[DIAGNOSTICS OF POSITION OF THE MOTOR AND TRIGGER POINTS: OF THE CHEWING MUSCLES FOR ZYGOMATIC COMPLEX FRACTURES].

Existing treatment methods of zygomatic complex fractures, which are complicated by contrac- ture of the masseter as a result of displaced bone fragments, have to be improved. Lack of muscle relaxation leads to the formation of local hypertonicity. In spasmodic muscle fibers varies perfusion and hypoxia occurs, which is accompanied by the release of inflammatory mediators and activation of pain receptors. Over time, areas formed local hypertonicity specific trigger points that contain multiple sensory loci and include one or more sensitive nerve endings. A device for the effective electromyographic study of masseters as a source of their condition and the dynamics of changes in masticatory muscles during patient treatment by improving the fixation system on the face of the patient and the introduction of more perfect spatial coordinate system for mathematical calculations masseter motor position (or triggered) point. Patients were examined before and in the dynamics of treatment according to our methodology, which included proper masseter relaxation, reposition and fixation of bone fragments and further medical therapy.

[Surgical rehabilitation in patients with zygomatic orbital fractures and orbital floor fractures].

The study presents the results of surgical management of 65 patients with zygomatico-orbital complex and orbital floor fractures according to a self-designed technique using polymer implants Reperen. Being a method of choice the technique reduces treatment time, promotes good esthetic results, reduces complication rate, and contributes to a patient's quality life improvement.

The prosthetic rehabilitation of a panfacial fracture patient after reduction: a clinical report.

Panfacial fractures involve trauma to the lower, middle, and upper facial bones and often require a team approach for management. Early and complete restoration of preinjury facial contours and function should be the goal of the oral and maxillofacial surgeon and the prosthodontist. When the intraoral landmarks are lost, overall facial anatomic landmarks can be used to restore the oral cavity. A patient with complex clinical panfacial fractures, including a vertically and horizontally malpositioned native alveolar bone and severe facial asymmetry, is presented. A functional and esthetic rehabilitation was successfully accomplished by using a partial removable dental prosthesis retained with telescopic crowns and magnetic attachments in the maxilla and osseointegrated implants to support a definitive dental prosthesis in the mandible.

Seqüela após redução de fratura zigomática empregando fio de Kirschner: relato de caso / Sequela after zygomatic fracture reduction using Kirschner wire: a case report

O presente trabalho objetiva apresentar e discutir um caso clínico em que o fio de Kirschner foi empregado para fixação do osso zigomático fraturado, não sendo removido após quatro semanas, como recomendado pela literatura, comportando-se como corpo estranho, e sendo então removido.

When can patients blow their nose and fly after treatment for fractures of zygomatic complex: the need for a consensus.

PURPOSE: To determine current professional advice to patients about refraining from nose blowing and air travel following treatment of zygomatic fractures. METHODS: A postal questionnaire was sent to 261 consultant oral and maxillofacial surgeons (OMFS) in the UK. They were asked about advice given to patients regarding length of time to refrain from nose blowing and air travel following treatment of zygomatic fractures. RESULTS: A total of 184 (71%) replies were received. Advice regarding the length of time to refrain from nose blowing and air travel ranged from no advice to 8 weeks. About 90% of respondents based their advice on common sense and traditional practice. CONCLUSIONS: Advice given to the patients following the treatment of zygomatic fractures varies widely. Most consultants based their advice on traditional practice and common sense. In the absence of widely accepted guidelines, there is a need for an agreement among clinicians on advice given to the patients.

Current practice of British oral and maxillofacial surgeons: advice regarding length of time to refrain from contact sports after treatment of zygomatic fractures.

OBJECTIVE: To find out the current practice of consultant maxillofacial surgeons in the United Kingdom regarding the advice that they give to patients after the treatment of zygomatic fractures. MATERIALS AND METHODS: We sent a postal questionnaire to 261 consultant maxillofacial surgeons in the United Kingdom. They were asked what advice they gave to patients about the length of time that they should refrain from contact sports after a zygomatic fracture. RESULTS: A total of 184 replies were received (70%). Advice about the length of time to refrain from contact sports ranged from none to 13 weeks; 165 (90%) of respondents based their advice on common sense and traditional practice. CONCLUSIONS: Advice given to the patients after the treatment of zygomatic fractures varies widely. Most consultants base their advice on traditional practice and common sense. No widely accepted evidence-based guidelines exist about post-operative advice concerning duration of avoidance of contact sports after zygomatic fractures.

[Individualized facial protection after fracture management of the nasal bone and zygomatic arch in professional soccer players]. / Individueller Gesichtsschutz nach Frakturversorgung am Nasenbein und Jochbogen bei Profifussballern.

BACKGROUND: The treatment of sport accidents in professional athletes requires special treatment modalities, especially concerning quick rehabilitation. CASE REPORT: As early as 5 days after treatment of a nasal bone fracture under local anesthesia on an outpatient basis, an individual nasal shield out of silicone and acrylate could be manufactured from a facial impression for a professional soccer player. This shield enabled unlimited participation in the ensuing premier league matches 7 and 14 days after the accident. The same treatment was performed for another team member after closed reposition of a zygomatic arch fracture. Treatment modalities and manufacturing of the facial protection masks in these two cases are presented as examples.

Internal fixation vs. conventional therapy in midface fractures.

The purpose of this review is to evaluate internal fixation by means of AO miniplates compared to conventional therapy for the treatment of complicated midface fractures. A more precise division of midface fractures into functional units than that afforded by the Le Fort classification was employed to categorize the complexity of injury. The criteria of evaluation were ease of functional rehabilitation, incidence of complications, and results of surgery. The classification system was helpful in surgical planning and in subsequent analysis of results. Forty-nine of the 92 midface fractures treated by open repair between July 1980 and January 1986 were malar fractures, and 41 of these had associated orbital fractures. The remaining 43 had Le Fort II or more complicated midface fractures, only 15 of which could be adequately categorized by the Le Fort classification. Twenty-two of the 43 patients with complicated midface fractures were surgically treated with internal fixation utilizing 67 AO miniplates. The remaining 21 patients were treated with conventional therapy utilizing a combination of intermaxillary fixation (IMF), and/or interosseous wiring, and/or primary bone grafting. Among the problems encountered were a nonunion of the midface in a delayed repair of a severely comminuted midface fracture, which required secondary split rib grafting. Three plates were removed because of intraoral extrusion. There were no plate-related infections. One of the advantages of internal fixation is that the need for primary bone grafting and external fixation is eliminated. Another is that intermaxillary fixation is needed less frequently, allowing immediate access to the oral cavity for control of airway, care of intraoral wounds, and rapid return to normal alimentation with full mandibular function. Most patients with no associated GI problems tolerated a soft diet within 6 days. Tracheostomy tubes were removed within 3 days if no pulmonary failure was present. We can conclude that internal fixation provides excellent stabilization and repair of complicated midface injuries with minimal complications and rapid return to function for most patients.