 through 2011. Military GSW data (2005 through 2011) were obtained from the US Department of Defense (DOD). The predictor variables were civilian versus military GSW events. The outcome variables of interest included the region of the face involved, race, gender, death during admission, hospital length of stay, and number of days in the intensive care unit (ICU). Descriptive statistics were computed. RESULTS: The sample was divided into military maxillofacial GSWs (n = 412) and civilian maxillofacial GSWs (n = 287 treated of 2,478 presented). A significant difference was measured between study groups regarding the region of the face involved (P = .0451), gender (P ≤ .0001), and race (P ≤ .0001). No significant relationship was measured regarding deaths during admission (P = .6510) for either study group. No standard deviation values for hospital length of stay or number of ICU days were provided by the DOD. The mean hospital length of stay for the military group was within the 95% confidence interval of the civilian group findings (6.0-7.6). The mean number of ICU days for the military group was not within the civilian group's 95% confidence interval (1.9-2.9). CONCLUSIONS: These data showed important differences in anatomic location, gender, and race distribution of maxillofacial GSWs between military and civilian populations. Limited analysis of hospital length of stay and number of ICU days might indicate no meaningful difference in hospital length of stay, although there was a statistical difference in the number of ICU days between the 2 populations. Future research comparing surgical strategies in these 2 environments could assist maxillofacial surgeons in providing optimal care to their patients.

Epidemiología de las fracturas mandibulares tratadas quirúrgicamente en el Instituto Traumatológico de Santiago (Chile): 10 años de revisión / Epidemiology of surgically treated jaw fractures in the Traumatology Institute of Santiago (Chile): a 10-year review

Los traumatismos en Chile son la tercera causa de muerte en la población general y la primera entre jóvenes. Se ha reportado una epidemiología variable alrededor del mundo asociada a diferencias demográficas y socioculturales, con escasos estudios en Latinoamérica. Objetivo. Conocer la epidemiología de las fracturas mandibulares en el Instituto Traumatológico de Santiago, Chile. Material y método. Estudio retrospectivo descriptivo de tipo cuantitativo en el Servicio de Cirugía Maxilofacial del IT, consistente en la recolección de datos mediante revisión de fichas clínicas de pacientes operados por fracturas mandibulares entre enero de 2001 y diciembre de 2010. Los datos fueron recopilados utilizando una base de datos Microsoft Access 2007 y luego tabulados y graficados con Microsoft Excel 2007. Resultados. De un universo de 783 fracturas faciales, 240 fichas de fracturas mandibulares operadas estuvieron disponibles para su análisis. La proporción hombres:mujeres fue de 5,9:1 y el grupo etario más afectado fue aquel entre 20 y 29 años. Las agresiones por terceros fueron su causa más frecuente. La mayoría de los pacientes fueron tratados en un promedio de 8,6 días desde su ingreso. En conclusión, estos resultados en general son concordantes con la literatura, salvo asociaciones entre sitio anatómico afectado y etiología (AU)

The traumatic injuries in Chile are the third cause of death in the general population and the first in young people. Their epidemiology varies around the world, and is linked to demographic and sociocultural differences, with few studies in Latin America. Objective. To determine epidemiological profile of the jaw bone fractures in the Traumatology Institute (IT) of Santiago, Chile. Material and method. Retrospective descriptive and quantitative study was conducted in the Maxillofacial Surgery Department of the IT, developed by recording data from a review of clinical records of patients with surgicaly treated jaw fractures. Data were collected between January-2001 and December-2010 using Microsoft Access 2007© and then tabulated and plotted using Microsoft Excel 2007©. Results. Out of a total of 783 facial fractures, 240 clinical files of surgically treated jaw fractures were available for analysis. The male:female ratio was 5.9:1, and the most afected age group was between 20 and 29 years old. The most frequent cause of the fracture was aggressions. Most patients were treated in an average of 8.6 days from admission. In conclusion, these results are consistent with the literature, except for the associations between the affected anatomical site and etiology (AU)

Are open mandibular fractures still an emergency?

