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At least 19 recordsLinked to original sources
PubMed1989

[Clinical study of mandibular condyle injury].

Mandibular condyle fractures develop frequently and show the variable type of injury and complication. New opinions have emerged from recent investigation into condylar fractures. The author investigated 246 patients with condylar fractures who visited SNUDH from January 1980 to August, 1988, 8. with regard to clinical and treatment aspects, area and displacement of fractures, associated teeth injury and other body injury, complications. At last I have got the following results. 1. The incidence to condylar fractures in a series of 765 mandibular fractures may be as high as 32.2%. 2. The male patients are 3 times more than female patients. The highest frequency was recorded in the group 21-30 years of age. (34.1%). 3. Falls caused the greatest number of condylar fractures (45.2%) and next was in assult (25.6%), traffic accidents (22.4%). 4. Unilateral condylar fractures were present in 74.8%, giving a left: right ratio of 1.2:1. In cases of unilateral fracture, subcondylar fractures were by far the commonest (32.9%) but in cases of bilateral fracture, condylar neck fractures were by far the commonest. In children under 15 years of age, condylar neck fractures were more common but in patients over 16 years of age, subcondylar fractures were common. 5. Anteromedial fracture dislocations were by far the commonest (20.3%). In children under 15 years of age, fracture deviations were common but in patients over 16 years of age, fracture displacements were common. 6. 44.7% of patients with condylar fractures sustained the teeth injuries. Teeth fractures were by far the commonest. 7. Single condylar fractures showed a frequency of 30.5%. Of the concomitant fractures elsewhere in the mandible, symphysis fractures were by far the commonest (54.1%). 8. Associated other body injuries showed a frequency of 28.0%. Of them, head injuries were by far the commonest. 9. The mean interval from injury to treatment was 14.3 days. Of the treatment of condylar fractures, open reduction was by far the commonest (70.3%). Closed reduction comprised 19.9% and functional therapy comprised 8.5%. 10. In 67 patients with possible follow up period, the following complications were developed, two ankylosis, anterior open bite, mouth opening limitation, mouth opening deviation.

Adolescent↗
PubMed1989

Pneumomediastinum and cervical emphysema subsequent to mandibular injury associated with a flare pistol shot.

Pneumomediastinum in patients with war injuries to the maxillofacial region can be a life-threatening condition. A case is presented of a flare-pistol-shot wound to the mandible which subsequently resulted in cervical emphysema, mediastinal emphysema, and pneumomediastinum, causing a critical condition. Maxillofacial surgeons should be alert to this problem when treating blast or multiple-shell injuries to the maxillofacial region.

Adult↗
PubMed1991

Electrophysiologic investigation of mandibular nerve injury.

Isolated lesions of the mandibular branch of the trigeminal nerve have only rarely been reported. We report the occurrence of an isolated lesion of the mandibular nerve associated with a unilateral mandibular fracture, and its substantiation electrophysiologically. A 65-year-old man was involved in a motor vehicle accident resulting in multiple fractures, including a unilateral mandibular fracture and temporomandibular joint dislocation. No evidence of intracranial pathology by CT scan was noted and the neurologic examination was nonfocal except for dysfunction of the mandibular nerve ipsilateral to the fracture site. Bilateral facial nerve latency and blink reflexes were normal. EMG evaluation of the muscles of facial expression and mastication demonstrated denervation confined to the muscles innervated by the mandibular branch of the trigeminal nerve. In patients complaining of facial sensory dysfunction, malocclusion, or weakness of muscles of mastication after mandibular fracture, an electrophysiologic examination can assist in evaluating cranial nerve integrity.

Aged↗
PubMed1991

Incidence of inferior alveolar nerve injury in mandibular third molar surgery.

This paper documents the incidence of inferior alveolar nerve injury and resultant sensory disturbance encountered in the removal of 100 consecutive impacted mandibular third molars. Five cases of anesthesia and/or paresthesia resulted and all but one of these resolved within six months. The lack of direct correlation between surgical exposure of the neurovascular bundle intraoperatively and the proximity of radiographic images of tooth root and mandibular canal, with the occurrence of sensory deficit, is noted. Our findings support the 1979 Recommendations of NIHCDCRTM*, upon which the policy of informed consent regarding nerve injury was based.

Adolescent↗
PubMed1989

[A case of greater auricular nerve autologous nerve grafting for inferior alveolar nerve injury by mandibular fracture].

The results of peripheral nerve repair have been greatly improved in the last few years following the introduction of micro-surgery and increased application of free autologous nerve transplants. In the field of oral surgery, a rich experience has been made in plastic and reconstructive repair. The inferior alveolar nerve is endangered by a series of mandibular fractures, with fracture lines running along the nerve canal. For plastic repair of the inferior alveolar nerve, we interpose an autologous transplant from the greater auricular nerve.

Adult↗
PubMed1992

Fractures of the mandible: role of the general dentist.

Mandibular fractures are the second most common facial fracture, the majority being the result of interpersonal violence, road traffic accidents, or sports injuries. Although most of these patients attend a hospital, it is not uncommon for patients with these injuries to present first to the general dentist, perhaps complaining of a loose tooth or abnormal bite. A careful history should be taken from the patient in order to identify the possibility of other injuries. Mandibular fractures are rarely life-threatening, although airway difficulties can arise. A systematic approach to diagnosis is essential if fractures are not to be missed, including radiological assessment in two planes at right angles. The initial treatment consists of airway management, control of fracture segments, and pharmacologic management. Most fractures have been traditionally managed by the use of intermaxillary fixation; however, increasing use is being made of open reduction and internal fixation techniques. Occasionally, general dentists are involved in the post-operative care of the patient following definitive management.

