RESUMEN
BACKGROUND: Presence of head injuries in patients with maxillofacial trauma is a lifethreatening condition. Prompt determination of head injury in these patients is crucial for improving patient survival and recovery. Hence, the need to know about the incidence of head injuries associated with maxillofacial trauma becomes an important aspect. MATERIALS AND METHODS: A total of 100 patients were included in the study. Patient with head injuries associated with maxillofacial fractures was accounted to determine the incidence and pattern of head injuries accompanying maxillofacial trauma. They were evaluated for epidemiological demographic and clinical characteristics. RESULTS: The present study had 91% predominance of male patients with age ranging from 1 to 75 years. 91% cases were as a result of RTA. The most frequent maxillofacial injury represented was the fractured mandible. The incidence of head injuries associated with maxillofacial trauma was 67 %. Among all the patterns of head injuries, concussion was the most common head injury associated with maxillofacial trauma. CONCLUSION: In our study, the risk of head injury increased significantly as the Glasgow Coma Scale score decreased and with increase in the number of facial fractures. There was association between head injury and maxillofacial trauma.
RESUMEN
BACKGROUND AND OBJECTIVES: Surgical removal of a mandibular impacted third molar is one among the most common oral surgical procedures. The objective of this study was to assess and identify risk indicators influencing extended operation time in relation to the surgical removal of mesioangular impacted mandibular third molar, position A, Class I and to evaluate the incidence of postoperative swelling, trismus, and pain. MATERIALS AND METHODS: A prospective cohort was implemented and the patients who presented for mandibular third molar removal which were impacted in position A, Class I were enlisted for the study. During 1 year between July 2014 and June 2015, a total of 40 patients were enrolled in the study. The evaluation of patient variables and radiographic variables was done preoperatively. Depending on the duration of time taken for an operation, patients were divided into three groups: Group I, Group II, and Group III. Postoperative complications such as swelling, trismus, and pain were assessed in each of the patients. STATISTICAL ANALYSIS: The statistical analysis was done among the groups using Chi-square test, and ANOVA. RESULTS: Among the six variables studied in this study including patient variables and radiographic variables, maximum interincisal opening, external oblique ridge, and root morphology were found to be dependent factors which influence the operating time. Moreover, other variables such as the crown root width ratio and the number of roots were independent factors. Swelling, trismus, and pain were statistically significant among groups and were directly related to operating time. CONCLUSION: We consider that the outcome of surgical removal of mandibular impacted third molar, position A, Class I depends significantly on relevant patients characteristics and radiographic variables which should be evaluated preoperatively as they are predetermined factors to avoid postoperative morbidity.
RESUMEN
BACKGROUND: Trigemino-cardiac reflex is a physiologic response of the body to pressure effects in the region of distribution of the trigeminal nerve. Oral and maxillofacial surgical procedures can induce the development of this reflex, which leads to significant changes in the heart rate and sinus rhythms. This study intends to evaluate the effects of this reflex in patients with facial fractures and its subsequent management. PATIENTS AND METHODS: A total of thirty-seven patients with facial fractures who reported to the Department of Oral and Maxillofacial Surgery at Basaveswar Teaching and General Hospital, Gulbarga during a period from July 2015-March 2016 were considered for the study. RESULTS: A male preponderance is observed with the most susceptible age group being 21-30 years. Twenty-three patients sustained mid-facial fractures alone, nine patients had isolated mandible fractures and five patients had fractures of both the mid-face and mandible. A relative bradycardia was observed in the patients with mid-facial trauma, both at the time of presentation and also during the surgical reduction of midfacial fractures which improved after completion of procedure in most of the patients. However, in two patients, the bradycardia progressed to a cardiac asystole during midface manipulation which required immediate halt of the procedure and intravenous administration of atropine. CONCLUSION: Trigeminocardiac reflex though physiologic, which usually tends to subside without complications is not to be neglected in the surgeries of the maxillofacial skeleton. A propensity for unforeseen complications due to this reflex has to be avoided by meticulous monitoring of the ECG.
RESUMEN
Fibrous ankylosis is a common complication of trauma to the temporomandibular joint (TMJ) in children. Proper treatment and regular follow-up is necessary for its successful management. This report highlights a case of posttraumatic fibrous ankylosis successfully managed with brisement force-gradual tractional forces applied to the TMJ under local anesthesia without any associated complications. Mouth opening increased significantly from 15 to 35 mm. The patient was advised to perform rigorous physiotherapy at home, to maintain interincisal opening of 35 mm. The case was followed up for 6 months with no decrease in mouth opening.