INTRODUCTION: Early surgical management is often advocated for fractures of the tooth-bearing portion of the mandible. A 6-hour delay has been mentioned for the fixation of these fractures. Our aim was to bring this paradigm into question. METHODS: All patients referred to our department from September 2012 to May 2014 for fractures of the tooth-bearing portion of the mandible were retrospectively included. For each patient, age, gender, aetiology of the fracture, and characteristics of the fractures were recorded. Tobacco and/or alcohol addictions, diabetes and mandibular dental condition were taken into account. We also noticed the preoperative delay and the occurrence of complications such as: haematoma, infection, wound dehiscence, osteosynthesis failure and pseudarthrosis. RESULTS: Among the 47 patients referred, 36 were treated with a delay of more than 6 hours (76.6%). In 88.8% of the cases, the reason for this delay was unavoidable. The mean delay time from trauma to surgery was 52 hours (range: 7-312). Forty-nine percent of the patients had comorbidities. Complications occurred in 6 patients leading to an overall complication rate of 16.67%. A statistically significant higher complication rate was observed among smokers (P=0.006). No statistical relationship was found between the delay and the occurrence of complications (P=0.994). This study suggests that fractures of the tooth-bearing portion of the mandible should no longer be considered as an emergency that must be treated within a 6-hour delay.

Risk factors associated with facial fractures.

The aim of the present study was to identify risk factors for facial fractures in patients treated in the emergency department of a hospital. The medical charts of 1121 patients treated in an emergency ward over a three-year period were analyzed. The independent variables were gender, age, place of residence (urban or rural area) and type of accident. The dependent variables were fractured mandible, zygoma, maxilla, nasal bone and more than one fractured facial bone. Statistical analysis was performed using the chi-square test (a < 0.05), univariate and multivariate Poisson distributions and the logistic regression analysis (p < 0.20). Maxillofacial trauma was recorded in 790 charts (70.5%), with 393 (35.1%) charts reporting facial fractures. Motorcycle accidents were found to be the main risk factor for mandibular fractures (PR = 1.576, CI = 1.402-1.772) and simultaneous fractures of more than one facial bone (OR = 4.625, CI = 1.888-11.329) as well as the only risk factor for maxillary bone fractures (OR = 11.032, CI = 5.294-22.989). Fractures of the zygomatic and nasal bones were mainly associated with accidents involving animals (PR = 1.206, CI = 1.104-1.317) and sports (OR = 8.710, CI = 4.006-18.936), respectively. The determinant for the majority of facial fractures was motorcycle accidents, followed by accidents involving animals and sports.

Risk factors associated with facial fractures

The aim of the present study was to identify risk factors for facial fractures in patients treated in the emergency department of a hospital. The medical charts of 1121 patients treated in an emergency ward over a three-year period were analyzed. The independent variables were gender, age, place of residence (urban or rural area) and type of accident. The dependent variables were fractured mandible, zygoma, maxilla, nasal bone and more than one fractured facial bone. Statistical analysis was performed using the chi-square test (a < 0.05), univariate and multivariate Poisson distributions and the logistic regression analysis (p < 0.20). Maxillofacial trauma was recorded in 790 charts (70.5%), with 393 (35.1%) charts reporting facial fractures. Motorcycle accidents were found to be the main risk factor for mandibular fractures (PR = 1.576, CI = 1.402-1.772) and simultaneous fractures of more than one facial bone (OR = 4.625, CI = 1.888-11.329) as well as the only risk factor for maxillary bone fractures (OR = 11.032, CI = 5.294-22.989). Fractures of the zygomatic and nasal bones were mainly associated with accidents involving animals (PR = 1.206, CI = 1.104-1.317) and sports (OR = 8.710, CI = 4.006-18.936), respectively. The determinant for the majority of facial fractures was motorcycle accidents, followed by accidents involving animals and sports.

Fratura de mandíbula: estudo epidemiológico de 70 casos / Mandible fracture: epidemiological study of 70 cases