General Practice, Dental↗
PubMed1991

Rigid fixation in the management of maxillofacial trauma.

1. Although intermaxillary fixation was the primary means of treating mandibular injuries, rigid plate fixation has eliminated the need for prolonged mandibulo-maxillary immobilization in many cases. 2. Prolonged intermaxillary fixation can result in poor nutritional support, poor oral hygiene, and the induction of gingival and masticatory muscle atrophy and temporomandibular joint dysfunction. 3. Rigid plate fixation requires specialized instrumentation and skills, and frequently external skin incisions, but the potential advantages of immediate postoperative function without prolonged jaw wiring makes this option more appealing.

External Fixators↗
PubMed1986

Dacron mesh tray and cancellous bone in reconstruction of mandibular defects.

We used a Dacron-urethane mesh tray filled with cancellous bone for mandibular reconstruction in 17 patients. Five patients with traumatic defects and two with benign tumors developed solid, functional mandibles. Among ten patients with squamous cell carcinoma, eight had successful reconstruction; one required a second procedure. Mandibles of two of three patients with osteoradionecrosis were successfully reconstructed, but only one of three primary reconstructions was initially successful. The Dacron-urethane mesh tray has the advantage of being stiff but malleable. It easily fits the defect, is radiolucent, and may be used either before or after radiotherapy. We recommend delayed reconstruction, adequate soft-tissue coverage, good immobilization of the mandible, no intraoral contamination, especially with osteoradionecrosis, and hyperbaric oxygen in patients who have been irradiated or have osteoradionecrosis.

Adult↗
PubMed1991

Oromandibular reconstruction using microvascular composite free flaps. Report of 71 cases and a new classification scheme for bony, soft-tissue, and neurologic defects.

We describe 71 cases of oromandibular reconstruction using microvascular composite free flaps. There was an overall flap success rate of 94%, while 97% of the patients in this series had their mandibles reconstructed with free vascularized bone flaps. Fifteen patients were rehabilitated with implant-borne dental prostheses. Primary repair of discontinuity defects of the inferior-alveolar nerve using a variety of nerve grafts was performed in 16 patients. A new classification scheme for composite defects of the oral cavity involving bone, soft tissue, and neurologic defects is proposed and applied in the description of each of the patients in this series.

Adult↗
PubMed1990

Reconstruction of mandibular discontinuity with autogenous iliac bone graft: report of 34 consecutive patients.

This article reviews 34 consecutive reconstructions of mandibular discontinuity defects done between 1972 and 1988. All reconstructions were performed secondarily with use of free iliac crest bone grafting. The technique is described, three cases are presented in detail, and results for the entire series are tabulated. These results show a 100% graft incorporation rate along with low overall morbidity.

Adolescent↗
PubMed1978

Mandibular reconstruction with bone grafts.

A total of 23 patients with partly resected mandible were repaired with autogenous bone grafts from the iliac crest and ribs. The reasons for reconstruction are presented in Table 1. The grafts healed without complications in 21 cases. With the exception of two of the cases with gunshot wounds, all patients recovered good mobility of the jaw and satisfactory mandibular contours. The patients had been folloed up for 6 months to 11 years. Radiographic examination at the last examination showed that resorption of the graft had been only slight or moderate. Through marrow-spongious bone grafts are regarded as best from an osteogenetic point of view, our cases showed that good results can be achieved also with solid block grafts. The authors discuss the use of plate osteosynthesis without IMF instead of other types of graft fixation and IMF. In six cases where the area of the graft was loaded with a prosthesis, resorption was not more extensive than in the other cases.

Adolescent↗
PubMed1990

The functional result of mandibular reconstruction.

A study was performed to determine if patients who underwent mandibular reconstruction were functionally rehabilitated. Five parameters were evaluated: deglutition, mastication, cosmesis, diet, and the use of dentures. Deglutition was not improved in patients who had mandibular continuity restored. Problems with deglutition were related to soft tissue resection. Mastication was poorer in the reconstructed group due to scarring, loss of the muscles of mastication, and inhibition of compensatory mandibular motion. Cosmesis was improved in patients who had immediate restoration of mandibular continuity. Cosmesis was not improved in patients with delayed mandibular reconstruction due to previous scarring. Prosthetic rehabilitation was poor in both groups of patients. Reconstructed patients had a greater number of hospitalizations due to management of, or complications from reconstructive surgical procedures. The results of this study suggests that restoration of mandibular continuity does not enhance the functional rehabilitation of the majority of patients with oral-pharyngeal malignancy.

Adult↗
PubMed1975

Reconstruction of the defective mandible.

In a clinical material consisting of 31 cases of mandibular defects, caused by tumour resection or by trauma, reconstruction has been carried out by means of a stabilizing titanium splint and autologous bone and marrow transplantation, the longest period of observation being 9 years. The functional results obtained are assessed with reference to the cause of resection. Different technical procedures are described and the objectives and the planning of reconstruction of the lower jaw are discussed.

Adult↗
PubMed1990

[Cancellous mandibular autografts and titanium mesh].

Pure cancellous bone transplants constitute an alternative to the usual cortico-cancellous grafts used in certain cases for restoring interrupting substance loss (ISL) in the mandible. The greater number of surviving transplant cells, the rapid revascularization and more complete osteogenesis that are achieved cause indications for this type of graft to be particularly well adapted for cases where local repair conditions are precarious, such as bullet wound related sequelae. Indications for their utilization also extend to patient who have had benign tumors excised. The titanium-made receiving splint designed by Pr. Dumbach is particularly well adapted to this type of restoration; it provides for necessary functional stresses to be translated to the implant, allowing for the latter's incorporation, while controlling the direction of osteogenesis, thereby yielding excellent morphological and functional results.

Bone Transplantation↗