INTRODUÇÃO: As fraturas de mandíbula são frequentemente causadas por traumatismo direto, mas, eventualmente, podem surgir fraturas patológicas, em função de lesões tumorais. A abordagem cirúrgica é determinada pelo tipo e pela localização da fratura na mandíbula. O objetivo deste estudo foi avaliar o perfil epidemiológico de 70 pacientes que sofreram fratura de mandíbula e foram operados no Instituto Dr. José Frota (Fortaleza, CE) no período de janeiro de 2005 a dezembro de 2009. MÉTODO: Foram analisados prontuários de 70 pacientes submetidos a cirurgia para correção de fratura de mandíbula, avaliando-se sexo, idade, cor, procedência, sítio anatômico da fratura, etiologia, fraturas associadas, tratamento, tempo de internação e complicações. RESULTADOS:Houve predomínio do sexo masculino (90 por cento), com média de idade de 28,25 + 11,04 anos. A maioria dos pacientes (80 por cento) era de cor branca e procedente do interior (68 por cento). Os locais da mandíbula mais acometidos foram a região da parassínfise, o corpo e o ângulo, tendo como principal causa os acidentes de trânsito (70 por cento), sendo os acidentes motociclísticos (55,7 por cento) mais prevalentes. As principais fraturas de face associadas foram de maxila do tipo Le Fort e zigomático-orbitário. O tratamento cirúrgico foi feito com fixação interna rígida na maioria dos pacientes (75 por cento). A única complicação foi infecção, observada em um paciente. CONCLUSÕES: A redução e a fixação das fraturas mandibulares devem ocorrer tão precisa e rapidamente quanto possível, visto que a maloclusão é uma complicação grave a longo prazo. Neste estudo, essa complicação não foi observada, havendo apenas um caso de infecção. Coincidindo com os achados de outros estudos, houve prevalência de adultos jovens do sexo masculino e de acidentes de trânsito como etiologia. As fraturas foram localizadas preferencialmente na região da parassínfise e corrigidas por meio de fixação interna rígida em 75 por cento dos casos.

BACKGROUND: Mandible fractures are most often caused by direct trauma, but occasionally, pathologic fractures may occur due to tumor lesions. The surgical approach is determined by the type and the location of the mandible fracture. This study aimed to evaluate the epidemiological profile of 70 patients who suffered mandible fracture and underwent surgery at Instituto Dr. José Frota (Fortaleza, CE) between January 2005 and December 2009. METHODS: We analyzed medical records of 70 patients who underwent surgical treatment for mandibular fractures and assessed gender, age, skin color, anatomic site of fracture, etiology, associated fractures, treatment, hospitalization and complications. RESULTS: There was male predominance (90 percent) among patients, with a mean patient age of 28.25 + 11.04 years. Most patients (80 percent) were Caucasian and from small towns (68 percent). The most affected jaw sites, in descending order, were the parasymphysis region, body, and angle. The major cause was traffic accidents (70 percent), with motorcycle accidents being the most prevalent (55.7 percent). The main associated facial fractures were maxilla fracture type Le Fort and zygomatic-orbital. Surgical treatment was carried out with rigid internal fixation in most patients (75 percent). The only complication was infection in one patient. CONCLUSIONS: Reduction and fixation of mandibular fractures should occur as accurately and quickly as possible, since malocclusion is an important long-term complication. In our study, we did not observe such a complication; there was only one case of infection. Concurrent with the findings of other studies, there was a prevalence of young adult males among patients, and traffic accidents were the main cause. The fractures were frequently located in the parasymphysis region and were corrected through rigid internal fixation in 75 percent of cases.

An inventory of mandibular fractures associated with implants in atrophic edentulous mandibles: a survey of Dutch oral and maxillofacial surgeons.

PURPOSE: The present study provides an inventory of the number of fractures that occurred in conjunction with implant placement in edentulous patients in the Dutch population from 1980 to 2007 and estimates the incidence with which this might occur. The study also sought to define the factors that increase the risk of fracture. MATERIALS AND METHODS: Questionnaires were sent to all 198 oral and maxillofacial surgeons working in 56 hospitals in the Netherlands. Questions were asked regarding the causes of fractures, the height of the edentulous mandible, and the methods of fracture treatment. RESULTS: Responses were received from 53 of the 56 departments. During the study period, 157 edentulous mandibles fractured in conjunction with implant treatment. All fractures occurred in mandibles with less than 10 mm of height, as measured in the symphysis. An incidence of less than 0.05% was estimated based on an estimated number of 475,000 patients treated with at least two implants during this time to support an overdenture. Reasons for early implant failures were insufficient bone volume, iatrogenic causes, nonintegration, and a narrow arch. Peri-implantitis, trauma, and explantation were associated with fractures occurring 1 year or more after implant placement. Several methods were employed to treat the fractured mandibles, including closed reduction, rigid fixation using osteosynthesis plates, and bone grafts with fixation. In 52% of patients, fracture healing was uneventful; however, in 48% of patients, complications were encountered, including osteomyelitis, nonunion, plate fracture, screw loosening, and dehiscences with subsequent infections. CONCLUSIONS: Mandibles with a height of 10 mm or less, as measured at the symphysis, are at risk of fractures and associated complications. The provision of proper informed consent regarding the advantages and disadvantages of placing implants in thin mandibles is essential.

Orofacial trauma in Brazilian basketball players and level of information concerning trauma and mouthguards.

Orofacial injuries are increasingly considered a public health problem in high impact sports. The purposes of this study were: to assess orofacial trauma (OT) history in basketball players, in relation to wearing mouthguards (MG), facial types, presence of mouth breathing and player's position in the game, also to check athletes' level of knowledge about trauma and MGs. Questionnaires were given to category A-1 adult athletes registered in 2006/07 in the State of São Paulo and Brazilian Basketball Confederation Championships, and National Team members. Of the total sample (n=388), 50% of athletes sustained orofacial injuries; dental trauma accounted for 69.7%, with emphasis on maxillary central incisors, followed by soft tissue (60.8%), in which lip injuries were the most prevalent. No relationship was found between trauma history and player's position (P=0.19), facial type (P=0.97), presence of mouth breathing (P=0.98), but there was statistically significant association between the prevalence of OT and lack of MG use (P≤0.0001). Of all the athletes affected, only 1% wore a MG at the time of the trauma, 26.5% did not know about the MGs and 10.6% did not know their functions. When trauma occurred, 79.6% replied one must look for the tooth at the accident site, 50% knew it must be stored in liquid, as replantation was possible (62.3%) and 75.8% believed elapsed time could influence prognosis. Basketball is a high impact sport with high prevalence of OT, particularly maxillary central incisor and lip injuries, but athletes did not use MGs. There should be more educational campaigns to inform players about orofacial injuries and their prevention in Brazilian basketball.

Maxillofacial injuries and dental trauma in patients aged 19-80 years, Recife, Brazil

Objetivo: Se llevó a cabo un estudio retrospectivo para evaluar las causas de traumatismomaxilofacial en Recife, Pernambuco, Brasil.Método: Se hizo una revisión de 186 pacientes con lesiones maxilofaciales de 19 a 83 años atendidosy tratados en el Hospital da Restauração entre Enero y Diciembre 2006, analizándoles segúnedad, sexo, etiología, localización de la fractura, traumatismo dentoalveolar y abuso de alcohol.Se llevó a cabo el análisis en Epi Info, utilizando el Chi cuadrado y la prueba exacta de Fisher.Resultados: Resultó que las lesiones maxilofaciales fueron más frecuentes en los hombres (89,2%)y en el grupo de edad de 19-28 años (46,8%). Accidentes de tráfico/motocicleta (23,7%) y violenciafísica (20,4%) fueron los factores etiológicos más comunes. Las fracturas faciales fueron detectadasen 90,9%, con una diferencia estadisticamente significativa entre el sexo y la fractura facial(p = 0,000). La fractura facial más común fue maxilar (29,1%), seguida por la de la mandíbula(27,5%). Hubo una asociación positiva entre la presencia de la fractura facial y el consumo dealcohol (p = 0,002). El traumatismo dentoalveolar estuvo presente en el 7,5% de los pacientes.Conclusión: La incidencia de las fracturas faciales en la población Brasileña es similar a la informadapreviamente en otros lugares. Las fracturas fueron más comunes en pacientes masculinos,principalmente debidas a accidentes de tráfico/motocicletas y a la violencia física(AU)

Aim: A retrospective study was undertaken to assess causes of maxillofacial trauma inRecife, Pernambuco, Brazil.Method: A review of 186 patients with maxillofacial injuries aged 19 and 83 years old seenand treated at the Hospital da Restauração between January and December 2006 wasconducted and were analyzed according to age, sex, etiology, site of fracture, dentoalveolartrauma and alcohol abuse. Analysis was made in Epi Info using the Chi-square and Fisher’sExact Tests.Results: It was found that maxillofacial injuries were most frequent in males (89.2%) and inthe 19-28 year age group (46.8%). Traffic accidents/motorcycle (23.7%) and physical violence(20.4%) were the most common etiological factor. Facial fractures were detected in 90.9%and a statistically significant difference between sex and facial fracture was found (p =0.000). The most common facial fracture was maxilla (29.1%), followed by the mandible(27.5%). A positive association between the presence of facial fracture and alcoholconsumption was observed (p = 0.002). Dentoalveolar trauma was present in 7.5% ofpatients.Conclusion: The incidence of facial fractures in Brazilian population is similar thanpreviously reported elsewhere. There were most common in male patients, mainly due totraffic accidents/motorcycle and physical violence(AU)

Fraturas mandibulares na cidade de Pelotas, Rio Grande do Sul / Mandibular fracture cases in Pelotas, Rio Grande do Sul, Brazil

Objetivos: Analisar os dados existentes na literatura, que mostra uma alta incidência de fraturas mandibulares e elucidar o contexto de sua ocorrência no universo dos pacientes atendidos pelo Pronto Socorro Municipal de Pelotas, Rio Grande do Sul, Brasil. Métodos: A partir dos registros referentes ao período de junho de 2001 a agosto de 2007, obtivemos 1 345 pacientes com fraturas faciais. Foram selecionados para este estudo 116 pacientes com fraturas mandibulares, nos quais os itens analisados foram: faixa etária, sexo, sítio mandibular fraturado, etiologia e período do ano. Resultados: Assim, encontramos 86,2% de indivíduos do sexo masculino. A faixa etária mais atingida foi a dos 20 aos 29 anos, com 36,2%, e os sítios mandibulares mais afetados foram o corpo com 29 casos (25%) e o côndilo com 26 casos (22,4%). As causas mais comuns destas fraturas foram as agressões físicas, com 37,1%. O verão foi o período do ano com a maior incidência de fraturas mandibulares, com 38 casos (32,8%). Conclusão: Observou-se, então, que os pacientes com fratura mandibular, atendidos no Pronto Socorro Municipal de Pelotas, Rio Grande do Sul, geralmente são homens, na faixa etária dos 20 aos 29 anos, com fratura do corpo mandibular e que foram vítimas de agressão física.

Objectives: To analyze the data in the literature, which show a high incidence of mandibular fractures. The aim of this research was to elucidate the context in which these fractures occur among patients attended at the first aid center of "Pronto Socorro Municipal de Pelotas", Rio Grande do Sul, Brazil. Methods: From the records referring to the period of June, 2001 to August, 2007, there were 1 345 patients with facial fractures. Of this total, 116 patients with mandibular fracture were selected for this study and the items analysed were: age, gender, mandibular fracture site, etiology and period of the year. Results: It was found that 86.2% of the sample were men. The most prevalent age was 20 to 29 years old representing 36.2%, and the most affected mandibular sites were the body, with 29 cases (25%), and the condyle, with 26 cases (22.4%). The most common cause of fractures was the physical aggression representing 37.1%. The period of the year with the highest incidence of mandibular fractures was the summer, with 38 cases (32.8%). Conclusion: It was therefore observed that the patients with mandibular fracture assisted at Pronto-Socorro Municipal de Pelotas, Rio Grande do Sul, Brazil, were generally men, 20 to 29 years old with mandibular body fracture and they were victims of physical aggression.

The epidemiology of mandibular fractures treated at Chiang Mai University Hospital: a review of 198 cases.

BACKGROUND: Mandibular fractures constitute a substantial proportion of maxillo-facial trauma cases in Chiang Mai. The present study investigated the prevalence, sex, age group, alcohol consumption, crash helmet use, causes, site, treatment, and postoperative result of mandibular fractures at Chiang Mai University Hospital, Thailand. MATERIAL AND METHOD: The medical records and radiographs of 198 patients treated for mandibular fracture at Chiang Mai University Hospital over a 1.5 year period (from 1 January 2005 to 30 June 2006) were reviewed Data on the patients' age, sex, alcohol and helmet use, mechanism of injury, site of fracture, treatment modality, and post-operative result were recorded and assessed. RESULTS: Men of 21 to 30 years of age sustained the most mandibular fractures. The ratio of males to females was 5:1. Most fractures were caused by motorcycle accidents (MCA) (75.75%), followed by body assault (13.63%), and falls (4.54%). Alcohol consumption was a contributing factor at the time of injury in 79% of fractures according to the information available. The most common fracture sites were, in descending order the parasymphysis (45.3%), angle (19.51%), condyle (15.68%), symphysis (13.24%), body (3.83%), and ramus (2.09%). Nearly 3/4 of all cases were treated by open reduction (76%). CONCLUSION: The incidence and causes of mandibular fracture reflect trauma patterns within the community and can provide a guide to the design of programs geared toward prevention and treatment.

Pattern of maxillofacial injuries in motorcyclists in Malaysia.

Motorcycle casualties represent significant number in road traffic accidents in Malaysia, and among all the injuries, facial injuries pose many significant problems physiologically, functionally, and aesthetically. The aim of this study was to analyze the pattern of maxillofacial as well as other injuries in motorcyclists who were seen at Hospital Universiti Kebangsaan Malaysia.Patients' records from January 2004 to December 2005 were reviewed. Data related to demographics, vehicle/object involved in collision, involvement as a rider or pillion, whether a helmet was worn or not, location of injuries on the face/facial bones, and other associated injuries were collected.A total of 113 cases of motorcycle accidents were recorded; 106 males and 7 females were involved. Mean age was 25.8 years. Among all the races, Malay had the highest involvement (72.3%), followed by Chinese (14.3%), Indians (8.9%), and others (5.4%). The types of collision were either a single-vehicle collision (i.e., skidded) or with another vehicle/s or object (e.g., tree, stone, or lamppost). The injuries were mainly seen on the lower face (46.9%) followed by midface (25.7%) and a combination of the midface and lower face (15%) and others (12.4%). The most frequent other associated injuries recorded were orthopedic and head injuries.

A 4-year retrospective study of mandibular fractures in a South Indian city.

The medical records of 238 patients treated for mandibular fractures at Sri Ramachandra Dental College and Hospital, India, over a period of 4 years were reviewed. Of the total 238 patients with mandibular fractures, 81% were males, and 19% were females. The majority of the patients were 21 to 30 years of age. Road traffic accidents, especially people traveling on motorcycles, accounted for 73% of all patients, with a high prevalence during the month of September and on Saturdays. The most common area of fracture was in the parasymphysis region (35.2%) followed by the condyle region (22.6%).

Estudo epidemiológico de 1758 fraturas faciais tratadas no Hospital da Restauração, Recife/PE / Epidemiological study of 1758 facial fractures treated at Hospital da Restauração in Recife, Pernambuco, Brazil

Este trabalho teve como finalidade realizar um estudo retrospectivo das fraturas faciais tratadas no Hospital da Restauração na cidade do Recife/PE, no período compreendido entre janeiro de 1988 a dezembrode 1998. Foram examinados 1486 prontuários e coletados dados relativos aos pacientes, etiologia dos traumatismos e localização anatômica das fraturas. As fraturas faciais perfizeram um total de 1758 fraturas com o gênero masculino, representando 84 por cento da amostra, sendo a faixa etária mais acometida entre 21 a 30 anos. As causas mais freqüentes foram as agressões, com 43 por cento da amostra, sendo a mandíbula o osso mais acometido. Conclui-se que pacientes masculinos, na 3ª década de vida, são os mais acometidos no traumatismo bucomaxilofacial, sendo as agressões interpessoais as causas mais comuns.

Complications and the time to repair of mandible fractures.

OBJECTIVE: Treatment delays in the operative management of mandible fractures are often unavoidable. We were interested in determining whether delays increased the incidence of complications in these patients. STUDY DESIGN AND SETTING: A retrospective chart review was performed on all patients who presented to the San Francisco General Hospital with an operative mandible fracture in 2002. On the basis of the number of days from initial injury to surgery, the patients were divided into two groups: those repaired in 3 days or less and those repaired after 3 days. The incidence of infectious and technical complications was then compared between these groups. Substance abuse was also evaluated for its role in complication risk. RESULTS: Of the 84 patients in the study, 11 had infectious complications, and 10 had technical complications. Although treatment delay did not increase the risk of developing an infectious complication, substance abuse considerably increased this risk. The incidence of technical complications was remarkably higher in patients repaired after 3 days. CONCLUSION: Although patients with mandible fractures treated after 3 days do not have a higher risk of developing an infectious complication, this risk is elevated in patients who abuse substances regularly. The risk of technical complications increases with treatment delay, and therefore the surgical team must be even more vigilant when reducing these fractures.

[Treatment of mandibular fractures in patients at the Department of Oral and Maxillofacial Surgery, University Hospital in Lublin in the years 1988-1997]. / Metody zaopatrzenia zlaman zuchwy u pacjentów leczonych w Klinice Chirurgii Stomatologicznej i Szczekowo-Twarzowej Akademii Medycznej w Lublinie w latach 1988-1997.

Between 1988-1997 in the Department of Dental and Maxillo-facial Surgery of Medical University in Lublin there were applied three types of fixation of mandible bone fracture. Depending on the kind of fracture and teeth condition with 692 (i.e. 60%) patients there was applied preservative treatment and 530 undergone surgery (i.e. 18.1%) and undergone surgical and orthopedic treatment (i.e. 21.9%). Upon analysis of treated population it was concluded, that during period of assessment there occurred significant change of implications for the application of fixation of mandible bone fracture and the leading method became mandible osteosynthesis with intraoral approach.